When you have SIBO, your intestinal motility isn’t functioning properly - called the Migrating Motor Complex (MMC). Your small intestines are not able to sweep food through from the small intestines to the large and you have food stagnation and fermentation. You’ll need to retrain your bowels and a prokinetic can help. There are natural prokinetics and pharmaceuticals. I will always vote to try the natural route first but for some folks like myself, the herbs just don’t work