SIBO
Bloating after meals, abdominal pain
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About SIBO
Small intestinal bacterial overgrowth, or SIBO, is a condition where an unusually large number of bacteria grow in the small intestine. This often includes types of bacteria that aren't typically found there. Also known as blind loop syndrome, SIBO usually happens when something, such as surgery or a disease, slows down the movement of food and waste through the digestive tract. This creates an ideal environment for bacteria to multiply.
When bacteria overgrow, they can cause a range of issues, including diarrhoea, weight loss, and malnutrition. Although SIBO is frequently a complication of abdominal surgery, it can also be caused by underlying structural issues or other medical conditions. While surgery may be necessary in some cases to correct the problem, the most common treatment is a course of antibiotics.
Digestive Enzymes
Verified Supplement
Why it works:
Replace missing enzymes → better digestion, less fermentable substrate. If fats/proteins/carbs aren’t digested because pancreatic enzymes are low, more undigested food reaches bact...
Instructions:
Note: the clinical context matters — enzyme replacement is standard when PEI is present (chronic pancreatitis, pancreatic surgery, cystic fibrosis, some pancreatic cancers). For pe...
Warnings:
Not a substitute for standard SIBO therapy — enzymes are supportive (especially when PEI is present)...
Studies:
Strong evidence that PERT works for pancreatic exocrine insu...
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Berberine
Verified Supplement
Why it works:
Antimicrobial Properties: Berberine exhibits broad-spectrum antimicrobial activity, targeting various bacterial species implicated in SIBO. This includes inhibition of bacterial gr...
Instructions:
Dosage Recommendations:. • Typical Dosage: The standard dosage for berberine in SIBO treatment ranges from 1,000 to 1,500 mg per day, divided into 2-3 doses taken with meals. Casa...
Warnings:
Common Side Effects:. • Gastrointestinal Distress: Users may experience side effects such as abdomin...
Studies:
BRIEF-SIBO Study: An open-label, non-inferiority randomized...
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Peppermint
Verified Herb
Why it works:
Peppermint oil's effectiveness for SIBO and its associated symptoms, such as those seen in Irritable Bowel Syndrome (IBS), stems from several key properties of its primary active c...
Instructions:
The instructions for using peppermint oil for SIBO are quite specific to maximize effectiveness and minimize side effects.. Formulation is Key: Use Enteric-Coated Capsules: This is...
Warnings:
While generally considered safe when used appropriately, peppermint oil is not without risks and pot...
Studies:
Much of the high-quality research on peppermint oil has focu...
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Allicin
Verified Supplement
Why it works:
Allicin is the primary bioactive sulfur compound derived from garlic (Allium sativum) and is responsible for its potent therapeutic properties. It is formed when garlic is crushed...
Instructions:
Using allicin for SIBO requires specific formulations and protocols to be effective, as the compound is notoriously unstable.. • Formulation is Key: Use Stabilized Allicin Products...
Warnings:
Blood-Thinning (Antiplatelet) Effects: This is the most significant warning. Allicin can interfere w...
Studies:
Herbal Therapy vs. Rifaximin for SIBO: A foundational study...
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Neem
Verified Herb
Why it works:
Neem's antimicrobial properties help eliminate the overgrowth of bacteria in the small intestine, restoring the balance and reducing symptoms associated with SIBO. Its ability to m...
Instructions:
Dosage Guidelines:. Standard Dosage: Recommended dose: 500-1000 mg twice daily with meals for six weeks (Birchwell). Clinical Protocol Dosage: Take 1 cap 3x per day for a total of...
Warnings:
Pregnancy and Breastfeeding:. Neem oil and neem bark are likely unsafe when taken by mouth during pr...
Studies:
Herbal vs. Antibiotic Efficacy: The response rate for normal...
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Grapefruit Seed Extract
Verified Supplement
Why it works:
Laboratory (in vitro) antibacterial activity. Multiple studies show GSE can inhibit a wide range of bacteria in lab tests (disc diffusion, MIC). That’s the main mechanistic rationa...
Instructions:
Common formulations: liquid tinctures (drops), capsules/tablets. Liquid is frequently used by practitioners because it’s easy to dose/titrate. Elissa Goodman stuffthatworks.health....
Warnings:
This is crucial — GSE has notable safety and interaction concerns.. • Drug interactions (major). Gra...
Studies:
No high-quality human RCTs showing GSE cures SIBO. I found i...
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Probiotics
Verified Supplement
Why it works:
Competitive exclusion & ecological replacement: some probiotic strains compete with overgrown bacteria, reduce pathogen adhesion, or secrete substances that inhibit growth of harmf...
Instructions:
A. Choose strain(s) with evidence. • Saccharomyces boulardii CNCM I-745 — Pooled and recent RCTs show benefit; commonly used dose in trials: 250 mg (or ~5×10^9 CFU equivalent of Sb...
Warnings:
May worsen symptoms in some people with SIBO. • Adding live bacteria to an already bacteria-overgrow...
Studies:
Zhong C. et al., 2017 — Meta-analysis (Journal of Clinical G...
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