Pediatric SIBO · Functional medicine for children

When the gut feels reactive to everything.

SIBO stands for small intestinal bacterial overgrowth. It means bacteria are growing in the small intestine in a way that can create gas, bloating, pain, reflux, nausea, constipation, diarrhea, food reactions, and a sense that almost every meal causes symptoms.

In children, SIBO can be missed because the symptoms look like ordinary constipation, IBS, reflux, picky eating, anxiety stomachaches, or food intolerance.

Symptoms that raise the question.

SIBO may be worth considering when a child has:

• Bloating or belly distention after meals.
• Gas, belching, nausea, or reflux.
• Constipation, diarrhea, or alternating stool patterns.
• Food sensitivity that seems to keep expanding.
• Symptoms that flare with certain carbohydrates or high-fermentation foods.
• Prior antibiotic use, stomach bug, motility issues, or long-standing constipation.
• Eczema, acne, headaches, anxiety, or fatigue alongside gut symptoms.

These symptoms do not prove SIBO. They tell us the gut needs a more specific map.

Testing and interpretation.

SIBO is commonly evaluated with hydrogen and methane breath testing. Kim’s source materials list SIBO testing through Genova when appropriate. Breath testing can be useful, but it needs careful preparation and interpretation. Constipation, transit time, recent antibiotics, diet, and testing technique can all affect results.

Sometimes stool testing is the better first step. Sometimes a pediatric GI referral matters first. The right test depends on the child.

Why constipation matters.

Motility is central. When the gut moves too slowly, bacteria have more opportunity to ferment in the wrong place. Methane patterns are especially associated with constipation. That is why SIBO care often needs to address stooling, hydration, minerals, meal routine, nervous-system regulation, and the broader microbiome.

How Calm Wellness approaches suspected SIBO.

We start with the story: stool pattern, bloating timing, food reactions, reflux, medications, antibiotics, illness history, stress, sleep, growth, prior labs, and what has already been tried.

Testing may include breath testing, stool testing, food sensitivity work, nutrient labs, or collaboration with pediatric GI. The plan may include food changes, motility support, gut lining support, targeted antimicrobials when appropriate, probiotics chosen carefully, and follow-up to prevent the pattern from returning.

Where to start.

Many suspected SIBO cases fit under Pediatric Gut Health or Chronic Constipation. If SIBO is part of a broader pattern with mold, Lyme, PANS/PANDAS, autoimmune clues, or multi-system symptoms, 4-Month Concierge may be a better fit than a short reset.