NATUROPATHIC DOCTOR IN ONTARIO
IBS vs SIBO
What’s the Difference and Does It Matter?
What is IBS? What is SIBO?
If you’ve ever gone down a Google rabbit hole about your digestive symptoms, you’ve probably seen two acronyms over and over: IBS and SIBO.
They share many of the same symptoms—bloating, gas, abdominal pain, constipation, diarrhea—so it’s no wonder people are confused. Are they the same thing? Is one causing the other? And do you actually need another label?
Let’s unpack this in a clear, practical way.
What is IBS again?
Irritable Bowel Syndrome (IBS) is a functional digestive condition defined by:
Recurrent abdominal pain
Changes in bowel habits (constipation, diarrhea, or both)
No obvious structural disease on scopes or imaging
It’s now understood as a disorder of gut–brain interaction, involving changes in motility, sensitivity, immune activity, and the nervous system.
What is SIBO?
SIBO (Small Intestinal Bacterial Overgrowth) means there is an abnormally high number of bacteria in the small intestine, where the bacterial load is normally lower than in the colon. Those bacteria ferment carbohydrates too early, which can produce:
Bloating and visible distension
Gas (often soon after meals)
Abdominal discomfort
Diarrhea, constipation, or a mix
Some experts now consider SIBO an underlying cause in a significant portion of IBS cases, especially IBS with diarrhea or bloating-predominant symptoms.
How are IBS and SIBO different?
In simple terms:
IBS is a syndrome – a collection of symptoms (pain + bowel changes) without a single structural cause.
SIBO is a specific diagnosis – too many bacteria in the small intestine.
You can have:
IBS without SIBO
SIBO without IBS
Or both at the same time
Symptom patterns can sometimes hint at one or the other. For example, some clinicians notice that:
IBS tends to be more pain-predominant
SIBO tends to be more bloating-predominant
But there’s a lot of overlap, so we can’t rely on symptoms alone.
How are IBS and SIBO diagnosed?
IBS is diagnosed using Rome IV criteria (symptom-based) and ruling out red flags with basic testing.
SIBO is diagnosed using:
Breath tests (lactulose or glucose), which measure hydrogen and methane gases after you drink a test solution
In rare cases, a sample of small intestinal fluid during endoscopy (more invasive, not commonly done)
At Sequence Wellness, we use:
Hospital-style lactulose/glucose breath testing
FoodMarble® at-home breath testing in selected cases
Does it matter which one I have?
Yes—because it can change the focus of treatment.
If your IBS symptoms are being driven by SIBO, then addressing the overgrowth (with diet, antimicrobials, motility support, etc.) can make a big difference. If SIBO is not present, we might focus more on gut–brain work, diet, microbiome balance in the colon, and hormone or stress factors.
That said, the core naturopathic pillars often overlap for both:
Identifying food triggers and using approaches like low FODMAP or Mediterranean-style diets
Supporting motility and digestion
Balancing the microbiome
Working on stress and the nervous system
Correcting nutrient deficiencies
How a naturopathic doctor can help
A naturopathic doctor can help you:
Decide if SIBO testing makes sense in your case
Interpret breath tests, stool tests, and basic labs together
Build a phased plan that might include diet changes, herbal antimicrobials, probiotics, prokinetics, and nervous system support
Coordinate care with your family doctor or gastroenterologist when medication or further investigation is needed
If you’re stuck wondering, “Is this IBS, SIBO, or both—and what do I do about it?”, this is exactly the kind of question we work through in virtual visits every day.
Dr. Sarah Goulding, Naturopathic Doctor
Dr. Sarah Goulding is a licensed naturopathic doctor in Ottawa Ontario and has a BSc in neuroscience and biology from Dalhousie University (2004), and did her 4-year naturopathic training at the Canadian College of Naturopathic Medicine (2010). She’s since accumulated over a decade of clinical experience, and refined her practice to focus on women’s health and digestion. She is licensed and registered as a Naturopathic Doctor in Ontario by The College of Naturopaths of Ontario (CONO) and is a member of the Canadian Association of Naturopathic Doctors (CAND) and the Ontario Association of Naturopathic Doctors (OAND).
Dr. Sarah Goulding blends science and compassion, and acts as a personal health researcher to help you navigate your health. Tools that she uses include nutrition, supplements and botanicals, bioidentical hormones, and lifestyle modifications. The closer you get to the root cause, the gentler the therapies needed to resolve the issue.
Dr. Elizabeth Miller, Naturopathic Doctor
Dr. Miller completed her doctor or naturopathic medicine degree at the Canadian College of Naturopathic Medicine, and holds a Master’s and Bachelor’s of science in Human Health and Nutrition from the University of Guelph. Her extensive knowledge of nutrition and her strong foundation in scientific research allows for a very thorough approach to your care. She is licensed and registered as a Naturopathic Doctor in Ontario by The College of Naturopaths of Ontario (CONO) and is a member of the Canadian Association of Naturopathic Doctors (CAND) and the Ontario Association of Naturopathic Doctors (OAND).
She is passionate about teaching holistic health to help women understand their bodies and get to the root cause of their health issues. Her areas of special interest include women’s health, hormonal health, gastrointestinal health, and pediatrics.
Dr. Janna Fung, Naturopathic Doctor
Dr. Janna Fung is a licensed naturopathic doctor with a special interest in dermatology and women’s health. She has a passion for evidence based preventative medicine and strives to empower patients with the knowledge to achieve their optimal health. She understands collaborations is the only way to develop realistic sustainable health/wellness results and strives to develop individualized health goals with patients.
