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If you have been experiencing ongoing bloating, abdominal discomfort, diarrhoea or unexplained digestive symptoms, you may have heard of Small Intestinal Bacterial Overgrowth (SIBO). While the name sounds complicated, SIBO is a treatable condition that can be identified and managed with the right care.

Your digestive system contains trillions of bacteria that help keep your gut healthy. Most of these bacteria normally live in the large intestine (colon).

SIBO occurs when too many bacteria grow in the small intestine, where there are usually far fewer bacteria. This excess bacterial growth can interfere with digestion, causing food to ferment too early and making it harder for your body to absorb important nutrients.

Symptoms of SIBO can vary from person to person and may include:

Diarrhoea, constipation, or alternating between both

Many of these symptoms can also occur with other digestive conditions, so it is important to have a proper medical assessment.

SIBO often develops when something slows the normal movement of food through the small intestine or changes its structure. Common contributing factors include:

Structural changes in the small intestine, such as diverticula

Digestive conditions such as coeliac disease or Crohn’s disease

Certain medications, including some acid-suppressing medicines, opioids and repeated courses of antibiotics

Sometimes, more than one factor is involved.

Treatment aims to reduce the excess bacteria, improve symptoms and address any underlying cause.

Specific antibiotics may be prescribed to reduce bacterial overgrowth. The choice of medication depends on your symptoms and test results.

Some people benefit from temporary dietary changes, such as a low FODMAP diet, which reduces certain carbohydrates that bacteria ferment. Because this diet can be restrictive, it is often best undertaken with guidance from an accredited practising dietitian.

If SIBO has affected nutrient absorption, your doctor may recommend supplements such as vitamin B12 or iron.

Managing conditions that contribute to SIBO can help reduce the chance of symptoms returning.

Unfortunately, SIBO can recur, particularly if the underlying cause cannot be fully corrected. If symptoms return, your gastroenterologist may recommend further assessment or additional treatment.

Long-term management focuses on treating the underlying condition where possible and developing a plan to help minimise recurrence.

When should you see a gastroenterologist?

If you have persistent bloating, diarrhoea, constipation, abdominal pain or unexplained digestive symptoms that are affecting your quality of life, it is worth seeking specialist advice.

A gastroenterologist can determine whether SIBO or another digestive condition may be responsible for your symptoms and recommend the most appropriate investigations and treatment.

Understanding Small Intestinal Bacterial Overgrowth (SIBO)

Most people expect their digestive system to return to normal after recovering from a gut infection. But for some, the symptoms don’t completely disappear. Instead, they evolve into a long-lasting pattern of abdominal discomfort, bloating, urgency, or altered bowel habits.
This condition is known as 

Post-Infectious Irritable Bowel Syndrome (PI-IBS)

PI-IBS is a well-recognised subtype of IBS that develops 

, such as food poisoning, viral gastroenteritis, or bacterial gastroenteritis. Even once the infection has resolved, the gut may take months — and sometimes longer — to regain its full function.

The infection can disrupt the balance of bacteria living in the gut.
This shift may affect digestion, immune regulation, and gut sensitivity.

Even after the acute illness settles, the gut lining may remain mildly inflamed.
This can lead to increased sensitivity to normal digestive movements — often felt as bloating, pain or cramping.

Commonly called “leaky gut,” this temporary change may allow particles to interact with the immune system more readily, contributing to lingering symptoms.

Food may move too quickly or too slowly through the digestive tract.
This can result in 

After infection, the nerves controlling the digestive system may become more reactive, amplifying normal sensations.

Symptoms can vary but frequently include:

Constipation, or alternating constipation and diarrhoea

Diagnosis: When to See a Gastroenterologist

A clear history of a recent gut infection

Persistent IBS-type symptoms after recovery

Your gastroenterologist may order stool tests, blood tests, or imaging depending on your history.

 such as unintentional weight loss, bleeding, persistent fever, or night-time symptoms.

Although PI-IBS can be challenging, it is a 

, and many people recover over time with the right support. Early assessment and a personalised management plan can significantly reduce symptoms and restore quality of life.

If you suspect you have PI-IBS, consult with a gastroenterologist for an accurate diagnosis and a treatment plan tailored to your digestive system’s recovery.

We provide personalised care and support for PI-IBS.

Post-Infectious Irritable Bowel Syndrome: Why Symptoms Persist After a Gut Infection

Irritable Bowel Syndrome (IBS) can cause chronic abdominal pain, bloating, gas, and changes in bowel habits. For many patients, diet plays a major role in symptom flare-ups. One of the most researched and effective dietary approaches for IBS is the Low FODMAP Diet.

FODMAPs are a group of short-chain carbohydrates found in many everyday foods. They can be poorly absorbed in the small intestine, where they draw in water and ferment in the colon—often leading to IBS symptoms.

These include foods containing certain fibres, lactose, excess fructose, and sugar alcohols.

The Low FODMAP Diet is not a long-term diet. It happens in three structured phases:

You temporarily reduce high-FODMAP foods to calm the gut and reduce symptoms.

You reintroduce FODMAP groups one at a time to identify personal triggers.

You return to the widest and most enjoyable diet possible—minimising only the FODMAPs that cause symptoms for you.

This step ensures nutritional balance and long-term sustainability.

60–80% of IBS patients experience significant symptom relief

- Bloating and abdominal pain often improve within 2–3 weeks

- Patients regain confidence in food choices and symptom control

The Low FODMAP Diet may help if you have:

**Important:** The diet should be supervised by a gastroenterologist or a registered dietitian trained in FODMAP therapy to avoid nutritional deficiencies and unnecessary restrictions.

You should meet with a specialist if you:

Have persistent symptoms despite dietary changes

Need help developing a safe, balanced meal plan

We provide personalised guidance, structured reintroduction plans, and support throughout your IBS management.

Low FODMAP Diet

Menopause is a major hormonal transition, and while most people associate it with hot flashes and mood changes, the digestive system is often affected as well. Many women notice new or worsening symptoms around this time—bloating, constipation, indigestion, or unpredictable bowel habits.

These changes are real, common, and medically understood. As gastroenterologists, we now recognise that menopause and gut health are strongly interconnected through the microbiome, digestion, and hormonal balance.

1. Declining oestrogen alters the gut microbiome

Oestrogen plays a role in maintaining the diversity and stability of the gut bacteria.
During perimenopause and menopause:

“Beneficial” bacteria populations may drop

Inflammation-associated bacteria may increase

These shifts can contribute to bloating, irregularity, and increased gut sensitivity.

Lower oestrogen and progesterone levels can 

slow the movement of food through the intestines

Heavier or uncomfortable digestion after meals

For others, the opposite may occur—episodes of loose stools or urgency during hormonal fluctuations.

The gut–brain axis becomes more reactive during hormonal transitions.
This may heighten the perception of normal gas or motility, amplifying:

4. Impact on metabolism and abdominal weight

Changes in the microbiome and slower motility can contribute to metabolic shifts, increasing abdominal fat storage and insulin resistance, even without major dietary changes.

Common Digestive Symptoms During Menopause

IBS symptoms worsening or newly developing

There is a group of gut bacteria involved in metabolising oestrogen.
When the microbiome changes during menopause, this group of bacteria can shift as well, affecting:

This is one reason why gut health is increasingly recognised as an important part of menopause care.

Many women with IBS report fluctuations in symptoms around perimenopause.
The reasons include:

Women who have never had IBS may also develop IBS-like symptoms during this time.

A gastroenterological assessment can help distinguish functional symptoms from other conditions that become more common with age, such as bile acid diarrhoea, coeliac disease, diverticular disease, or microscopic colitis.

 from vegetables, fruits, legumes, whole grains, flaxseed, and chia seeds. Fibre supports motility, feeds beneficial bacteria, and reduces bloating over time.

Daily intake of yogurt, kefir, sauerkraut, kimchi, or miso may enhance microbial diversity.

Essential for bowel regularity and optimal digestion.

Movement improves gut motility and reduces bloating.

Meditation, yoga, and paced breathing can calm the gut–brain axis and reduce symptom flares.

Depending on symptoms, a gastroenterologist may recommend:

Low-FODMAP diet (short-term, dietitian-guided)

Hormone replacement therapy may indirectly support gut health by stabilising hormone fluctuations. Your doctor can advise whether it is suitable.

Symptoms significantly affect your daily life

Bowel habits have changed suddenly or unexpectedly

You have persistent bloating, abdominal pain, or reflux

Symptoms are not responding to dietary changes

You notice red-flag signs such as weight loss, bleeding, or night-time symptoms

Menopause is a natural life stage, but the digestive changes that accompany it can be disruptive.
Understanding the connection between hormones and gut function empowers women to take control of their digestive health, improve comfort, and maintain quality of life.

If you’re experiencing new or worsening gut symptoms around menopause, a gastroenterology assessment can help identify the underlying cause and guide effective treatment.

We offer a personalised assessment can help identify the cause of your symptoms and provide a management plan tailored to menopause-related digestive changes.

Menopause and Gut Health: What Every Woman Should Know

Recent update to bowel cancer screening age

As of July 1, 2024, the National Bowel Cancer Screening Program lowered the eligibility age for free, at-home faecal occult blood testing (FOBT) from 50 to 45 years.

As part of the National Bowel Cancer Screening Program, eligible patients receive a free at-home FOBT.

A positive FOBT result indicates the presence of hidden blood in the stool, which can be a sign of various gastrointestinal conditions. It's important to note that whilst FOBT is a useful screening tool, it does not directly detect colorectal cancer but suggests the need for further investigation.

Potential Causes of Positive FOBT Results:

 A positive FOBT can be indicative of colorectal cancer, though not all positive results are due to cancer.

 Benign growths and precancerous growths can bleed leading to positive FOBT results.

 Conditions like diverticulosis can cause bleeding in the colon, resulting in a positive test.

 Swollen blood vessels in the rectum or anus can bleed, leading to positive results.

 Conditions like ulcerative colitis or Crohn's disease can cause intestinal bleeding.

 Abnormal blood vessels in the colon can lead to bleeding detected by FOBT.

If a FOBT result is positive, a colonoscopy is typically recommended to identify the source of bleeding. This procedure helps in diagnosing the underlying cause of the bleeding, facilitating early intervention, and improving patient outcomes.

- being booked directly for a colonoscopy with a valid referral for their General Practitioner without the need for a prior consultation with a gastroenterologist. 

You can make an inquiry through our website or upload your referral through our website.

Recent updates to colorectal cancer screening guidelines in Australia have introduced significant changes to the recommended starting age for FOBT. As of July 1, 2024, the National Bowel Cancer Screening Program lowered the eligibility age for free, at-home FOBT from 50 to 45 years. This means that individuals aged 45 to 74 are now encouraged to participate in biennial (every two years) screening

 The recommended age to begin FOBT screening is now 45 years for individuals at average risk of bowel cancer

 Eligible individuals should complete the free, at-home FOBT every two years.

 Those aged 50 to 74 will continue to receive test kits by mail. Individuals aged 45 to 49 can request their first kit online or by calling the National Cancer Screening Register

These changes aim to enhance early detection of bowel cancer, improving treatment outcomes. It's important to note that individuals with a family history of bowel cancer or other risk factors may need to start screening earlier or undergo more frequent testing. Consulting with a healthcare provider can help determine the most appropriate screening schedule based on personal risk factors.

For further information regarding the free bowel screening test or how to do the test, please visit:

https://www.health.gov.au/our-work/national-bowel-cancer-screening-program/about-the-national-bowel-cancer-screening-program

Free at-home bowel cancer screening test

Adequate bowel preparation is a critical component of ensuring a successful colonoscopy, as it provides the clearest view of the colon and rectum, allowing the physician to detect potential abnormalities such as polyps, tumours, or inflammation. To achieve the best possible outcomes, it is essential to follow the prescribed preparation guidelines precisely.

Below is a comprehensive guide to ensure effective bowel preparation.

Adhere to Your Physician’s Instructions

Your gastroenterologist will provide personalised instructions for bowel preparation based on the type of solution prescribed. It is paramount to follow these directions carefully, as the effectiveness of the procedure largely depends on the thoroughness of bowel cleansing.

Dietary Adjustments Prior to the Procedure

: You may be instructed to reduce fibre intake to avoid residual material in the colon. High-fibre foods, such as whole grains, nuts, seeds, fruits, and vegetables, should be limited during this period.

Water, clear broths, and clear fruit juices (e.g., apple or white grape juice)

Plain gelatin (without artificial colours)

Avoid solid foods, dairy, alcohol, and beverages with pulp or artificial colouring, particularly red or purple, as they can interfere with the procedure.

Laxative Preparation: Key to Colon Cleansing

Your gastroenterologist will typically prescribe a bowel prep solution, designed to induce frequent bowel movements and thoroughly clear the colon. Important tips include:

: You will likely be asked to take the solution in two phases—half the dose the evening before your colonoscopy and the remaining portion several hours before the procedure. Ensure you follow the timing precisely to maximize effectiveness.

: In addition to the bowel prep solution, drinking ample 

 is essential. This helps prevent dehydration and ensures the solution works effectively. Continue to hydrate well throughout the preparation phase.

As the laxative solution begins to work, you will experience frequent and urgent bowel movements. It is crucial to stay near a bathroom during this phase, as the colon empties rapidly. Have items such as wet wipes and soothing ointments on hand to minimise discomfort.

Adequate hydration is essential during bowel prep, as the process can lead to fluid loss. Aim to drink plenty of 

, but avoid drinks with dyes or pulp. Staying well-hydrated will help alleviate potential side effects like dizziness or fatigue and support the effectiveness of the laxatives.

Discuss any regular medications with your gastroenterologist. Certain medications, such as those for diabetes, hypertension, or heart disease, may need to be adjusted before the procedure. Some medications may need to be temporarily suspended, particularly those that affect blood clotting or gastrointestinal motility. Always consult your healthcare provider regarding the timing of your medications during the prep period.

 and any liquids that are not part of the clear liquid diet.

, as it can lead to dehydration and interact with your medications.

Refrain from drinking beverages with artificial colours (e.g., red, purple, or blue) as these can mimic blood during the colonoscopy, potentially complicating interpretation of the results.

While bowel preparation is generally well-tolerated, some individuals may experience nausea, bloating, or mild abdominal cramping. These symptoms are typically temporary but can be distressing. If you have trouble tolerating the solution, or experience excessive discomfort, contact your gastroenterologist for guidance.

 prior to your procedure. This means no food or drinks (except for clear liquids) should be consumed within this period. This ensures that your stomach is empty, reducing the risk of aspiration during sedation and making the procedure safer and more effective.

After the colonoscopy, you will be monitored as the effects of sedation wear off. Due to the sedative medications used, you will not be able to drive or operate machinery, so it is important to arrange for transportation home. You may feel slightly bloated or experience mild cramping after the procedure, but these symptoms usually resolve within a few hours.

Proper bowel preparation is essential for a high-quality colonoscopy. By following your doctor’s instructions for diet, medication, and the bowel prep solution, you will help ensure that the procedure is as effective as possible. The clearer your colon is, the more likely it is that any potential issues—such as colorectal cancer, polyps, or inflammatory conditions—will be detected early, improving outcomes and enabling timely intervention.

If you have any questions or concerns about the bowel preparation process, please reach out to your gastroenterologist.

How to get the best out of your bowel preparation for colonoscopy

Maintaining optimal gut health is crucial for overall well-being, as the digestive system plays a vital role in nutrient absorption, immune function, and even mental health. In this blog post, we will explore what gut health is, why it matters, and practical tips to promote a healthy digestive system.

Gut health refers to the balance and function of the gastrointestinal (GI) tract, which includes the stomach, small intestine, and large intestine (colon). A healthy gut is characterised by a diverse community of beneficial bacteria (microbiota), effective digestion and absorption of nutrients, a robust immune system, and minimal inflammation or gastrointestinal symptoms.

Nutrient Absorption: Proper digestion allows the body to absorb essential nutrients from food efficiently.

Immune System Support: The gut microbiota plays a crucial role in immune function, helping to protect against infections and regulate inflammation.

Mental Health: Emerging research suggests a link between gut health and mental well-being, influencing mood and cognitive function.

Overall Well-Being: A healthy gut can reduce the risk of digestive disorders such as irritable bowel syndrome (IBS).

Eat a Balanced Diet: Include a variety of fibre-rich foods (fruits, vegetables, whole grains), probiotics and prebiotics (garlic, onions, bananas) to support a diverse microbiota.

Stay Hydrated: Drinking plenty of water helps maintain digestive health and prevents constipation.

Manage Stress: Chronic stress can impact gut health. Practise relaxation techniques such as deep breathing, meditation, or yoga.

Exercise Regularly: Physical activity supports healthy digestion and helps maintain a balanced microbiome.

Limit Unhealthy Habits: Reduce intake of processed foods, sugary snacks, and excessive alcohol, which can disrupt gut bacteria balance.

Get Enough Sleep: Aim for 7-8 hours of quality sleep each night to support overall health, including digestive function.

Avoid Smoking: Smoking can harm the digestive system

If you experience persistent digestive symptoms such as abdominal pain, bloating, diarrhoea, or constipation, it's essential to consult with a gastroenterologist. They can evaluate your symptoms, perform diagnostic tests if needed, and recommend appropriate treatment to address any underlying gastrointestinal issues.

Prioritising gut health through healthy lifestyle choices can have profound benefits for your overall well-being. By nourishing your gut with a balanced diet, managing stress, and adopting healthy habits, you can support a healthy digestive system and enjoy a better quality of life.

For expert guidance on maintaining gut health or managing digestive concerns, contact us. We provide personalised care and support for your gastrointestinal health needs.

For Patients

Blog for Patients

Understanding Small Intestinal Bacterial Overgrowth (SIBO)

Post-Infectious Irritable Bowel Syndrome: Why Symptoms Persist After a Gut Infection

Low FODMAP Diet

Menopause and Gut Health: What Every Woman Should Know

Free at-home bowel cancer screening test

How to get the best out of your bowel preparation for colonoscopy

Understanding Gut Health: Tips for a Healthy Digestive System

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