How do I know if my IBS symptoms are actually SIBO?

SIBO and IBS can cause similar symptoms, including bloating, gas, diarrhea, constipation, and abdominal discomfort. Breath testing can help determine whether bacterial overgrowth is contributing.

Why does SIBO keep coming back after treatment?

SIBO can recur when underlying contributors such as impaired motility, methane overgrowth, structural issues, or medication factors are not addressed alongside treatment.

Why can SIBO cause symptoms outside the gut?

SIBO can interfere with nutrient absorption and contribute to deficiencies that may affect energy, concentration, and overall well-being. Evaluation can identify whether deficiencies are present.

How long does SIBO treatment take?

A standard antibiotic course runs approximately two weeks, though more complex cases may require longer or combination protocols. Dietary changes and prokinetic support are typically continued beyond the antibiotic phase to consolidate results and reduce the likelihood of recurrence.

SIBO Treatment in Los Angeles

Precision Breath Testing to Uncover Small Intestinal Bacterial Overgrowth

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Understanding SIBO

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Small intestinal bacterial overgrowth, or SIBO, occurs when bacteria that normally populate the large intestine migrate into and colonize the small intestine, where bacterial counts are meant to stay low. Once established, this overgrowth disrupts the normal digestive process, interfering with nutrient absorption, irritating the intestinal lining, and producing excess gas through bacterial fermentation of undigested food.

SIBO is far more common than most patients realize, and it is routinely misdiagnosed or dismissed entirely. Its symptoms overlap significantly with irritable bowel syndrome, food intolerances, and other functional GI disorders, which means many patients spend years managing the wrong condition. At Innovative GI, Dr. Cameron Sikavi, widely regarded as the best GI doctor in Los Angeles, uses precise breath testing and thorough clinical evaluation to determine whether SIBO is the source of your discomfort and, if so, exactly what type you are dealing with.

Signs and Symptoms of SIBO

SIBO produces a recognizable pattern of symptoms, though their severity varies widely from patient to patient. Because these symptoms are shared by several other GI conditions, accurate testing is the only reliable way to confirm the diagnosis. Common signs and symptoms of SIBO include:

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Persistent bloating, particularly after eating, that does not resolve with dietary changes

Excessive gas and belching

Abdominal cramping or generalized discomfort

Chronic diarrhea, chronic constipation, or an alternating pattern of both

Nausea, especially following meals

A sensation of fullness that arrives earlier than expected during eating

Unexplained fatigue or brain fog

Nutrient deficiencies, including iron, B12, and fat-soluble vitamins (A, D, E, and K), which result from bacterial interference with absorption

Unintentional weight loss in more severe or prolonged cases

If you have been told your symptoms are consistent with IBS but have not responded to standard IBS treatments, SIBO may be the underlying cause. Dr. Sikavi develops a targeted diagnostic plan based on your symptom history, medical background, and prior test results rather than defaulting to a generic workup.

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Types of SIBO

Not all SIBO is the same. The bacterial overgrowth present in the small intestine produces different gases depending on the organisms involved, and identifying which type is present directly shapes the treatment approach.

Hydrogen-Dominant SIBO

The most common form, hydrogen-dominant SIBO, is typically associated with diarrhea-predominant symptoms and is identified by elevated hydrogen levels on breath testing.

Methane-Dominant SIBO (Intestinal Methanogen Overgrowth)

When methane-producing organisms are the primary culprit, patients more commonly experience constipation-predominant symptoms. This form, now more precisely referred to as intestinal methanogen overgrowth (IMO), requires a distinct treatment approach from hydrogen-dominant SIBO.

Hydrogen Sulfide SIBO

A less commonly identified but clinically significant form associated with diarrhea, urgency, and a characteristic sulfur odor. Detection requires specialized testing that goes beyond standard breath panels.

Identifying the specific type of SIBO present is not a minor detail. It determines which treatment protocol is most appropriate and significantly influences long-term outcomes.

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We have designed the entire testing experience around clarity, comfort, and efficiency, from your first call to your final follow-up. Here is what the SIBO diagnostic process looks like at Innovative GI:

How SIBO Is Diagnosed

Preparation Is Not Complicated

You will follow a specific preparatory diet for 24 hours before the test and fast the morning of your appointment. Dr. Sikavi reviews your full symptom history, medication list, and relevant medical background in advance so the testing is as targeted and informative as possible.

The Breath Test Is Non-Invasive and Painless

You will drink a small sugar solution and provide breath samples at regular intervals over approximately two to three hours. The samples measure hydrogen and methane concentrations in your breath, which reflect the fermentation activity of bacteria in your small intestine. No needles, no sedation, and no discomfort.

Results Are Interpreted With Clinical Context

Dr. Sikavi interprets your breath test results alongside your symptom pattern, history, and any relevant prior testing to arrive at a complete clinical picture before recommending a course of action.

A Personalized Treatment Plan Follows

If SIBO is confirmed, Dr. Sikavi develops an individualized protocol addressing the specific type of overgrowth identified. Treatment typically involves targeted antibiotic therapy, dietary modification, and prokinetic support to prevent recurrence.

How SIBO Is Treated

Effective SIBO treatment in Los Angeles goes beyond a single course of antibiotics. Because recurrence is common, Dr. Sikavi takes a comprehensive approach that addresses both the overgrowth itself and the underlying conditions that allowed it to develop.

Targeted antibiotic therapy

Rifaximin is the most commonly used antibiotic for hydrogen-dominant SIBO due to its localized action in the GI tract and low systemic absorption. Methane-dominant cases typically require a combination protocol. The specific regimen is determined by your breath test results and clinical presentation.

Dietary modification

A low FODMAP diet or elemental diet reduces the fermentable carbohydrates that feed bacterial overgrowth and helps manage symptoms during and after treatment. Dr. Sikavi provides specific dietary guidance tailored to your case.

Prokinetic therapy

Impaired gut motility is one of the most common underlying drivers of SIBO recurrence. Prokinetic agents help restore normal intestinal movement, reducing the conditions that allow bacteria to accumulate in the small bowel.

Nutritional support

When SIBO has caused significant nutrient depletion, targeted supplementation addresses deficiencies in B12, iron, and fat-soluble vitamins to support recovery and overall well-being.

Follow-up breath testing

Repeat testing after treatment confirms eradication and provides a baseline for ongoing monitoring. If symptoms return, Dr. Sikavi investigates promptly rather than assuming the original treatment was sufficient.

Frequently Asked Questions About SIBO

Why Patients Choose Innovative GI for SIBO Testing in Los Angeles

SIBO hides behind other diagnoses, mimics common GI disorders, and frequently goes undetected by physicians who are not actively looking for it. At Innovative GI, Dr. Sikavi's investigative approach to chronic digestive symptoms means SIBO is always on the differential when the clinical picture warrants it.

If you’re looking for the best SIBO doctor in Los Angeles, Dr. Cameron Sikavi is a board-certified, UCLA-trained gastroenterologist who earned his medical degree from Chicago Medical School and completed a specialized fellowship in Gastroenterology and Hepatology at UC Irvine. A published researcher with deep expertise in functional GI disorders and advanced diagnostics, he brings the same precision to SIBO evaluation that he applies to every complex case, replacing uncertainty with a clear, evidence-based path forward.

Our gastroenterology practice, located directly across from Cedars-Sinai Medical Center in the heart of West Hollywood and Beverly Grove, was designed to feel different from a typical GI clinic:

In-office lactulose and glucose breath testing for accurate, same-visit SIBO diagnosis
Comprehensive evaluation covering all three SIBO subtypes, including hydrogen sulfide
Individualized treatment protocols based on the specific type and severity of overgrowth
Dietary and prokinetic guidance integrated into every treatment plan
A focused, concierge-level environment where the best SIBO specialist in Los Angeles gives you his full, undivided attention
Convenient access from Beverly Hills, West Hollywood, Mid-Wilshire, and the broader Westside

Ready to find out whether bacterial overgrowth is the source of your chronic digestive symptoms?

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