I had an opportunity to connect with Josh Sabourin, the publisher of SIBO Survivor to discuss the options for treating SIBO (small intestinal bacterial overgrowth) and IBS (irritable bowel syndrome) in people who:

  • Can’t tolerate antibiotics
  • Fail to get better on antibiotics
  • Just choose not to take them

NOTE: Refer to the end of this page if you are not familiar with SIBO.

Even though antibiotics are commonly prescribed (mostly off label) for SIBO and many people don’t think you can address it without them, there is an active debate about whether antibiotics represent the best first-line approach and what role should diet and other holistic approaches play.

Here are some of the questions we address:

  • If you don’t want to use antibiotics, what are the options?
  • Is it just diet or are there other requirements?
  • Is it even possible to treat SIBO with antibiotics long term if you do not change a diet, adopt pro-digestion behaviors and address the underlying causes?

Watch the video for 3 steps you can take to address SIBO and related issues without drugs or antibiotics

Take home messages:

  • Science-based diets (Fast Tract Diet is discussed in this video) should be the first-line therapy for SIBO and related conditions before antibiotics.
  • It’s critical to identify and address underlying causes that are specific to you, and this should be part of the process. There are many underlying causes, and this is an active area of research. Refer to the graphic below for some examples.
  • You may need help in identifying the relevant underlying causes in your case so that they may be addressed.



Small intestinal bacterial overgrowth is a condition where too many bacteria are present in the small intestine where they ferment carbohydrates and produce acids, enzymes, toxins and gases that result in a variety of challenging symptoms and also damage our villi and microvilli needed for healthy digestion. Unfortunately, SIBO is linked to a wide variety of digestive and other health issues including:

  • IBS
  • Acid Reflux, GERD
  • Fibromyalgia
  • Chronic fatigue syndrome
  • Rosacea
  • Autoimmune conditions
  • Interstitial cystitis
  • Celiac disease
  • Crohn’s
  • Pancreatitis
  • Sjögren’s syndrome
  • Cystic fibrosis, and more