top of page

Michael Traub, ND, DHANP, FABNO

Kailua-Kona, Hawaii | USA

Dr. Traub received his undergraduate degree in biological sciences at the University of California at Irvine. He graduated from National College of Naturopathic Medicine in 1981 and completed a two-year residency there in Family Practice and Homeopathy. He is board certified in Classical Homeopathy and Naturopathic Oncology. He has served as medical director of Ho’o Lokahi, an integrative clinic in Kailua Kona, Hawaii for the past 30 years. His father was a dermatologist, and this inspired Dr. Traub to undertake extra study in

this subject and become the leading expert in dermatology in the naturopathic profession. He has taught dermatology at 5 of the 7 accredited naturopathic medical schools in North America, and in 1985 published "Essentials of Dermatologic Diagnosis and Natural Therapeutics."

"SIBO in Athletes"


Physical exercise can be both beneficial and harmful for the gastrointestinal tract in a dose-effect relationship between its intensity and health. Mild-to-moderate intensity exercises play a protective role against colon cancer, diverticular disease, cholelithiasis and constipation, whereas acute strenuous exercise may provoke heartburn, nausea, vomiting, bloating, flatulence, abdominal pain, diarrhea, fecal incontinence and even gastrointestinal bleeding.

One quarter to one half of elite athletes are hampered by the gastrointestinal symptoms that may deter them from participation in training and competitive events, including marathons, cycling races, and triathlons. These symptoms are 1.5-3.0 times higher in elite athletes than recreational exercisers.

Vigorous exercise-induced gastrointestinal symptoms are often attributed to altered motility, mechanical factors or altered neuroimmunoendocrine secretions, but causative mechanisms are not completely understood. Gastrointestinal disturbances during or immediately after exercise are common among runners, affecting 20-50% of long-distance runners. The mechanical irritation of the GI tract during running can change intestinal motility, and exercise causes a reduction of the mesenteric blood flow. Both may contribute to the symptoms mentioned above, and both are well known risk factors for development of small intestinal bacterial overgrowth (SIBO). Clinical manifestations of SIBO are similar to the complaints of long-distance runners. We will examine the evidence for the hypothesis that SIBO is present in long distance runners with frequent GI symptoms due to the high weekly training volume with irritation of GI motility and repeated impairment of mesenteric perfusion.


Training, lifestyle modifications, meal composition, adequate hydration and avoidance of excessive use of some medications are the recommendations. If small intestinal bacterial overgrowth (SIBO) is diagnosed, treatment that is appropriate for the individual athlete must be provided.

Learning Objectives:

  • Understand how mechanical irritation of the GI tract and reduction in mesenteric blood flow may or may not be due to small intestinal bacterial overgrowth.  

  • Understand what modifiable factors may prevent the GI symptoms that can deter athletes from participation in training and competitive events. 

  • Understand what forms of treatment for SIBO may be most suited for athletes.

  • Understand how TBI can be a risk factor for SIBO.

Past Conference Participation

2017 Integrative SIBO Conference - Chicago, Illinois

~ Featured Speaker ~

"SIBO and Skin Disease" (with Dr. Leonard Weinstock, MD, FACG)

2017 NMSA Annual Conference - Phoenix, Arizona

~ Featured Speaker ~

"One ND's Party to Success - A provocative look at naturopathic medicine in today's world"

2018 Integrative SIBO Conference - New Orleans, Louisiana

~ Panelist ~

2019 Integrative SIBO Conference - Seattle, Washington

~ Panelist ~

2020 Integrative SIBO Conference - San Diego, California

~ Featured Speaker ~

"SIBO In Athletes"


2017 Integrative SIBO Conference Teaser

bottom of page