SIBO through a Functional Medicine Lens: A Multimodal Evidence-Based Approach Beyond Antibiotics
Document Type
Poster Presentation
Publication Date
4-17-2026
Keywords
fsc2026
Abstract
Background: Small Intestinal Bacterial Overgrowth (SIBO) is a syndrome of excessive or altered bacteria in the small intestine. While symptoms like bloating, gas, and diarrhea are common, conventional management faces significant hurdles. Current breath testing—the diagnostic mainstay—demonstrates low sensitivity, ranging from 42% to 54%. Furthermore, a reliance on antibiotics alone often fails to address underlying pathophysiology, leading to high recurrence rates.
Purpose: This evidence-based practice project evaluates gaps in conventional SIBO management and proposes a Functional Medicine framework to improve clinical outcomes.
Evidence Synthesis: Conventional models prioritize bacterial eradication but frequently overlook root causes like Migrating Motor Complex (MMC) dysfunction or mucosal damage. Clinical literature reveals a lack of randomized control trials specifically for chronic diarrhea in SIBO, highlighting a major knowledge gap. Integrating advanced diagnostics—such as GI-MAP, Organic Acids Testing (OAT), and Intestinal Barrier Assessment (AIBA)—allows for a more precise identification of dysbiosis and "leaky gut".
Proposed Framework: This poster advocates for the 5R Program, a multimodal intervention strategy:
- Remove & Replace: Use herbal antimicrobials (Berberine/Oregano) and digestive support (HCL/Enzymes).
- Reinoculate: Introduce low-risk probiotics and prebiotics strategically.
- Repair: Heal the intestinal barrier using agents like L-Glutamine and Aloe Vera.
- Rebalance: Address HPA axis dysfunction and lifestyle factors to prevent recurrence.
Implications for Practice: Transitioning from an antibiotic-only model to a comprehensive, individualized, and holistic 5R framework addresses the "why" behind bacterial overgrowth. By targeting root causes, clinicians can provide more effective, systemic care for patients with complex GI presentations.
Publication Information
Grams, Katherine, "SIBO through a Functional Medicine Lens: A Multimodal Evidence-Based Approach Beyond Antibiotics" (2026). Fisher Showcase 2026. Paper 230.
https://fisherpub.sjf.edu/fsc2026/230
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