Quick answer
SIBO is often a downstream consequence, not the primary root cause. If relapse keeps happening, the missing layer is usually upstream: migrating motor complex dysfunction, structural factors, low stomach acid defense, bile flow issues, or untreated inflammatory drivers.
- What fails most: antimicrobial-only cycles without root-cause correction.
- What works better: diagnosis + phased strategy + relapse prevention.
- Core principle: clear overgrowth, then protect the terrain.
Why recurrence is common
People often feel better during treatment then regress because bacterial load was reduced but the environment that enabled overgrowth was not fixed.
- Impaired motility (MMC weakness)
- Constipation or slow transit
- Post-infectious changes
- Acid suppression context and digestive defense issues
- Bile and pancreatic insufficiency patterns
- Biofilm-protected microbial persistence
A practical root-cause sequence
- Characterize pattern: symptom map + bowel pattern + likely gas phenotype.
- Test smart: breath testing and targeted rule-outs (celiac, inflammation, H. pylori when indicated).
- Phase treatment: reduce load, improve motility, restore digestion, rebuild tolerance.
- Relapse prevention: meal spacing, motility support, bowel regularity, reintroduction strategy.
Where holistic strategy fits
Holistic care is not anti-science. It is systems medicine: connect gut, nervous system, liver-bile axis, immune signaling, sleep, stress, and nutrient status into one plan.
Medical disclaimer: Educational content only, not medical advice. Persistent or severe symptoms require clinician-guided diagnosis and treatment.