Today I’m super excited to bring you a guest post by Dianne Rishikof.  Welcome, Dianne!

Note from Sylvie: SIBO is one of my favorite topics (I wrote an entire series on the topic, as well as an ebook). The toughest thing about SIBO is that recurrence is pretty common.  That’s right… that means that after you’ve treated it, you can’t just go back to pretending it never happened in the first place.  Dianne is going to break it down for us and give some actionable ways you can keep SIBO away for good.

Some patients can trace the development of their IBS or SIBO, and remember it starting after an episode of a stomach bug or food poisoning. This is the key to understanding how SIBO develops for many. More importantly, this is the key to keep SIBO from returning!

Cleansing Wave

There is a migrating motor complex, more easily termed “cleansing wave” that happens in the gut. This is a muscular contraction from the top of the small intestine to the bottom (20 feet down the tract). The purpose is to clear out all the debris from the small intestine, where it doesn’t belong, and move it along to the large intestine. This cleansing wave happens every 90 minutes whenever we are not actively digesting. So, when you are digesting after each meal, there is no cleansing wave happening. But, a few hours later, if you are done digesting and do not eat again, then you will have a cleansing wave. A wave also will also occur every 90 minutes while you are sleeping or resting. It takes a few hours to digest a meal. So, someone who is snacking or grazing all day will not have a cleansing wave except while he or she is sleeping. Someone who eats breakfast at 7am and then lunch at noon will have a cleansing wave sometime in the late morning.

What happens to cleansing waves when we have SIBO?

Some microbes kill our ability to create the migrating motor complex. A virus or bacteria that causes the stomach flu or food poisoning can also release a toxin that kills the cells in our gut that control the cleansing wave. They do this for their own survival. If they destroy our ability to clean them out of our small intestine, then they get to set up camp and thrive. Even if we get over a bout of illness from a noxious microbe, the damage has been done. The cleansing waves won’t happen anymore, and we can develop an overgrowth of any microbes.

The cleansing wave is the key to keeping bacteria out of the small intestine.

You need to do whatever you can to restore cleansing waves and optimize the motility of your small intestine so the SIBO doesn’t return.

Things that promote cleansing waves

Waiting four to five hours between meals, no snacking.

o   Since the cleansing wave  happens only when we are not digesting food, we need to have a significant break between meals. This four to five hours allows a cleansing wave to occur after each meal. This means all the debris and bacteria from that meal are cleared out of the small intestine.

Nothing to eat between dinner and breakfast, no snacking at night.

o   Nighttime is the best way to get a really good small intestinal clean out. Giving your digestive track 10-12 hours of rest not only will you have a few cleansing waves, but the digestive tract will get a break. It is stressful to digest and absorb. This rest is important for the digestive tract.


Lemon juice or apple cider vinegar on an empty stomach.


This is a liquid herbal supplement.


You can eat it as food, drink it as tea, or take a supplement.


This supplement is the amino acid precursor to serotonin. Serotonin is the ‘feel good’ neurotransmitter but another lesser known function is motility in the digestive tract.


This is a combination supplement with ginger, 5HTP, and acetyl-l-carnitine. If you take this, you do not want to also take additional supplements of ginger or 5HTP.


The vagus nerve is one of many important nerves in your body. You can stimulate the vagus nerve by gargling and this has been shown to help with motility in the gut. You have to gargle and hum at the same time. Do this every night before bed and try to do it for a few minutes even if you want to stop sooner.

Note from Sylvie:  Check out Dianne’s incredible ebook, Health Takes Guts: Your Comprehensive Guide to Eliminating Digestive Issues, Anxiety and Fatigue. Get your copy today. 

This article is an excerpt from the ebook: Health Takes Guts®: Your Comprehensive Guide to Eliminating Digestive Issues, Anxiety, and Fatigue. Dianne Rishikof, MS, RDN, LDN, IFNCP has spent years helping hundreds of clients as a functional nutritionist and gut health expert. Now, she has compiled her successful treatment methods into this book. It offers you the key to feeling better by fixing your problem at its root.

Have you dealt with SIBO recurrence? How are you tackling it? Let us know in the comments!

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Sylvie McCracken is a former celebrity assistant in Hollywood turned full time entrepreneur currently living in Ashland, Oregon with her kids. She writes about treating and preventing health conditions with real food and natural remedies, as well as anything else she feels like writing about because she's a rebel like that. 😉 he also mentors health professionals turned entrepreneurs on her other site,