Functional medicine — gut health
SIBO Treatment in St. Louis
SIBO — small intestinal bacterial overgrowth — is a common but under-evaluated cause of bloating, abdominal discomfort, irregular bowel habits, food intolerance, and the broader 'something is wrong with my gut' picture. At Simply Health Integrated Medical in St. Louis, SIBO evaluation is done within a functional medicine framework that includes breath testing when appropriate, structured treatment planning, and the broader gut, stress, and motility context. Dr. Bryan Deloney, DC, MS-Functional Medicine, leads the evaluation.
What to expect
Simply Health Integrated Medical helps patients understand symptoms, goals, and options before recommending a care path.
The next step is a consultation request or direct call so the team can determine whether the clinic is a good fit for your needs.
What SIBO actually is
Small intestinal bacterial overgrowth means there are more bacteria in the small intestine than there should be. The small intestine is normally low-bacteria; the colon is where most gut bacteria live. When that distribution shifts, the symptoms are typically bloating (especially after meals), abdominal discomfort, gas, irregular bowel habits, and sometimes food intolerance, fatigue, or skin changes. SIBO is associated with IBS, often overlaps with thyroid issues, and has known links to motility problems.
Why SIBO gets missed
Conventional gastroenterology workups often focus on excluding serious disease — colonoscopy, endoscopy, celiac screen, basic stool studies — and stop there. SIBO requires breath testing (lactulose or glucose, sometimes with hydrogen and methane measured) which is not routinely ordered in many primary care or GI workflows. Patients with classic SIBO symptoms and 'everything normal' on standard workup are often the ones who benefit from a SIBO-specific evaluation.
Three SIBO subtypes — hydrogen, methane, hydrogen sulfide
SIBO subtypes are categorized by which gases the overgrown organisms produce. Hydrogen-dominant SIBO often presents with diarrhea or loose stool. Methane-dominant (now called intestinal methanogen overgrowth or IMO) often presents with constipation, slow motility, and bloating. Hydrogen sulfide SIBO is the newest-recognized pattern. The subtype affects treatment, so identifying which pattern is present matters.
How SIBO is treated
Treatment is typically structured in phases. Phase 1 often includes targeted antimicrobials (pharmaceutical such as rifaximin and/or herbal protocols), dietary modification appropriate to the patient, and addressing motility. Phase 2 focuses on prokinetic support to reduce relapse and broader gut healing. Phase 3 is sustain — diet, lifestyle, and stress strategies to keep results in place. Treatment is rarely a single course; the relapse rate is meaningful, which is why the broader plan matters.
SIBO and the bigger picture
SIBO rarely exists in isolation. Thyroid dysfunction, low stomach acid, chronic stress, certain medications (proton pump inhibitors, opioids), prior abdominal surgery, structural issues, and motility disorders are all known contributors. A complete SIBO evaluation looks at why the overgrowth happened in the first place rather than just treating it and waiting for relapse.
Realistic expectations
SIBO recovery is rarely fast. Many patients see meaningful symptom improvement within 4 to 12 weeks of starting structured treatment, but the relapse rate is real and the long-term plan matters. The evaluation sets milestones so progress can be tracked, and the plan includes prokinetic and lifestyle support to reduce relapse.
Request a SIBO evaluation
If you are dealing with chronic bloating, abdominal discomfort, irregular bowel habits, or 'something is wrong with my gut' and standard workups have not landed on an answer, request a SIBO evaluation. The next step is a workup that takes SIBO seriously rather than excluding it by default.
Frequently asked
Common questions
▸Where can I get SIBO treatment in St. Louis?
Simply Health Integrated Medical at 12977 N Forty Dr, Suite 105, St. Louis, MO 63141 offers functional medicine SIBO evaluation and treatment planning. Led by Dr. Bryan Deloney, DC, MS-Functional Medicine. By appointment 24/7. Call (636) 590-4686.
▸What are the symptoms of SIBO?
Common symptoms include bloating (especially after meals), abdominal discomfort, gas, irregular bowel habits, food intolerance, fatigue, and sometimes skin changes. SIBO is associated with IBS, thyroid dysfunction, and motility problems. Symptoms can mimic other GI conditions, which is why testing matters.
▸How is SIBO diagnosed?
SIBO is typically diagnosed by breath testing — lactulose or glucose breath test measuring hydrogen and methane. The test takes a few hours and is non-invasive. Stool tests and other labs may complement breath testing but do not replace it for SIBO specifically.
▸How long does SIBO treatment take?
A typical course of treatment lasts 4 to 12 weeks for initial symptom improvement, though the broader plan including prokinetic support and lifestyle work continues longer to reduce relapse. SIBO is rarely a one-and-done treatment; the long-term plan matters.
▸Will SIBO come back after treatment?
Relapse is common in SIBO, which is part of why the evaluation looks at why the overgrowth happened in the first place. Underlying contributors (thyroid, motility, stress, medications, structural issues) need to be addressed alongside the antimicrobial phase to reduce recurrence.
▸What is the difference between SIBO and IBS?
IBS is a clinical diagnosis based on symptom patterns. SIBO is one specific cause that can drive IBS-pattern symptoms. Studies suggest a meaningful proportion of IBS patients have underlying SIBO. Testing for SIBO specifically can identify whether the IBS diagnosis has an underlying treatable driver.
▸Do I need a special diet for SIBO?
Many patients benefit from dietary modification during SIBO treatment — low-FODMAP, specific carbohydrate, or other patterns depending on the case. Diet alone rarely resolves SIBO, but it can reduce symptoms and support the broader treatment plan. The right diet depends on the subtype and the individual.
▸Is SIBO treatment covered by insurance?
Some labs and prescriptions may be covered depending on the plan. The functional medicine evaluation and bundled treatment programs are often not insurance-billed. Cost is reviewed during the evaluation.
Next step
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If this page sounds like what you are looking for, request a consultation or call the office so the team can help you choose the right starting point.