Tummy troubles? 6 signs it could be SIBO – and what to do about it
Some midlife symptoms come as no surprise – a few hot flushes, a little more fatigue, maybe a shift in how our bodies handle certain foods. But others feel more confusing: bloating after our usual breakfast, brain fog by 3pm, or meals that leave us feeling heavy and unsettled.
It’s easy to blame hormones. But what if it’s our gut that’s asking for help?
Enter SIBO: aka Small Intestinal Bacterial Overgrowth. A condition that has long flown under the radar, but could be the culprit of many a troubled tum…
What is SIBO?
SIBO occurs when bacteria that normally live in the large intestine begin to overgrow in the small intestine, where they’re not supposed to be.
“This overgrowth leads to excessive fermentation of food and gas production, disrupting digestion and nutrient absorption,” says Marilia Chamon, a registered nutritional therapist, SIBO specialist and founder of Gutfulness Nutrition. “This can trigger symptoms such as bloating, fatigue, brain fog, and food sensitivities – the kind many women assume are just part of hormonal changes.”
Because the symptoms come on slowly and often change with different foods, it’s easy to put them down to stress, age, or just ‘one of those things’. One clinical study found that up to 78% of people diagnosed with IBS actually had SIBO.
Hormones, digestion and the slowdown we don’t talk about
Oestrogen and progesterone help to keep the gut moving. So, when levels drop during menopause, digestion slows. Food travels more slowly through the digestive tract – a function known as gut motility. This can lead to a lingering sense of fullness, and the feeling that digestion just isn’t what it used to be.
“Oestrogen supports the strength of the gut wall, while progesterone helps things flow,” says Marilia. “When both decline, motility slows, opening the door for bacteria to start building up in the small intestine.”
But hormones aren’t the only factor. Low stomach acid, disrupted bile flow, poor sleep, chronic stress, and even some supplements like iron can all interfere with gut function.
It often builds gradually: a few meals that feel harder to digest, an unpredictable gut that’s more reactive than it used to be. Over time, those shifts can start to feel normal – even when they’re not.
Is it your gut or your hormones?
Bloating, brain fog, and low energy are common in midlife and are often put down to hormones. But when these symptoms seem to change with what we eat, or consistently flare up after meals, our gut might be trying to tell us something.
“SIBO symptoms can mirror menopause in so many ways,” says Marilia. “But if you notice your symptoms worsening after eating – especially discomfort or distension – that’s a red flag.”
Another clue? Unpredictable digestion. While hormone-related symptoms tend to follow a monthly or seasonal rhythm, SIBO shows up more directly in the gut. Constipation, diarrhoea, or a draining mix of both are common, along with growing sensitivity to foods that never used to be a problem.
Testing, treatment, and taking back control
If this sounds familiar, it may be time to look a little deeper. One way to diagnose SIBO is through a non-invasive breath test.
“If you suspect SIBO, the most accurate test is a breath test that measures hydrogen and methane gases produced by bacteria,” says Hassan Almuaathen, pharmacist and co-founder of ZEN Healthcare. “These gases are detected after drinking a sugar solution that feeds any bacteria lurking in the small intestine.”
“These tests are simple to do,” adds Marilia. “And if carried out by a qualified practitioner, they can offer real clarity.”
Treatment, meanwhile, isn’t a one-size-fits-all. Some people respond well to antibiotics, while others prefer herbal antimicrobials, but both Hassan and Marilia agree it’s rarely just about the bacteria.
“SIBO is usually the result of underlying issues that allow bacteria to overgrow, like slow gut motility or adhesions,” says Marilia.
Everyday habits can make a real difference. Eating slowly, leaving four to five hours between meals, and cutting back on grazing gives the gut time to reset. Gentle movement, better sleep, and even a few deep breaths before eating can all support recovery.
“Don’t just chase the bacteria,” adds Hassan. “Support the terrain. That means looking at the full picture – how food is moving through the gut, whether stomach acid and bile are doing their jobs, and how lifestyle stress might be interrupting digestion. That’s what leads to lasting change.”
Tuning in to your gut
One of the most frustrating parts of midlife is feeling like our symptoms don’t quite add up, or worse, that they’re being explained away as ‘just hormones’. When lingering tiredness, digestive discomfort, or mental fuzziness don’t improve with the usual approaches, it’s hard to know where to look next.
“SIBO isn’t rare,” says Marilia. “It’s just rarely recognised – especially in women navigating hormonal shifts.”
The good news? With the right diagnosis and support for the full digestive picture, gut health can be restored. And when digestion starts to rebalance, other things often shift too – energy, sleep, mood, and even our sense of clarity.
“Gut health isn’t a side issue,” adds Hassan. “It’s central. When your digestion is working well, everything else feels a little easier to manage.”
Could it be SIBO?
Some signs our gut might be asking for attention:
Bloating after meals
Especially if it worsens throughout the day or comes on quickly.
Feeling full too fast
Even small meals can feel heavy or leave you uncomfortably full.
Constipation, diarrhoea or both
Unpredictable bowel habits that don’t follow a clear pattern.
Brain fog or fatigue that lifts with food changes
If reducing carbs or sugar seems to ease symptoms.
Growing food sensitivities
Foods that used to feel fine now leave you uncomfortable or reactive.
Foul-smelling gas
A less talked-about sign of fermentation in the gut.
If any of these resonate, talk to your healthcare provider to explore whether SIBO might be playing a role.
