Ronald Grisanti D.C., D.A.B.C.O., DACBN, MS, CFMP

There appears to be a direct correlation between restless leg syndrome (RLS) and irritable bowel syndrome (IBS).

What is restless leg syndrome?

RLS is a disorder in which a person experiences uncomfortable urges to move their legs. Symptoms typically occur during times of rest or inactivity, particularly in the evening and into the night and may contribute to insomnia. These bothersome urges are often relieved with movement. It is estimated that RLS affects approximately 7-10% of the population

What Causes RLS?

Researchers have identified the following as possible contributors to the problem:

  • Genetic predisposition
  • Problems with the neurotransmitter dopamine
  • Problems with the metabolism of iron
  • Problems with nervous system motor pathways

Clinical studies are showing that some people who have certain gastrointestinal disorders have a higher rate of RLS, including celiac disease, Crohn’s disease, and IBS.

Studies estimate that approximately one-fourth to one-third of IBS patients may also have RLS.

The specific gut issue associated with RLS is a condition called Small Intestine Bacterial Overgrowth (SIBO).

SIBO is a condition in which rare gut-residing bacteria are over-represented in the gut.

Why does SIBO cause restless legs?

Chronic inflammation caused by SIBO or gut dysbiosis [when there’s an unhealthy balance of types of gut bacteria] in the colon may release additional hepcidin — a hormone that can decrease iron availability in the brain and contribute to RLS.

A Stanford findings suggest that, potentially, treating a person’s SIBO may help resolve the brain iron deficiency that contributes to RLS.

Promising Treatment

In one study, 13 IBS patients who tested positive for SIBO using breath testing were treated with the antibiotic rifaximin for a period of 10 days. Following treatment, according to the study, 10 of these patients experienced “at least 80% improvement” in their RLS symptoms. At a later follow-up date, half of these patients reported complete relief from their RLS.

For a more comprehensive natural treatment for SIBO, evaluation and functional lab testing are available to determine the most effective plan. This may include dietary recommendations specific for SIBO and natural botanicals (herbs) that are effective in treating SIBO.


Although the studies are small I believe there is hope that in patients suffering with IBS (SIBO) and RLS, treatment to eradicate SIBO could in fact be helpful.