Gut Health

Treating SIBO and IBS with the 5R’s Framework


Gastrointestinal issues are one of the main reasons why patients come into a doctor’s office. Certainly, irritable bowel syndrome (IBS) is the primary gastrointestinal diagnosis. Despite being a common disease, IBS’s etiology is still unknown due to the heterogeneity of its symptoms. The new hypothesis points to the fact that underlying infectious illness may cause IBS, and the bacteria overgrowth in the small intestine (SIBO) could explain the apparition of symptoms.

Observation concludes that the incidence of new-onset IBS symptoms is commonly reported after acute infectious gastroenteritis. In addition, breath tests have been able to determine the presence of SIBO in patients with IBS. Furthermore, after treatment, a reduction of SIBO resulted in an improvement of IBS’s symptomatology. 

IBS symptomatology:

  • Abdominal pain.
  • Bloating.
  • Altered bowel movements.
  • Constipation in women.
  • Diarrhea in men.

Furthermore, these symptoms are usually paired with secondary complications due to the connection between the gut and the body’s systems.

Neural signaling and IBS

The presence of IBS can cause detrimental symptomatology in the nervous system. Issues like autonomic dysfunction, sensitization of primary afferents, central pain amplification, and visceral hypersensitivity are complications attributed to IBS.

Immune dysregulation

Patients with IBS have elevated proinflammatory cytokine levels, intestinal permeability, and mast cells in the mucosa. However, the main reason is not yet elucidated since a previous infection can cause these mechanisms.


Small intestinal bacterial overgrowth (IBS) is commonly found in patients with IBS. Indeed, the bloating symptoms of IBS are associated with the increase of fermentation and gas production by intestinal bacteria. In addition, the risk of developing IBS rises after suffering from infectious gastroenteritis due to a disruption of colonizing bacteria.

How to treat SIBO and IBS? 5R’s Framework

Orthomolecular medicine seeks to treat upstream and deal with the root cause of disease. Restoring gastrointestinal health and treating the gut are the main focal points to treat SIBO and IBS. Therefore, what seems fair is to develop a treatment plan that focuses on removing the nocive gastrointestinal environment and replacing all the gastric secretions. Furthermore, the reinoculation of beneficial bacteria with probiotics and prebiotics is vital to repair and rebalance well-being.

5R’s Framework

  1. Remove: Eliminating stressors that might affect the GI environment may include the use of an elimination diet or taking medication to remove pathogenic bacteria.
  2. Replace digestive secretions: bringing back proper digestive function may lead to the use of digestive enzymes, promote adequate hydrochloric acid production and bile acid secretion.
  3. Reinoculate: Replenishing the beneficial bacteria may need the supplementation of probiotics and prebiotics.
  4. Repair: detecting and treating the gut lining is crucial for the absorption of essential nutrients. Therefore, the proper nourishment of this tissue might benefit from L-glutamine supplementation to maintain the rapid enterocyte turnover.
  5. Rebalance: having good lifestyle choices that promote stress relief and balance can promote a sense of well-being. Reducing stress is a crucial part of gut health.

Disease progression is something that we can modulate by resetting our gut health. Resetting is the first step. However, to promote better gut health, we need to provide our beneficial bacteria with the proper prebiotics to flourish. Our nutritional decisions influence our microbiome variety and balance. – Ana Paola Rodríguez Arciniega, MS


Thompson, John Richard. “Is irritable bowel syndrome an infectious disease?.” World journal of gastroenterology vol. 22,4 (2016): 1331-4. doi:10.3748/wjg.v22.i4.1331

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The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional, licensed physician, and not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the musculoskeletal system’s injuries or disorders. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and issues that relate to and support, directly or indirectly, our clinical scope of practice.* 

Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. Read More.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, CTG*


phone: 915-850-0900

Licensed in Texas & New Mexico


Dr. Alex Jimenez

Specialties: Stopping the PAIN! We Specialize in Treating Severe Sciatica, Neck-Back Pain, Whiplash, Headaches, Knee Injuries, Sports Injuries, Dizziness, Poor Sleep, Arthritis. We use advanced proven Integrative Wellness therapies focused on optimal mobility, posture control, health Instruction, functional fitness, Nutrition, and structural conditioning. In addition, we use effective "Patient Focused Diet Plans," Specialized Chiropractic Techniques, Mobility-Agility Training, Cross-Fit Protocols, and the Premier "PUSHasRx Functional Fitness System" to treat patients suffering from various injuries and health problems. Ultimately, I am here to serve my patients and community as a Chiropractor, passionately restoring functional life and facilitating living through increased mobility. So join us and make a living with mobility a way of life. Blessings.

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