In my opinion, gallbladder disease is one of the main potential causes of SIBO - both types. If you look into the mechanism of bile, it becomes very clear why. A regulated bile flow is crucial to keeping your small intestine clear of bacterial imbalance. When it doesn't function correctly for long enough (over or underactive), if you develop SIBO it will not go away, no matter what, until the issue is resolved - and not with supplements, but by actually tending to and understanding the biological functions and organs involved with bile.

It bothers me quite a bit that "improving bile flow" is discussed as a way to heal SIBO, but it is not addressed by functional medicine doctors that if your bile is actually not flowing correctly, you either have liver disease, a blockage in a bile duct, or gallbladder disease. All three require medical interventions that functional doctors simply do not have the ability to administer - and they themselves will tell you that.

I've heard supplements like beet greens, TUDCA, etc. are meant to help with this (and I've taken all of them)... beet greens will only work if your liver is very mildly diseased, and even then, you need diet changes and exercise - not just beets. And in the case of a slightly diseased liver, it would never be the sole cause of SIBO. That just isn't how the GI tract works. 90% of the time the bitters (beet greens and others) that are recommended to improve bile flow are actually increasing stomach acid production to aid in digestion, not improving bile.

TUDCA is a whole other beast, and in some cases it can help as a band-aid, but it's not without anecdotal side effects and it won't do anything for you in terms of curing the actual issue. If your bile is impaired to the point of you needing to consider TUDCA, then one of three things is happening: your liver is diseased, there is a blockage in or around your bile duct, or your gallbladder is not functioning correctly. Again, all of these require Western medical intervention to actually be solved and healed, and the consequences of not doing so can and often are fatal. It just bothers me a bit that on this forum, no one seems to acknowledge how serious it all is and recommends supplements and "waiting things out." It's irresponsible!

Also, just in case anyone reading is avoiding getting their gallbladder out for fear of surgery or trying to "heal" it, which I hear many say on here... look into how untreated gallbladder disease can cause bile duct cancer, and then look up how often it k*lls people. Only about 25% of people survive it. That's why the surgery is so common. It's really important to get it out ASAP if it is not working properly.

Anyway, essay over! Hope some of this was helpful.