SIBO is categorized based on the type of gas produced during bacterial fermentation. Each subtype presents with different symptoms and requires a different treatment strategy.
| Type | Gas Produced | Common Symptoms | Considerations |
|---|---|---|---|
| Hydrogen-Dominant SIBO | Hydrogen | Bloating, gas, loose stools, or alternating bowel patterns | Often caused by overgrowth of fast-fermenting bacteria. |
| Methane-Dominant Overgrowth (IMO) | Methane | Chronic constipation, abdominal distention | Caused by methane-producing archaea, not technically bacteria, and typically more treatment-resistant. |
| Hydrogen Sulfide SIBO | Hydrogen Sulfide | Foul-smelling gas, diarrhea, fatigue | Difficult to detect without specialized testing; requires a nuanced treatment approach. |
Common Signs of SIBO Include:
Persistent bloating, especially after meals
Excessive gas or belching
Diarrhea, constipation, or alternating bowel habits
Nutrient deficiencies or unexplained fatigue
Headaches, brain fog, or skin issues
Accurate diagnosis is key. At Whole Gut Health, we use the latest diagnostic tools to identify the presence and type of SIBO.
Testing options may include:
Breath Testing using glucose or lactulose substrates to measure hydrogen and methane gas levels.
TrioSmart™ Testing, which includes measurement of hydrogen sulfide gas.
Functional Lab Work to assess for related nutrient deficiencies, inflammation, and digestive enzyme markers.
We select testing protocols based on your symptoms and medical history to ensure accurate and actionable results.
Our Three-Phase SIBO Protocol Includes:
Assessment and Root-Cause Identification
Comprehensive lab work
In-depth intake and history
Identification of contributing factors (e.g., motility issues, medication use, previous infections)
Targeted Intervention
Prescription or herbal antimicrobials based on your SIBO type
Methane-producing overgrowths may require combination therapies
Elemental diet may be recommended in select cases
Rebuilding and Prevention
Motility support (including prokinetic agents if necessary)
Strategic reintroduction of gut-healing foods
Long-term microbiome support to prevent recurrence
Dr. Alexandra Shustina, NYC’s and Miami’s premier gut health specialist doctor is a board-certified gastroenterologist and internist. She is a gut health specialist with training in conventional gastroenterology and functional gut health. She is an expert in the gut microbiome and its role in health and wellness.
At Whole Gut Health, our care is led by experienced functional medicine clinicians with a deep understanding of the gut microbiome and advanced diagnostics. We combine evidence-based strategies from conventional gastroenterology with a functional and integrative lens to give you the clarity and support needed for long-term healing.
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