Can Probiotics Treat SIBO?

You may also be interested in the section of my blog dedicated to gut health, click here, in particular:

• SIBO: Natural Treatment Considerations
• SIBO: What Causes It?

Can Probiotics Treat SIBO?

For all of these reasons and given their ability to repopulate the microbiota, it should come as no surprise that there has been considerable recent interest in the use of probiotics and prebiotics in SIBO.

Probiotics are living organisms, including lactic acid bacteria and nonpathogenic yeasts, that provide health benefits to the host. Based on a considerable volume of laboratory studies, a variety of mechanisms whereby such benefits may be conferred have been identified:

• Competition with pathogens
• Production of bacteriocins
• Inhibition of bacterial translocation,
• Enhancement of mucosal barrier function
• Downregulation of inflammatory responses
• Metabolic effects
• Modulation of gut motor and sensory responses
• Signalling between luminal bacteria, the intestinal epithelium, and the immune system.

Which Probiotics Are Best To Treat SIBO?

Probiotics that have been investigated and discussed in the research include:

• Soil based probiotics
• Single strain probiotics
• Broad spectrum probiotics
• Saccharomyces boulardii – a yeast strain probiotic

At this point in the research we can’t confirm which probiotics are best but numerous benefits have been discussed including:

• Initial therapy
• Maintenance of eradication/suppression of SIBO
• The prevention of undesired effects of antibiotics

Let’s look at these and consider specific options.

Listen to the world renowned Dr. Siebecker discuss pro kinetics, probiotics and SIBO:

Do Soil Based Probiotics Treat SIBO?

A study by Gabrielli and colleagues provided some promising data from a study on Bacillus clausii which produced a rate of normalisation of hydrogen breath tests that was comparable to antibiotics. This probiotic is found in ‘Just Thrive‘.

The study by Khalighi and colleagues serves to shed some new light on the role of probiotics and prebiotics in the treatment of SIBO. In this study, patients with symptoms suggestive of SIBO were tested for its presence using a lactulose breath test. Thirty patients with a positive breath test were identified, all treated for three weeks with an antibiotic.

At the end of this treatment period they were randomised into two groups, one to receive a synbiotic preparation called Lactol; a proprietary formulation that combined the probiotic Bacillus coagulans  with prebiotics in the form of fructo-oligosaccharides) for 15 days of each month followed by an antibiotic for the remaining 15 days, and the other, to receive the antibiotic for the first 15 days of each month with no treatment for the remaining 15 days; each group was treated and followed for six months.

At the end of the six months SIBO breath tests and symptom assessments were repeated and compared to baseline.

Those in the probiotic group had significant reductions in pain, bloating, belching and diarrhoea in comparison to the control group. Indeed, all of those in the probiotic group reported complete resolution of abdominal pain in comparison to only 7 of 15 in the antibiotic only group.

Lastly, post-treatment SIBO breath testing was noted to be negative in 93% of those in the probiotic group in comparison to 66% in the antibiotic only group.

• Bacillus Coagulans

Lactobacillus Probiotics And SIBO

In a small study, both Lactobacillus casei and Lactobacillus acidophilus strains cerela proved effective in treating chronic diarrhoea related to bacterial overgrowth; others showed efficacy in terms of symptomatic benefit among patients with SIBO and functional intestinal distention.

• L. Rhamnosus GG is excellent for diarrhoea and helpful in binding histamine when an issue.
• Biogaiia has been shown to lower methane gas.

Does Saccharomyces Boulardii Treat SIBO?

S. Boulardii is one of the most well researched probiotics and a staple within many of my programs.

In a study looking at patients with patients with systemic sclerosis saccharomyces boulardii lead to better results. The authors concluded:

S. boulardii in monotherapy or in combination improves the gastrointestinal outcomes in SSc.

In a study that used a combination of Saccharomyces boulardii, Bifidobacterium lactis, Lactobacillus acidophilus, and Lactobacillus plantarum the authors found that:

thirty days after the end of treatment, a 71.3% decrease of the total IBS score was detected in patients with IBS and SIBO compared to 10.6% in those without SIBO

• Saccharomyces Boulardii

Summary

Given the various potential adverse effects associated with the use of antibiotics and prolonged courses of antibiotics, in particular, the definition of a therapeutic role (whether in initial therapy, maintenance of eradication/suppression of SIBO, or in the prevention of undesired effects of antibiotics) for probiotics and prebiotics in SIBO would represent a major step forward.

References

1. Probiotics, prebiotics & synbiotics in small intestinal bacterial overgrowth: Opening up a new therapeutic horizon!: click here.
2. Effectiveness of Saccharomyces boulardii and Metronidazole for Small Intestinal Bacterial Overgrowth in Systemic Sclerosis: click here.
3. Effect of a Preparation of Four Probiotics on Symptoms of Patients with Irritable Bowel Syndrome: Association with Intestinal Bacterial Overgrowth: click here.