Your breath test showed elevated gases. But it didn't tell you why your small intestine can't clear them - or which bacteria are producing them. We identify what's actually driving your SIBO so treatment works the first time, not the fifth.
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Standard SIBO treatment relies on breath tests, which measure hydrogen and methane gas production. You fast, drink a sugar solution, and breathe into tubes. If gases are elevated, the test is positive.
Sounds straightforward. But breath tests have significant limitations that explain why so many people relapse.
1. They Measure Gas, Not the Source
A positive breath test tells you gases are elevated - but not which bacteria are producing them. Is it E. coli? Klebsiella? Streptococcus? Each requires different treatment. Without knowing the species, antimicrobial selection is guesswork.
2. They Miss Hydrogen Sulfide SIBO
Some bacteria produce hydrogen sulfide gas instead of hydrogen or methane. Standard breath tests don't measure this. If you have "rotten egg" gas, bladder irritation, or react badly to sulfur-rich foods, you may have this inflammatory form of SIBO - but your breath test shows nothing.
3. They Don't Explain WHY
A breath test confirms bacterial gases are elevated. It doesn't tell you what disrupted your gut's ability to clear them. Was it PPI medication suppressing stomach acid? Slow motility? Post-infectious damage? Without understanding the driver, you're treating symptoms, not the cause.
4. They Miss the Large Intestine
Many "SIBO-like" symptoms actually stem from dysbiosis in the large intestine. Breath tests only assess the small intestine - missing half the picture.
The Prana Thrive Difference:
We use metagenomic sequencing to analyse the DNA of bacteria throughout your gut. We identify which species are imbalanced, what they're producing, and why your system isn't clearing it. That's how we create protocols that actually stick.
🔬THE MICROBIOLOGIST'S PERSPECTIVE
"SIBO isn't really about bacterial overgrowth - it's about metabolite dominance. Certain bacteria produce ammonia, methane, or hydrogen sulfide faster than the microbiota or your body can clear them. When I analyse metagenomic results, I'm looking for which species are driving that metabolite production and what's compromising your gut's ability to 'mop up' those byproducts. If we focus on killing bacteria without fixing the clearance issue, they just come back. That's why we focus on the why, not just the what."
Victoria Samios, Microbiologist
SIBO relapse rates are notoriously high - up to 60% within six months. This happens because most treatments target the bacteria while ignoring what allowed the imbalance to develop.
Driver #1:
PPI and Acid-Suppressing Medications
We see this constantly. Proton pump inhibitors (PPIs) like Nexium and Somac reduce stomach acid - which sounds helpful for reflux, but stomach acid is your first line of defence against bacterial imbalance. When acid is suppressed long-term, bacteria that should be killed in the stomach survive and populate the small intestine. If you've been on PPIs for months or years, this may be the missing piece.
Driver #2:
Impaired Motility (The "Sweeping" Problem)
Your small intestine has a built-in cleaning mechanism called the Migrating Motor Complex (MMC) - a "sweeping wave" that moves bacteria and debris through between meals. When motility slows (from stress, post-infectious damage, or other factors), bacteria stagnate instead of being cleared. This is why some people relapse within weeks of finishing treatment - the bacteria return because the sweeping mechanism isn't working.
Driver #3:
Post-Infectious Damage
Many SIBO cases start after food poisoning, gastro, or traveller's diarrhoea. The initial infection damages the gut's motility and immune function, creating conditions where bacterial imbalance can take hold. If your symptoms started after a gut infection, this history matters for treatment.
Driver #4:
Low Stomach Acid (Beyond PPIs)
Even without medication, some people naturally produce insufficient stomach acid - especially as they age or under chronic stress. Low acid allows bacteria to survive passage into the small intestine, where they shouldn't be thriving.
Caused by bacteria fermenting carbohydrates and producing hydrogen gas. Often linked to faster transit time and species like Klebsiella and Aeromonas.
Symptoms: Bloating within 30-90 minutes of eating, urgency, loose stools.
Caused by archaea (technically not bacteria) like Methanobrevibacter smithii. Methane gas slows gut motility significantly.
Symptoms: Severe bloating, constipation, feeling of incomplete evacuation, sometimes weight gain.
Often missed by standard breath tests. Caused by sulfate-reducing bacteria producing hydrogen sulfide gas, Bilophila or even “benefical” Firmicutes.
Symptoms: "Rotten egg" gas, bladder irritation, body aches, intolerance to sulfur-rich foods (eggs, garlic, onion).
🌿THE NATUROPATH'S PERSPECTIVE
"After working with over 2,000 clients, I've learned that SIBO treatment fails when we only focus on killing bacteria. The real question is: what stopped your gut from regulating itself? For some clients, it's years of PPI use suppressing their stomach acid. For others, it's impaired motility after food poisoning. Until we identify and address that driver, the imbalance just returns. That's why our protocols always include restoring your gut's natural regulatory mechanisms - not just antimicrobials."
Amanda Ledwith, Naturopath
See how we fix SIBO
(5 min)
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SIBO evaluation call
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Unlike conventional approaches that just manage symptoms, our AIM Method™ addresses the root cause of your SIBO and guides you to lasting healing.
Analyse: Identify the Full Picture
We go beyond breath testing. Using metagenomic sequencing, we identify which bacterial species are driving your symptoms, what metabolites they're producing, and what's compromising your gut's ability to clear them. Victoria (our microbiologist) reviews every result to catch patterns automated reports miss.
Integrate: Targeted Treatment + Driver Correction
We build a protocol specific to your SIBO type and underlying drivers:
Reduce: Targeted antimicrobials matched to your specific bacterial species
Restore: Motility support to restart your gut's natural clearing mechanism
Address: Root cause correction (PPI weaning support, stomach acid optimisation, post-infectious repair)
Monitor: Prevent Relapse
We don't hand you a protocol and disappear. For 4-6 months, we guide you through treatment, adjust based on your response, and systematically reintroduce foods so you're not stuck on a restricted diet forever. We retest to confirm resolution - not just symptom improvement.
SARAH'S STORY
"My breath test was negative - but I clearly had SIBO"
Sarah had severe bloating, alternating constipation and diarrhoea, and brain fog for three years. Her GP ordered a breath test, which came back negative. She was told it was "just IBS" and to manage stress.
The breakthrough:
When Sarah came to Prana Thrive, metagenomic testing revealed elevated Klebsiella pneumoniae - a gas-producing bacteria the breath test missed - plus depleted protective species. We also discovered she'd been on PPIs for four years for mild reflux, which had disrupted her stomach acid and allowed the bacterial imbalance to develop.
The outcome:
We used targeted antimicrobials for the Klebsiella, supported her stomach acid recovery, and worked with her GP on PPI weaning. Within eight weeks, her bloating reduced by 70%. By four months, she had complete symptom resolution and was eating foods she'd avoided for years.
MARK'S STORY
"The antibiotics worked... for two months"
Mark tested positive for hydrogen SIBO and took Rifaximin. He felt amazing - for about eight weeks. Then the bloating returned, worse than before.
The breakthrough:
Our analysis revealed Mark's motility had never recovered after a severe bout of food poisoning two years earlier. His gut wasn't "sweeping" properly, so every time he killed the bacteria, they just regrew in the stagnant environment.
The outcome:
We treated the SIBO again, but this time we added prokinetic support to restart his migrating motor complex. By addressing the motility driver, we stopped the regrowth cycle. One year later, Mark remains symptom-free.
Read more client success stories
You deserve to know why your SIBO keeps returning. You deserve a protocol based on your specific bacterial imbalance and underlying drivers - not a generic template.We've helped over 2,000 Australians find their root cause.Let's find yours.
No pressure. No obligation.
Just clarity on what's actually driving your symptoms and whether our approach can help.
We're based in Perth, Western Australia, and work with clients
across the entire country via secure video consultation.
Perth & WA,
Sydney & NSW,
Melbourne & VIC,
Brisbane & QLD,
Adelaide & SA,
Hobart & TAS,
Canberra & ACT,
Darwin & NT
and regional and remote areas throughout Australia.
Your test kit ships Australia-wide with prepaid return postage included.
Whether you're in Perth or Cairns, you receive the same comprehensive analysis from our microbiologist Victoria and naturopath Amanda.