Understanding SIBO & Gut Health
Small intestinal bacterial overgrowth (SIBO) occurs when bacteria in the small intestine proliferate excessively, impairing digestion and overall well-being.
Typical symptoms include bloating, abdominal discomfort, fatigue, and digestive issues. These imbalances are often associated with diet, stress, and changes in the microbiome.
A targeted microbiome analysis helps to better understand the causes and sustainably improve gut balance.
These are exactly the holistic profiles that ORY Berlin offers with modern partner laboratories – for a full picture of your gut.
Overgrowth in the small intestine – what SIBO actually is, simply explained
SIBO (small intestinal bacterial overgrowth) shows whether too many microorganisms are gathering in the small intestine, which is normally low in germs. It can feel as though your digestive system is permanently in rush hour: bloating, abdominal cramps, changing stools — and sometimes even headaches, tiredness or sleep problems.
A laboratory check helps to identify the jam and clear it deliberately.
Our sound basis for this is the practical information from ORY Berlin: modern, well-founded laboratory diagnostics plus personal support — exactly the combination needed for complex topics such as SIBO.
The large intestine is a bustling city for the microbiome. The small intestine is more the quiet suburban terrace – normally far fewer microbes live here.
With SIBO this balance tips: the number of microbes in the small intestine rises sharply, carbohydrates are “pre-digested” there, and gases such as hydrogen and methane form – the belly feels bloated and digestion gets muddled.
How SIBO is measured:
The practical gold standard is a breath test (H₂/CH₄). You drink a sugar solution (e.g. lactulose), then hydrogen and methane in your breath are measured at fixed intervals.
An early rise within 90 minutes points to SIBO. Current guidelines recommend measuring hydrogen (H₂) and methane (CH₄) at the same time – methane is often linked to a tendency towards constipation.
Medical Perspective Guidelines Recommend –
depending on the findings – targeted antimicrobial strategies, support for motility and an individualised approach to diet.Breath tests should measure H₂ & CH₄; test protocols (e.g. 10 g lactulose) are now standardised. The ACG guideline (2020) also stresses that SIBO is no fringe topic, but often sits behind irritable bowel, tiredness or unexplained abdominal complaints – and, treated in good time, can be stabilised very well.
Who is affected?
SIBO has no single face – many cases go unrecognised. Studies show that women and older people are affected more often. Alongside genetic disposition, motility disorders, hormonal changes, stress and certain eating habits play a part.
Main causes and risk factors:
- Mechanical factors: tumours of the small intestine, post-operative adhesions, defecation disorders
- Systemic conditions: diabetes mellitus, scleroderma, amyloidosis, metabolic syndrome
- Motility disorders: irritable bowel syndrome, pseudo-obstruction, mitochondrial dysfunction
- Medication: opiates and proton pump inhibitors slow bowel movement or reduce the stomach acid that holds bacteria back
- Malabsorption: pancreatic insufficiency, liver cirrhosis, coeliac disease, IBD, lactose or fructose intolerance
- Immune deficiency: e.g. sIgA deficiency, a weakened immune system
- Age & diverticula: “bacterial niches” form when food collects in folds of the gut lining
How SIBO is measured:
The practical gold standard is a breath test (H₂/CH₄). You drink a sugar solution (e.g. lactulose), then hydrogen and methane in your breath are measured at fixed intervals.
An early rise within 90 minutes points to SIBO. Current guidelines recommend measuring hydrogen and methane at the same time – methane is often linked to a tendency towards constipation.
When the balance tips: symptoms & triggers
Typical symptoms:
Bloating, cramps
Diarrhea or constipation
Fullness, distension
Fatigue, headaches,
Sleep disturbances, low mood
Because the gut communicates with the entire body via the nervous and immune systems – and if there's chaos there, you'll feel it in your head too.
Why does this happen?
Slower bowel movement: e.g. due to irritable bowel syndrome, medication (acid blockers, opiates)
Malabsorption & underlying diseases: e.g. celiac disease, liver or pancreatic problems
Weaker mucosal immune system: e.g. due to stress, age, or chronic inflammation
The methane twist:
Studies show that methane-positive breath tests are frequently associated with constipation (IBS-C) – indicating a completely different "traffic situation" in the gut than hydrogen dominance.
What does SIBO mean for health and everyday life?
In the short term, the symptoms are bothersome. In the long term, however, chronic dysbiosis can lead to nutrient deficiencies – for example, in vitamin A, D, E, B vitamins, iron, or calcium. The intestinal lining also becomes irritated, and the immune system is under constant stress. Therefore, it is worthwhile to consider further
laboratory values when a breath test is abnormal – e.g.:
Calprotectin (inflammatory marker)
Zonulin & Histamine (intestinal mucosal barrier)
Bile acid balance
sIgA (mucosal immunity)
What you can do yourself – practical lifestyle leversSome simple measures help to relieve the small intestine:
Take test preparation seriously:Eat lightly the day before, no alcohol, no probiotics, arrive on an empty stomach – this makes the test more reliable.
Eating rhythm with breaks:3–4 meals per day, no constant snacking – this allows the "Migrating Motor Complex" to recover, which regularly "sweeps through" the small intestine.
Movement as a motor:Daily moderate activity (e.g., walks, yoga, cycling) stimulates intestinal motility.
Sleep & stress balance:The intestine loves rhythm. 7–9 hours of sleep and conscious relaxation (breathing, meditation, nature) help.
Check nutrients:If results are abnormal, be sure to check vitamin and mineral profiles – this fits perfectly into ORY Berlin's holistic concept.
→ All of these factors can tip the delicate balance of the small intestine microbiome.
Take-away for practice
- Where SIBO is suspected: a full medical history (motility factors, medication, underlying conditions), sound testing (breath test + additional markers) and interdisciplinary coordination.
- Treatment should be individual: identify the cause (e.g. motility disorder, stasis), improve the diet, and support the mucosal barrier where needed.
- Monitoring: check nutrients, avoid recurrence, long-term follow-up.
