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SIBO & Probiotics

By Aglaee Jacob

SIBO, or small intestinal bacterial overgrowth, is an infection of the small intestines that is especially common in people suffering from IBS, or irritable bowel syndrome, and other gastrointestinal diseases, according to Dr. Allison Siebecker at The role of probiotics to promote gastrointestinal health is more studied and recognized, but more data is needed to establish their role in the management of SIBO.


It is normal to have a certain level of bacteria in your small intestines, but when these levels exceed normal, you can experience a lot of unpleasant side effects. SIBO is diagnosed with a hydrogen breath test similar to the test used to diagnosed lactose intolerance, but using either lactulose or glucose instead of lactose. The typical IBS symptoms of bloating, flatulence, cramping, diarrhea and constipation can be due to SIBO, but SIBO can also cause or aggravate headaches, heartburn, nausea, weight loss, anemia, joint pain, depression, autism, fatigue, skin problems and respiratory problems, according to Dr. Siebecker.


Antibiotics are one of the main treatment used to correct a SIBO infection, but if you are prone to SIBO, the infection is likely to come back if the underlying problem is not corrected. For a longer-lasting solution, some people turn to more natural options, such as herbal antiobiotics, elemental formulas or a strict grain-free, starch-free and sugar-free diet, such as the Specific Carbohydrate Diet or Gaps diet. Probiotics should definitely be taken after taking antiobiotics to replenish the healthy bacteria in your gut, but they can also be used in conjunction with a more natural treatment approach to correct SIBO infection.

Probiotics and SIBO

SIBO is a relatively recently recognized condition and more studies are needed to better understand it and treat it. A study published in the August 2008 issue of "World Journal of Gastroenterology" showed that a probiotic containing Lactobacillus casei, strain Shirota, did not significantly reduce SIBO-related symptoms with the exception of flatulence in the 14 participants who completed the six-week study. However, larger scale and longer term studies with other strains of probiotics may yield different results in the future.

Start Slowly

If you want to give probiotics a try, you can either choose a good quality probiotic supplement or eat fermented foods, such as yogurt, kefir, raw sauerkraut or kombucha. Making your own fermented foods is a cheap and easy way to include multiple strains of probiotics. Whether you choose to go with supplements or fermented foods, introduce probiotics slowly. Start with very small dose and increase very gradually. For example, if you want to try raw sauerkraut or yogurt, have 1 teaspoon a day for the first few days and gradually work your way up. If you use supplements, choose the lowest possible dose at first and gradually increase it if you tolerate it well. Some people with SIBO can experience a worsening of their symptoms when introducing probiotics, so it is important that you assess your individual tolerance, which can vary with different dosage and strains of probiotics.

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