The Truth About IBS, SIBO, and Why Everything You've Been Told Might Be Wrong

If you have IBS, you've probably been told some version of the following: manage your stress, try fiber supplements, eat more probiotics, and learn to live with it.

I'm here to tell you that advice — while well-intentioned — is incomplete at best and actively harmful at worst for a large percentage of people with IBS. And I say that not as someone who read about it in a textbook, but as someone who lived it.

My Story (Because It Matters Here)

In high school, I started restricting my diet. The IBS that followed was miserable — bloating, pain, unpredictable digestion that made me afraid to eat. Doctors told me to add fiber. It made everything worse. I became scared of food altogether.

In the early 2000s, I was working alongside Dr. Mark Pimentel's team at Cedars-Sinai when his research on SIBO was emerging. I took the breath test. I tested positive. For the first time, my suffering had a name — and a treatment plan.

That experience shaped everything. It's why I became a dietitian specializing in IBS and SIBO. It's why I wrote The Beginner's Guide to Low FODMAP. And it's why I will never tell a client to "just manage it."

What Most Doctors Get Wrong About IBS

I want to be clear: I have enormous respect for physicians. But the research on IBS and SIBO is relatively new, and most medical training hasn't caught up. Studies suggest that up to 80% of people diagnosed with IBS actually have SIBO — small intestinal bacterial overgrowth — as the root cause.

SIBO happens when bacteria colonize the small intestine where they don't belong. Every time you eat, they ferment your food, produce gas, and cause the symptoms you know too well: bloating, distension, constipation, diarrhea, or the lovely combination of both.

Here's where the standard advice goes sideways: if you have bacterial overgrowth and you start taking probiotics or fiber supplements, you are feeding the bacteria. You will feel worse. And then you might be told — again — that it's stress, or anxiety, or just how your gut works.

It is not in your head. It is in your gut. And there is a difference.

What Actually Works

The most important step is getting tested. A SIBO breath test is non-invasive and will tell you whether bacterial overgrowth is present and what type — hydrogen, methane (IMO), or hydrogen sulfide. Each type responds to somewhat different approaches, which is why cookie-cutter treatment rarely works.

From there, treatment typically involves:

Medical treatment — Antibiotics like Xifaxan, or herbal antimicrobials for those who prefer a more natural approach. I work with clients on both options and help them communicate clearly with their doctors to get the right treatment.

The low FODMAP diet — Developed by Monash University researchers, this evidence-based elimination diet removes the fermentable carbohydrates that feed bacteria and cause symptoms. I want to be honest: the diet is detailed and it takes guidance to do it right. But it is not a forever diet. The elimination phase is often just 2–4 weeks, followed by a structured reintroduction to identify your specific triggers.

Long-term maintenance — This is where most programs fail people. Getting through the elimination phase is step one. Understanding which foods work for your body, building back a varied diet, and living freely — that's the real goal.

What Are Your Odds?

Here's what the research shows, and what I see consistently in my practice:

• About 1 in 3 people with SIBO can eliminate it completely
• About 2 in 3 achieve 80–90% symptom improvement

That means the overwhelming majority of people who commit to this process get their lives back. They stop planning around their stomach. They travel, eat at restaurants, and feel like themselves again.

What You Can Do Right Now

If any of this resonates — if you've been suffering with bloating, IBS, or digestive issues that haven't responded to standard care — please don't wait another year to get answers.

I offer virtual nutrition programs nationwide. I will help you navigate testing, treatment, and the low FODMAP diet from start to finish. You will never feel lost or alone in this process.

Twenty-five years of clinical experience. A personal history with SIBO. Two published books. And a genuine commitment to helping you get better.