Severe Cases of IMO
SIBO Breath Test
Stool Microbiome Test
Hi Friends,
Did you know that some people have gut microbes that produce methane gas—just like cows?
This condition, known as Intestinal Methanogen Overgrowth (IMO), is caused by an overgrowth of ancient bacteria-like organisms called archaea, specifically Methanobrevibacter smithii. Methane gas can significantly slow the motility in the gut, leading to chronic constipation, bloating, and slow digestion.
Why Is It Called IMO Instead of Methane SIBO?
IMO was previously known as Methane SIBO, a subtype of Small Intestinal Bacterial Overgrowth (SIBO). However, because methane gas can be produced in both the small intestine and colon, the term Intestinal Methanogen Overgrowth (IMO) is now the updated terminology.
How Do We Diagnose IMO?
There are two main ways to identify IMO:
✅ SIBO Breath Test – Measures hydrogen and methane gas levels being produced by your intestines
✅ Stool Microbiome Testing – Measures levels of M. smithii from your stool.
SIBO vs. IMO: What’s the Difference?
SIBO comes in two main forms:
🔹 Hydrogen SIBO → Associated with diarrhea (IBS-D)
🔹 Methane SIBO (IMO) → Associated with constipation (IBS-C)
In IMO, archaea consume hydrogen gas and convert it into methane, which slows intestinal motility and causes constipation. This explains why people with IMO often have low hydrogen levels but high methane levels on their breath test.
My Personal Journey with SIBO
As many of you know, treating SIBO is a passion of mine. I personally battled this condition and spent years researching its root causes to develop a lasting solution.
Symptoms of IMO
If you struggle with:
✅ Chronic constipation
✅ Bloating
✅ Slow digestion
✅ Gas that doesn’t respond to probiotics
You may have IMO!
Conventional Treatment: Antibiotics with High Relapse Rates
The standard medical treatment for IMO involves two antibiotics: Xifaxan + Neomycin, taken together. However, many patients experience a high relapse rate or find that antibiotics don’t fully resolve their symptoms.
A Natural Approach to IMO: Herbal Antimicrobials
The good news? IMO can be effectively treated with natural herbal antimicrobials:
🌿 Berberine + Oregano + Allicidin (Garlic extract) → Kills methane-producing archaea
🌿 Hydrogen SIBO is treated with just Berberine + Oregano
Unlike antibiotics, herbal treatments not only eliminate IMO but also restore balance to the gut microbiome, clearing out other forms of dysbiosis, both bacterial and even fungal. The herbs provide anti-inflammatory benefits as well!
Keys to A Successful Treatment
Killing the bad bacteria is just one step in the process. To successfully overcome SIBO, we must also:
✅ Support motility – Essential Magnesium + Motility Activator at bedtime
✅ Enhance digestion – Digestive Enzyme Pro + Betaine & Pepsin after meals
✅ Follow a SIBO-friendly diet – Low FODMAP & Low Lectin
✅ Reduce Inflammation with Spore Probiotic IgG
If you or a loved one suffers from chronic constipation or bloating, I highly recommend getting tested for SIBO and IMO. Diagnosis is the first step toward healing your gut and reclaiming your health!
📺 Watch my video on my 4-phase Herbal Protocol for SIBO (Hydrogen & Methane) to learn more!
Many people with IBS and gut issues often digest cooked fruit better than raw fruit.
Making a berry sauce is a great way to get concentrated antioxidants like anthocyanins and vitamin C!
1 bag of organic mixed berries 32 oz (raspberries, blueberries, blackberries, and strawberries)
1/4 cup of maple syrup
1 tablespoon vanilla extract
Pinch of salt
Put all the ingredients in a pot, cover and heat on medium heat.
After 5 minutes, give it a stir.
As the berries start to sizzle and liquify, you can increase the heat to high until it begins to simmer.
Then lower the heat and allow to simmer uncovered so that the sauce can reduce down and thicken (another 10-15 minutes). Use the back of a large spoon to gently smash the berries.
This sauce is amazing on top of yogurt or kefir with some chopped walnuts. My personal favorite is to have it on top of goat kefir, which is a rich source of butyric, caprylic, and medium chain fatty acids and is often better tolerated by those with traditional cow’s milk sensitivity.
This recipe is fun and easy to make, tastes incredible, and does wonders for your gut microbiome!
Let’s Spread Awareness About IMO!
Thank you for spending this time with me. If today’s message resonated with you, I invite you to share it with anyone in your life who struggles with bloating or chronic constipation. So many people suffer in silence, not knowing that IMO could be the missing piece of their health puzzle. Let’s spread awareness and help more people find real, lasting relief—because everyone deserves to feel good in their gut!
Rajsree Nambudripad, MD
