The link between SIBO and acid reflux is often due to poor digestion allowing bacteria to overgrow in the small intestine and thus causing symptoms of SIBO such as acid reflux. Poor upper digestive function in the form of low stomach acid, insufficient enzyme production, and reduced bile flow can allow for bacteria to overgrow in the small intestine and contribute to the uncomfortable symptoms of acid reflux and indigestion.
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How does SIBO cause acid reflux?
When there is an excessive amount of bacteria in the small intestine, as in the case with SIBO, these bacteria produce gas, which builds up and puts pressure on the small intestine and stomach (hello bloating). When enough pressure builds up, it can push the acid from the stomach up into the esophagus, causing the common symptom of acid reflux.
Fermentation from bacteria in the small intestine is how SIBO can cause acid reflux.
Acid Reflux and SIBO
Acid reflux is one of the symptoms of small intestinal bacterial overgrowth. Other common symptoms of SIBO include:
- a bloated stomach
- burping
- upper abdominal bloating
- diarrhea
- heartburn
- indigestion
- excessive gas
- bloating after eating
- stomach pains
- intolerance to fiber and prebiotics
An intolerance to resistant starches found in bananas and potatoes or high FODMAP foods such as onion, garlic, and asparagus often indicate a small intestinal bacterial overgrowth.
Foods to avoid when SIBO is the cause of heartburn
Many people notice that spicy or acidic foods and high histamine foods may trigger heartburn due to an inflamed gut lining or release of histamine in response to high histamine foods.
What people often miss is that it is the fermentable carbohydrates, high fiber foods, and refined carbohydrates that are problematic when SIBO is the cause of heartburn.
Highly fermentable carbohydrates are resistant starches found in bananas and potatoes or high FODMAP foods such as onion, garlic, and asparagus. Corn, legumes, wheat, and high fiber are also often problematic. These are foods to avoid if someone has SIBO and acid reflux or if you notice any of these highly fermentable foods as your trigger.
Refined carbohydrate foods are full of sugar, which is fuel for bacteria to feed upon and grow in excess. If you notice that your acid reflux or abdominal bloating occurs, SIBO is likely the underlying cause of your acid reflux.
Understanding the SIBO and acid reflux connection
When the terrain of the small intestine gets out of balance due to poor digestive function, bacteria that thrive in the large intestine begin to grow in excess in the small intestine causing small intestinal bacterial overgrowth, also known as SIBO.
These bacteria are fed by prebiotics, which are indigestible fibers that are fermented by gut bacteria. Foods high in fiber are the fuel for our microbiome to thrive.
High FODMAP foods fermentable carbohydrates become problematic when there is an excess of bacteria in the small intestine that ferment upon these fibers and thus produce excessive gas that puts pressure on the stomach causing acid reflux and bloating.
Following a low carbohydrate SIBO diet or low fodmap diet for some time can be beneficial by limiting the fuel needed by bacteria to thrive.
How to prevent SIBO and acid reflux by improving digestive function
If Sibo is underlying your heartburn symptoms, then the answer to relieving your reflux starts with improving your digestive function and terrain of the small intestine to prevent the overgrowth of SIBO in the small intestine.
Improving bile production and flow is key to preventing small intestinal bacterial overgrowth as bile is a natural anti-microbial that helps to sterilize and keep the small intestine clean and free of excess bacteria. Seeking Health’s Gallbladder Nutrients helps to improve bile flow along with Optimal PC.
Providing digestive support in the form of seeking health’s digestive enzymes helps to ensure the breakdown of all food including, carbohydrates and various fibers so that there aren’t undigested carbs for bacteria in the small intestine to ferment. Fermentation and the production of gas from bacteria in the small intestine are how SIBO can cause acid reflux.
Slippery elm for heartburn
If you are currently experiencing acid reflux symptoms and want a natural heartburn remedy to relieve acid reflux, you can use slippery elm powder. Take 1 tsp of slippery elm in a cup of warm water and drink that to help coat and soothe the upper digestive to prevent stomach acid from irritating the esophageal or intestinal lining.
Taking one scoop of Optimal Gi Powder is another option for soothing the digestive lining. Keep in mind that you will still want to address the underlying cause of your reflux and not just the symptom of acid reflux.
I used to suffer from acid reflux regularly. Utilizing enzymes and liver gallbladder support (optimal PC) was a game-changer for reducing my acid reflux caused by SIBO and improving my digestion.
I can finally say that I no longer get acid reflux at all or need slippery elm as I addressed the root cause of my acid reflux.
For more information on how high fermentable foods and SIBO cause acid reflux, I highly recommend reading Heartburn: Fast Tract Digestion by Normon Robillard.
Grab my gut health guide to start improving your digestion and find out what digestive organ needs the most support.
This SIBO resource guide will help you to heal SIBO naturally.
If you are struggling with SIBO Dr Nirala Jacobi from the SIBO Doctor has a very informative patient SIBO success course to beat SIBO for good. This course covers
- additional underlying causes of SIBO
- testing for SIBO
- Symptoms of SIBO
- types of SIBO
- biphasic SIBO diet
- antimicrobials for SIBO
and much more!
Dr Nirala Jacobi has been my go-to resource for information on SIBO. There is so much to know about SIBO and the SIBO success plan covers all the essentials that you need to know about SIBO so you can beat SIBO for good

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