Welcome to this blog post, aimed at providing helpful information. With over 34 years of experience in treating patients, I have found that 75% of the cases I encounter, both in my office and around the world, are related to gastrointestinal (GI) issues. Among these, SIBO (Small Intestinal Bacterial Overgrowth), IBS (Irritable Bowel Syndrome), and IBD (Inflammatory Bowel Disease) form a significant portion. However, managing SIBO and SIBO-related anxiety goes beyond just following a low FODMAP diet. Understanding the underlying causes (“why”) behind its development is crucial for the effective handling of SIBO, preventing relapses, and reducing associated anxiety. Simply treating SIBO without addressing the root causes may lead to relapses in the future. This is what I do every day in my practice.

Please feel free to contact me for a complimentary 15-minute consultation to see if we’re a good fit. Respectfully, Dr. Marcus Ettinger – 714-639-4360.

Introduction: Mastering Stress: Step-by-Step Techniques for Managing SIBO-Related Anxiety

SIBO or Small Intestinal Bacterial Overgrowth is a digestive disorder that can cause various symptoms like bloating, gas, abdominal pain, and diarrhea. Anxiety is one of the most common symptoms experienced by SIBO patients. It is natural to feel anxious when you are dealing with a chronic illness like SIBO that can impact your daily life. However, anxiety can make your symptoms worse and interfere with your quality of life. Anxiety can even contribute to the development of SIBO. Therefore, it is important to learn some effective stress management techniques to manage your anxiety and improve your overall well-being.

In this blog post, I will discuss step-by-step stress management techniques for SIBO-related anxiety that you can incorporate into your daily routine. Ideally, these techniques should be performed outside in sunlight, especially by moving water (lake, waterfall, or ocean…) or in an open green space (park or lightly wooded forest).  

Table of Contents:

Solfeggio Frequency 528Hz
Deep Breathing
Progressive Muscle Relaxation
Mindfulness Meditation
Guided Imagery
Cognitive Behavioral Therapy
Self-Care Practices
Frequently Asked Questions About Stress Management Techniques For SIBO-Related Anxiety


Sunlight (UV, visible, and infrared) has been shown to have a positive impact on managing anxiety. Exposure to natural sunlight can help regulate mood and alleviate symptoms of anxiety. Sunlight exposure triggers the release of serotonin, a neurotransmitter known as the “feel-good” hormone, in the brain, which can help improve mood and reduce anxiety levels. Spending time outdoors in natural sunlight, especially during the morning hours, can also help regulate the body’s circadian rhythm, which plays a key role in managing stress and anxiety. Incorporating the techniques below with the anxiety-reducing power of natural sunlight can supercharge the effectiveness of every one of them.

Solfeggio Frequency 528Hz

Solfeggio frequency 528 Hz, also known as the “Miracle” or “Love” frequency, has gained popularity as a potential tool for managing anxiety. Some believe that listening to music or tones with this frequency can help reduce anxiety, promote relaxation, and bring about a sense of inner peace. Proponents of Solfeggio 528 Hz claim that it can stimulate positive vibrations and harmonize energy, leading to a state of balance and tranquility.

Youtube video (9hr) – Solfeggio 528 Hz ACTIVATE SELF-HEALING & Positive Transformation 

Deep Breathing

Deep breathing is a simple and effective stress management technique that can be practiced anywhere and anytime. It helps to calm your mind and body and reduce anxiety. Here are the steps to practice “Box Breathing” as well as some helpful links:

  1. Sit or lie down in a comfortable position.
  2. Close your eyes and focus on your breath.
  3. Inhale deeply through your nose for 4 seconds.
  4. Hold your breath for 4 seconds.
  5. Exhale slowly through your mouth for 4 seconds
  6. Hold the exhale for 4 seconds.
  7. Repeat this cycle for 4-8 repetitions. This is known as “Box Breathing”.

More breathing techniques:

Progressive Muscle Relaxation

Progressive Muscle Relaxation is a technique that involves tensing and relaxing different muscle groups in your body to reduce muscle tension and anxiety. Here are steps to practice progressive muscle relaxation:

  1. Sit or lie down in a comfortable position.
  2. Close your eyes and take a deep breath.
  3. Tense the muscles in your feet and hold for 5 seconds.
  4. Release the tension and relax for 10 seconds
  5. Move to your calf muscles and repeat the same process.
  6. Continue this process, moving up your body to your shoulders and neck.
  7. Finally, tense all your muscles and hold for 5 seconds, then release and relax.
  8. Take a few deep breaths and enjoy the feeling of relaxation.

Youtube video – How to do Progressive Muscle Relaxation

Mindfulness Meditation

Mindfulness meditation is a technique that involves focusing your attention on the present moment without judgment. It helps to reduce anxiety and improve overall well-being. Here are steps to practice mindfulness meditation:

  1. Find a quiet and comfortable place to sit.
  2. Close your eyes and take a deep breath.
  3. Focus your attention on your breath and the sensation of breathing.
  4. If your mind wanders, gently bring your focus back to your breath.
  5. Continue this practice for 5-10 minutes.

Youtube video – Daily Calm | 10 Minute Mindfulness Meditation | Be Present


Yoga is a mind-body practice that combines physical postures, breathing techniques, and meditation to reduce stress and anxiety. Here are some yoga postures that can help to relieve SIBO-related anxiety:

  1. Child’s Pose (Balasana).
  2. Cat-Cow Stretch (Marjaryasana-Bitilasana).
  3. Downward-Facing Dog (Adho Mukha Svanasana).
  4. Tree Pose (Vrksasana). 
  5. Corpse Pose (Savasana).


Exercise is a natural stress reliever that helps to release endorphins, which are the body’s feel-good chemicals. It can also improve your mood and reduce anxiety. Here are some exercise options for SIBO patients. These activities should always be performed outside, if possible:

  1. Walking, Jogging, or Cross-Country Running.
  2. Swimming.
  3. Bike Riding/Cycling.
  4. Yoga or Tai Chi.
  5. Hiking.

Guided Imagery

Guided imagery is a relaxation technique that involves using your imagination to create calming and positive mental images. It can help to reduce stress and anxiety by redirecting your thoughts away from negative feelings. Here are steps to practice guided imagery:

  1. Find a quiet and comfortable place to sit or lie down.
  2. Close your eyes and take a few deep breaths.
  3. Imagine yourself in a peaceful and serene place, such as a beach, forest, or meadow.
  4. Engage all your senses and vividly imagine the sights, sounds, smells, and sensations of this place.
  5. Stay in this imagined place for a few minutes, enjoying the relaxation and tranquility.

Youtube video – 10-Minute Guided Imagery for Reducing Stress and Anxiety

Cognitive Behavioral Therapy

Cognitive Behavioral Therapy (CBT) is a type of therapy that can help you identify and change negative thought patterns and behaviors that contribute to anxiety. It focuses on understanding and changing the way you think and behave in response to stressors. Here are some CBT techniques that can be helpful for SIBO-related anxiety:

  1. Thought Awareness: Identify and challenge negative thoughts that contribute to anxiety.
  2. Cognitive Restructuring: Replace negative thoughts with more positive and realistic ones.
  3. Behavioral Activation: Engage in enjoyable activities and behaviors that promote relaxation and well-being.
  4. Problem-Solving: Develop effective strategies for coping with stress and anxiety.

Helpful Links:


Aromatherapy, the use of essential oils for therapeutic purposes, has been explored as a potential approach for managing anxiety related to Small Intestinal Bacterial Overgrowth (SIBO). Some essential oils, such as lavender, chamomile, bergamot, frankincense, and ylang-ylang are known for their calming properties and may help promote relaxation, reduce stress, and alleviate anxiety symptoms. Aromatherapy can be administered through various methods, including inhalation, topical application, and diffusion. However, it’s crucial to use essential oils safely and consult with a qualified aromatherapist or healthcare professional before incorporating aromatherapy into a SIBO-related anxiety management plan. Some essential oils that can be helpful for anxiety are:

  1. Lavender: Known for its calming and relaxing properties.
  2. Roman chamomile: Helps to reduce anxiety and promote sleep.
  3. Bergamot: Helps to uplift mood and reduce stress.
  4. Frankincense: Promotes relaxation and deep breathing.
  5. Ylang-ylang: Known for its calming and sedative effects


Journaling is a therapeutic technique that can help you express and process your thoughts and emotions. It can be a helpful tool for managing anxiety related to SIBO. Here are some journaling prompts that can be useful:

  1. Write down your thoughts and feelings about your SIBO-related anxiety.
  2. Reflect on any triggers or patterns related to your anxiety.
  3. Write about your coping strategies and what has worked for you in managing stress.
  4. Express gratitude and positive aspects of your life.
  5. Write down any fears or concerns related to SIBO and how you can address them.

Helpful links:

Self-Care Practices

Self-care is an essential aspect of stress management for SIBO patients. Taking care of yourself physically, mentally, and emotionally can help to reduce anxiety and improve your overall well-being. Here are some self-care practices to consider:

  1. Get enough sleep: Sleep plays a crucial role in managing stress and anxiety. Aim for 7-9 hours of quality sleep each night to support your physical and mental well-being. Establish a regular sleep routine and create a relaxing bedtime routine to promote restful sleep.
  2. Eat a healthy diet: Avoid trigger foods that worsen your SIBO symptoms and eat a balanced diet.
  3. Stay hydrated: Drink plenty of water throughout the day.
  4. Practice good gut health: Follow a SIBO-specific diet plan (Low FODMAP) and take care of your gut with probiotics and digestive enzymes.
  5. Limit caffeine and alcohol: Both caffeine and alcohol can worsen anxiety, so use them in moderation or avoid them altogether.
  6. Prioritize time for hobbies and activities you enjoy: Engaging in activities that you enjoy and that bring you pleasure can help to reduce stress and anxiety. Make time for hobbies, interests, and activities that make you happy and provide a sense of fulfillment.
  7. Practice mindfulness: Mindfulness involves being fully present, in the moment, without judgment. Incorporate mindfulness practices into your daily routine, such as mindful breathing, mindful eating, or a body scan meditation. Mindfulness can help to reduce stress and anxiety by promoting awareness and acceptance of the present moment.
  8. Stay connected: Spend time with supportive friends and family, and engage in activities that bring you joy.
  9. Practice self-compassion: Be kind and understanding to yourself, and practice self-compassion when dealing with anxiety.
  10. Exercise outside regularly: Physical activity as well as sunshine can help to reduce stress, release happy chemicals like serotonin and endorphins, and improve overall well-being. Find an exercise routine that suits your abilities and preferences, such as walking, yoga, or swimming.
  11. Practice relaxation techniques: Incorporate relaxation techniques such as deep breathing, progressive muscle relaxation, or meditation into your daily routine. These techniques can help to calm the mind and body and reduce anxiety.
  12. Limit exposure to stressors: Identify and minimize sources of stress in your life as much as possible. This may include setting boundaries, delegating tasks, or avoiding triggers that worsen your anxiety.
  13. Seek support: Don’t hesitate to reach out for support from trusted friends, family members, or a mental health professional. Talking about your concerns and emotions can provide validation, perspective, and guidance in managing SIBO-related anxiety.


In conclusion, managing stress and anxiety related to SIBO is crucial for overall well-being and symptom management. Incorporating stress management techniques, such as cognitive-behavioral strategies, relaxation techniques, aromatherapy, journaling, self-care practices, practicing self-compassion, getting enough sleep, prioritizing time for hobbies and activities you enjoy, and practicing mindfulness, can help you effectively cope with SIBO-related anxiety. Remember that self-care is an ongoing process, and it’s important to prioritize your mental health along with your physical health in managing SIBO. Implementing these stress management techniques into your daily routine, along with seeking support when needed, can contribute to better health outcomes and improved quality of life.

FAQ: What is SIBO-related anxiety?
Answer: SIBO-related anxiety refers to anxiety or heightened stress levels that may arise in individuals who have Small Intestinal Bacterial Overgrowth (SIBO), a condition where there is an abnormal overgrowth of bacteria in the small intestine.

FAQ: Why is stress management important for SIBO patients?
Answer: Stress management is crucial for SIBO patients as stress can trigger or exacerbate gastrointestinal symptoms, including SIBO. Managing stress can help reduce the severity and frequency of SIBO-related symptoms, and improve overall well-being.

FAQ: What are cognitive-behavioral strategies for managing SIBO-related anxiety?
Answer: Cognitive-behavioral strategies are techniques that focus on identifying and changing negative thought patterns and behaviors. Examples include cognitive restructuring, reframing negative thoughts, and developing healthy coping mechanisms to manage anxiety related to SIBO.

FAQ: Can relaxation techniques help with SIBO-related anxiety?
Answer: Yes, relaxation techniques such as deep breathing, progressive muscle relaxation, and meditation can help to reduce stress and anxiety associated with SIBO. These techniques promote relaxation and calm the mind, which can aid in managing anxiety symptoms.

FAQ: How can aromatherapy be used for stress management in SIBO patients?
Answer: Aromatherapy involves using essential oils to promote relaxation and reduce stress. Essential oils like lavender, chamomile, and peppermint can be used in various ways, such as diffusing, inhaling, or adding to a bath, to help manage stress and anxiety in SIBO patients.

FAQ: How can journaling help with SIBO-related anxiety?
Answer: Journaling can be a helpful tool for managing SIBO-related anxiety as it allows individuals to express their thoughts and emotions, gain clarity, and identify triggers or patterns related to their anxiety. Writing in a journal can be cathartic and aid in managing stress.

FAQ: What are some self-care practices for managing stress in SIBO patients?
Answer: Self-care practices for managing stress in SIBO patients can include regular exercise, healthy eating, adequate sleep, relaxation techniques, spending time in nature, connecting with loved ones, and engaging in activities that bring joy and relaxation.

FAQ: How can practicing self-compassion help with SIBO-related anxiety?
Answer: Practicing self-compassion involves being kind and understanding towards oneself. It can help individuals with SIBO-related anxiety to cultivate self-care, self-acceptance, and self-soothing techniques, which can alleviate stress and promote emotional well-being.

FAQ: Can getting enough sleep impact SIBO-related anxiety?
Answer: Yes, getting enough sleep is important for managing SIBO-related anxiety. Poor sleep can worsen anxiety symptoms, while sufficient sleep can help regulate mood, reduce stress, and improve overall mental well-being.

FAQ: How can mindfulness be incorporated into stress management for SIBO patients?
Answer: Mindfulness practices, such as mindful breathing, eating, or body scans, can help SIBO patients manage stress and anxiety by promoting present-moment awareness, reducing rumination, and cultivating a non-judgmental attitude towards thoughts and emotions.

FAQ: Can getting enough natural sunlight help with SIBO-related anxiety?
Answer: Sunlight exposure has also been linked to improved mood and mental well-being due to its effects on serotonin production in the brain. Adequate sunlight exposure may help regulate circadian rhythms, improve sleep, and reduce the risk of mood disorders like depression.

Helpful Links and References:

SIBO Doctor Located In Orange County, CA
Mast Cell Activation Syndrome, IBS, Dysbiosis, SIBO
What Is SIBO and How Might It Affect Your Mental Health? – Small Intestinal Bacterial Overgrowth (SIBO) could be causing your anxiety.
Personality, Anxiety, and Stress in Patients with Small Intestine Bacterial Overgrowth Syndrome. The Polish Preliminary Study
Antimicrobial treatment improves tryptophan metabolism and mood of patients with small intestinal bacterial overgrowth

Fructose Intolerance and IBS Connection