Dr. Yousef Sadat Nejad, ND

Dr. Yousef Sadat Nejad, ND Naturopathic Doctor 🩺
Lifestyle Medicine, Prevention and Nutritional Science Fanatic

When you don’t feed your gut bacteria enough fibre, they can start eating YOU instead. 👇⠀Here is a genuinely wild fact a...
09/05/2026

When you don’t feed your gut bacteria enough fibre, they can start eating YOU instead. 👇

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Here is a genuinely wild fact about your gut.

The bacteria living in your intestines have to eat something. And new research shows that when they are not getting enough dietary fibre, they turn to your gut’s protective mucus lining as a backup food source.

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🛡️ WHY THAT MATTERS

That mucus layer is your intestinal wall’s first line of defence. It is part of what keeps bacteria where they belong and off the gut wall itself.

When fibre runs low, microbes begin degrading that lining, and fibre suppresses this process (Ludwig Institute, 2026).

A thinner, patchier barrier is a bigger deal than it sounds, especially in a compromised gut.

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⚠️ THIS IS WHERE IT GETS NUANCED

If you have a compromised or flare-prone gut, this cuts both ways.

In conditions like SIBO, IBS, IBD, and leaky gut (increased intestinal permeability), the barrier is already under strain, so protecting the mucus lining matters even more.

But here is the catch: in these same conditions, aggressively loading up on fermentable fibre can feed an overgrowth or trigger a flare. More fibre is not automatically the fix, and it can backfire.

This is exactly why fibre changes in SIBO, IBS, and IBD should be sequenced and personalised with your care team, not treated as a blanket rule.

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🌿 WHAT “FEEDING YOUR GUT” LOOKS LIKE

For most healthy guts, variety is the goal: a range of plant fibres from whole grains, legumes, vegetables, and fruit gives your microbes what they need instead of your mucus lining.

This is part of the reasoning behind the “fibremaxxing” trend right now, and it lines up with what microbiome researchers have said for years: feed your microbes, or they will find their own food.

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If your gut is compromised, get the timing and type right first.

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Save this and share it with someone doing everything “right” for their gut.

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Educational only, not medical advice.

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09/04/2026

You switched to decaf hoping your gut would settle. Nothing changed.

Here is likely why. 👇

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Everyone blames caffeine. But caffeine is only one of several ways coffee affects your digestive tract, and decaffeination only addresses that one.

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☕ WHAT DECAF DOESN’T TOUCH

Coffee also stimulates gastrin release and gastric acid production, with or without caffeine.

And it is one of the more potent triggers of the gastrocolic reflex, the signal that increases colon activity after you eat or drink. That is the urgency so many people feel right after a cup.

Neither of those effects depends on caffeine being present.

Which means for many people, decaf produces much the same reaction as regular. You changed the wrong variable.

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✅ WHAT TENDS TO HELP MORE THAN DECAF

→ Drink coffee with food rather than on an empty stomach. This blunts the acid and reflex response considerably.
→ Delay your first coffee until about an hour after waking, rather than letting it hit an empty stomach first thing.
→ Reduce volume rather than eliminating entirely. A smaller cup is often tolerated when a large one is not.
→ Notice whether it is coffee specifically or hot drinks generally, since temperature also stimulates motility.

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⚠️ ONE EXCEPTION

If you have active reflux or GERD, the “with food” advice can shift, so that one is worth checking with your provider rather than assuming.

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None of this means you have to give up coffee.

It means the variable worth adjusting is usually context, not caffeine content.

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Save this if decaf never made the difference you expected.

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Your digestive system essentially has an off switch.And chronic stress holds it down. 👇⠀Here is something most SIBO advi...
09/03/2026

Your digestive system essentially has an off switch.

And chronic stress holds it down. 👇

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Here is something most SIBO advice skips entirely.

Digestion operates under the parasympathetic branch of your nervous system. “Rest and digest” is not a wellness slogan, it is a fairly literal description of the only state in which the machinery actually works.

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🧠 ONE NERVE RUNS ALMOST ALL OF IT

The vagus nerve carries most of that signalling.

It drives your gastric acid, your pancreatic enzymes, your bile flow, and the clearing wave that sweeps the small intestine between meals.

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⚠️ WHY STRESS FEEDS SIBO

This is why chronic stress is not just an unpleasant add-on to SIBO. It directly impairs the mechanism that keeps the small intestine clear of bacteria.

Low vagal tone means reduced motility, reduced acid, and reduced clearance. Three of the main permissive conditions for overgrowth, all at once.

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🔄 WHY YOU RELAPSE DESPITE DOING EVERYTHING RIGHT

Some people get the diet right, get the antimicrobials right, and still relapse.

The structural and biochemical work was correct. The system running it was never supported.

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🌿 WHAT ACTUALLY HELPS (in order of value)

→ Slow exhales before eating. Extending the exhale relative to the inhale measurably shifts autonomic balance. Two to three minutes is enough.
→ Eat sitting down, no screen, no keyboard. Eating while working keeps you in the wrong state the whole meal.
→ A short walk after eating instead of straight back to the desk.
→ Consistent sleep, since autonomic regulation deteriorates fast with sleep debt.
→ Genuinely address chronic stressors where you can, not just their symptoms.

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Ten quiet minutes before a meal does more for many people than another supplement.

It is also free, which tends to make it undervalued.

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Save this if your SIBO keeps returning despite doing everything right.

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09/02/2026

If food seems to sit in your stomach for hours, and your SIBO keeps coming back, these two things may be connected. 👇

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It is called gastroparesis, delayed gastric emptying with no physical blockage. Food stays in the stomach far longer than it should.

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🩺 HOW IT SHOWS UP

→ Feeling full after just a few bites
→ Nausea
→ Bloating high in the abdomen rather than low
→ In more pronounced cases, vomiting undigested food hours after eating

In people with diabetes, it often shows up as unpredictable blood sugar, because absorption timing becomes erratic.

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🔗 THE SIBO CONNECTION

Delayed gastric emptying disrupts the timing of the clearing wave downstream in the small intestine.

And the same nerve dysfunction that slows the stomach, whether from diabetes, vagus nerve injury, or another cause, often slows small intestinal motility too.

That is why gastroparesis and SIBO co-occur far more often than chance would suggest.

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⚠️ WHY TREATING SIBO ALONE FALLS SHORT

If gastroparesis is driving the motility problem, clearing the overgrowth does not change what caused it.

In that situation, recurrence is not surprising. It is predictable.

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👤 WHO IS AT HIGHER RISK

Long-standing diabetes, past vagus nerve injury or upper GI surgery, opioids or GLP-1 medications, and connective tissue disorders, though in a substantial number no cause is found.

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🧪 HOW IT IS ASSESSED

A gastric emptying study, most commonly scintigraphy, arranged through a gastroenterologist. This is genuinely coordinated care, not something to manage in isolation.

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But there is a lot you can do alongside that to support emptying naturally, meal size and texture, positioning after meals, blood sugar support, and gentle options like ginger.

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Want the connection explained in full, plus the supportive strategies that help?

Comment “GASTRO” and I will send it to you.

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If your bloating sits high, comes with early fullness, and has resisted SIBO treatment, raise this with your physician.

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Alcohol advice for IBS does not transfer neatly to SIBO.The mechanisms are different. 👇⠀In IBS, the main variable is the...
09/01/2026

Alcohol advice for IBS does not transfer neatly to SIBO.

The mechanisms are different. 👇

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In IBS, the main variable is the fermentable carbohydrate content of the drink, which is why choice matters so much. B**r behaves very differently from gin.

In SIBO, three effects apply to the ethanol itself, largely regardless of what you are drinking.

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🌊 THE MOTILITY EFFECT

Alcohol impairs the clearing wave that sweeps the small intestine during fasted periods.

Since impaired clearance is central to both developing and maintaining SIBO, this is the most significant of the three.

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🧱 THE BARRIER EFFECT

Alcohol increases intestinal permeability, and acetaldehyde, its principal metabolite, is directly irritating to the intestinal lining.

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🔥 THE SUBSTRATE EFFECT

Alcohol is fermentable. In a small intestine already carrying an excess bacterial population, that means adding fuel exactly where it is least useful.

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🥃 WHY CLEAR SPIRITS AREN’T A FIX

Switching to clear spirits is genuinely helpful advice for many people with IBS.

In SIBO it often produces less benefit than expected, because these three effects apply to the ethanol itself, not just the carbs.

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📅 THE PRACTICAL VERSION

During active treatment, most protocols advise avoiding alcohol through the antimicrobial phase and early recovery. This is a defined window, not a permanent position.

Afterwards, many people tolerate moderate alcohol reasonably well once overgrowth has been addressed and motility is supported.

Reintroduce gradually rather than all at once, and pay attention to timing:

→ Not with meals if you are working on meal spacing, since it interrupts the fasting window
→ Not on consecutive days during recovery
→ Not at all during antimicrobial treatment

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Save this if alcohol advice for your gut has never quite added up.

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08/31/2026

If gut health advice has consistently made you worse, there is a good chance you have been treating the wrong part of your gut. 👇

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Two completely different problems produce almost identical symptoms, and they call for nearly opposite approaches. Telling them apart matters more than almost anything else in this space.

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📍 THE DISTINCTION

SIBO is an excess of bacteria in the small intestine, where the population should be low.

Colonic dysbiosis is an altered bacterial community in the large intestine, where the population should be large.

Different location. Different problem. Different treatment.

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⏱️ TIMING IS YOUR BIGGEST CLUE

Small intestinal fermentation (SIBO) usually causes bloating within 1 to 3 hours of eating, because food arrives there quickly.

Colonic fermentation usually shows up 4 to 8 hours later, or overnight, because food takes much longer to reach the colon.

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⚖️ WHY IT CHANGES TREATMENT

SIBO treatment aims to REDUCE bacteria in the small intestine.

Colonic dysbiosis treatment often does the opposite, INCREASING diversity and fermentable fibre.

Apply the fibre-heavy approach to someone with active SIBO, and you reliably make them worse. This is a common reason people say gut health advice backfired on them.

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🔄 THE COMPLICATION

Plenty of people have both.

That is why sequencing matters: treat the small intestinal overgrowth first, then rebuild colonic diversity. Doing it in reverse frequently fails.

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🧪 HOW THEY ARE TESTED

They are confirmed by two different tests.

→ SIBO is assessed with a breath test
→ Colonic dysbiosis is assessed with a comprehensive stool analysis

Different location, different test.

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Save this. If gut health advice has consistently made you feel worse, this distinction is very often the reason.

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You have treated your SIBO three or four times. It keeps coming back.And nobody has asked about your surgery. 👇⠀If you h...
08/27/2026

You have treated your SIBO three or four times. It keeps coming back.

And nobody has asked about your surgery. 👇

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If you have had abdominal or pelvic surgery and SIBO that keeps returning despite good treatment, there may be a structural explanation nobody has raised with you.

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🩹 WHAT ADHESIONS ARE

Bands of fibrous scar tissue that form between abdominal structures after surgery, infection, endometriosis, or significant inflammation.

They are a normal part of healing. Most people who have had abdominal surgery have some.

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🔄 WHY THEY DRIVE SIBO

Adhesions can tether loops of bowel to each other or to the abdominal wall, creating kinks, angulation, or areas of narrowing.

Content moves through those segments more slowly.

And slower transit is the central permissive condition for bacterial overgrowth.

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👤 WHO THIS MAY APPLY TO

Anyone with prior abdominal or pelvic surgery, including caesarean section, appendectomy, hernia repair, gallbladder removal, and laparoscopy.

Also relevant for endometriosis, and for anyone with a history of peritonitis or serious intra-abdominal infection.

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🔍 THE CLUE IN THE HISTORY

SIBO that responds to treatment and then returns reliably, in someone with a surgical history, where motility support and the usual root-cause work have already been done without lasting change.

Assessment is hard. Adhesions are notoriously difficult to image, CT and MRI often look normal, so diagnosis is largely clinical, based on history and pattern.

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🤲 WHAT CAN BE DONE

Manual visceral therapy from a trained practitioner, ongoing motility support, and in selected cases surgical review, though because surgery itself creates adhesions, that decision belongs with a surgeon.

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The honest caveat: evidence for manual adhesion therapy is limited and largely from small studies. It is a reasonable option in the right case, not an established treatment.

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Save this and share it with anyone whose SIBO keeps returning after surgery. It gets missed almost universally.

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Educational only, not medical advice. Always work with your provider.

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08/26/2026

Nobody has ever asked you how many courses of antibiotics you have had in your life.

That is a real gap, because the number actually matters👇

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Antibiotics do not only clear the infection you were treating. They reduce bacterial diversity throughout your entire gut, and that diversity is part of what makes your gut resistant to overgrowth in the first place.

A diverse, established community competes for space and resources. A depleted one does not.

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🧬 THE PART MOST PEOPLE MISS

Recovery after a single course takes months, and studies suggest it is frequently incomplete. Some species simply do not return.

Repeated courses compound that effect.

And childhood exposure appears to matter particularly, because the community was still establishing.

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⚖️ THE DIFFICULT TRUTH

This creates a genuinely tricky situation, because antibiotics are also how we treat SIBO.

Rifaximin is an antibiotic. Necessary, effective, and not consequence-free.

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🔑 WHAT THIS ACTUALLY MEANS

To be unambiguous: this does NOT mean refusing antibiotics when they are clinically indicated. Untreated infection is far more dangerous than reduced diversity.

It means the recovery phase afterward is not optional.

Rebuilding diversity through dietary variety, fermented foods once tolerated, adequate fibre once the small intestine has settled, and targeted probiotic support where appropriate, that work is part of the treatment, not an afterthought.

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It also means your antibiotic history belongs in your intake. If you have had many courses, especially in childhood or clustered in a short window, that shapes what your gut is starting from and what your recovery needs to look like.

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Worth writing down what you can remember before your next appointment. Most people have never counted.

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Want the evidence-based steps to actually rebuild after repeated antibiotics?

Comment “REBUILD” and I will send it to you.

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The most useful thing you can do for SIBO costs nothing.And most people are doing the exact opposite. 👇⠀If you have SIBO...
08/25/2026

The most useful thing you can do for SIBO costs nothing.

And most people are doing the exact opposite. 👇

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If you have SIBO and you are eating little and often because it feels gentler on your gut, you may be working directly against your own treatment.

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🌊 YOUR GUT HAS A CLEANING WAVE

Your small intestine has a clearing mechanism called the migrating motor complex (MMC).

It only runs when you are NOT digesting.

It needs roughly 90 minutes to 2 hours of genuinely empty time before it activates, then it sweeps residual food and bacteria downward, out of the small intestine.

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🔄 EATING RESETS IT

Here is the critical detail.

Eating does not just slow the wave down. It stops it completely and resets the cycle to the beginning.

And this applies to far less than a meal. A handful of nuts. Milk in your coffee. A piece of fruit. Anything with calories restarts the clock.

So grazing every 90 minutes across a 14-hour day means that cleaning wave barely runs at all, which is exactly the environment where bacteria establish and persist.

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🍽️ THE WHOLE INTERVENTION

→ 3 to 4 hours between meals, nothing but water in between
→ Black tea or black coffee is usually fine, anything with milk or sugar is not
→ 12 hours or more overnight where you can, when the wave is most active
→ 3 structured meals instead of 6 small ones

This is the opposite of common gut-health advice, and it is appropriate for this specific condition.

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⚠️ TWO IMPORTANT CAVEATS

This is not for everyone. Anyone with blood sugar instability, anyone underweight, pregnant, or with a history of restrictive eating should speak with their practitioner before changing meal timing.

And it is a supporting strategy, not a treatment on its own.

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But it costs nothing, and most people with SIBO are doing the opposite.

Save this and try it for two weeks. It is the cheapest thing on the list and rarely explained properly.

08/24/2026

🚨 SIBO IS NOT JUST BLOATING 🚨

Your fatigue, brain fog, and thinning hair might not be “just SIBO.”

They could be signs that SIBO is quietly stealing the nutrients your body needs.

Most people hear SIBO and think about bloating, gas, constipation, or diarrhoea. But bacterial overgrowth in the small intestine can also interfere with nutrient absorption, creating symptoms far beyond the gut.

🧠 B12
Bacteria may consume B12 before your body can absorb it. A normal serum B12 result does not always rule out functional deficiency. Methylmalonic acid, also called MMA, can provide a clearer picture.

🩸 IRON
Iron is absorbed high in the small intestine, where overgrowth may occur. Inflammation can also affect how your body handles iron. Ferritin may show depleted iron stores before haemoglobin falls.

🌿 VITAMINS A, D, E AND K
These fat soluble vitamins may be affected when bacterial overgrowth disrupts bile function and fat digestion.

⚡ ZINC AND MAGNESIUM
These nutrients may become depleted, especially with diarrhoea or ongoing poor absorption.

Here is the twist 👀

Folate can sometimes read HIGH because certain bacteria can produce it. High folate alongside low or borderline B12 is a pattern worth investigating.

Fatigue, brain fog, hair thinning, low mood, and slow healing are often blamed on “living with gut symptoms.” But sometimes they are deficiency symptoms that deserve proper assessment.

If you are being assessed for SIBO, ask your qualified healthcare professional whether it is appropriate to check:

✅ B12 plus MMA
✅ Ferritin
✅ Vitamin D
✅ Zinc
✅ Magnesium
✅ Folate

Nutritional assessment belongs alongside SIBO treatment, not only after it. Testing and repletion should always be personalised to your symptoms, history, and results.

💬 Comment NUTRIENT and I will send you the PDF with the nutrient checklist.

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