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The Five Must-Knows for Treating SIBO
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March 15, 2018

RFR 163: The Root Causes of SIBO & the Influence of Food Fears, Stress & Anxiety with Angela Pifer, SIBO Guru

In Episode 163 of The Real Food Reel, Steph Lowe and I explore SIBO, the potential causes of SIBO and how SIBO is a secondary condition and must be treated in this way. We you will learn the significance of food fears, stress and anxiety and so much more.

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from 4 people

Angela Pifer

Hi Mike, this is such a great question! We have tinctures, herbal blends, single high dose herbs... there are a lot of options to choose from, when creating an effective treatment. If a patient reacts to one herb, we have other options waiting in the wings. It is best to treat with higher dose herbs for shorter time. If this isn't an option, then really work on motility, supporting digestion, etc., and target dysbiosis as needed. It may be that over time, higher dosages can be used. Starting slow and building up over time, is a great approach!

Angela Pifer | March 28, 2018


Great information as always, Angela. For those like me who have a positive IBSCheck test result but negative breath test and have had IBS symptoms for 10-plus years, how long do you tend to keep someone on antimicrobials? Can efficacy of eliminating SIBO symptoms with a lower does of antimicrobials for a longer duration get to the same result as someone who does a higher does of microbials for shorter period of time? When someone reacts negatively to a higher does of microbials, do you then switch to a lower dose for a longer period?

Mike | March 19, 2018

Angela Pifer

Thanks Patty - prolonged periods of stress can definitely increase the risk of getting SIBO. This can alter motility, immune function, lower stomach acid, reduce the amount of digestive enzymes present. It has never been shown to be a primary cause. The stress of having to go through treatment, change the diet and all of a sudden pay attention to day to day symptoms, can be very wearing on the system. As with any treatment plan, disposition, social engagement, happiness, etc... will play a role in recovery.

Angela Pifer | March 16, 2018


I listened to your podcast. I'm so impressed by your approach to treating the whole body, not just the small intestine. I was really interested in the section of the podcast where you spoke about potential causes of SIBO. Am I correct in saying that you consider a period of prolonged and intense stress as a potential cause of SIBO getting started? Just moving past the stress and being away from that situation doesn't seem to be enough to get me back to normal, though. I've treated the SIBO muiltiple times, but it keeps coming back - or maybe it never went away. My doctors haven't been too good at retesting at the appropriate time.

Patricia | March 15, 2018

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