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SIBO and Gut Motility: How to support the Migrating Motor Complex (MMC)

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Imagine your gut has a night shift cleaning crew. They clock in after you've finished eating, quietly sweeping away leftover food particles, bacteria, and debris so your digestive tract is fresh and ready for the next meal. Sounds ideal, right?

But what if that crew never showed up?

If you've been diagnosed with SIBO (Small Intestinal Bacterial Overgrowth), or you're stuck in the cycle of bloating, constipation/diarrhea, and food sensitivities despite "doing everything right," there's a strong chance this gut housekeeping crew, also known as the Migrating Motor Complex, isn't doing its job.

The Migrating Motor Complex (MMC) is one of the most overlooked and underappreciated components of digestive health. It's not just about what you eat, it's also about what your body does between meals.

And if that rhythm is off, bacteria can linger where they don't belong, causing symptoms to persist or return, even after rounds of antibiotics, herbal antimicrobials, or restrictive diets.

In this blog, I'll uncover the powerful connection between SIBO and gut motility, break down exactly what the Migrating Motor Complex is, and show you how to restore its rhythm naturally with lifestyle tweaks, targeted supplements, and root-cause healing strategies.

What is SIBO?

SIBO stands for Small Intestinal Bacterial Overgrowth, a condition where excessive bacteria or the wrong type of bacteria, which are normally found in the large intestine, begin to colonize the small intestine.

Another organism that falls under the SIBO umbrella that can cause trouble in the intestines is methanogens, which produce methane gas. Since they are technically not bacteria, they got another name: Intestinal Methanogen Overgrowth (or briefly, IMO).

These overgrowths can interfere with digestion, nutrient absorption, and hormone balance, triggering inflammation and fermenting food before your body can properly break it down, leading to a cascade of frustrating symptoms. (1)

Common signs and symptoms of SIBO

  • Persistent bloating (especially within 30–60 minutes after eating) that tends to get worse by the end of the day
  • Gas and belching
  • Constipation, diarrhea, or a mix of both
  • Abdominal pain or discomfort
  • Reflux symptoms (heartburn, GERD)
  • Food intolerances (especially to FODMAPs, histamines, or starches)
  • Fatigue and brain fog
  • Nutrient deficiencies (such as B12, iron, or fat-soluble vitamins)
  • Weight loss or, conversely, unexplained weight gain
  • Skin issues (eczema, acne, rosacea)

Many people with SIBO feel like their gut is always off, no matter how clean their diet is or how many supplements they try. And if this sounds like you, you're not alone; studies suggest SIBO may affect up to 80% of people with IBS symptoms. (2)

But why does SIBO happen in the first place?

SIBO is rarely a standalone condition. It's usually a symptom of a deeper dysfunction.

Some of the common root causes could be:

  • Sluggish gut motility: If food and bacteria aren't being moved efficiently through the small intestine, bacteria can accumulate.
  • Low stomach acid (hypochlorhydria): Can't kill off incoming microbes from food.
  • Structural issues: Adhesions from abdominal surgery, endometriosis, or infections can physically restrict flow.
  • Previous food poisoning: Can trigger autoimmune damage to the nervous system of the gut.
  • Stress and vagus nerve dysfunction: Disrupts digestive signals and gut motility.
  • Medications: Especially proton pump inhibitors, opioids, and certain antibiotics.

One of the primary factors contributing to SIBO recurrence is impaired gut motility, particularly a disruption in the Migrating Motor Complex. Without this natural housekeeping mechanism, even successful SIBO treatment can result in frustrating relapses. (3)(4)

What is gut motility (and why does it matter so much for SIBO)?

If digestion is a symphony, gut motility is the rhythm section. It keeps things moving, sets the pace, and ensures all the elements stay in harmony.

When that rhythm slows down or skips a beat, it creates the perfect storm for digestive chaos, including the development or recurrence of SIBO.

So, what is gut motility?

Gut motility refers to the coordinated movements of your gastrointestinal (GI) tract that move food, liquid, and waste from your stomach through your intestines and ultimately out of your body.

Think of it like a conveyor belt: as your gut processes food, it needs to keep everything flowing smoothly from the stomach to the small intestine, and eventually to the colon and out.

But gut motility isn't just one type of movement. Your gut has multiple tools in its toolbox, each with a specific role. In fact, your digestive system uses different types of motility patterns depending on whether you're eating, digesting, or fasting. (5)

Here's the breakdown:

  • Peristalsis: These are wave-like contractions that propel food forward. Think of it like squeezing a tube of toothpaste; this is the main force that moves food from one section of the gut to the next, especially after eating.
  • Segmentation: These are rhythmic contractions that occur mainly in the small intestine. They mix and churn food, helping with nutrient absorption and exposing the contents to digestive enzymes. Segmentation doesn't move food forward, but rather helps "knead" it in place.
  • Pendular movements: These are gentle back-and-forth muscle contractions that also help mix contents in the small intestine. They're slower and subtler than peristalsis or segmentation, but help maintain contact between nutrients and the gut lining.

These contractions are generated by smooth muscle layers organized into circular and longitudinal bundles. The interstitial cells of Cajal (ICC) act as pacemakers, generating spontaneous electrical activity (slow waves) that coordinate muscle contractions. (6)

The Migrating Motor Complex (MMC): This only gets activated between meals and during fasting, acting like your gut's janitor, sweeping residual food particles and bacteria out of the small intestine. (7) This prevents the accumulation of residue and helps inhibit bacterial overgrowth in the small intestine.

Signs of sluggish gut motility

If your gut motility is off, your gut will usually try to get your attention. Symptoms of impaired motility often overlap with SIBO, which is no surprise, as impaired motility is a major cause and perpetuator of bacterial overgrowth.

Here are common signs of gut motility issues:

  • You feel full or bloated hours after eating
  • You wake up bloated, even without eating late at night
  • Your bowel movements are infrequent, incomplete, or irregular
  • You feel like food sits in your stomach forever
  • Nausea
  • Constipation that worsens with travel, stress, or changes in your eating schedule

And if you've already treated SIBO, but your symptoms keep coming back, there's a good chance your gut motility hasn't been addressed, especially the Migrating Motor Complex, which is often neglected in conventional care.

Many SIBO protocols focus on eliminating bacteria through the use of antibiotics, herbal antimicrobials, or restrictive diets. And while that can be helpful in the short term, it doesn't address the why behind the bacterial overgrowth.

That's where gut motility, particularly the Migrating Motor Complex, plays a role. Without restoring that crucial cleaning cycle, SIBO often returns within weeks or months.

SIBO and Gut Motility: How to support the Migrating Motor Complex (MMC)

What is the Migrating Motor Complex?

If your digestive system were a kitchen, you could think of the Migrating Motor Complex as your cleanup crew. While peristalsis, segmentation, and pendular movements help prepare and serve the meal, the MMC shows up after the feast to scrub the counters, sweep the floor, and take out the trash.

Without it? Leftovers linger. Dishes pile up. And in your gut, that means food residue and bacteria stick around far too long, setting the stage for bacterial overgrowth and inflammation.

The Migrating Motor Complex is a pattern of electromechanical waves that occurs in the gastrointestinal tract during fasting, typically starting 90 to 120 minutes after your last meal. It's made up of a series of muscular contractions that move from your stomach through the small intestine in a predictable, cyclical pattern. (7)

Its main jobs are to:

  • Sweep out indigestible food particles, mucus, and sloughed cells
  • Prevent bacterial overgrowth in the small intestine
  • Help reset the system before the next meal arrives

And here's the catch: it only activates when you're not eating, which is why constant snacking (even on healthy foods or drinking caloric beverages!) can inadvertently shut it down.

When the Migrating Motor Complex isn't functioning properly, bacteria, especially those that normally live in the large intestine, can begin to colonize the small intestine.

Once they're there, they ferment carbohydrates before your body can absorb them, leading to the well-known symptoms of SIBO.

If you've already gone through SIBO treatment, you probably know that symptom relief is often temporary.

That's because most SIBO protocols heavily focus on killing off the bacteria, but don't address the motility dysfunction that allowed the overgrowth in the first place.

In fact, a study led by Dr. Mark Pimentel—one of the foremost SIBO researchers—found that damage to the MMC is a key driver of post-infectious IBS and recurrent SIBO. After a bout of food poisoning, your immune system may mistakenly attack the nerve cells in your gut responsible for coordinating MMC contractions. (8)

That means your body's ability to clean the small intestine between meals is compromised, leaving bacteria free to multiply and symptoms to return.

What controls the Migrating Motor Complex?

MMC activity isn't random. It's highly orchestrated by a variety of systems in your body. If any of these are out of sync, the entire cycle can be disrupted.

Here are the major players:

  1. Nervous system signals:
  • Enteric Nervous System (ENS): Often referred to as the "second brain," this network of neurons in the gut coordinates muscle contractions and digestive reflexes.
  • The Vagus Nerve: The primary communication highway between your brain and gut. Stress, trauma, and poor sleep can all affect vagal tone and impair MMC signaling. (7)
  1. Key hormones that regulate the MMC:

Activators:

  • Motilin: This is the primary hormone that triggers MMC activity. Secreted by the small intestine in the fasting state, motilin spikes every 90–120 minutes to initiate phase III of the MMC (the strongest contraction wave). Motilin secretion is inhibited by food and certain medications, like PPIs and macrolide antibiotics. (9) However, research shows that erythromycin mimics motilin and can be used as a prokinetic agent for MMC support. (10)
  • Ghrelin: Often called the "hunger hormone," which is secreted by the stomach and helps stimulate MMC contractions. It's part of the reason your stomach growls when you're hungry. Ghrelin is also suppressed by frequent eating or grazing, which is another reason why spacing meals is essential for maintaining MMC health. (11)
  • Serotonin (5-HT): About 95% of your body's serotonin is made in the gut, and it plays a major role in regulating motility. It acts on receptors in the ENS to promote the coordination and strength of MMC waves.
    • Low serotonin = slow motility and potential constipation
    • High serotonin (often seen in IBS-D) can lead to rapid transit and diarrhea

Modulators or inhibitors:

  • Insulin – MMC is suppressed in the fed state (especially with high insulin spikes)
  • Cholecystokinin (CCK) – Released in response to fat and protein; slows gastric emptying
  • Gastrin – Promotes gastric activity during meals, but may interrupt MMC
  • Somatostatin – Inhibits motilin and slows overall GI motility (12)(13)

Key note: MMC is fasting-state driven, so hormones that are elevated during digestion often suppress it.

  1. Neurotransmitters that fine-tune MMC function:

These chemical messengers act locally within the gut wall to regulate contraction patterns:

  • Acetylcholine (ACh) – Main excitatory neurotransmitter; stimulates gut contractions
  • Nitric Oxide (NO) – Relaxes smooth muscle to allow coordinated movement
  • Tachykinins – Enhance contractions; involved in sensory signaling
  • Adenosine Triphosphate (ATP) – Modulates responses in smooth muscle
  • Vasoactive Intestinal Peptide (VIP) – Helps coordinate intestinal motility and blood flow (14) (15)
  1. Interstitial Cells of Cajal (ICCs):

These are specialized smooth muscle cells found in the wall of the gastrointestinal tract. They act like the electrical timing system of the gut, generating slow waves that initiate MMC contractions. They are akin to specialized "pacemaker" cells that initiate MMC waves. They respond to neurotransmitters such as acetylcholine and are essential for coordinating rhythmic movement. (16)
Damage to ICCs, often due to inflammation, autoimmune reactions (like post-infectious IBS), or oxidative stress, can severely impair MMC function. (17)

The takeaway?

Your gut's ability to "clean house" between meals depends on a complex neuro-hormonal network. Disruptions in just one area—like low motilin, impaired vagal tone, or inflammation affecting neurotransmitter signaling—can shut down the Migrating Motor Complex, allowing food and bacteria to stagnate in the small intestine.

This is why addressing SIBO or IBS without supporting MMC function often leads to short-term relief but long-term relapse.

What disrupts the Migrating Motor Complex?

You've met The Migrating Motor Complex, your gut's behind-the-scenes janitor that quietly keeps things tidy between meals. But what happens when that cleaning crew calls in sick… or just never shows up?

Unfortunately, MMC dysfunction is incredibly common and almost always overlooked in conventional gut care. Whether you're dealing with recurring SIBO, IBS, or just chronic bloating that won't budge, understanding the root causes of disrupted motility is essential for lasting healing.

Let's take a closer look at what can throw your MMC off track.

  1. Post-infectious autoimmune damage

One of the most well-studied causes of impaired MMC function is post-infectious IBS. After an episode of food poisoning or gastroenteritis, your immune system may "mistakenly attack" a protein called vinculin, which is expressed in the Interstitial Cells of Cajal (ICCs), the pacemaker cells that help initiate MMC activity. (17)(18)

This autoimmune reaction can lead to:

  • Loss of MMC wave initiation
  • Uncoordinated or weak contractions
  • High relapse risk for SIBO
  • Mild, persistent inflammation in the gut
  • Changes in the gut microbiota (19)

  1. Chronic stress and vagal nerve dysfunction

The vagus nerve is your brain's direct hotline to your gut. It plays a central role in stimulating the Migrating Motor Complex through parasympathetic (rest-and-digest) signals.

Any interruption (such as by vagotomy or neuropathy) can decrease its function, and even chronic stress, especially trauma, burnout, or even unresolved emotional tension, can suppress vagal tone, essentially turning down the volume on the signal that tells your gut, "Hey, time to clean up." (20)

  1. Frequent eating and grazing

Even the healthiest snack can interfere with the Migrating Motor Complex.

Because the MMC only activates in the fasted state, every time you eat—even a small bite—it hits the pause button. This means:

  • Eating every 1–2 hours = no time for the MMC to clean
  • MMC cycles never complete → stagnation → bacterial overgrowth

The best you can do is to space meals at least 3.5–4 hours apart to give the MMC a chance to run its course. (21)

  1. Medications that impair gut motility

Several common medications can interfere with MMC function by altering neurotransmitter signaling or smooth muscle activity (22):

  • Proton pump inhibitors (PPIs) – Reduce stomach acid and impair motilin release
  • Opioids and narcotics – Significantly slow gut motility at every level
  • Anticholinergics – Suppress acetylcholine, a key neurotransmitter for MMC activation
  • SSRIs and SNRIs – Alter serotonin levels and may affect motility, depending on the individual
  • Birth control pills – Can subtly affect motility via hormone regulation (although human studies are limited on this)

If you're taking any of these, it doesn't mean you need to stop, but you do need a strategy to support your gut in the meantime.

  1. Poor sleep and circadian disruption

MMC activity follows a circadian rhythm, with peak activity during nighttime and fasting windows. If your sleep is inconsistent, or you're dealing with insomnia, shift work, or late-night eating, MMC cycles can be thrown off.

Studies have shown that sleep deprivation impairs GI motility, reduces gastric emptying, and increases inflammatory cytokines that affect neurotransmission in the gut. (23)

  1. Underlying conditions that affect gut motility

Several chronic conditions can impair the body's ability to generate or respond to the Migrating Motor Complex (24):

  • Diabetes (especially Type 1) – Can lead to autonomic neuropathy, damaging the nerves that trigger MMC waves
  • Hypothyroidism – Slows down all metabolic processes, including motility
  • Ehlers-Danlos Syndrome (EDS) – Affects connective tissue in the gut wall and may impair signaling
  • Scleroderma and autoimmune conditions – Can damage smooth muscle and nerve plexuses in the GI tract
  • Parkinson's disease and Multiple Sclerosis – Affect the nervous system and vagal output to the gut

 

Why this matters for SIBO

You can clear out the bacteria with antibiotics or herbs, but if your gut motility remains impaired, those bacteria will likely return.

That's why understanding and addressing what's disrupting your MMC is critical for:

  • Long-term SIBO recovery
  • Preventing relapse
  • Reducing bloating, constipation, and fatigue
  • Restoring natural hunger and digestive rhythms

And the good news? While many of these factors are out of your immediate control, there are plenty of ways to support and repair the Migrating Motor Complex naturally.

How to support and restore the Migrating Motor Complex

By now, it's clear that the Migrating Motor Complex is a non-negotiable piece of long-term digestive healing, especially if you're struggling with SIBO, IBS, or sluggish gut motility.

But the best part? You can take steps today to reactivate and support your MMC.

Nutritional and supplemental support for MMC function

Certain nutrients and compounds can help regulate or enhance MMC function, especially if they support serotonin production, smooth muscle contraction, or nerve signaling.

5-HTP

5-Hydroxytryptophan (5-HTP) is an amino acid that serves as a precursor to serotonin (5-HT), a neurotransmitter that plays a crucial role in regulating intestinal motility through the enteric nervous system. (25)

Typical dosing: 50–100 mg, 1–3 times daily,  30 minutes before meals or at bedtime (start low to monitor mood and gut response) (26)

Do not take 5-HTP with medications that increase serotonin levels, such as:

    • SSRIs (e.g., fluoxetine, sertraline)
    • SNRIs (e.g., venlafaxine, duloxetine)
    • MAO inhibitors (e.g., phenelzine, tranylcypromine)
    • Tricyclic antidepressants
    • Some pain medications (e.g., tramadol, meperidine)
    • Combining these increases the risk of serotonin syndrome, a potentially life-threatening condition with symptoms like agitation, confusion, rapid heart rate, high blood pressure, and shivering.

Always check with your doctor before trying 5-HTP, especially if you take any medications or have chronic health conditions, as there are quite a few interactions with different kinds of medications.

Magnesium (Citrate or Glycinate)

Magnesium supports smooth muscle relaxation and neuromuscular signaling, which are essential for the rhythmic contractions of MMC waves. Adequate magnesium levels help maintain regular bowel movements by drawing water into the intestines, softening stool, and making evacuation easier. (27)

Typical dosing: 200–400 mg/day, taken in the evening or spread throughout the day.

Note: Magnesium citrate may also help support bowel regularity in cases of constipation. Taking too much magnesium (especially citrate or oxide forms) may induce diarrhea.

Ginger root extract

Acts as a gentle prokinetic, stimulating gastric emptying and small intestinal contractions (stimulates phase III MMC contractions). Ginger not only stimulates stomach contractions but also speeds up the rate at which food empties from the stomach. This way, it reduces delays that can lead to symptoms like bloating, indigestion, and nausea. (28) (29)

Typical dosing: ranging from 200 mg to 1,200 mg of dried ginger extract, 30–60 minutes before meals or at bedtime.

Ginger root extract is generally considered safe; however, caution is advised if you have a bleeding disorder, are on blood-thinning medications, are pregnant or breastfeeding, have heart problems, or are preparing for surgery.

Prokinetics

Prokinetic agents are used to support or restore the Migrating Motor Complex (MMC), particularly in conditions such as SIBO, gastroparesis, or chronic constipation, where gut "housekeeping" motility is impaired. These agents help by stimulating or normalizing the frequency, strength, or timing of MMC contractions, effectively functioning as the "intestinal sweepers" that clear debris and bacteria from the small intestine during fasting. (30)

Prokinetics are typically recommended to be taken after completing antimicrobials for SIBO to help keep bacteria moving out and prevent or at least delay relapse.

Common pharmaceutical prokinetics may include:

  • Erythromycin (Low-Dose) – generally 50 mg at bedtime, compounding might be necessary to get to this low dose (31)
  • Prucalopride – typically 0.5-1 mg at bedtime (32)
  • Low Dose Naltrexone (LDN) - typically 2.5 mg for diarrhea types or 5 mg for constipation types, at bedtime (33)

These medications should be prescribed by your doctor, but be sure to inform yourself about the potential side effects beforehand.

Fortunately, some great natural prokinetics could also be utilized. Please note that, apart from a few, most of these natural prokinetics haven't been officially studied for SIBO.

  • Iberogast (STW 5): is a herbal blend in a liquid form, made up of 9 herbal extracts. (34) The general dosage for supporting MMC is approximately 30-60 drops at bedtime.
  • Prodigest /MotilityPro / MegaGuard (a standard blend of artichoke leaf and ginger root extracts) (35). The typical recommended dose is 1-2 capsules, 20 to 30 minutes after meals, or 2 capsules at night, taken before bed.
  • MotilPro (Pure Encapsulations):  a blend of vitamin B6, ginger root, amino acid acetyl L-carnitine, and 5-HTP. The typical dosage consists of 2 capsules taken at bedtime. Be cautious if you are taking antidepressants or other medications due to 5-HTP.
  • Motility Activator (Integrative Therapeutics): also a proprietary blend of artichoke leaf and ginger root extracts. The recommended dose is typically 2 capsules at bedtime.
  • SIBO-MMC (Priority One): This contains a combination of vitamin B6, Chinese red dates, flax oil, ginger, and an herb called Griffonia simplicifolia (a natural source of 5-HTP). The typical dosage may consist of 3 capsules taken at bedtime. The same precaution is warranted here if you take antidepressants or St. John's wort due to 5-HTP content. (36)

Before choosing a prokinetic, discuss this option with your practitioner, as there may be contraindications or potential interactions, especially if you take medications, other supplements, or have a medical condition (e.g., gallstones, high blood pressure, bowel obstructions).

Melatonin

Melatonin is primarily known for its role in regulating sleep-wake cycles, but it also plays a direct regulatory role in gastrointestinal motility. It helps coordinate Phase III of the MMC, improves smooth muscle contraction, and has anti-inflammatory properties in the gut.

Acts via gut melatonin receptors in the GI tract; influences serotonin signaling, which is also key for MMC activity. (37) (38)

Often helpful for people with IBS, SIBO + sleep issues, or those with circadian disruption (shift workers, insomnia, etc.).

Typical dosing: 0.5–3 mg at night before bed (higher doses are not necessarily better and can desensitize receptors over time). (39)

Lion's mane mushroom (Hericium erinaceus)

Supports nerve regeneration and neuroplasticity, including vagus nerve function. It may help repair damage to ICC (Interstitial Cells of Cajal) and ENS (Enteric Nervous System) caused by food poisoning, post-infectious IBS, or chronic inflammation. Improves gut microbial diversity for better digestive function. (40)

Typical dosing: 500– 3,000 mg/day, divided throughout the day, possibly with meals. It's recommended to start slowly and with low dosages, especially if you're new to mushrooms.

 

Lifestyle & meal timing strategies

This is where the Migrating Motor Complex really depends on you. Your daily rhythms either support it or shut it down.

Meal spacing

  • MMC only runs when you're not digesting, so aim for 3.5–4 hours between meals, without snacks.
  • This allows your gut to complete a full MMC cycle between meals.

 

3 Simple Yet Powerful Strategies for SIBO Warriors to Alleviate Bloating Naturally guide.Want a step-by-step guide to meal spacing and more strategies?

If you're ready to start taking control of your gut healing journey, grab my free guide:

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This guide is perfect if you're looking for actionable tips you can start today, and no crazy supplements or strict diets are required.

Yes, I need this!

Overnight fasting (12–14 hours)

  • An overnight fast gives your gut the longest window to clean house, supporting detox, gut lining repair, and microbial balance.

 

Prioritize deep sleep

Deep sleep, the restorative, slow-wave stage of the sleep cycle, contributes significantly to healthy gut and overall body.

  • Aim for 7–9 hours per night to regulate vagus nerve activity and MMC signaling. (41)
  • Avoid screens with blue light before bed, keep your room cool and dark, and try gentle breathing exercises if you struggle to fall asleep.

Gentle movement

  • Light walking after meals helps signal the gut to move, improves gastric emptying, and may indirectly support MMC cycles. (42)
  • Even 10 minutes post-meal can help!

 

Gut motility MMC support strategies

 

Nervous system & vagal nerve support

Because the Migrating Motor Complex is regulated largely by the vagus nerve and enteric nervous system, nervous system health is non-negotiable for restoring motility.

Vagal tone exercises

These simple tools can help improve parasympathetic activity:

  • Gargling vigorously (until your eyes water!)
  • Humming or singing loudly
  • Deep belly breathing (3–4-5 breath: inhale for 3, hold for 4, exhale for 5)
  • Cold exposure (cold shower, splash on the face)

Consider trauma-informed therapies

If you have a history of chronic stress, trauma, or anxiety, working with a somatic therapist, nervous system coach, or polyvagal-informed practitioner can be transformative, not just for your mind but also your gut.

Putting it all together

You don't need to make every change to support the Migrating Motor Complex, but even small adjustments to your rhythm, nutrition, and nervous system support can make a significant difference.

Here's a simple starter plan:

  1. Start spacing meals 4 hours apart
  2. Add ginger tea or a ginger capsule between meals
  3. Take magnesium at night
  4. Try 5-HTP (if appropriate) to boost serotonin
  5. Get 7+ hours of sleep
  6. Practice 1 vagus nerve stimulation activity daily

These are the kinds of steps that don't just treat symptoms, they create a foundation for gut resilience.

The bottom line

If you've made it this far, you now know something most people—even many practitioners—don't:

The long-term solution to SIBO, bloating, and recurring gut issues lies not just in removing bacteria, but in restoring the function of the Migrating Motor Complex.

This underappreciated "cleaning wave" is the gut's way of preventing overgrowth in the first place. When it's disrupted by stress, post-infectious changes, hormone imbalance, or constant snacking, it creates the perfect conditions for bacteria to stagnate, ferment food, and cause all those symptoms you've been trying to fix with diet alone.

The key takeaway? Killing the bugs is only half the job. If you want lasting relief from SIBO and IBS, you have to repair the rhythm.

The good news is that rhythm can be restored.

Through simple yet holistic strategic changes, such as spacing your meals, getting deep sleep, supporting your vagus nerve, and using well-researched supplements like ginger and 5-HTP, you can provide the Migrating Motor Complex with the conditions it needs to fire again.

 

 

 

Disclaimer: 

The information provided on this site is for educational purposes only, is not intended as medical advice, and does not claim to diagnose, heal, treat, or cure any conditions. Always consult with a healthcare professional before starting any dietary regimen, supplement, or lifestyle changes, especially if you have underlying health conditions or are taking medication. 

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Is a Carnivore Diet Good for SIBO?

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In recent years, there has been an increased interest in diets like the Carnivore diet to overcome health challenges. For many, this seems to be a controversial diet that involves eating primarily or only animal-based products. While some experts have praised the diet for its potential health benefits, others have raised concerns about its safety and effectiveness. In particular, several questions have been raised about the potential of a carnivore diet to improve or worsen Small Intestinal Bacterial Overgrowth (SIBO). Here, I look at the latest research on this topic.

Carnivore diet for SIBO

What is SIBO?

Small Intestinal Bacterial Overgrowth (SIBO) is an increasingly common digestive disorder in which bacteria that typically inhabit the large intestine spread to the small intestine and begin to overgrow. This condition can be caused by a variety of contributing factors, including low stomach acid, gut dysbiosis, structural issues, certain medications, and many other factors.

Common symptoms of SIBO include abdominal pain and bloating, gas, diarrhea and/or constipation, nausea, weight loss/gain, fatigue, and malnutrition. If left untreated, SIBO can lead to further health complications. Treatment options range from antibiotics, herbal medicines, and probiotics to dietary and lifestyle changes. It is crucial to test if you suspect your symptoms may point in the direction of SIBO. The best way is through breath testing when hydrogen, methane (or even hydrogen sulfide if the TrioSmart test is used) gases are measured. (1)

What is a Carnivore diet?

Many dietary approaches encourage consuming plenty of fruits and vegetables. You may even have heard the expression: "eat the rainbow" (of vegetables) or increase your fiber intake.

Well, fibers and prebiotics are indeed crucial to feeding good gut bugs. However, people with IBS (Irritable Bowel Syndrome) and SIBO may find that adding more fibers worsens their gut symptoms, resulting in excess bloating and constipation.

Now, the Carnivore diet takes the opposite approach.

The Carnivore diet is basically a meat-only, zero-carbohydrate diet. It means you can't eat plant-based food like vegetables or fruits (although there are several variations of the Carnivore diet, one of them is what Dr. Paul Saladino represents nowadays, allowing honey, fruits, and raw dairy products.)

Followers of this diet are encouraged to eat animals from nose to tail, including organ meats (liver, kidneys, heart, etc.). The emphasis on organ meat is significant because it contains all vital nutrients such as B vitamins, fat-soluble vitamins (A, D, E, and K), and minerals, including iron, magnesium, copper, zinc, etc. They are often referred to as "natural multivitamins." (2) In Western cultures, people are not accustomed to eating organ meat, and it may even sound distasteful to many. However, eating animals from nose to tail is quite normal in many Eastern cultures.

The Carnivore diet advocates claim that the diet heals many chronic health conditions, from depression, weight problems, and blood sugar regulation issues to fertility. However, it is essential to note that these claims are not backed up by any scientific evidence (yet).

What can you eat on a Carnivore diet?

The Carnivore Diet focuses solely on animal-based food items and typically includes foods such as:

  • Red meat, including beef, lamb, pork, venison, and buffalo, preferably fattier cuts of meat (and possibly grass-fed AND grass-finished meat)
  • Poultry, like chicken and turkey, or organ meats
  • Low-mercury fish like wild salmon, sardines, and herring and seafood like oysters, mussels, crabs, clams, shrimp, lobster, or scallops
  • Other animal products and foods like eggs, tallow, duck fat, bone broth, bone marrow, ghee butter
  • Raw dairy products, butter, cheese (if tolerated or no autoimmune issues present)
  • (Raw honey)
  • Water
  • Quality Salt

It's essential to note that various versions of the Carnivore diet exist. So, one approach may allow raw honey or pork, while the other doesn't. (2)

What can't you eat on a Carnivore diet?

The Carnivore diet restricts all the other food groups, such as:

  • All vegetables and fruits
  • Most dairy products
  • Legumes (beans and lentils)
  • Nuts and seeds like almonds, pistachios, pumpkin seeds, flax seeds, etc.
  • All grains and grain-based products, including rice, wheat, bread, quinoa, pasta, etc.
  • All forms of alcohol, including beer, wine, liquor, etc.
  • All types of sugars
  • Other beverages include tea, coffee, soda, fruit juice, etc.

Can a Carnivore Diet Help Treat SIBO?

Currently, the most common approaches for treating SIBO involve antibiotics, antimicrobials, or the Elemental diet. These approaches have varying success rates. According to studies, around 45% of patients will have recurrent SIBO following the completion of antibiotic therapy. (3) Another study showed that herbal antimicrobial therapy could be just as effective as antibiotics. (4) The Elemental diet seems to be the most effective treatment option, as a 14-day Elemental diet was shown to have around an 80% success rate. (5)

We can also choose from a wide variety of SIBO diets that aim to reduce certain carbohydrates to decrease symptoms like bloating, diarrhea, constipation, abdominal pain, and more. I wrote about the pros and cons of these SIBO diets to understand their mechanisms.

But till today - according to my knowledge - there were no exclusive studies on using any SIBO diet as a treatment option (except the Elemental diet).

In Holistic and Functional medicine, we know that lifestyle changes and addressing the underlying causes are crucial in resolving SIBO and preventing relapse.

So what about the Carnivore diet?

One small observational study (6) found that five participants who followed a zero-carb carnivore diet for at least four weeks tested negative for SIBO at the end of the trial period. Now, it is vital to mention that this study has not been peer-reviewed or validated, and it is a small study to draw long-term conclusions.

But here is what they found:

"Results: five patients who followed the carnivore diet for four weeks or longer tested negative for SIBO, and the one patient who only endured the diet for two weeks had a near complete eradication of her hydrogen elevation. Methane values were generally low both before and after the dietary treatment, but there was a significant decrease in patients 3 and 5.

Conclusions: The carbohydrate, zero fibre, carnivore diet shows great potential for being a readily available, cost-effective, and equally effective alternative treatment for SIBO. According to our observations, it also results in better satisfaction after meals, decreases cravings for sweets, and generates weight loss in patients where it is needed."

This small study observed a positive effect on normalizing the breath test, but we definitely need to wait for more data.

The Carnivore diet pros and cons for SIBO

What are the Benefits of a Carnivore Diet for SIBO?

Since the Carnivore diet is a relatively "new trend," there is not much (official) research on its benefits.

Symptom and (disease) management

Other studies investigated the benefits of low-carb diets on health and showed noticeable improvements in weight loss and metabolic markers. (7) Many people support their statements using research on the ketogenic diet.

One survey by Harvard University showed "adults consuming a carnivore diet experienced few adverse effects and instead reported health benefits and high satisfaction." (8)

Since the diet eliminates all inflammatory and processed foods (seed oils, additives, preservation, and more) and all plant foods that may trigger food sensitivities (oxalates, lectins, salicylates, etc.), it makes sense that many advocates of the carnivore diet report better mood, focus, and more energy, improved insulin sensitivity, better gut health, mental clarity, libido, and weight loss as inflammation reduces.

Regarding SIBO, people generally experience less or no bloating and gassiness because the diet eliminates bacteria's primary food source: carbohydrates (including fiber)! Excess bacteria in the small bowel can become an issue due to their fermentation process leading to bloating, gas, and other symptoms. So yes, it can provide relief in terms of symptoms. But it is also essential to be aware that research shows that our gut microbiome needs fiber to function optimally. Many health issues stem from dysbiosis (an imbalance between beneficial and pathogenic bacteria). To feed your good microbes, they need fiber. (9) There is also more discussion if SIBO is actually also a form of dysbiosis.

Healing a Leaky gut

One of the possible reasons why many autoimmune warriors report improvement in their health could be due to healing the leaky gut with the diet. The Carnivore diet encourages bone broth and animal food sources rich in various amino acids and other nutrients (like glutamine, collagen, and omega-3 fatty acids). These amino acids are the building blocks of the intestinal lining. (10)

Calming down the immune system

It can also help calm down the immune system. Since the gut lining is healing, and most of the possible triggering foods have been removed from the diet, inflammation decreases, not triggering the immune system anymore. Therefore the body has time to focus on repair, and some symptoms like skin, mood, sleep, and gut issues slowly fade away.

What are the Potential Risks of a Carnivore Diet for SIBO?

Promoting food fear & metabolic inflexibility

We can all agree that the Carnivore diet is restrictive by eliminating whole food groups. Therefore the diet can be difficult to sustain long-term due to a lack of variety, especially for those who tend to be a foodie. Additionally, there is a potential risk of under-eating, which can impact metabolism and nutrient levels.

It can also lead to social isolation, as eating out can become a real challenge.

I often hear that people are scared to reintroduce foods to the diet due to presumed symptoms. Others who tried the reintroduction process soon backed up because they realized that previously tolerated foods no longer worked for their bodies. This is happening because of metabolic inflexibility. (Metabolic flexibility is the ability to respond or adapt to changes in metabolic demand.) (11) So, in this case, their gut is incapable of adapting to the "new" foods, possibly due to the dysbiosis from a one-sided diet.

Changes in the gut microbiome

A small study found that in just five days, participants who switched to an animal-based diet experienced significant detrimental changes to the gut microbiome, including a dramatic increase in strains of bacteria in the gut that cause inflammation and have been linked with Crohn's disease and ulcerative colitis.

"The animal-based diet increased the abundance of bile-tolerant microorganisms (Alistipes, Bilophila, and Bacteroides) and decreased the levels of Firmicutes that metabolize dietary plant polysaccharides (Roseburia, Eubacterium rectale, and Ruminococcus bromii)...Finally, increases in the abundance and activity of Bilophila wadsworthia on the animal-based diet support a link between dietary fat, bile acids, and the outgrowth of microorganisms capable of triggering inflammatory bowel disease 6. In concert, these results demonstrate that the gut microbiome can rapidly respond to altered diet, potentially facilitating the diversity of human dietary lifestyles." (12)

Possible nutrient deficiencies

It can lead to nutrient deficiencies if the diet is not designed well. Some folks prefer to consume only lean and muscle meat, which may not provide all the essential nutrients as organ meats. This is why it is crucial to practice nose-to-tail eating (including bone marrow, brains, liver, pancreas, and kidneys). For those who can't accept the thought of eating organ meats, organ meat supplements could be a solution.

Some advocates promote adding quality salt (Celtic or Himalayan salt) to the diet to get enough trace minerals.

Ignoring the root causes and lifestyle changes

Many use this diet as a quick fix. But this band-aid approach may mask the underlying problems, especially when we talk about nervous system dysregulation, stored trauma, hidden infections, (mold) toxicity, and structural issues that can all contribute to SIBO, and the Carnivore diet alone may not resolve.

Sometimes people focus too much on their diet and ignore all other aspects of their health like sleep, stress management, relationships, exercise, environment, and so on. But lifestyle factors are the actual foundational steps of any healing journey. This is why holistic coaching & functional nutrition can be powerful in eliminating mindset blockages, limiting beliefs that may stand in your way, and finding strategies to implement the necessary lifestyle changes to reach your health goals. It can also guide you in finding the underlying causes to prevent SIBO relapse in the future.

It may not be suitable for everyone

People with specific health challenges like chronic kidney diseases, adrenal and thyroid dysfunctions, and eating disorders are not recommended to follow this diet.

Those with histamine intolerance may also need modifications. Fresh animal foods generally contain a lower amount of histamine. Reducing or avoiding aged or processed meats, cheeses, hydrolyzed collagen, bone broth, and shellfish is better as they can trigger histamine-related symptoms. (This might change later, though, if the cause of histamine issues is a Leaky gut, for example).

Is the Carnivore Diet good to follow?

My intake on this question is that the Carnivore diet may be helpful for people with chronic conditions as a therapeutic approach to reduce inflammation and allow time for the body to calm down and heal. It may be a good strategy to be on the Carnivore diet for 3-4 weeks and support the gut healing process, implement the necessary lifestyle changes, and have a plan on how to reintroduce plant-based foods to the diet to feed the beneficial gut microbes. But I wouldn't follow it long-term as a new lifestyle.

 

 

Disclaimer: 

The information provided on this site is for educational purposes only, is not intended as medical advice, and does not claim to diagnose, heal, treat, or cure any conditions. Always consult with a healthcare professional before starting any dietary regimen, supplement, or lifestyle changes, especially if you have underlying health conditions or are taking medication. 

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