Wrong Probiotics Could Be Triggering Your SIBO

Probiotics are defined as microorganisms that have beneficial effects on the intestinal microbiome. Over the years they have attracted interest from researchers and clinicians for their positive impacts on gut health and gastrointestinal (GI) diseases. But what about SIBO? Are probiotics good for SIBO where there is an overgrowth of bacteria? Remember that SIBO is not caused by “bad” bacteria only. Even “good” bacteria can cause SIBO if they grow out of control in your gut.  So can taking probiotics cause SIBO or make it worse? In this article we are going to talk about SIBO and probiotics. 

In fact, one clue that you may have SIBO is that when you take a probiotic containing lactobacillus or bifidobacterium you have an exacerbation of your symptoms such as more gas, bloating, constipation, diarrhea or other digestive symptoms. But does this mean you should not take probiotics? Just because some probiotics might trigger SIBO, it doesn’t mean that you should dismiss all probiotics immediately. Probiotics can be indispensable in helping you correct dysbiosis (unbalanced gut flora) after treatment – particularly treatment with antibiotics and natural antimicrobials.

Probiotics: Adding Fuel to the Fire

Treating SIBO is a multi-step multi pronged approach. The first step is to remove the foods that feed it. A Low FODMAP/SIBO diet eliminates sugar, alcohol, and many carbohydrates or FODMAPS.

Second, you need to attack the bad bacteria or reduce number of good bacteria. Depending on the type of gas produced by your gut organisms (hydrogen or methane).

Third step is to restore the beneficial bacteria with SIBO probiotics. The problem with many probiotics on the market is that they simply don’t work for SIBO. Taking the wrong probiotics can actually make the overgrowth and the symptoms of SIBO worse.

Here’s why: Your small intestine is not meant to have much bacteria in it. When you do have bacteria in the small intestines (where they don’t belong) they can interfere with digestion and nutrient absorption. This is why some people lose weight when they have SIBO. When it comes to bacteria you want your bacteria levels to be just right for optimal digestion and absorption.

For this reason, I believe soil-based probiotics for SIBO are the best probiotics to start with when you first find out or are diagnosed with SIBO.

Some Probiotics Contain Ingredients That Can Trigger SIBO.

Consider this list of some of the most commonly available probiotics that you may have seen.

1. Jarro Dophilus: Contains maltodextrin, tapioca starch, dairy and soy
2. Florastor: Contains lactose
3. Align: Contains lactose
4. Culturelle: Contains inulin
5. Jarrow Ideal Bowel Support: Contains potato starch and soy
6. Pears YB: Contains pectin
7. Probio Pure’s: Contains tapioca starch

Taking any of these probiotics while you have SIBO, could work against your SIBO treatment.  They could possibly just fuel the overgrowth of bacteria in the small intestines and make it harder to restore balance.

How (the Right) Probiotics Help SIBO

Just because some probiotics might trigger SIBO, it doesn’t mean that you should dismiss all probiotics immediately. Probiotics can be indispensable in helping you correct dysbiosis (unbalanced gut flora) after treatment – particularly treatment with antibiotics or herbal antibiotics for SIBO

 

 

How the Right Probiotics Could HELP Your SIBO:

1. Probiotics help modulate the gut’s immune system
2. Probiotics produce anti-microbial compounds that help illuminate pathogens. These compounds are vital for keeping levels of “bad” bacteria under control and preventing and treating dysbiosis.
3. Probiotics strengthen the gut mucosal barrier and prevent pathologic bacteria from clinging to the GI tract walls.
4. Probiotics improve motility

Best Probiotics For SIBO

Most probiotics fit within one of the categories you see below. If you experience a bad reaction or SIBO flare up, you might need to change the kind of probiotics you are taking. My best recommendation when it come to SIBO is First Test, Its helpful to get a blue print of whats wrong and where your microbiome needs help. Next Implementing the Right kind of SIBO probiotic.

It’s easiest to start with one of the below categories and layer from there to avoid an adverse reaction that you can’t get to the bottom of. Those who tolerate a variety can work their way up to all three.

Types of Probiotics for SIBO

Lactobacillus and bifidobacterium blends:

Both Lactobacillus and Bifidobacterium strains are widely studied for their treatment of various infectious and inflammatory conditions.

Lactobacilli are lactic-acid forming bacteria that are notorious for playing a prominent role in food fermentation, as well as having a diverse clinical and experimental profile in disease treatment.

This species of probiotic has been recently studied for its ability to colonize the GI tract and restore microbiota-host symbiosis, an important element in treating gastrointestinal pathologies such as SIBO.

Word of Caution. When bacteria are present in the small intestine, the bacteria usually identified are often one of these species, which is why some clinicians avoid using lacto-bifido blend probiotics in the initial treatment strategies. This doesn’t mean that you shouldn’t use or don’t need lactobacillus species if you have SIBO, I have used these strains found in Lactoprime plus very successfully with many of my patients.

Multiple strains of lactobacillus display probiotic qualities beneficial for SIBO, for example this clinical trial concluded that supplementation with both Lactobacillus casei and Lactobacillus acidophilus was effective in treating bacterial overgrowth and related symptoms in patients who also suffer from IBS.

For those that have low levels of either lactobacillus species or Bifidobacterium species you may want to try Lactoprime Plus.  lactoprime plus is broad-spectrum, 12-strain blend of seven Lactobacillus and five Bifidobacterium species is provided in a base of purified plant cellulose. This formula is free of inulin and other prebiotics and polysaccharides, making it suitable for those who strictly adhere to the Specific Carbohydrate Diet (SCD™), SIBO, GAPS diet, or who have similar dietary restrictions. This potent blend of 25+ billion CFUs offers significant support in favorably augmenting gastrointestinal microflora and enhancing immune responsiveness to pathogens.

Saccharomyces boulardii:

S. boulardii is a beneficial yeast that is an-all around powerhouse for IBS, SIBO, immune deficiency, leaky gut, and traveler’s diarrhea. S. boulardii has a tremendous impact on Secretory IgA levels which plays an integral role in the immune system of the microbiome.

Low SIgA often allows bacterial overgrowth to occurs and high levels of SIgA often point towards some kind of infection or overgrowth of bacteria or yeast.

Very often patients with with Candida are afraid of S. boulardii because it is a yeast. But…….S. boulardii is a GOOD yeast because of its ability to crowd out pathogenic or disease causing yeast like Candida Albicans and Candida Glabrata.  It’s also been shown that Saccharomyces boulardii decrease hydrogen gas in cases of confirmed SIBO.

Clinically, S. boulardii has exhibited an ability to regulate intestinal microbial homeostasis, stabilize the GI barrier, and modulate the immune system by mimicking the protective effects of healthy gut flora.

Several studies show that S. boulardii can enhance nutrient absorption, which is crucial for patients with SIBO suffering from malnutrition and nutrient deficiencies, two possible symptoms associated with the condition.

A 2019 RCT out of the Journal of Digestive Diseases and Sciences gave SIBO patients S. boulardii capsules for four weeks and saw a significant decrease in diarrhea, abdominal pain, and gas/bloating, as well as a 33% eradication of SIBO with just S. boulardii supplementation alone (a 55% eradication was seen when treated with a combination of the probiotic with an antibiotic).

Soil Based Probiotics- The Best and Safest Place to Start with Probiotics

Soil-based probiotics have a natural, seed-like structure that makes them hardier than lacto-based probiotics. Therefore, soil-based probiotics survive the journey through the stomach with the help of far fewer colony-forming units (CFUs) than lactobacillus-based supplements. This is due to the formation of endospores, which can withstand stomach acid, bile salts, and pancreatic enzymes that would normally destroy the bacteria.

Bacillus coagulan is a spore-forming probiotic bacteria known for its exceptional stability and efficacy in treating intestinal disorders, and it has even been recognized as a safe probiotic strain by the FDA.

It is thought to be one of the best probiotics for SIBO & a hot topic in the medical community due to its curative effects on gut health via inhibiting the growth of pathogenic bacteria, facilitating excretion & digestion through enzyme secretion, and normalizing immune function.

These characteristics of soil-based probiotics are also what make them the best probiotics for SIBO and why I recommend people who have SIBO to start here FIRST.

 

Studies Showing Why We Need Probiotics When We Have SIBO:

• A pilot study compared probiotics to antibiotic treatment for SIBO. The group taking probiotics had an 82% improvement compared to 52% for the antibiotic group.  Strains used were Lactobacillus casei, Lactobacillus plantarum, Streptococcus faecalis and Bifidobacterium brevis. Both groups also were on a diet that limited legumes, alcohol, leafy greens and dairy. (Source)
• A study had patients take a 6-week course of Lactobacillus casei. 64% of the patients had a negative breath test afterwards. (Source)
• A study gave SIBO patients two billion spores of Bacillus clausii 3x per day for 1 month. 47% of the patients had negative breath tests afterwards. (Source)

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