Therapieresistente Bauchschmerzen und SIBO - myBioma

Therapy-resistant abdominal pain and SIBO

... when your (large intestine) microbiome is in the wrong place.

Since our level of knowledge about this Microbiome has increased significantly in recent years, research is now increasingly focusing on it SIBO (Small intestinal bacterial overgrowth).

This is becoming more and more common Improper colonization and overgrowth of bacteria in the small intestine as a clinical picture.

But what exactly happens here? Is this an answer to treatment-resistant, unexplained abdominal pain? Come with us and explore this topic with us!

It should be mentioned at the outset that SIBO usually manifests itself through non-specific symptoms . This can make it difficult to distinguish from irritable bowel syndrome .

SIBO Irritable Bowel Syndrome Graphical representation
Pathophysiology (the study of the disease processes and functional disorders) in SIBO. (1)

More precisely, it is a “Too much” unfavorable bacteria in the small intestine , leading to symptoms such as bloating, abdominal pain, nausea, fatigue and changes in bowel movements.

It can even go so far that fats, proteins and micronutrients are no longer properly absorbed by the body ( malabsorption ). Also favor Operations that affect the movements of the small intestine, a potential occurrence of SIBO .

Actually, the stomach and the beginning part of the small intestine only contain very few bacteria . The amount of these is largely determined by the Stomach acid , the bile , from enzymes (enable chemical reactions in the body) and Immunoglobulins (protein molecules to combat pathogens), as well as from Bowel movements (Peristalsis) kept in check.

Bacterial colonization of the intestinal sections as a graphic representation As shown in the picture, you can clearly see the increase in bacteria the closer you get to the colon. (2)

The closer you get via the “forwarding” of the small intestine about the Ileocecal valve (separates the two structures) dem colon approaches, the more more Bacteria can be found that actually live in the large intestine. Normal, forward ones Bowel movements , as well as one functioning ileocecal valve are a prerequisite to prevent the bacteria from “migrating backwards” from the large intestine into the small intestine SIBO so now either through anatomical , immunological , as well enzymatic problems, or, if the two main regulatory mechanisms, Bowel movements and Stomach acid production to control the number of bacteria in the small intestine is altered.

Graphical representation: Diagnostic points for SIBO
Diagnostic points for SIBO. (1)

Intestinal contraction is the purpose Onward transport of the food pulp, as well as of Microorganisms . If this movement is restricted, for example by certain medications or diabetes mellitus, this can affect the small intestine's ability to Self-cleaning affect.

The exact definition of SIBO is therefore: Bacterial overgrowth defined by a abnormally high amount of bacteria and at the same time the presence of “wrong” (large intestine) bacteria in the small intestine, which can ferment carbohydrates into gas.

Furthermore, this can lead to a Damage to the mucous membrane of the small intestine, which can mean that essential building blocks (carbohydrates, proteins, fats, iron, vitamin B12) from food can no longer be absorbed.

Diagnosis and possible treatment algorithm when SIBO is suspected. (1)
Diagnosis and possible treatment algorithm when SIBO is suspected. (1)

These building blocks now serve as food for the microorganisms, which subsequently (through fermentation processes) leads to a... bloating/flatulence , acidic stools , or Deficits in nutrient supply leads.

One Therapy of SIBO is therefore as follows:

1. correction underlying diseases or anatomical peculiarities – if this is possible

2. Antibiotic therapy or use of plant substrates

3. Adjustment of diet

The Reduction of fermentable carbohydrates is an effective dietary adaptation to control symptoms.

Regular exercise is incredibly important for your microbiome, your brain and your entire body. (3)
Regular exercise is incredibly important for your microbiome, your brain and your entire body. (3)

In summary, it should be emphasized again how important it is for us to take a good look at our microbiome drink , get enough move and yourself healthy to nourish .

All this supports digestive processes and movements so that they can take place properly and your bacteria do not get lost from the large intestine to the small intestine.

A healthy diet also contributes significantly to a resilient microbiome. This is how you stay productive and fit in everyday life! (4)
A healthy diet also contributes significantly to a resilient microbiome. This is how you stay productive and fit in everyday life! (4)

Find out now what SIBO has to do with Hashimoto's thyroiditis (chronic inflammation of the thyroid gland).

Do you know what the composition of your microbiome is? With the myBioma microbiome analysis You can find out from the comfort of your own home what your intestinal bacteria are like and whether they help keep you healthy.


This article is intended for informational purposes only and should not be construed as medical information or instructions. The recipes are intended for inspiration and are not intended as therapeutic measures. If you have any health problems, we recommend that you contact a doctor or other expert immediately.


  1. Dr. med. Martin Wilhelmia; Diana Studerus, EBSD with MDPD with SV (02/28/2018). ” The answer to treatment-refractory abdominal problems?; SIBO: “small intestinal bacterial overgrowth””. from

  2. Fehlbesiedlung-sibo/




  • Dr. med. Martin Wilhelmia; Diana Studerus, E. B. S. D. m. M. D. P. D. m. S. V. (28.02.2018). ” Die Antwort auf therapierefraktäre Bauchbeschwerden?; SIBO: «small intestinal bacterial overgrowth» “. from
Medical Doctor and Microbiome Expert
Ina is a medical doctor and is passionate about analysing the gut microbiome and its importance for health!