Do You Have Hot Belly?

I was lucky. During my career in law enforcement I enacted a “no fart rule” and had 100% compliance (with people, not K9’s). If you rode in my car, I would promptly pull over if you had to expel what I coined “ass atoms”.  And although I understood that most guys have fun trying to out-gas each other in confined spaces. For us girls, its no Bueno.

If you want to scientifically blame someone else for your 1-man salute, read on.

There are several reasons for chronic “hot belly” (credit: Sgt. Smithers, 1998) , a.k.a. gas, heartburn, bloating, blow-outs and belching. But I’m going to focus on the most common one called ‘Small Intestinal Bacterial Overgrowth’ or SIBO.  Which is an accumulation of bacteria in the small intestine.  Let me oversimplify this.


Your mouth, esophagus, stomach, small intestine and colon are all part of your “gut”. Although we are full of bacteria, the vast majority of healthy bacteria is in our large intestine (colon). Take probiotics? This is where it goes.

Your stomach (sterile) breaks food down, your small intestine (very few bacteria) absorbs the liquified nutrients and the colon ferments carbohydrates using abundant healthy bacteria. The colon also absorbs water and electrolytes. What’s left is poop that goes out the rectum. *Fun fact: your poop gets its brown color from ‘bilirubin’, a byproduct of red blood cell breakdown and from bile salts.


In SIBO, the bacteria in your colon overgrow, invade your small intestine and turn rogue. As a result, the normal digestion and absorption of food that normally occurs in your small intestine is derailed. And like a wild frat party, the lining of your small intestine can get damaged, causing a leaky lining.

Because your intestinal lining is now damaged, some nutrients can’t make it through for absorption. The rogue bacteria love this because it’s more food for them to repopulate.  After stuffing themselves, they produce gas which you then get to enjoy as belching, farting, bloating, constipation, diarrhea and abdominal pain.

Yes. You can literally blame these bacteria for your gas.

Bacteria can also enter the bloodstream, which can cause chronic fatigue and body pain.  They also give off acids that, in high amounts, can cause brain issues.

*Here is an extensive list of other conditions connected to SIBO (cause/effect/coexisting) like weight problems and depression. And an extensive list of symptoms. It’s a big deal shared by a lot of people.


If researchers could nail down the cause, we could prevent this. Unfortunately they’re still trying to figure out what definitively causes SIBO. But there are a few strong correlations.

Your body’s own natural protection to kill bacteria may have failed like HCL (the acid in your stomach), bile, enzymes and immune system. Structurally there may be an obstruction (tumor) or change in gut peristalsis (the waves that move food forward). Lifestyle factors are a biggie too. These include S.A.D. diet, chronic use of antibiotics or pain relievers, and food poisoning.


The most commonly used test is called the hydrogen breath test.  Remember when I said you could blame bacteria for your love puffs? It’s because they actually emit two kids of gas, hydrogen or methane.  This gas gets funneled through your lungs and then can be tested.


Dr. Allison Siebecker, a specialist in SIBO, created a symptom relief guide.  Handy to have if you’re going on a date or riding a two-man car for the next 12 hours. The one I like is Activated Charcoal ( which is famously known for adsorbing toxins and bacteria. It does the same for gas. If you live life dangerously, like eating off taco trucks, it’s good to have this handy anyway.


It’s a pretty simple algorithm: reduce the bacteria, heal the intestinal lining and prevent relapse. Unfortunately, unless you know what initially caused your SIBO, it’s hard to permanently cure. Let’s break this down.

Bacteria can be eliminated by 4 things: antibiotics, herbal antibiotics, diet and an “elemental diet”.  I won’t bore you with what antibiotics do (kill bacteria).

An anti-bacteria diet is normally used in conjunction with antibiotics.  A common approach is called a Low FODMAP diet.  It removes highly fermentable foods like apples, potatoes, garlic and mushrooms from your diet since these are the ones bacteria love the most.

Colorful FODMAP cheat sheet here.

An elemental diet is a shake that you drink for 1-2 weeks. And that’s the bulk, if not all, of your meals. It’s hard to do but very effective. The shake is just nutrients plus macros (calories) broken down into their basic form so digestion is minimal and it starves the bacteria.

*Something to keep in mind. SIBO treatment is not an overnight fix. It can take months (or years) to correct. If you suspect you have SIBO, please talk to your physician as diet alone doesn’t usually fix the problem.


You’ve probably heard of ‘Irritable Bowel Syndrome’ or IBS. The main symptoms of SIBO overlap those of IBS like gas, belching, diarrhea, abdominal pain and constipation. It’s estimated 20% of the US population is suffering from IBS (that’s about 60 million people). Of this 20%, it’s also estimated SIBO is the underlying cause of IBS in about 60% of them, possibly even as high as 84%. So in the conventional world, SIBO can be easily mistaken for IBS.


*Disclaimer: This statement has not been evaluated by the Food and Drug Administration.This product is not intended to diagnose, treat, cure, or prevent any disease.

*The medical and/or nutritional information on this site is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay seeking it because of something you have read on this Web site.

*Heads Up! Some of my posts contain affiliate links. All that means is you don’t pay a penny more but I get a small commission to keep writing articles for you.


Pimentel M, Chow EJ, Lin HC. Normalization of lactulose breath testing correlates with symptom improvement in irritable bowel syndrome. a double-blind, randomized, placebo-controlled study. Am J Gastroenterol. 2003;98(2):412-9.

Lin HC. Small intestinal bacterial overgrowth: a framework for understanding irritable bowel syndrome. JAMA. 2004;292(7):852-8.

Canny GO, Mccormick BA. Bacteria in the intestine, helpful residents or enemies from within?. Infect Immun. 2008;76(8):3360-73.

Rezaie A, Pimentel M, Rao SS. How to Test and Treat Small Intestinal Bacterial Overgrowth: an Evidence-Based Approach. Curr Gastroenterol Rep. 2016;18(2):8.

Naka K, Watarai S, Tana, et al. Adsorption effect of activated charcoal on enterohemorrhagic Escherichia coli. J Vet Med Sci. 2001;63(3):281-5

Jain NK, Patel VP, Pitchumoni CS. Efficacy of activated charcoal in reducing intestinal gas: a double-blind clinical trial. Am J Gastroenterol. 1986;81(7):532-5.

(just for fun)

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