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How To Prevent Another SIBO Recurrence

A SIBO (Small Intestinal Bacterial Overgrowth) recurrence or SIBO relapse is incredibly common. In fact, some studies show that more than 45% of people with SIBO are reinfected or experience SIBO symptoms again within just a few months of their SIBO treatment and that percentage increases in older people and people with multiple health problems.

I would say that percentage is probably even higher based on all the people I talk to everyday that tell me about their recurrent SIBO. Here’s my question for you, Have you or even your doctor ever considered the role your livers involvement in SIBO treatment.

You see….. if your doctor is only prescribing antimicrobials or Rifaximin/Xifaxin and recommending a low FODMAP diet in treating SIBO, your are guaranteed to fail and have another SIBO relapse. Heres an article on the 4 Mistakes People Make on Low FODMAP diet

If you find yourself feeling defeated in your journey for better gut health and you have one SIBO relapse after another, I hope today’s video on ways to support your liver when you have SIBO or IBS will help you realize that there is so much that can be done to regain your gut health when we think about this from a functional medicine perspective.

If you are just joining me for the first time, I’m Dr Hagmeyer, I’m a functional medicine doctor and the clinic director here at Dr where we help provide answers and solutions for people who struggle with chronic digestive tract problems using lifestlye and functional medicine.

If you are still struggling with recurrent SIBO, be sure to watch todays video all the way to the end. Because in today’s video I want to help you not understand the crucial and overlooked role the liver plays in SIBO, but I also want to share with you a number of ways you can support your liver when you have SIBO so you can prevent SIBO relapse.

You see, supporting your liver when you have SIBO and digestive tract problems is essential in restoring your healthy gut and here’s why…


It’s bad enough our liver is constantly being taxed and burdened by pollution, medications, poor diet, processed foods, pesticides, but when you have SIBO, there is another toxin your liver and gall bladder are being subjected to and burdened by and these are endotoxins.

Endotoxins are produced by gram negative bacteria and they cause a number of problems when you have SIBO and they are a major cause for a SIBO recurrence.

These endotoxins, irritate the mucosal lining of the digestive tract causing irritation of the lining of your small intestine, leading to a leaky gut (1) allowing toxins to slip into the bloodstream triggering inflammation(2). This inflammation can impair liver and gallbladder function leading to reduced bile flow contributing to kidney and gallbladder stones.

Remember your liver filters your blood, it makes Bile, it’s involved in over 200 different reactions in your body, but when these endotoxins overwhelm your liver you’re going to suffer with poor detoxification, inflammation, impaired bile flow, your going to experience oxidative stress at the cellular levels, you’re going to have depleted glutathione and levels and all of this risk factors ultimately is going to end up in a relapse of your SIBO. I have seen this hundreds and hundreds of times when treating SIBO.

Here’s the other thing…. No matter how well you follow and adhere to a low fodmap diet or SIBO diet you need to remember that there are many causes to SIBO and successful long term success to SIBO treatment requires a multipronged approach that includes liver and gallbladder support.

Prevent a SIBO Relapse By Supporting Your Liver

  1. Increase Bile production and Bile Flow

Like I have been mentioning, One thing we need to do when we have SIBO or prevent a SIBO recurrence, is making sure we have sufficient bile production and sufficient bile flow.

People who have SIBO often have reduced bile acids production that leads to a congested liver and a congested gallbladder and when your liver and gallbladder is congested you’re going to experience problems with bile production leading to symptoms of bladder stones, kidney stones, diarrhea, gas, bloating, stomach cramps, erratic bowel movements, weight loss, and as the disease progresses pale clay colored stools.

But here is why bile and healthy bile flow are so important to your digestive tract. Bile contains bile acids, which are critical for digestion and nutrient absorption of fats and fat-soluble vitamins in the small intestine. Many of these fat soluble vitamins like A,D,E,K are very important to gut health. 2nd bile is antimicrobial and it helps keep gut bacteria levels low. Poor bile flow leads to increased gut flora in the small intestines. 3rd, bile stimulates gi tract motility. Poor bile flow slows down motility leaving more time for food and fibers to sit in the gut to be fermented by SIBO bugs. I see many of my clients have improvement in SIBO symptoms from just increasing bile flow!

There are few natural ways to improve bile flow that I want you to be aware of and I recommend that you talk with your functional medicine doctor about which of these ways are best to implement. Usually, a combination of these are needed for optimal bile production and bile flow.

So here are ways to increase bile production and bile flow.

4 Ways to Increase Bile Production and Bile Flow

  • Bitter herbs increase bile flow. Milk thistle, dandelion greens or dandelion tea, goldenrod, juicing beets and beet greens, gentian these are all great ways to improve bile flow.
  • Eating Foods Rich in Choline. Not only is Choline a bile salt, but choline is needed for the production of acetylcholine which is an important neurotransmitter that plays a vital role to digestion and gut motility. Foods that contain choline include eggs, liver and beef. Choline can also be taken in supplement form.
  • Another great way of increasing bile production is supplementation with Taurine. Your body uses taurine to make bile salts.
  • But if you don’t have a gall bladder, direct supplementation with bile salts like Oxbile and choline is another option. I recommend talking to your functional medicine doctor to see which is most appropriate for you Oxbile, choline or Taurine.
  1. Bind up endotoxins from the gut

The next thing we want to think about when it comes to supporting the liver when we are trying to prevent SIBO recurrence is binding up these microbes and the endotoxins that these bacteria produce.

When you bind up these toxins in your digestive tract and then get them out of the body you are taking an important step at taking stress off your liver which in turn reduces inflammation, reducing endotoxin load.

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Remember that bile not only helps your digestive tract absorb fats, bile removes toxins from the body. So, we need to have good bile flow and we need to trap these toxins and microbes. Now…

To bind up these toxins and bacteria, I often use things Immunoglobulins like the ones we see in SBI protect as well as a supplement like GI detox that contains charcoal, and clay.

Studies show that immunoglobulin G, can bind up the microbes in the GI tract and eliminate them prior to activating the immune system.

  1. Reduce Oxidative Stress

The next thing we want to think about when it comes to supporting the liver and preventing SIBO relapse is oxidative stress.

Oxidative stress is defined as a disturbance in the balance between the production of reactive oxygen species (free radicals) and antioxidant defenses.

Oxidative stress is one of the main reasons for cellular damage and cell toxicity.

One of the best ways to reduce oxidative stress and cellular damage is to Increase your Glutathione Levels.

In fact the majority of my SIBO patients are put on supplemental liposomal glutathione to help increase glutathione levels and reduce oxidative stress and cell damage.

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Glutathione is one of the most important things to help the liver detox toxins and this again is something that should be implemented in your SIBO treatment program and improve your SIBO symptoms.

There are a number of ways that you can increase glutathione levels through your diet, but with all my patients, I recommend a combination of dietary strategies alongside specific supplementation to boost glutathione levels.

From a dietary standpoint be sure to increase your protein intake. I recommend eating anywhere between .5-1 gram per pound of body weight every day. If you are not dealing with any histamine issues collagen and gelatin from bone broth can be another great way to naturally supply your body with the raw materials to make glutathione but just be careful if you experience anxiety as the histamines found in bone broth can increase anxiety.

Additional Information on Glutathione

Whey protein can be another way to increase glutathione levels. Whey protein also has the ability to strengthen your immune system, reduce inflammation, maintain muscle mass and help with leaky gut. If your diet is really restricted and you are in a bad place with flare ups, it may be necessary to bring out the big guns and jump right into glutathione supplementation.

There are many different kinds of glutathione supplementation these days, but I recommend a liposomal glutathione.

Whey protein can be another way to increase glutathione levels. Whey protein also has the ability to strengthen your immune system, reduce inflammation, maintain muscle mass and help with leaky gut.If your diet is really restricted and you are in a bad place with flare ups, it may be necessary to bring out the big guns and jump right into glutathione supplementation.

There are many different kinds of glutathione supplementation these days, but I recommend a liposomal glutathione.

How To Prevent SIBO Another SIBO Relapse-

  1. Limit environmental toxin exposure

Reducing toxins from household cleaners, food, beauty products, hygiene products and more can help reduce backups in the liver. Here are some tips when it comes to reducing toxins:

  • Avoid using plastic containers (use glass water bottles and storage containers)
  • Buy organic food when possible
  • Filter your water and avoid storing in plastic. 
  • Buy non-toxic household products and Cleaners
  • Buy non-toxic hygiene and beauty products like bleach free tampons, make-up, body wash, shampoo, conditioner, nail polish, hair products, sunscreen and skin care products
  • The Environmental Working group has a great website to help you choose better non-toxic options for you and your family.

Points To Remember When It Comes To Preventing Another SIBO Relapse

Just as a quick summary, there are many things that need to be considered that fall under this umbrella of supporting your liver. Today we talked about 4 ways to support your liver when you have SIBO. I talked about improving bile production and bile flow, I talked about reducing oxidative stress, I talked about the importance of binding up the endotoxins, I talked about eliminating toxins in your environment. I talked about some of the foods that can help with this and I talked about some of the supplements that do this as well. Its always best to implement a combination of dietary changes, and supplements in these cases.

All of these things thing when implemented into your SIBO treatment program can improve your SIBO symptoms and will help prevent another SIBO recurrence.

One thing I will tell you is that this is very easy to overlook the connection between the liver and SIBO, but If you are someone who has had multiple relapses, there are some missing pieces to your BIG picture.

The liver could be one of those pieces that needs attention. If you haven’t watched my SIBO video series, I encourage you to check the description box, and I will leave links to those videos. Also, If you feel like you hit a brick wall in your SIBO treatment program, or you feel that the doctor you are working with is missing some of the pieces of your health puzzle, the best way to get in touch with me is by going to my website and clicking on the start here button.

One last thing, If you struggled with SIBO or SIBO recurrence and you found that supporting your liver with some of the things I talked about today made a big difference for you, drop me a comment below, tell me about your experience? What did you find helpful?

Additional Articles To Read and Review Related to SIBO

  1. 10 warning signs you have SIBO & When To Get Tested
  2. Breath Kind Of testing for SIBO 
  3. Eradicate SIBO by incorporating Biofilm Disruptors
  4. SIBO and Prokinetics- The Missing Piece In Treating SIBO 
  5. Why SIBO Treatments Fail Most Of The Time-Part I
  6. Part 2 Why SIBO Treatments Fail Most Of The Time-Part II
  7. 4 Common Mistakes Made On Low FODMAP and SIBO Diet
  8. Feeling Worse After Taking Probiotics ? Learn Why
  9. Best Probiotics To take When You Have SIBO and When To Introduce Them 
  10. How Food Poisoning Triggers Autoimmune IBS-D
  11. What You Need To Know Before Getting Tested For SIBO
  12. 5 Food Additives You Should Avoid, If You Have SIBO
  13. Ileocecal Valve Release- Self Massage-How, When And Where To Massage Your Ileocecal Valve
  14. Why The Ileocecal Valve Holds The Key to IBS and SIBO- What It Is and Why It’s Important 
  15. Vicious cycle of Nutritional Deficiencies Associated With Low FODMAP and SIBO Diet
  16. SIBO/IBS And The Connection To Thyroid Disease
  17. Why Antibiotics May Not Be The Best Approach for SIBO
  18. Medications That Cause IBS, SIBO and Leaky Gut
  19. Studies Now Connect Fibromyalgia and Chronic Pain to Bacterial Overgrowth (SIBO)

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