SIBO & Small Intestinal Bacterial Overgrowth Treatment
in Portland, OR
Specialized naturopathic and functional medicine care for SIBO, SIFO, and chronic digestive dysfunction — accepting new patients in-person and virtually.
Or call us at 503-770-0670
Located at 1901 N Killingsworth St, Portland, OR
Accepting PacificSource, Regence BCBS, and Moda insurance.
What Is SIBO — and Why Does It Go Undiagnosed?
Small Intestinal Bacterial Overgrowth (SIBO) occurs when bacteria that normally reside in the large intestine migrate into and colonize the small intestine. The resulting fermentation of carbohydrates produces hydrogen, methane, or hydrogen sulfide gas — driving the bloating, pain, motility changes, and nutrient malabsorption that characterize the condition.
Research estimates that SIBO is present in up to 78% of patients diagnosed with IBS. Despite this prevalence, it is routinely missed in conventional care — either because breath testing is not ordered, results are misinterpreted, or treatment stops at symptom management without addressing the underlying cause of bacterial migration.
At our Portland clinic, we approach SIBO differently. Rather than simply eradicating bacteria, we investigate why the overgrowth occurred — and address the structural, motility, immune, and dietary factors that drive recurrence.
Common Signs and Symptoms of SIBO
SIBO produces a wide range of symptoms that overlap with many other digestive conditions, which is part of why it is so frequently misdiagnosed. Patients often present with a combination of the following:
SIBO produces a wide range of symptoms that overlap with many other digestive conditions, which is part of why it is so frequently misdiagnosed. Patients often present with a combination of the following:
-
Abdominal bloating (especially after meals)
-
Excessive gas and belching
-
Diarrhea, constipation, or alternating bowel habits
-
Abdominal cramping and pain
-
Heartburn or GERD-like symptoms
-
Nausea after eating
-
Food intolerances (multiple foods, worsening over time)
-
Chronic fatigue and low energy
-
Brain fog and difficulty concentrating
-
Nutrient deficiencies (B12, iron, fat-soluble vitamins)
-
Unexplained weight loss or weight gain
-
Skin issues including rosacea and eczema
-
Joint pain and systemic inflammation
-
Anxiety tied to digestive symptoms
Comprehensive SIBO Testing
We use lactulose and glucose hydrogen/methane breath testing to identify hydrogen-dominant, methane-dominant (IMO), and mixed-pattern SIBO. For patients with hydrogen sulfide involvement, we assess clinical presentation alongside additional markers. Breath test interpretation is informed by the full symptom picture — not just threshold values in isolation.
Identifying the Root Cause
SIBO recurs when the underlying driver is not addressed. We systematically evaluate the most common root causes, including impaired migrating motor complex (MMC) function, low gastric acid or digestive enzyme production, structural adhesions, hypothyroidism, mast cell activation, prior food poisoning (post-infectious SIBO), and ileocecal valve dysfunction.
Individualized Treatment Protocols
Treatment is tailored to your specific SIBO type, pattern, history, and root causes. Protocols may include herbal antimicrobials, pharmaceutical options where appropriate, targeted prokinetic therapy, elemental diet, specific dietary modification (including low-fermentation and bi-phasic approaches), and biofilm-disrupting strategies for refractory cases.
Prevention and Long-Term Support
Eradicating SIBO without a maintenance strategy leads to relapse for the majority of patients. We develop individualized prevention protocols including prokinetics, dietary frameworks, motility support, and follow-up breath testing to confirm clearance and monitor for recurrence.
Related Conditions We Commonly Address Alongside SIBO
-
SIFO (Small Intestinal Fungal Overgrowth)
-
IBS-D / IBS-C / IBS-M
-
Candida & Biofilms
-
GERD & Heartburn
-
Leaky Gut / Intestinal Permeability
-
Microbiome Imbalances
-
Histamine Intolerance
-
MCAS
-
Post-Infectious IBS
-
Food Intolerances
-
Celiac Disease (co-management)
-
Crohn's Disease (co-management)
-
Microscopic Colitis (co-management)
-
Ulcerative Colitis (co-management)
Who We See
Our practice serves patients across the Portland metro area and throughout Oregon. Dr. Sand also offers virtual educational consultations for clients outside of Oregon who are seeking guidance on navigating SIBO testing and integrative care.
We work with patients who:
-
Have a confirmed SIBO diagnosis and need a comprehensive treatment plan
-
Have been treated for SIBO before but continue to relapse
-
Suspect SIBO based on symptoms and have not yet been tested
-
Are managing IBS and want to investigate whether SIBO is a contributing factor
-
Need support understanding and interpreting their own breath test results
Insurance & Appointments
Dr. Sand and Dr. Emrick accept the following insurance plans at Open Wellness Clinic in Portland:
-
PacificSource
-
Regence BlueCross BlueShield
-
Moda Health
-
Cigna, Aetna, UMR and UnitedHealthcare (Dr. Emrick)
We offer both in-person appointments at our North Portland clinic and virtual visits for Oregon residents. New patient appointments are 60 minutes to allow for a thorough intake.
Ready to Get to the Root of Your Digestive Symptoms?
Start with a free 15-minute intro call to share your history and find out if our practice is the right fit. No commitment required.
Book a Free 15-Min Intro Call with Dr. Sand below. Or call us at 503-770-0670.
Located at 1901 N Killingsworth St, Portland, OR