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Dr. Shustina is an incredibly knowledgeable doctor who truly takes time to find root cause.
RG
Rochel Gordon
Condition · Gastrointestinal
Small Intestinal Bacterial Overgrowth (SIBO)
Chronic bloating, abdominal pain, or “food baby” distention by day’s end aren’t normal — they’re tell-tale signs your small intestine may be hosting far more microbes than nature intended. Up to 70% of patients diagnosed with IBS actually have underlying SIBO, which is why our team prioritizes accurate testing and a precise, subtype-aware treatment plan rather than generic symptom management.
What Exactly Is SIBO?
SIBO stands for Small Intestinal Bacterial Overgrowth. It occurs when there’s an abnormal increase in bacteria in the small intestine, where bacterial levels should normally be much lower than in the large intestine. This overgrowth interferes with normal digestion and absorption, ferments carbohydrates into excess gas, and damages the intestinal lining — driving a cycle of bloating, pain, and unpredictable bowel patterns that often gets misdiagnosed as IBS.
Types of SIBO and Their Characteristics
SIBO is categorized by the type of gas produced during bacterial fermentation. Each subtype presents differently and requires its own treatment strategy — without the right subtype identification, care is generic and often ineffective.
| Subtype | Gas Produced | Common Symptoms | Considerations |
|---|---|---|---|
| Hydrogen-Dominant SIBO | Hydrogen | Bloating, gas, loose stools, or alternating bowel patterns. | Often caused by overgrowth of fast-fermenting bacteria. Typically responds well to targeted antimicrobials. |
| Methane-Dominant Overgrowth (IMO) | Methane | Chronic constipation, abdominal distention, slow transit. | Caused by methane-producing archaea (not technically bacteria). May require combination therapies; more treatment-resistant. |
| Hydrogen Sulfide SIBO | Hydrogen sulfide | Foul-smelling gas, diarrhea, fatigue, sulfur-egg burps. | Difficult to detect without specialized testing. Requires a nuanced treatment approach. |
Why SIBO Impacts More Than Digestion
When bacteria proliferate in the small intestine, the effects extend well beyond digestion. Overgrowth damages the intestinal lining, drives nutrient malabsorption (particularly B12, iron, and fat-soluble vitamins), and triggers low-grade systemic inflammation. The result is a body-wide ripple — fatigue, brain fog, skin issues, and mood changes — that rarely connects back to the gut without the right workup.
Common Signs of SIBO Include
Persistent bloating, especially after meals
Excessive gas or belching
Diarrhea, constipation, or alternating bowel habits
Nutrient deficiencies (B12, iron, fat-soluble vitamins)
Unexplained fatigue or low energy
Headaches or brain fog
Skin issues or rosacea-like flares
Food intolerances that seem to multiply over time
Joint pain or unexplained inflammation
Diagnostic Options at Whole Gut Health
Accurate SIBO diagnosis is the foundation of effective treatment — and the right test depends on your symptom pattern. At Whole Gut Health we use the latest diagnostic tools to identify both the presence and the specific type of overgrowth driving your symptoms.
Testing options may include:
SIBO Breath Testing using glucose or lactulose substrates to measure hydrogen and methane gas production.
TrioSmart™ Breath Testing — advanced 3-gas panel that also measures hydrogen sulfide, the gas behind the most overlooked SIBO subtype.
Applied Kinesiology (muscle testing) to identify root causes and triggers — a broader signal than laboratory tests alone.
Osteopathic Visceral Evaluation to assess motility, structural restrictions, and the small-bowel environment.
Comprehensive Stool Analysis to evaluate the broader microbiome, inflammation markers, and digestive function.
Functional Lab Work including nutrient assessments, inflammatory markers, and digestive enzyme function.
We customize testing protocols based on your unique symptom pattern and medical history to ensure we identify the right subtype and all contributing factors.
Our approach
Why Whole Gut Health is different
At Whole Gut Health, we go beyond conventional symptom management and traditional functional medicine protocols. We trust your body's innate ability to heal itself when given the right support.
In Dr. Shustina's many years of practice, she has seen that many digestive diseases have their root cause in emotional traumas and unhealed wounds. When these underlying causes are healed, the body can heal from the inside out in a lasting way.
We focus on the mind-gut connection, incorporating energy healing techniques, personalized nutrition that evolves as you heal, and integrative approaches addressing mind, body, and spirit. If this resonates with you, contact our office to schedule your consultation and take the first step on your healing journey.
Our SIBO Treatment Approach
Our three-phase SIBO protocol moves from identifying the subtype and its drivers, to clearing the overgrowth, to rebuilding motility and microbiome resilience so the overgrowth doesn’t come back.
Phase 1 — Assessment & Root-Cause Identification
- In-depth intake and medical history review
- Breath testing to identify SIBO subtype (hydrogen, methane, hydrogen sulfide)
- Comprehensive lab work and functional testing
- Applied kinesiology to surface contributing factors
- Evaluation of motility, previous infections, and medication effects
- Assessment of stress and gut-brain dysfunction
Phase 2 — Targeted Intervention
- Herbal antimicrobials matched to your specific SIBO subtype
- Selective use of prescription antibiotics when indicated
- Motility support via visceral manipulation and targeted supplementation
- Combination therapies for methane-dominant overgrowth
- Personalized diet with strategic food reintroductions
- Energy medicine and breathwork to support the gut-brain axis
Phase 3 — Rebuilding & Prevention
- Strategic reintroduction of gut-healing foods
- Ongoing motility support to prevent stagnation
- Long-term microbiome restoration and diversity building
- Sustainable lifestyle and nervous-system practices
- Monitoring to catch and address early recurrence
Expert-Led, Personalized Care
Dr. Alexandra Shustina is a board-certified gastroenterologist and internist specializing in complex digestive disorders, gut health, and the gut–brain connection. Drawing from both conventional gastroenterology and integrative medicine, she takes a comprehensive approach to uncovering the underlying factors contributing to illness and guides patients toward lasting wellness.
At Whole Gut Health, every patient receives highly personalized care rooted in a deep understanding of digestive health, nutrition, the gut microbiome, and the interconnected systems that influence overall well-being. By combining evidence-based medicine with a thoughtful, individualized approach, we help patients move beyond symptom management and create a clear path toward long-term healing and vitality.
Frequently Asked Questions
Common questions, answered
What is SIBO?
+
SIBO stands for Small Intestinal Bacterial Overgrowth. It occurs when there's an abnormal increase in bacteria in the small intestine, where bacterial levels should normally be much lower than in the large intestine.
What are the different types of SIBO?
+
SIBO is categorized based on the type of gas produced during bacterial fermentation:
Hydrogen-Dominant SIBO
- Gas produced: Hydrogen
- Common symptoms: Bloating, gas, loose stools, or alternating bowel patterns
- Often caused by overgrowth of fast-fermenting bacteria
Methane-Dominant Overgrowth (IMO)
- Gas produced: Methane
- Common symptoms: Chronic constipation, abdominal distention
- Caused by methane-producing archaea (not technically bacteria)
- May be more treatment-resistant
Hydrogen Sulfide SIBO
- Gas produced: Hydrogen Sulfide
- Common symptoms: Foul-smelling gas, diarrhea, fatigue
- Difficult to detect without specialized testing
- Requires a nuanced treatment approach
What are the common signs and symptoms of SIBO?
+
- Persistent bloating, especially after meals
- Excessive gas or belching
- Diarrhea, constipation, or alternating bowel habits
- Nutrient deficiencies or unexplained fatigue
- Headaches or brain fog
- Skin issues
How is SIBO diagnosed?
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Accurate diagnosis is essential for effective treatment. Testing options include:
Breath Testing
- Uses glucose or lactulose substrates
- Measures hydrogen and methane gas levels
TrioSmart™ Testing
- Advanced testing that includes measurement of hydrogen sulfide gas
- Provides comprehensive gas analysis
Functional Lab Work
- Assesses related nutrient deficiencies
- Checks for inflammation markers
- Evaluates digestive enzyme function
Testing protocols are selected based on your specific symptoms and medical history to ensure accurate and actionable results.
What does SIBO treatment involve?
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Our comprehensive three-phase SIBO protocol includes:
Phase 1: Assessment and Root-Cause Identification
- In-depth intake and medical history review
- Comprehensive lab work
- Functional testing strategies including applied kinesiology
- Identification of contributing factors such as: Motility issues
- Medication use
- Previous infections
Phase 2: Targeted Intervention
- Herbal antimicrobials based on your SIBO type
- Rare use of prescription antibiotics
- Motility support using visceral manipulation and targeted supplementation
- Methane-producing overgrowths may require combination therapies
- Targeted and personalized diet
Phase 3: Rebuilding and Prevention
- Strategic reintroduction of gut-healing foods
- Motility support
- Long-term microbiome support to prevent recurrence
- Sustainable lifestyle changes to maintain and prevent
Why is it important to identify the specific type of SIBO?
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Each SIBO subtype presents with different symptoms and requires a different treatment strategy. For example:
- Hydrogen-dominant SIBO may respond well to certain antimicrobials
- Methane-dominant overgrowth often requires combination therapies and is more treatment-resistant
- Hydrogen sulfide SIBO needs specialized testing and a nuanced treatment approach
Can SIBO recur after treatment?
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Yes, SIBO can recur if underlying causes aren't addressed. This is why our protocol includes a comprehensive rebuilding and prevention phase that focuses on:
- Supporting proper gut motility
- Healing the intestinal lining
- Maintaining long-term microbiome balance
- Addressing root causes that led to SIBO initially
What makes your approach to SIBO treatment different?
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At Whole Gut Health, we combine evidence-based comprehensive strategies from conventional gastroenterology, osteopathic medicine, and energy healing using a functional and integrative approach. Our care is led by Dr Shustina, a board-certified gastroenterologist, experienced in functional medicine with deep understanding of:
- The gut microbiome
- Advanced diagnostics
- Personalized treatment protocols based on your specific SIBO type and underlying causes
Who provides SIBO care at your practice?
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Dr. Alexandra Shustina is a board-certified gastroenterologist and internist who serves as Miami's premier gut health specialist. She has training in both conventional gastroenterology and functional gut health, with expertise in the gut microbiome and its role in health and wellness.
How do I get started with SIBO testing and treatment?
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The first step is scheduling a comprehensive consultation where we'll:
- Review your symptoms and medical history
- Determine the most appropriate testing strategy
- Develop a personalized treatment plan based on your specific needs
Contact our office to schedule your initial consultation and begin your journey toward optimal gut health.
Reviews
The body remembers when it's finally heard
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Dr. Shustina goes to the root level of the issue, not only superficial, so there's healing.
LG
Leah Glickman
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She has significantly improved my health. I was suffering from Ulcerative Colitis and now live normally.
ML
Monica LaBadia
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Dr. Shustina has helped me change my lifestyle and heal my gut in a way I thought impossible.
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Dalit Lonstein
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She listens to patients and treats conditions, not symptoms.
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Gabriela Salazar
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Dr. Shustina is the best doctor I have ever been to. She assesses the root of the problem.
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M. S.
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She is an outstanding doctor who understands the body's ability to heal itself and holistic remedies.
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Sibel Sebi Sharabi
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Dr. Shustina has a wealth of knowledge and is helping me heal years of gastrointestinal issues.
DC
Daniela Chaparro
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Dr. Shustina is an amazing doctor. She diagnosed my cancer early and saved my life.
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Mordechai Weinstein
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After one session with Dr. Shustina, my digestive pain went away.
TP
Taryn Parascand
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Doctor Shustina is the absolute best. She has helped me resolve numerous issues other doctors dismissed.
RS
Rachel S.
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Dr. Shustina is a fantastic doctor who truly cares. Her holistic approach attacks the root cause.
CS
Clay Simonsen
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