Dr. Daniel Ricciardi

SIBO vs IBS 👇

IBS (Irritable Bowel Syndrome)
    •    A label doctors give when you have stomach pain and bathroom problems, but common tests don’t show a clear cause
    •    It’s basically “we don’t know exactly why, but here’s what’s happening”
    •    Can be caused by SIBO, leaky gut, stress, food sensitivities, etc, or a combination of all
    •    Types: mostly constipated (IBS-C), mostly diarrhea (IBS-D), or a mix of both (IBS-M)
    •    Common Treatments: avoid certain trigger foods, manage stress, sometimes medication for cramping

SIBO (Small Intestinal Bacterial Overgrowth)
More recently being called:

👉hydrogen SIBO (hydrogen gas)
👉intestinal methanogen overgrowth (IMO - methane gas)
👉intestinal sulfide overproduction (ISO - hydrogen sulfide gas)

    •    A specific problem where certain microbes overgrow in your intestine
    •    You CAN test for this — a breath test measures gases the bacteria produce
    •    Has actual causes: your gut isn’t “sweeping” things through properly, low stomach acid, past infections, certain medications
    •    Types depend on which gas shows up: one type usually causes more diarrhea, another causes more constipation
    •    Treatment: specific antimicrobials to kill the extra bacteria, plus fixing whatever caused it in the first place so it doesn’t come back

The review you didn’t know you needed.

If you have IBS, you’ve probably been told:

Take a probiotic and eat more fiber.

And for some people, that works great!

But for others, probiotics and fiber can actually make bloating, gas, and abdominal discomfort worse.

Why?

One possibility is SIBO — small intestinal bacterial overgrowth.

Fiber is normally beneficial because gut bacteria ferment it, primarily in the colon.

But with SIBO, bacteria are present where they shouldn’t be — in the small intestine.

So when you add more fermentable fiber, you may be giving those bacteria more fuel.

More fermentation.
More gas.
More pressure.
More bloating.

And probiotics aren’t automatically the answer either.

Adding more bacteria to a gut that’s already experiencing microbial imbalance doesn’t guarantee you’ll feel better.

There’s another piece that often gets overlooked:

The gut barrier.

Your intestinal lining and mucus layer help protect the tissue underneath from what’s inside your gut.

When this barrier becomes compromised, it can contribute to immune activation and intestinal symptoms.

This is often referred to as increased intestinal permeability, or “leaky gut.”

So if you have IBS and you’re getting more bloated the harder you try to eat healthy, don’t automatically assume you need more fiber or probiotics.

Sometimes you need to ask a different question:

“Why is my gut reacting this way in the first place?”
Because healthy foods aren’t automatically healthy for every gut, in every situation.

Addressing things like SIBO, motility, fermentation, inflammation, and gut-barrier function may be more important than simply adding more fiber and probiotics.

Client review - Adam

The scoop on leaky gut 👇

Your gut lining acts like a filter, letting the good stuff in and keeping harmful things out. But when it becomes “leaky,” toxins, bacteria, and food particles can activate your immune system… triggering inflammation and symptoms throughout the body.

It might be the hidden reason behind your bloating, brain fog, or skin issues. 

Some things that can cause leaky gut:

Chronic stress
Poor sleep
Antibiotics
NSAID medications
Highly processed foods
SIBO/Candida/Parasites
Low Vitamin D
Gluten
Histamine overload

Signs you might have it:

Persistent bloating
Food sensitivities
Brain fog
Always feeling tired
Acne
Psoriasis
Irregular bowel movements
Chronic headaches

5 Signs You Have LOW Stomach Acid (Not High) 👇

Everyone blames “too much acid” for these symptoms. In my experience, it’s usually the opposite.

Stomach acid isn’t just there to “digest food”, it activates enzymes, kills pathogens, and unlocks nutrients like B12, iron, and zinc. When it’s too low, the whole downstream chain breaks.

Here’s what that actually looks like:

1️⃣ Heartburn (Counterintuitive, I know). But low acid means food sits in your stomach longer, ferments, and creates pressure that pushes acid (even a small amount) up into your esophagus. The burn isn’t from too much acid, it’s from acid ending up where it shouldn’t.

2️⃣ Frequent burping: Especially within 30-60 min of eating. This is often gas from fermenting, undigested food.

3️⃣ Feeling overly full for hours: Low acid slows gastric emptying. Food just sits there. That “I ate a normal meal but feel like I swallowed a brick” feeling? That’s this.

4️⃣ Undigested food in your stool: If you’re seeing recognizable bits of what you ate (especially protein), acid didn’t break it down enough for your enzymes to finish the job.

5️⃣ Bloating right after eating (not hours later): Bloating that shows up within the first 30-60 minutes usually points to poor breakdown up top, not a lower-GI issue like SIBO.

Want a rough at-home estimate? Try this Baking Soda Stomach Acid Test

Step 1: Mix ¼ tsp baking soda into 4-6 oz cold water.
Step 2: Drink first thing in the morning, before eating or drinking anything else.
Step 3: Time how long until you burp.

✅ Burping several times within 2-3 minutes → generally suggests adequate acid levels
❌ No burping (or very delayed) after 3-5 minutes → may suggest low stomach acid

Important caveat (say this so it doesn’t read as medical advice): this test is a rough screening tool, not a diagnosis.

Breakdown of each 👇

Digestive aids (digestive enzymes, betaine HCl, ACV, ox bile, bitters): Support the mechanical/chemical breakdown of food when native digestive output is insufficient - enzymes for macronutrient breakdown, betaine HCl and ACV for low stomach acid, ox bile for fat emulsification, bitters to stimulate overall secretory response via the mouth-to-gut reflex.

Probiotics (Lactobacillus, Bifidobacterium, S. boulardii, Bacillus): Introduce or support beneficial/commensal organisms to compete with pathogens, modulate immune response, and produce metabolites - species vary by use case.

Prebiotics/fiber (psyllium, PHGG, inulin, FOS): Non-digestible substrates that feed beneficial bacteria and/or add bulk, although fermentable ones (inulin, FOS) can be double-edged in SIBO/IMO since they also feed overgrowth; PHGG tends to be better tolerated.

Postbiotics (butyrate, propionate): End-product short-chain fatty acids from bacterial fermentation - butyrate in particular is the preferred fuel for colonocytes and supports gut barrier integrity and anti-inflammatory signaling, delivered directly rather than relying on fermentation to produce them.

Mucilaginous herbs (slippery elm, DGL, marshmallow root, aloe vera): mucus-forming ingredients which can be beneficial for gastritis and general GI lining irritation.

Carminative herbs (fennel, ginger, peppermint): Relax GI smooth muscle and reduce spasm, easing gas, bloating, and cramping - peppermint oil specifically has trial data in IBS via antispasmodic action.

Gut barrier support (glutamine, colostrum, vitamin D): Broader category targeting the structural and immune integrity of the intestinal lining itself — glutamine fuels enterocyte repair, colostrum supplies immunoglobulins and growth factors (IGF-1, TGF-β) that support tight junction function and mucosal immunity, and vitamin D regulates tight junction protein expression and modulates local immune response.

Mucoprotectants (xyloglucan + pea protein - Bloat Blocker ): Form a physical, adherent barrier over the intestinal mucosa that protects against irritants and toxins post-meal, mechanistically distinct from mucilaginous herbs.

Same food. Different day. Different result.

If that sounds familiar, you don’t have a food problem, you have a gut problem.

Restricting further won’t fix an inconsistent gut. It just shrinks your world while the actual issue (motility, bacterial overgrowth, an irritated gut lining) goes untreated.

Your gut should handle the same meal the same way, practically every time. If it doesn’t, something else is probably going on.

6 ways to fix IBS 👇

1. Choose simple, whole foods. Stick to foods with minimal (or zero) added ingredients. Fewer additives means less work for your gut, easier digestion, and often noticeably fewer symptoms right away. Start here before trying anything else.

2. Relax before meals. Digestion runs on your parasympathetic (“rest and digest”) nervous system, so eating while stressed or rushed works against you. Take a few slow breaths, sit down, and give your body a calm signal that it’s safe to digest.

3. Eat mindfully. Chew thoroughly, skip chugging liquids with meals, and stop before you’re stuffed. This reduces the workload on your gut and helps prevent bloating and discomfort after eating.

4. Try digestive support. Apple cider vinegar, ox bile, or digestive enzymes can help, especially if you’re low in stomach acid, bile, or enzyme production, or if you tend to eat while stressed (which blunts your natural digestive output).

5. Keep up with your regular doctor visits. Get your labs done, request scans if they’re covered, and follow up on anything notable. Ruling out serious causes with your doctor should always come before self-treating.

6. Dig deeper if symptoms persist. A stool test, SIBO breath test, or parasite panel can help uncover root causes that basic steps alone won’t fix.