Root Causes of SIBO: Why It Comes Back Again and Again

Here’s what’s really behind chronic or recurring SIBO:

1. Weak Gut Motility (a.k.a. Sluggish Peristalsis)

If your gut doesn’t move food along fast enough, bacteria stays too long and starts feeding. This is what we call a motility issue, and it’s the #1 precursor to SIBO.

What causes weak peristalsis?

• Visceral adhesions (from surgery, trauma, infection, birth)
• High sympathetic tone (chronic stress keeps your gut frozen)
• Low stomach acid
• Liver congestion (which impacts bile flow)
• Zinc, sodium, and potassium deficiencies

None of these are fixed with antibiotics. You need to address these functionally.

2. Low Digestive Enzymes

SIBO thrives when food isn’t fully digested. Low stomach acid, low bile, and low pancreatic enzymes all lead to partially digested food sitting in your small intestine, feeding the beast.

Signs you have low digestive enzymes:

• Acid reflux
• Bloating after meals
• Constipation or diarrhea
• Brain fog and fatigue

Common causes:

• H. pylori
• PPIs (acid blockers)
• Birth control
• Liver/gallbladder dysfunction
• Mineral deficiencies

This is why you can’t just take a random digestive enzyme supplement and expect results. You need to rebuild your own production system.

3. History of Antibiotic Use

Antibiotics wipe out your microbiome, kill good bacteria, and weaken your immune defense. They can be the original reason you developed SIBO — or why you keep getting it back.

They also disrupt:

• Stomach acid production
• Bile flow
• Gut lining health

And yes, this includes the very antibiotic treatments prescribed for SIBO. (Oh, the irony.)

4. Other Pathogens (H. Pylori, Candida, Parasites, Mold)

If you have SIBO, you also have one or more other infections.

I never see SIBO without co-infections.

Especially:

• H. pylori (lowers stomach acid, fuels overgrowth)
• Candida (same root causes, similar symptoms)
• Parasites (block motility, cause constipation)
• Mold (lowers immunity, feeds bacteria and candida)

If your practitioner isn't testing for these, they’re missing the bigger picture.

5. Oral Infection or Cavitations

Yes, your teeth can cause gut problems.

You swallow a liter of spit a day, and if there’s pathogenic bacteria hiding in your gums, under crowns, or in bone infections (cavitations), it’s seeding your gut with bacteria constantly.

This is one of the most missed root causes I see. It’s not in your gut. It’s in your mouth.

Testing That Works (And What to Skip)

Stop wasting your money on breath tests that only confirm what you already know.

Here’s what to test instead:

• Organic Acids Test (OAT) — shows candida, mold, bacterial overgrowth
• GI Map (by Diagnostic Solutions) — detects H. pylori, parasites, enzyme production
• Hair Tissue Mineral Analysis (HTMA) — reveals mineral status for stomach acid, bile, and energy
• Visceral Adhesion Self-Tests — reveals fascia restrictions (what most protocols completely miss)

You don’t need a SIBO test to fix SIBO.

You need root cause testing.