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SIBO and Constipation

SIBO and Constipation

Today, Chris Gebhart joins Dr Nirala Jacobi to speak about SIBO and constipation.

Chris works at Resonance Complementary Therapies in Melbourne, Australia, and has been working with SIBO for 3-4 years.  Chris graduated as a Naturopath from the Southern School of Natural Therapies in 1995, has done post graduate studies in Japanese Acupuncture.

Chris works with his partner, Natalie Cruttenden, also a Naturopath and SIBO practitioner.  Chris introduced Dr Jacobi to the use of the herbal medicine, pomegranate, in SIBO treatment, which is also touched on today.

Topics discussed in this episode include:

  • Chris’s journey to becoming a SIBO treating practitioner.
  • Methane dominant SIBO and the constipation relationship.
  • Chronic constipation beyond SIBO treatment – what is Chris seeing in his clinic with constipated patients who remain constipated even though methane levels are dropping?
  • Post SIBO treatment therapies to support healthy digestion throughout the entire digestive tract.
  • Resetting and stimulating peristalsis in the large intestine.
  • The importance of supporting bowel movements during the antimicrobial SIBO treatment phase .
  • The theory that high methane on baseline that remains elevated throughout the test reflects IBS-C and not necessarily SIBO (via SIBO breath testing).

Chris’s clinical pearls for treating constipation, and supplemental supports:


Prescript Assist

  • Partially Hydrolysed Guar Gum (PHGG)
  • Herbal based laxatives
    • Metagenics laxatone
    • Mediherb cascara complex
  • Xymogen Probiomax Plus Sachets
  • Bioceuticals Ultra Biotic 500 in later phases of SIBO treatment.

Dr Jacobi’s supplement supports for peristaltic action

– Bifidobacterium Lactis HN019
– Found in Probiomax, and Orthoplex Multigen Biotic.
– Mutaflor – beneficial E.coli

  • Repair work to consider after Neomycin use.

Dr Jacobi’s bowel retraining techniques:

  • – PHGG use
  • – Flaxseeds, chia seeds, and dietary adjustment to support bowel movements for patients with high methane production in the large intestine.
  • – Anatomical squatting position for best evacuation alignment.
  • SIBOtest’s Resource – Retraining a Sluggish Colon

  • Coffee enemas – Chris and Dr Jacobi’s opinions for therapeutic use.
  • Kinesiological testing for the function of sphincters of the abdomen.
  • Sphincter work and what type of constipation patients may respond better
  • Chris’s seed blend for moving the bowels – chia seeds, linseeds, pumpkin seeds, sunflower seeds, almond.
  • Methanogen specific herbal support
  • Removing Methanobrevibacter smithii by moving the bowels.
  • Testing available for high baseline methane and high methane throughout, and when to use this test – Methane Spot Test.
  • Pomegranate – when to use it, what form to use, how often to use it, and Chris’s results from using it.
  • Other herbs for treating SIBO and Small Intestinal Fungal Overgrowth (SIFO), including Usnea and Horopito.
  • The Biphasic Diet and reintroducing FODMAP foods.
  • The damage to the villi in light of SIBO and repercussions of this.
  • SIBO relapse, and how to integrate a repair phase to lessen the occurrence of this, either post treatment, or pretreatment (as indicated in the The Biphasic Diet)
  • Chris’s treatments for gut repair:
    – Prebiotic rotation.
    – Lactulose
    – Bimuno galacto-oligosaccharide (GOS)

Fibre integration
– Soluble
– Insoluble


Colonic foods (polyphenols)
-Green tea


  • Dr Jacobi’s gut repair program

– Vitamin A
– Zinc – 60mg
– Bimuno GOS

– Stress as a factor in sluggish bowels.
– Supporting serotonin for gut motility.



  • Dr Jacobi’s supplement supports for peristaltic action:

– Bifidobacterium Lactis HN019
– Found in Probiomax, and Orthoplex Multigen Biotic
– Mutaflor – beneficial E.coli
– Squatty Potty
– Easy Stool

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About the Author

Dr Nirala Jacobi BHSc ND (USA)

Dr. Nirala Jacobi, BHSc, ND (USA) graduated from Bastyr University in 1998 with a doctorate in naturopathic medicine. She practiced as a primary care physician in Montana for 7 years before arriving in Australia and is still a licensed physician in the USA.

Dr Jacobi is considered one of Australia’s leading experts in the natural treatment of small intestine bacterial overgrowth (SIBO), a common cause of IBS. She is a national and international speaker on this topic and her annual SIBO Webinars and SIBO Master Classes are popular and well-attended.

She frequently lectures on her Bi-Phasic SIBO diet and herbal approaches for the treatment of SIBO.  Dr Jacobi is the medical director of SIBOTest, an online testing service and educational portal for practitioners.  She also has a busy practice in northern New South Wales and offers mentorship sessions for practitioners

"Since specialising in SIBO our practice has grown enormously, people are seeking us out for the treatment. Specialising in SIBO as a business owner has…what do I say…made us busy!"

"Because there are the clearly defined treatment protocols to follow, the treatment outcomes are excellent."

Natalie Cruttenden
Natalie Cruttenden Resonance Complementary Therapies

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