Small intestinal bacterial overgrowth (SIBO) is a condition that affects your gut health. Natural treatments like probiotics, dietary changes, and herbal supplements may help, though more research is needed. Antibiotics are the first line of medical treatment.
If you live with SIBO, you may seek natural strategies to alleviate occasional symptoms. Although some home remedies may help, doctors often recommend medical intervention.
What is SIBO?
SIBO refers to excess bacterial growth in the small intestine that causes persistent gastrointestinal symptoms.
Your gut is home to a diverse family of healthy bacteria that help digest your food. They’re also called your gut microbiota or your gut flora. Sometimes, too much of a good thing may not be ideal.
Symptoms of SIBO may include:
bloating
nausea
stomach pain
diarrhea
constipation
nutrient malabsorption
Possible risk factors that can contribute to SIBO include:
gut motility issues
certain anatomical abnormalities
hypochlorhydria (low stomach acid that makes digestion difficult)
suppressed immunity challenges,including human immunodeficiency virus (HIV)
Natural strategies may improve SIBO symptoms in some people. However, the effectiveness of these approaches often depends on the underlying cause. Therefore, it’s best to consult a healthcare professional for tailored advice.
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Probiotics are live bacteria that can help restore your gut flora balance.
A 2017 research review states that probiotic supplements may improve SIBO and associated symptoms. Probiotic supplements could be especially effective for reducing stomach pain.
However, researchers emphasize the need for more research. It would help better understand which strains of probiotics and what amounts are the most effective to treat SIBO. Further, the effectiveness of the strains may differ from person to person.
Dietary changes
Adjusting your eating plans may play a role in managing SIBO naturally, although research is mixed on what does and doesn’t work.
For instance, the low FODMAP diet (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) limits certain carbohydrates that can feed SIBO bacteria. Clinical guidelines from the American Journal of Gastroenterology explain that this diet has shown promise in reducing SIBO symptoms for some individuals.
Meanwhile, a 2022 review, including 34 studies, explored how an IBS-friendly diet could affect SIBO. The research states that probiotics, mindful eating practices, and fiber supplements improve symptoms, while a low FODMAP diet does not.
Extensive studies would help learn more about the effect of diet on SIBO. Ultimately, it’s best to talk with a healthcare professional for tailored advice on which eating patterns may support your SIBO healing.
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Herbal supplements
According to 2021 research on herbal treatments for SIBO, herbs with antimicrobial properties — including cloves, garlic, thyme, cinnamon, and black cumin — might benefit SIBO symptoms.
However, existing studies do not have enough evidence to verify these results. More research will help us learn about the effects of herbs on SIBO.
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You may require medical treatment if you do not get enough relief from natural remedies or if your SIBO is severe.
A 2020 research review from the American Gastroenterological Association states that antibiotics are often the first and primary SIBO treatment approach. However, the authors also indicate that research is scarce on which types to use, the optimal treatment duration, and the strength of the antibiotics you need.
Common antibiotics used to treat SIBO may include:
Rifaximin may be the one with the most evidence behind it. It is a nonabsorbable antibiotic, which means it is not well absorbed in the gut. So, it mainly affects the small intestine, not your whole body, which may lead to fewer side effects.
How to prevent SIBO
Many conditions can contribute to the development of SIBO, so prevention and treatment can differ from person to person.
General tips to improve your gut health and reduce your risk of developing SIBO include:
Eat a gut-friendly diet: According to a 2017 article, certain foods can help keep your gut microbiota healthy. These foods include fiber sources like oats, fermented dairy products like yogurt, unsaturated fats like fish oil, and lean protein like whey.
Exercise: A 2019 review states that regular exercise may improve gut microbiota diversity and health. For example, regular jogging, walking, or strength exercises.
Limit antibiotic use: As per a 2020 article, overuse or misuse of antibiotics can create an imbalance in your gut bacteria. It’s important only to take antibiotics as directed by a healthcare professional.
Address underlying conditions: Working with a healthcare professional to manage underlying conditions like IBS, HIV, or pancreatitis may subsequently improve SIBO.
Summary
Natural strategies like probiotics, dietary changes, and herbal supplements may improve SIBO symptoms for some individuals, although research does not validate natural treatments for this condition.
In severe cases or when natural efforts are ineffective, medical treatment with antibiotics like rifaximin or metronidazole may be helpful.
Nickles MA, et al. (2021). Alternative treatment approaches to small intestinal bacterial overgrowth: A systematic review. https://pubmed.ncbi.nlm.nih.gov/33074705/
Wielgosz-Grochowska JP, et al. (2022). Efficacy of an irritable bowel syndrome diet in the treatment of small intestinal bacterial overgrowth: A narrative review. https://www.mdpi.com/2072-6643/14/16/3382
Zhong C, et al. (2017). Probiotics for preventing and treating small intestinal bacterial overgrowth: A meta-analysis and systematic review of current evidence. https://pubmed.ncbi.nlm.nih.gov/28267052/