Hydrogen SIBO occurs when excess bacteria in the small intestine produce elevated levels of hydrogen gas, which can contribute to bloating, abdominal discomfort, diarrhea, and digestive symptoms. Dr. Elena Ivanina takes a root-cause approach to hydrogen SIBO, using advanced testing to understand why bacterial overgrowth developed and help restore a healthier gut.
What is Hydrogen SIBO?
Hydrogen SIBO is an overgrowth of hydrogen-producing bacteria in the small intestine, including species such as E. coli and Klebsiella. These bacteria ferment carbohydrates and produce excessive hydrogen gas, disrupting normal digestive function. Hydrogen SIBO can cause diarrhea or constipation, along with bloating, gas, abdominal pain, and other digestive symptoms. The specific symptoms you experience can depend on your microbiome, the extent of bacterial overgrowth, and other underlying factors affecting your gut.
Symptoms:
- Diarrhea or constipation
- Abdominal bloating or distension
- Excessive gas
- Abdominal pain or cramping
- Changes in bowel habits
- Nausea
- Indigestion or discomfort after eating
- Food intolerances or sensitivities
- Fatigue
- Brain fog
- Skin issues like rosacea
- Nutrient deficiencies such as low vitamin b12
Why does hydrogen SIBO happen?
Your GI tract contains trillions of bacteria, but most of them normally live in the colon rather than in the 20 feet of small intestine. Stomach acid, intestinal motility, digestive secretions, immune defenses, and the ileocecal valve help maintain this balance. Hydrogen SIBO develops when these protective mechanisms are disrupted, allowing bacteria to overgrow in the small intestine and ferment carbohydrates, producing excessive hydrogen gas.
Sometimes, several factors contribute to the bacterial overgrowth, including:
- Chronic use of medications that reduce stomach acid like proton pump inhibitors or PPIs (ex. Nexium)
- Impaired intestinal motility that allows bacteria to accumulate
- Dysfunction of the migrating motor complex (MMC) such as after an infection
- Previous abdominal or intestinal surgery affecting anatomy or motility
- Structural abnormalities that create areas where bacteria can collect
- Intestinal adhesions, strictures, or obstructions
- Reduced digestive secretions or changes in intestinal pH
- A weakened or impaired immune system
- Inflammation affecting normal intestinal function such as Crohn’s disease
- Changes to the gut microbiome following antibiotic use
- Certain gastrointestinal or systemic conditions that impair gut motility
- Specific conditions such as Endometriosis, MCAS, POTS, and EDS
Meet Dr. Elena Ivanina, hydrogen SIBO specialist
Dr. Elena Ivanina is a triple board-certified integrative gastroenterologist and functional medicine expert specializing in SIBO and complex digestive conditions. As the founder of Gut Love, she combines conventional gastroenterology with functional medicine, diagnostic testing, microbiome science, and nutrition. Her approach to hydrogen SIBO goes beyond just identifying bacterial overgrowth. She investigates why SIBO developed, addresses contributing factors, and creates personalized treatment strategies to manage overgrowth, support digestive function, rebuild the microbiome, and help reduce the risk of recurrence.
Hydrogen SIBO FAQs
How is hydrogen SIBO diagnosed?
Hydrogen SIBO is commonly evaluated with a breath test that measures hydrogen levels after you consume a test substrate such as lactulose. An abnormal rise in hydrogen can indicate bacterial fermentation occurring in the small intestine. Dr. Ivanina may also recommend additional testing to investigate potential root causes.
How is hydrogen SIBO treated?
Treatment depends on your test results, symptoms, medical history, and underlying causes. Depending on your individual needs, treatment may involve prescription antibiotics or herbal antimicrobials, nutritional strategies, and measures to support intestinal motility.
Can hydrogen SIBO come back after treatment?
Yes. SIBO can recur, particularly when the factor that allowed bacteria to overgrow remains unresolved. Dr. Ivanina’s approach includes investigating issues such as impaired motility, anatomical changes, medications, and other contributing factors to address more than just bacterial overgrowth.
Learn More with the Heal SIBO Program
Created by Dr. Elena Ivanina, DO, an integrative holistic board-certified gastroenterologist and SIBO specialist, the Heal SIBO Program gives you a clear, root-cause framework for understanding SIBO, from symptoms and lab tests to treatment options and recurrence prevention.
The program includes a 35-minute educational video with Dr. Ivanina, a SIBO Root-Cause Evaluation Framework, a Symptoms & Signs Guide, and an educational guide to herbal antimicrobials—everything you need to become a more informed participant in your own healing journey and have a more productive conversation with your healthcare provider.
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