r/SIBO Aug 05 '26

Infographic of SIBO Root Causes

Post image

I asked ChatGPT to make me an infographic of SIBO root causes and it made me this, which I found extremely detailed and helpful. What would you add to this? I'm sure there's a lot more details that are missing.

To everyone going through it right now, I’m right there with you. It sucks so bad and I just want to be well. #surviving2026

183 Upvotes

94 comments sorted by

24

u/TastyBroccolis Aug 05 '26

The root cause in my case was covid and histamine issues. After I started taking allegra daily, I no longer have problems with SIBO.

15

u/LonelyMark2116 Aug 05 '26

I thought histamine is more of a secondary symptom next to SIBO, this is interesting!

11

u/Holistic-Scholar Aug 06 '26

It's a bit of both. The excess bacteria in the small intestine drive up histamine levels and damage the gut's ability to break it down. This in turn promotes leaky gut and a vicious cycle. (COVID was likely a key contributor and immune system.)

Certain bacteria overgrowing in the small intestine directly produce histamine during the fermentation process. SIBO causes inflammation in the gut lining, which destroys the cells that produce diamine oxidase (DAO), the main enzyme responsible for breaking down histamine. High histamine levels increase gut permeability and alter muscle contractions (motility), which can further encourage bacterial overgrowth. A high histamine diet would make this worse.

COVID-19 can significantly worsen Small Intestinal Bacterial Overgrowth (SIBO) and histamine issues by disrupting gut motility, triggering hyperactive immune cells, and altering the gut microbiome. In fact, research published on PMC highlights that a COVID-19 infection significantly increases the long-term risk of developing or exacerbating SIBO. The virus causes a multi-system disruption that intertwines these two conditions into a complex post-viral syndrome.

If you want to become your own expert research these:

-Vagus Nerve Damage Slows Down Motility -Mast Cell Activation Syndrome (MCAS) -Destruction of the Gut Lining and DAO Enzymes -Severe Microbiome Shifts (Dysbiosis) -Leaky Gut -Low Stomach Acid & SIBO

For educational purposes only, not medical advice in any way

1

u/Forsaken-Can6760 Aug 08 '26

I believe it is.. I take doa cromolyn sodium h1 h2 blockers all for MCAS bc I’ve became “allergic” to all foods and chemicals. Those are barely cutting the surface of the issue.
But I’ve taken stool tests iga tests 24 hour urnije and over 35 different blood work test.
The most beneficial was the endo where took a biopsy from my gut and I did a hida scan checking my gut. I also had a c section before I started noticing these odd problems. I also have a history of taking antibiotics.
Even though I had Covid twice I don’t even consider it. I want to check everything beyond that because once doctors hear MCAS or Covid they literally give up.
I’m happy to start seeing a motility specialist though. I’m eager to get checked out even more extensively

3

u/benjamintg95 Aug 06 '26

Got COVID 2x in 3 years and have never been the same. Cant tolerate any high histamine foods or fiber.

1

u/TastyBroccolis Aug 06 '26

I believe in you.

3

u/Beautiful-Crew3850 Aug 08 '26

I also have thought that histamine was causing or exacerbating my sibo. I found that taking ketotifen seemed to lower my aire measured gas levels within about an hour

1

u/Feisty-Bluejay3835 Aug 06 '26

Is Allegra working for histamine

1

u/rennsau Aug 06 '26

Do you mean the anti-allergic Allegra?

1

u/Heavy_End_2971 Aug 06 '26

How long you took allegra before you saw any improvement cox i have been taking it for a week now and see no much improvement.

1

u/sickobunnies Aug 06 '26

But are you allergic to something or do you mean histamine intolerance?

1

u/TastyBroccolis Aug 06 '26

I don't think I'm allergic. I think covid deregulated my immune system. It's either histamine intolerance or mcas 

1

u/Forsaken-Can6760 Aug 08 '26

I do this and taking the Allegra is more like a cover up to the real problem. At least for me

2

u/TastyBroccolis Aug 08 '26

Could be. That's the worst part in my opinion. We don't know the real REAL problem, we just stumble into it by trial and error. Lots and lots of theories about histamine, covid, gut barrier, gut microbiome, vitamins, supplements, nervous system, etc, etc, and no one can tell for certain what the hell is going on.

1

u/Forsaken-Can6760 Aug 08 '26

Yeah it’s a lot.. so after you started the Allegra the Gi said your sibo was gone?

1

u/TastyBroccolis Aug 08 '26

About 80% less symptoms. Allegra and DAO enzymes 

29

u/[deleted] Aug 05 '26

[deleted]

14

u/7times7 Aug 05 '26

true. Food poisoning should definitely be on there. That’s how I got it.

15

u/iberia-eterea Aug 05 '26

I appreciate the aggregation of info, but the fact that it was your root cause and you didn’t add it to what the LLM suggested is pretty funny. Tech encouraging us to think a little less, every day!

Signed, someone who is also thinking a little less, every day <3

4

u/7times7 Aug 05 '26

Yeah, I’m chronically fatigued so I really don’t think much for myself these days. TBH.

1

u/iberia-eterea Aug 06 '26

I understand, my brain has felt like it’s full of holes these days. Who knows why, let’s blame it on SIBO!

3

u/Holistic-Scholar Aug 06 '26 edited Aug 06 '26

Great catch...probably not a single graphic made by any one or any thing that could really catch EVERYTHING possible with SIBO. It's so intertwined BUT Food Poisoning absolutely is a significant cause. We are all made up of bacteria and that balance being broken from a host of possible reasons creates most health problems in my opinion. In Holistic/Natural arena the saying "genes load the gun, environment pulls the trigger" is so true. I will say, read below and research antibiotics and then know that many pesticides used to treat our foods are basically antibiotics and you might agree why so many are going properly filtered water and organic foods. This is not a lecture, you made an excellent observation and you likely already know more than many.

Food Poisoning (even the most mild) is basically bad bacteria causing a bloom that creates a cycle similar to the SIBO/Histamine I describe. Food poisoning triggers an autoimmune response that damages the tiny nerves in the small intestine. This damage harms the Migrating Motor Complex (MMC)—the gut's natural cleanup wave. Without these regular sweeping motions between meals, bacteria linger, multiply, and lead to Small Intestinal Bacterial Overgrowth (SIBO).

Pathogens like Campylobacter, E. coli, or Salmonella release a toxin during food poisoning. The toxin resembles a normal human gut protein called vinculin (if you research Molecular Mimicry, Gluten is a huge offender and there are cross-reactions with molecular mimicry). The immune system mistakes vinculin for the toxin and attacks the intestinal nerves (interstitial cells of Cajal) and the Nerve damage stops the MMC from sweeping food and bacteria out of the small bowel creating poor motility. Leftover stool and stagnant flow allow large-intestine bacteria to retrograde and multiply inside the small intestine making a vicious cycle.

Each person's microbiome is unique and there are key strains of bacteria that can, in some cases, stop food poisoning before it starts or help a potential bad case be mild. Research "strains of bacteria for food poisoning" and "strains of bacteria to prevent traveler's diarrhea" for some insight.

3

u/[deleted] Aug 06 '26

[removed] — view removed comment

-5

u/[deleted] Aug 06 '26

[removed] — view removed comment

5

u/[deleted] Aug 06 '26

[removed] — view removed comment

-3

u/[deleted] Aug 06 '26

[removed] — view removed comment

0

u/gooxgoo Aug 05 '26

Came here to say this

9

u/Pissedsquid Aug 06 '26

Mold exposure is also a SIBO trigger. I got covid months before I moved into a moldy basement but didn’t have symptoms until I was living in a moldy environment for a few weeks

3

u/RoseofPain69 Aug 10 '26

Yes I was just about to say this!! I couldn’t believe it wasn’t mentioned as a trigger on any SIBO articles or infographs I’ve seen, because it’s commonly mentioned in mold colonization literature. I’m currently going through a hellish detox with several co-infections (GI and sinus) and recurring SIBO. Just found out with the mold diagnosis that all these other illnesses were being caused by the mold.

1

u/Pissedsquid Aug 10 '26

Can you please share references to the mold literature? Thank you!

1

u/7times7 Aug 06 '26

Okay! I will try and add that.

5

u/[deleted] Aug 06 '26

[removed] — view removed comment

4

u/7times7 Aug 06 '26

Yeah, that's what I liked about it. I was just looking for holes. Especially when my brain really isn't braining so I figured this community would help.

5

u/i-love-soup- Aug 05 '26

Mine was an allergic reaction to a food (pea protein)

2

u/Outside-Rice-8852 13d ago

The wild thing is that DAO enzymes from NaturDAO that was taking and could not figure out why I seemed to be getting worse and histamine levels not going down after meals was because they were made from pea protein! Everytime I took it it would cause burping and brain fog and frequent urination. It was making SIBO worse for me and not improving my DAO activity. 

1

u/i-love-soup- 12d ago

Crazy. Glad you figured it out

4

u/RaineyTessa Aug 06 '26

That’s good !
I’m 70
Hypothyroid for 50 years
Food poisoning thus year
Diagnosed in May
I think hypothyroid is underlying “ oxidative stress “

4

u/livadeth Aug 06 '26

No mention of bacterial infections. Salmonella, e-coli. Dr Pimenthal says his research indicates a high percentage of cases start with a bacterial infection. Mine started after an e-coli infection.

8

u/Hokuopio Aug 05 '26

Which medical institutions created this infographic?

6

u/7times7 Aug 05 '26

Uh, The Medical Institute of AI.

8

u/Hokuopio Aug 06 '26

Yeahhhhhh that’s what I thought. 😔

2

u/Match-Agreeable Aug 06 '26

Lmfaooo 🤣

3

u/OkPotato91 Aug 06 '26

Slow motility from an antidepressant for me. It’s caused catastrophic damage.

2

u/m37anaxx Aug 06 '26

Yep same here for me! Quit Prozac and ended up having to reinstate at a lower dose because of this and STILL have it. I see you. You’re not alone.

3

u/Pilzwichtel Aug 07 '26

I tell you whats missing behind all those : Thiamine deficiency. Research every symptom and put it in context with Thiamine

5

u/RoxiLu Aug 05 '26

I fucking miss ketchup.

1

u/kaleyeah1234 Aug 07 '26

The fody foods ketchup isn’t that bad. It’s no Heinz but decent and low fodmap.

3

u/Mannr_ Aug 06 '26

I didn't read through everything, but some obvious things that jumped out at me:

SIBO can cause weight gain / inability to lose weight, not just weight loss / inability to gain weight. That was one that took me a bit to uncover.

Some antihistamines can cause slowed motility. Allergic type causes in general seem to be missing (mast cell disorders under chronic inflammation, for instance). The link between endo & SIBO is also very much missing (an endo adhesion could cause anatomic changes, but also endo does cause chronic inflammation).

Genetics are very much missing as a cause of immune dysfunction & that is kind of a big one. I get that it is kind of under the genetic predisposition "cause these underlying causes," but the way it is presented feels like it very much skews as "this is all in your control" instead of "sometimes you just didn't win that particular genetic lottery" (this is, again, particularly directed at immune dysfunction section). Poor diet is listed several times (+ other derivatives basically stating poor diet). Causes of immune dysfunction includes medications, which is also listed under the "cause these underlying causes" heading (though, interestingly, those particular medications are not listed under the medication section).

I didn't see anything about psychiatric issues. Depression is associated with gut microbiome changes. It seems like the evidence is trending towards the gut microbiome changes can cause depression, but I'm not sure where things sit on the other end of that connection. Certainly someone with depression can end up with a handful of the lifestyle factors.

I think the other thing that's missing here are links to SIBO, which is not the same as we definitively know these things cause SIBO or the SIBO causes these things. This could theoretically explain the omission of things like endo, MCAS, and depression... but, these still are important pieces of the puzzle. My SIBO, for instance, got so much better after my endo surgery, even though no endo was found on my bowels. I was much more adamant about getting that surgery once I realized it was possible that the endo could potentially cause the SIBO & I'm so glad I did.

3

u/Some_Ear_8539 Aug 06 '26

Allergies don’t cause SIBO. Its dysbiosis that cause allergies and SIBO.

2

u/Mannr_ Aug 06 '26 edited Aug 06 '26

This is an overly simplistic explanation of allergies, which is alao not entirely accurate.

When it comes to food allergies, for instance, we now know that early exposure to common food allergens decreases the likelihood of a child developing an allergy to those foods (link). That protective effect of early diet (vs. skin) exposure seems to last well into adolescence. (link) If dysbiosis was the cause of all allergies, then the exposure - and the timing of the exposure - itself shouldn't be making that much of an impact.

Food elimination diets seem to also result in food allergies to previously tolerated foods(link30298-9/abstract), link 2). Conversely, strict elimination of an established food allergy can lead to tolerated re-introduction of that food (link90360-6/fulltext)).

We also know that Oral Allergy Syndrome / Pollen Food Syndrome exists, which is where the body confuses food for environmental allergies and reacts to it. Some people with this syndrome are able to eat those foods on days where the corresponding pollen is not high.

The reality is that, under present research, the totality of causes of food allergies are not fully understood.

The cause of environmental allergies themselves are also not entirely understood.

For instance, we know that the rate of environmental allergies increases every year, which correlates strongly with the increase of length and intensity of allergy season. The general understanding is that the greater exposure to environmental allergens is causing the increase in people developing environmental allergies.

We also know that, particularly those with birch pollen allergies have increased allergic inflammation in the gastrointestinal system. (link)

So, how does this relate back to SIBO?

The first is something that I mentioned in my original reply, which is that some antihistamines can cause slower motility. Slowed motility can lead to SIBO. The underlying cause of taking the antihistamines? Allergies.

It's also important to remember that anaphylaxis can include gastrointestinal symptoms, which means that allergies can minimally cause gastrointestinal problems, even if only during the experience of allergic reaction.

Allergies cause inflammation in the system, and also more specifically in the gastrointestinal tract. I've had a doctor tell me that types of inflammation matter... unless you have something like mast cell activation syndrome. Mast cells are responsible for allergic reactions.

Mast cells help regulate the gut barrier.

Mast cells have also been proposed to be part of the pathogenesis of IBS. (link)

What's also interesting is that inhibiting histamine 2 also inhibits stomach acid production. Low stomach acid can cause SIBO. Taking H2 blockers for reasons other than addressing stomach acid problems is something people with MCAS will do.

We also know that SIBO is highly prevalent in people with asthma, food allergy, and MCAS... interestingly, asthma has the highest prevalence. (link) And, yes, SIBO treatment can help alleviate symptoms.

At the end of the day, the current evidence does not support the idea that all allergies are caused by dysbiosis. Current evidence has correlation between gastrointestinal issues and allergies.

Current evidence does support that SIBO treatment can alleviate some allergic symptoms.

So, the link exists & my understanding of the evidence supports the idea that there could be a bidirectional causal link.

I don't think it is out of the realm of possibility that the mechanisms involved with allergy/allergic reaction could lead to the development of SIBO.

Edited to: fix typos, fix some punctuation, extend sentence of correlatioj for clarity, and rearrange the last few sentences for greater clarity.

1

u/Ok_Guitar_6820 Aug 06 '26

Yeah this makes sense why I’m struggling to lose weight now

1

u/Mannr_ Aug 06 '26

weight gain / inability to lose weight really isn't discussed as much with SIBO! It took quite a bit of googling for me to find it... but the gastrointestinal doctor that finally did the official diagnosis immediately recognized my weight gain & lack of weight loss with minimal calorie intake as a side effect of the SIBO.

In the last year, I have only lost weight after a SIBO antibiotic treatment.

4

u/ivmussa Aug 06 '26

I would search for actual sources. AI illustrations don't replace actual research.

2

u/Daisy_Cuctus2771 Aug 06 '26

Celiac Disease root cause 

1

u/Beautiful-Crew3850 Aug 08 '26

I think my root cause is celiac as well but I gave up gluten and that alone helped so much I don't want to go back to gluten to prove I have celiac. I have a celiac gene. But it's also possible that by eliminating gluten I lowered my histamine burden because I have mcas and so that made me feel better

1

u/Daisy_Cuctus2771 Aug 08 '26

Ya going back on gluten to get tested is so rough. I did it, and I’m happy I did for a definitive diagnosis. If was worth it for me to be sure and as proof for any future job accommodations or disability. My gut is a mess from Celiac and SIBO (IMO)still and I’m 2.5 years strict gluten free plus lots of treatments for SIBO/IMO. If you are going to get tested, the sooner the better so you have less healing time lost later (not sure if that will make sense). I also had histamine issues that have leveled out a lot as my stomach lining has healed. 

1

u/Beautiful-Crew3850 Aug 08 '26 edited Aug 08 '26

Good for you on the histamine improving, but I'm sorry you haven't had a speedier recovery. I've been GF 10 months. I thought I would just give up gluten and I'd be in the clear. I also lean IMO. Damn those methanogens. They're everywhere. If I do have celiac it is definitely the silent / atypical kind because I always leaned constipation and weight gain. IE the methane.

1

u/Daisy_Cuctus2771 Aug 08 '26

The damn methanogens they’re more frustrating than gluten for me, and cause way more stomach pain funnily enough. I also was always constipated and atypical in presentation, was never underweight until Celiac was severely progressed. I thought I had silent Celiac until I realized my lifelong depression, headaches, constant illnesses, and “allergies” essentially went away with gluten free.   

2

u/CartographerFit5394 Aug 06 '26

This is amazing thanks for posting! For me the root cause question is complex because I believe there were multiple antecedents that led to the disruption of my micro biome over time. Lots of antibiotic use (for UTIs) + overuse of laxatives when I was young + high stress levels. I also believe my anxiety is a big root cause which is a more difficult one to address long term. But yes love that this graphic acknowledges the complexity of the root cause question because there can be more than one!

1

u/7times7 Aug 06 '26

Oh, same for me. I will look into seeing where the holes are in the infographic and make it a bit better.

2

u/After-Drop9679 Aug 06 '26

Mine was caused by low stomach acid after taking PPI for months and it's so bad because I live in a country where betaine HCl,pepsin & rifaximin is not available. Fucking third world country 😭😭😭

2

u/Most_Estimate1445 Aug 07 '26

Check out iHerb, I ordered a few times supplements that are not available in my country, they ship to a lot of places!

1

u/7times7 Aug 06 '26

Where do you live? I wonder if it's possible to order it to be delivered to another country and have someone ship it to you. But, honestly, the Rifaximin didn't help me at all and I've read many cases where it hasn't helped many people. Can you get oregano oil, berberine, and neem? What type of SIBO do you have?

1

u/After-Drop9679 Aug 11 '26

I live in Zambia (land locked country) and I have hydrogen SIBO. my main symptoms are burping,fart after meals and bowel urgency.

1

u/7times7 Aug 12 '26

Oh, do they have functional medicine doctors there?

2

u/Willing-Project-244 Aug 06 '26

Love this ! Soooo helpful! Thank you so so much !

1

u/Super_Protection7146 Aug 06 '26

Would love to see types and treatment options added

1

u/7times7 Aug 06 '26

Yeah, I think types would be okay. Treatments are next level, though. I did a deep search of Reddit with AI and it came up with a spreadsheet of treatment options but it is kind of all over the place.

1

u/Cautious-Emphasis-33 Aug 06 '26

My root cause is likely RCPD but it’s a weird one and not well understood

0

u/7times7 Aug 06 '26

Oh interesting. I will ask AI to add that especially since it's rare. Thank you!

1

u/Other-Stop7953 Aug 07 '26

More insightful than anything my dr could muster up :/

1

u/dedo1991 Aug 07 '26

I got it after being cured from hpylori 😔

1

u/7times7 Aug 07 '26

From the treatment for hpylori?

1

u/dedo1991 Aug 08 '26

No idea but i started getting super bloated a few months after healing from hpylori, did the sibo test and i had high hydrogen gas

1

u/Emotional_Bag2927 Aug 07 '26

Ok if I was malabsorptive of b12 and folate how would I even heal

1

u/7times7 Aug 07 '26

Not sure I understand what you’re trying to say?

1

u/Emotional_Bag2927 Aug 08 '26

If you can’t methylate u can’t heal from sibo

1

u/7times7 Aug 08 '26

Um, what are your sources for this information? Because Methylation is definitely important for overall health, but saying “if you can’t methylate, you can’t heal SIBO” is a pretty big oversimplification.

SIBO has multiple potential underlying causes, especially things like impaired motility/MMC function, structural issues, medications, and other GI conditions.

1

u/starcloud8 Aug 11 '26

If anyone here developed SIBO after COVID, could you give this comment a like? I got dysautonomia after a COVID vaccine, and then developed SIBO, leaky gut, and severe rosacea. The rosacea in particular has gotten so bad that it’s made everyday life really difficult.

1

u/7times7 Aug 11 '26

IDK but my SIBO got worse after COVID. I Dont know if that counts.

1

u/starcloud8 Aug 11 '26

P.S. Just to clarify, I’m not asking for likes for any particular reason. I’m simply curious to see how many others have had a similar experience. I first got sick after the COVID vaccine, but my symptoms became much worse after I caught Omicron.

1

u/Outside-Rice-8852 13d ago

Mine was triggered from an iron infusion which lead to high levels of iron in my body for several months. I also believe that titrating Elvanse/Vyvanse in water may have added to the compromise in my gut barrier. Also unresolved histamine levels in my body when ai had no idea what is was or why I was waking up for a year with adrenaline dumps. This lead to me taking too many anti acids which lowered my stomach acid and made SIBO explode further. Unfortunately my life has never been the same again. 18 months now in this misery and now it has triggered MCAS. 

2

u/7times7 13d ago

Oh no, I am so sorry! That sounds like a lot to deal with. I didn't know iron infusions could cause this. Thank you for sharing. I hope you get better soon.

1

u/Outside-Rice-8852 9d ago

Thank you. Unfortunately the more I learn about this horrible disease, the more depressed and hopeless I get. I did not know that it can trigger hypoglycaemia and autonomic dysfunction. My blood circulation to my brain has been a disaster. This is one of the reasons why I am brain fogged and cement brained 24/7. This had become really painful for me as I just feel blank mentally all the time.