Small Intestinal Bacterial Overgrowth (SIBO) has been gaining acceptance as an underlying cause of gastro-intestinal symptoms like irritable bowel syndrome. This post goes into the misconceptions around SIBO, how the movement of food plays a part in SIBO, as well as the immune system, the vagus nerve, and food poisoning. What is SIBO? SIBO was first discovered in 1939 but rifaximin was not approved for its treatment until 2015. A landmark study published in 2000 by Pimentel et all at Cedars-Sinai Medical Center put SIBO on the map. It identified SIBO as being present in 78% of patients with irritable bowel syndrome (IBS) and found that treatment with antibiotics improved symptoms. There is a misconception that SIBO is an infection, when in actuality SIBO is the presence of excess colonic bacteria in the small intestine. In contrast to the large intestine, the concentration of the bacteria in the small intestine rarely exceeds 1,000 organisms/ml. This is because gastric acid secretion and intestinal motility limit the overgrowth of bacteria in the small intestine. When these protective mechanisms against excessive bacterial growth fail, small intestinal bacterial overgrowth (SIBO) can result. When the Body’s Protective Measures Fail Upon ingestion of food, gastric acids...