Q&A: Do Probiotics Help SIBO?

This video addresses a common question regarding the use of probiotics for Small Intestinal Bacterial Overgrowth (SIBO), particularly during or after treatment.

Please see the Probiotics for SIBO page, for the most up-to-date information and recommendations.

The Probiotic-SIBO Paradox

• Study Findings: Research suggests that certain probiotics can be highly effective, even showing potential to eradicate SIBO.
• Clinical Discrepancy: However, this success often doesn't translate into clinical practice. Practitioners frequently struggle to replicate these positive outcomes with patients.

Probiotics Studied for SIBO:
Studies have investigated several types of probiotics for SIBO, including:

• Spore probiotics (e.g., Bacillus clausi)
• Lactobacillus and bifidus strains (e.g., Lactobacillus reuteri)
• Probiotic yeasts (e.g., Saccharomyces boulardii)

All these types have demonstrated significant positive results in research settings.

Real-World Clinical Experience:
Despite promising study results, clinical application shows varied outcomes:

• Intolerance: Many individuals cannot tolerate probiotics at all, reporting worsened digestive symptoms.
• Modest Benefit: A significant portion of people experience a moderate benefit (around 20-25%), which is helpful but not transformative.
• Rare Success: A small number of individuals report feeling substantially better.

Specific Probiotic Strains to Consider:
While studies show a broad range can be beneficial, some strains have specific associations:

• Lactobacillus reuteri: Has been noted for its potential to help lower methane and constipation (and also hydrogen levels).
• Lactobacillus plantarum: Is considered very helpful.
• Bifidis infantis: (marketed as Align in the US) is also reported to be very beneficial.

Guidance for Choosing Probiotics
Given the complexities, the advice is to:

• Consider strains like L. reuteri, L. plantarum, and B. infantis.
• Refer to Dr. Siebecker's curated lists of probiotics that have shown clinical benefit or strong research backing at Fullscript and on the Probiotics for SIBO page.

Products Mentioned:
- SIBO Probiotics at Fullscript (15% off)
- L. reuteri (Amazon)
- L. plantarum (Amazon)
- Align (Amazon)