SIBO: An Integrative, Evidence-Based Approach with Functional Medicine
Small Intestinal Bacterial Overgrowth (SIBO) is more common than many realize, yet its symptoms and long-term effects are often overlooked or misattributed. At Austin Medicine, we use an integrative framework, including advanced testing through Rupa Health, to diagnose and resolve SIBO with the support of clinical data.
What is SIBO?
SIBO occurs when excessive bacteria accumulate in the small intestine, disrupting digestion and nutrient absorption. Studies estimate SIBO prevalence at 6–15% in healthy people, but up to 78% in those with irritable bowel syndrome (IBS) (Pimentel et al., 2020).
Common Symptoms:
SIBO’s symptoms often overlap with other digestive issues, but data shows the most frequent complaints include:
Bloating (up to 60% of cases)
Diarrhea (40%)
Abdominal pain
Excess gas
Constipation or alternating bowel patterns
Fatigue and weakness
Unintentional weight loss
Nutrient deficiencies (notably B12, iron, and fat-soluble vitamins)
Long-Term Effects:
Untreated SIBO can have lasting consequences:
Chronic nutrient malabsorption (leading to anemia, osteoporosis, neuropathy)
Persistent gut inflammation
Increased intestinal permeability (“leaky gut”)
Worsening IBS and food sensitivities
Lower quality of life and increased healthcare use
A 2017 study found SIBO is linked to significant reductions in quality of life and higher medical costs (Ghoshal et al., 2017).
Integrative Diagnosis:
Functional Medicine enables access to specialty lab testing for SIBO, including lactulose and glucose breath tests; considered the gold standard for non-invasive diagnosis (Rezaie et al., 2017). Additional integrative assessments may include:
Comprehensive stool analysis (to evaluate dysbiosis and inflammation)
Nutritional panels (to detect deficiencies)
Gut permeability and food sensitivity testing
A personalized SIBO plan at Austin Medicine may include: The best of all modalities:
Antimicrobials: Rifaximin, an FDA-approved antibiotic, shows a 70% success rate (Pimentel et al., 2011). Herbal antimicrobials (like berberine and oregano oil) are also effective (Chedid et al., 2014).
Dietary Therapy: Low FODMAP or elemental diets can significantly reduce symptoms (Staudacher et al., 2017).
Motility Support: Prokinetics (ginger, low-dose erythromycin) help prevent recurrence by improving gut motility.
Root Cause Resolution: Addressing underlying triggers such as hypothyroidism, stress, or structural GI issues is essential for long-term success.
Follow-Up Testing: Repeat breath tests confirm eradication and guide ongoing care.
Final Thoughts:
Using Rupa Health’s advanced diagnostics and a blend of conventional and natural therapies, Austin Medicine delivers a personalized, integrative path to SIBO resolution. Our goal is to address the whole person, not just the symptoms to restore lasting gut health.
- Dr. Lauren Hutson, Austin Medicine
Meet the Author
Dr. Lauren Hutson is an experienced Primary Care Provider with degrees in Neuroscience and Biology from the University of Texas at Austin. She completed her residency at Baylor Scott & White, Texas A&M, with ABIM certification in Internal Medicine and has developed a strong focus on preventive care and chronic illness management. During the COVID-19 pandemic, she provided critical care as a Hospitalist in New Mexico, exemplifying her commitment to saving lives.
Dr. Hutson is also trained in Functional Medicine, is ABHRT and SSRP certified, and holds ABCN certification pending- these tools help exemplify her passion for root cause approach and healing the body as a whole. She practices medicine at the cellular level, focusing on enhancing longevity and optimizing long-term health by addressing root causes. She believes that all disease can start in the gut, and has authored a book on gut health to share her insights on the microbiome’s role in overall wellness.
Her front-line experiences during the pandemic inspired her to emphasize preventive health and health span over lifespan, investing in personalized strategies that empower patients to live healthier, longer, and more vibrant lives.
