The Truth About IBS, SIBO, and Why Everything You've Been Told Might Be Wrong

If you have IBS, you've probably heard some version of this: manage your stress, take fiber, try probiotics, and learn to live with it.

I'm going to be honest with you — that advice has made a lot of people significantly worse. And I say that not from a textbook, but from personal experience and 25 years of watching it happen in my practice.

My story — because it matters here.

In my younger years, I started restricting my diet. What followed was years of IBS so disruptive I became genuinely afraid of food. Doctors recommended fiber. It was awful — things got worse, not better. I felt like my body had turned against me.

Then, in the early 2000s, I was working alongside Dr. Mark Pimentel's team at Cedars-Sinai as his research on SIBO was emerging. I took the breath test — one of the first people ever to do so. I tested positive for Small Intestinal Bacterial Overgrowth.

Suddenly everything made sense. The fiber making things worse? Of course — I was feeding bacteria. The bloating after every meal? The bacteria fermenting my food. For the first time, I wasn't sick. I had a condition with a name, a cause, and a treatment plan.

That moment is why I do what I do. And it's why I will never tell a client to just manage it.

What most doctors are missing.

I want to be clear that I have enormous respect for physicians. But the research on IBS and SIBO is still relatively new, and most doctors simply weren't trained in it. Studies suggest that up to 80% of people diagnosed with IBS actually have SIBO as the root cause.

Here's where standard advice goes wrong: if you have SIBO and you start taking probiotics or loading up on fiber, you are feeding the bacteria. You will feel worse. And when you go back to your doctor feeling worse, you might be told — again — that it's stress, or anxiety, or just how your gut works.

It is not in your head. It is in your gut. And there is a very real difference.

What testing looks like.

A SIBO breath test is simple, non-invasive, and tells you whether bacterial overgrowth is present and what type — hydrogen, methane (IMO), or hydrogen sulfide. Each type responds to a somewhat different approach, which is why generic treatment rarely works.

This is one of the most important things I do for my clients: help them understand what they actually have and make sure they're getting the right test and the right treatment. I work with both conventional antibiotics like Xifaxan and herbal antimicrobials for those who prefer a more natural route.

What treatment looks like.

Once we know what we're dealing with, we treat it. And then we use the low-FODMAP diet to starve the bacteria, heal the gut lining, and rebuild a diet that actually works for your body.

The low-FODMAP diet is not a forever diet. It has three phases — elimination, reintroduction, and maintenance — and the elimination phase is often as short as two weeks. By the end of reintroduction, you'll know exactly which foods your body tolerates and which ones cause problems. Most people end up with a diet far less restrictive than they feared.

About one in three people with SIBO resolve it completely. Two in three see 80–90% improvement. That means the overwhelming majority of people who commit to this process get their lives back.

You've spent enough time managing this.

Twenty-five years of clinical experience. A personal history with SIBO. Two published books. And a genuine commitment to getting you better — not just helping you cope.

If you've been suffering with digestive issues that haven't responded to standard care, I'd love to talk.