What is SIBO?

SIBO is the acronym for “Small intestinal bacterial overgrowth,” defined as excessive bacteria in the small intestine, or small bowel. SIBO occurs when the bacteria that normally live in the large intestine, migrate upstream to proliferate in the small intestine. Here, they ferment the starches we eat before we can digest them, causing gas, bloating, heartburn and other symptoms of IBS. But beyond discomfort, these bacteria can damage the delicate small intestinal lining, leading to nutrient malabsorption, intestinal hyper-permeability (“leaky gut”), and altered motility.

How do bacteria get into the small intestine?

Your digestive system keeps things moving thanks to the migrating motor complex (MMC), which transfers bacteria down into the lower intestine when the body is fasting between meals and at night. Anything that inhibits the MMC can allow bacteria to accumulate in the small bowel. Food poisoning, for example, may trigger gut neuropathy and stasis, leading to overgrowth, known as Small Intestinal Bacterial Overgrowth (SIBO). Even stress can disrupt the MMC, affecting the gut lining at the same time.

Another suspected cause of SIBO is deficient stomach acid, often from the overuse of antacids. Some health professionals suspect that problems with the colon’s microbiome can be a trigger; more research is still needed. Others believe that mechanical problems with the valve between the large and small intestines may cause bacteria to escape into the small bowel.

How is SIBO diagnosed?

At the Hong Kong Digestive Health Centre, we use a SIBO Breath Test in order to check for SIBO. This breath analysis measures elevated hydrogen and methane, both byproducts of fermentation in the small intestine. (Excess hydrogen corresponds to diarrhea-predominant IBS; methane corresponds to constipation-dominant IBS.)

The test is very simple. You’ll need to schedule three hours to come in to the HKDHC after a 24 hour adjusted simple diet. You will breathe into a bag multiple times over the time (click on the link to see a video demonstration). We’ll collect the samples and within 2 weeks you’ll have your results.

How is SIBO treated?

At the Hong Kong Digestive Health Centre, we administer the SIBO Protocol. This is a 6 week program that includes natural herbal treatments and a suggested diet. These treatments are considered equivalent to pharmaceutical interventions with fewer side effects. We also offer a number of other beneficial supplemental products for your GI and digestive health.


The cost for the SIBO Breath Test is HK$ 2,600.

The cost for the 6-week SIBO Protocol is HK $2,800.

To book a consultation or test, please click here or call us +852 3619 5220 or email us: health@asiabiobank.com.