Welcome back to the root cause medicine podcast. I'm your host for today, Dr. Kate Kresge,

and this episode is a masterclass in one of the most underdiagnosed, misunderstood, and often

mistreated conditions in gastrointestinal health, small intestinal bacterial overgrowth, or

SIBO. Joining us is Dr. Allison Sebecker, an internationally recognized SIBO expert,

naturopathic physician and educator whose work has

helped to define the clinical landscape of this condition over the past decade. Her name is

synonymous with evidence-based SIBO care and her courses and protocols have shaped how thousands

of clinicians diagnose, test, and treat this complex syndrome. In this conversation, we cover the updated

clinical definitions of

SIBO and its nuanced subtypes, hydrogen, methane, and hydrogen sulfide, and what makes each

distinct from a mechanistic and symptomatic perspective. We discuss why impaired gas handling, not just

production, is key to symptom expression, and how motility deficits, especially in the

migrating motor complex, set the stage for chronic relapse. She gives us a comprehensive

breakdown of the top risk factors for developing SIBO, detailed insights on testing, including

when to use lactulose versus glucose, how to interpret flatline patterns, and why timing matters more than

you think. And finally, we discuss a strategic comparison of treatment options, herbal

medications, pharmaceuticals, and elemental diets, and how to select and sequence therapies

based on gas type and severity. Now, this is actually part one of a series on CPBO that we've done with Dr. Seabucker.

In the next episode, after this one, we're going to discuss things like nutrition, emerging

research. That's where we really get into the nitty gritty of how to make diets work for

people with SIBO. Whether you're new to SIBO or you're treating refractory cases in your

practice, this episode today is packed full of high

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