If you are looking for an effective solution for handling SIBO then probiotics is the right one. Because it deals with the root cause than just masking up the symptoms.
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As the name itself says, SIBO (small intestinal bacterial overgrowth) refers to abnormal presence of bacteria in the small intestine. This usually happens when the bacteria present in large intestine invade the small intestine and take over the flora in it.
Taking probiotics will keep the abnormal growth in control, strengthen the mucosal barrier in the gut and prevent the bacteria from invading the small intestine.
So, if you want to try probiotics for treating your SIBO problem then we have listed down the best supplements for you. If you want to know the factors we considered while choosing them then read our buying guide.
Top 8 Recommended Probiotic Supplements for SIBO
After a thorough research and testing, we have selected the best probiotic supplements for SIBO. However, we recommend checking with your doctor before trying out…
|Major Probiotic Strain
|Check the Price
|Klaire Labs Lactoprime Plus Scd Compliant
|Bifidobacterium infantis 35624
|Check the Price
|Kirkman Labs – Bifido Complex
|Check the Price
|Bacillus Indicus (HU36TM)
|Check the Price
Out of all of the 4 products, Ortho Molecular has taken the first place because it is one of the most recommended probiotic supplement by doctors. Even though it is a bit pricey, it is completely worthy…
Best Probiotic Supplements for SIBO: 2020 Review
This probiotic supplement contains the strain of Saccharomyces Boulardii, which is actually a yeast strain but not bacteria. This is the only beneficial yeast that is considered to be probiotic. It is effective in combating the pathogenic bacteria and reduces inflammation in the small intestine. As it cannot colonize the GI tract, this has to be taken continuously. Usually, it is recommended to take it along with a bacterial strain that can colonize the gut.
This product doesn’t contain any prebiotics that can worsen the SIBO. The product is manufactured in an innovative BioShield technology process to ensure reliable and consistent supplement to the customers.
The micro-organisms in this supplement are first protected, sealed and freeze dried away from light, moisture, oxygen, and heat. This enables the microorganism in hibernation state which allows them to be dormant until they re-exposed to moisture present in the GI tract. Each capsule of this supplement contains 7 bacterial strains (which includes Saccharomyces Boulardii) which can withstand the ability to withstand harsh stomach environment and reach the small intestine to provide their benefits.
- Doesn’t contain prebiotics
- Nor refrigeration needed
- Specially formulated for room temperature storage
- Contains 7 bacterial strains
- 2 billion CFU of Saccharomyces Boulardii
- Vegetable capsules
- A little pricey
The main bacterial strain of this supplement is Bifidobacterium Infantis, which is proven to be effective in reducing abdominal pain, bloating and bowel difficulty. Many studies have suggested that it works by playing an immune-modulating role. Usually, this specific bacterial strain is difficult to find in probiotic supplements.
This probiotic supplement doesn’t contain any prebiotics, polysaccharides or any other off-limit ingredients. It contains 7 bacterial strains of Lactobacillus species with 19+ billion BFU’s and 5 bacterial strains of Bifidobacterium species with 6+ billion CFU’s.
This supplement enhances immune system response which helps to keep several inflammations and infections at bay. Recommended dosage is 1 capsule per day with a large meal.
- Doesn’t contain prebiotics and other fillers
- Vegetarian capsule
- Contains 12 bacterial strains and 25+ billion CFU’s
- Physician formulated, trusted and approved
- Specific Carbohydrate Diet (SCD) compliant
- It should be refrigerated
Many SIBO and IBS sufferers have found successful results with soil based probiotics. Usually, soil based probiotics are only available with a doctor’s prescription. Fortunately, only company brand is available that provides soil based probiotics without a prescription which is Prescript Assist.
This product contains 29 bacterial strains, out of which Bacillus Indicus plays a major role. These bacterial strains help to support healthy microflora and intestines. As these capsules are highly viable, they can withstand the stomach acidity and safely reach the intestines.
The bacterial species present in this supplement are inherently resilient, many tests have proven that they can maintain 95% viability even after exposure to 98F+ heat for two years. Recommended dosage is 1 – 2 capsules per day as directed by the physician.
But this product contains certain prebiotics as well. As now two SIBO cases are same, some may get relief from capsules with prebiotics as well. So it is better to give it a try and know how you react. If not, you can go with any other probiotic supplement.
- Doesn’t need refrigeration
- Vegetarian capsules
- Doesn’t contain milk, eggs, peanuts, gluten, corn, tree nuts, shellfish, and soy
- Doesn’t contain any added preservatives or fillers
- Soil based probiotics
- 2 years of expiry date from manufacturing date
- A little expensive
- Not for those who are taking dietary probiotics for first time
VSL 3 is known for providing highest concentration of beneficial probiotic supplement in the market. Unlike tablets or capsules, this supplement comes in powder form.
Each packet contains 112.5 billion live colony forming bacterial cells – which is pretty high enough to treat some serious health issues like IBS, Ulcerative Colitis, Ileal pouch or SIBO.
As soon as the bacteria cells reach your intestines, they attach to the GI tract and create a barrier which acts as a shield against pathogenic bacteria. This supplement also helps in minimizing the intestinal fluid flow rate – this is achieved by tightening junctions between stomach cells.
Each packet contains 8 different dried probitic bacteria that include – B. breve, B. infantis, B. longum, L. acidophilus, L. plantarum, L. paracasei, L. bulgaricus and streptococcus thermophilus. This combination of bacterial strains is perfect for improving digestive and intestinal health.
Some studies have proved that VSL 3 was very effective in relieving IBS and other similar digestive issues. (5)
This is a medical grade probiotic supplement, so you don’t have to worry much about the safety. It doesn’t contain any fillers, flavors or allergic ingredients.
- High potency of live bacterial cells.
- Packaged carefully in ice box.
- 8 live bacterial strains and 112.5 CFU’s.
- Powder form – so you can add it to your food (cool).
- Shipped within 2 days.
- Needs to be refrigerated.
- A bit pricey.
Microbiome Plus + is a Canadian-based supplement manufacturer who claims to provide complete gastrointestinal healthy dietary supplement. Unlike other colon-enhancing supplements, it is much more digestible and popular one.
This brand provides an advanced combination of prebiotics and probiotics – which is perfect for treating SIBO and other IBS related issues. Each capsule contains 600mg scFOS and 3.5 billion probiotic CFU’s. The bacterial strain it contains is L-reuteri NCIMB 30242 which is known to support normal inflammatory response and digestive health.
It doesn’t contain any allergens and free from gelatin. So, even vegans and vegetarians can take this supplement. You have to store this supplement in a cool and dry place. Refrigeration is not recommended or necessary.
- Safe and natural formula.
- Proven ingredients to improve digestive health.
- Combination of prebiotics and probiotics.
- No side effects haven reported.
- No money back guarantee.
If you are looking for affordable probiotic supplement for treating SIBO then Align has to be your choice. It is one of the most prescribed supplement by gastroenterologists.
It contains patented probiotic strain Bifidobacterium 35624TM. This strain is known to strengthen your digestive system and maintain the gut balance. Each capsule of this supplement contains 1 billion cells which stay potent and viable until expiration.
This supplement undergoes vigorous testing to ensure it is safe, potent and pure. The capsule size is small which makes it easy to swallow.
They are packed in a blister pack to protect them from light and moisture. They have to be stored in dark and dry place. They don’t require any refrigeration so you can take them with you while travelling.
However, it contains milk so people with lactose intolerance should avoid taking it. The outer shell of the capsule is made of cellulose so even vegans can take it.
- Gastroenterologist recommended product.
- 1 billion cells.
- Safe, potent and pure.
- Blister packed.
- No refrigeration required.
- Helps maintain digestive health.
- Contains milk. Not suitable for lactose intolerant people.
Jarrow Formulas has been a very good distributor and supplier of dietary supplements at affordable prices. Ideal bowel support is one of their best supplements good for SIBO and GI tract.
It contains 10 billion beneficial colony forming units in one capsule. This supplement has the most clinically documented probiotic strain – L. plantarum 299v. This strain plays a main role in nutritional and digestion process. Apart from that, it also metabolises fibers and sugars into vital nutrients.
The Ideal Bowel Supplement by Jarrows Formulas is shelf stable. So, you don’t have to refrigerate it. And moreover you can carry them with you on the road. All the capsules are blister packed in order to provide superior protection – this ensures the bacterial cells are viable until date of expiration.
These supplements do not contain any artificial ingredients, flavours and fillers. The outer shell of the capsule is made up of cellulose, so it is suitable for vegans too.
This product is manufactured in cGMP certified facility. And they are also tested to meet strict standards, strength and purity. The manufacturer sends them in insulated package to ensure proper product delivery.
- Clinically proven bacterial strain L. plantarum 299v
- Vegetarian and vegan.
- 10 billion cells per capsule.
- Stable at rom temperature.
- Manufactured in cGMP certified facility.
- Evaluated and tested.
- Guaranteed to be viable until expiration.
- May cause bloating in the initial days. So, it is better to start slowly.
The main bacterial strain present in this product is Bifidus Lactis. This product has been proven to enhance the immune system which reduces the occurrence of antibiotic- associated diarrhea and support bowel movements. It also helps to support intestinal health by aiding the production of lactic acid and acetic acid which improve acidic levels in the intestine.
This product is developed with bifido complex advanced formula which supports GI and immune system health with its bacterial strains. It contains 4 Bifidobacterium strains with 15 billion CFU’s. If you are looking for a hypoallergenic probiotic dietary supplement for treating SIBO then this product is the right choice.
Recommended daily dosage is 2 capsules daily with a large meal. In case, if you are taking other supplements for any medical condition then consult the doctor for proper dosage.
- Hypoallergenic probiotic formula
- The bottle contains 60 vegetarian capsules
- Inulin and prebiotics free
- Made in USA
- Tested to be free of over 950 environmental contaminants
- Specially designed for people with dietary sensitivities
- Needs to be Refrigerated
Causes of Developing SIBO
Our GI tract is a muscular tube which helps the digested food travel to colon. Usually, the combined action of stomach muscles and small intestine pushes the food from stomach, through small intestine and colon.
The action also expels some bacteria from the small intestine which helps to limit the bacterial growth in the small intestines. However if this condition is interfered then bacteria will not be properly expelled, leading to excess bacterial multiplication in the small intestines – known as SIBO. Abnormal muscle activity can also allow bacteria to spread backwards from the colon to small intestine.
Improper muscular activity can be caused by many reasons. Some of them include…
- The normal activity of intestine muscles can be altered due to neurological and muscular diseases. Diabetes mellitus is a condition where the nerves that control intestinal muscles are damaged. Scleroderma is another condition that damages the intestinal muscles. These both cases also trigger SIBO development.
- Temporary or discontinuous obstruction in the small intestine activity can interfere the food travel leading to SIBO. Some of the causes for small intestine obstruction include scarring and Crohn’s disease.
- Diverticuli are small pouches present in the small intestine. They allow bacteria to multiply inside them leading to SIBO.
Symptoms of Small Intestinal Bacterial Overgrowth
Symptoms of SIBO include…
- Bloating, gas and distension
- Body aches and fatigue.
- Weight loss.
- Severe and prolonged overgrowth may interfere digestion and absorption of food. This can lead to vitamin and mineral deficiencies.
The SIBO symptoms can be chronic and last long. Some people may experience intensity fluctuations over months or years. Generally, people think SIBO is a chronic health condition. However, you can get rid of it by addressing digestion issues, increase digestive enzymes and balance gut flora. This is possible by maintaining healthy food and lifestyle habits. And moreover, it is recommended to stay away from stress – as it can cause, worsen and lead to SIBO recurrence.
Can Probiotics Make SIBO Worse?
In some cases, probiotics can worsen the symptoms. There is only one way to know whether probiotics work for you or not – is to test them. Below are few reasons why probiotics can worsen the symptoms. Check out if you are experiencing any one of them…
- Improper Timing: Right now, your gut may be too sensitive and not in a state to handle such effects currently.
- Migrating Motor Complex Issue: If you have weak cleaning waves in your small bowel then adding new bacteria cells can increase the issue, leading to more fermentation.
- Abundance of Specific Strain: If any bacterial strain is already present in increased amounts then taking the same probiotic may not be effective. So, trying a different strain can be helpful.
Scientific Researches that Prove the Effectiveness of Probiotics in Treating SIBO
There are very less number of studies conducted to know the efficiency of probiotics in SIBO as it is a new term in the medical field. Here’s is one of them…
1. As per a pilot study conducted at Center for Medical Education and Clinical Research, Argentina – it is observed that probiotics has shown a promising efficacy than metronidazole in people suffering with SIBO.
In this study, 25 patients were given probiotics containing Lactobacillus plantarum, L. casei, Streptococcus faecalis and B. brevis for 5 days continuously. After that, the dosage was slightly elevated. They were provided with a diet that has reduced amounts of alcohol, legumes, dairy and leafy greens. This group was later compared with patients who were taking metronidazole. When the results were checked – only 52% people who metronidazole showed improvement, but when it comes to patients who took probiotics, 82% of them has observed improvement. (1)
2. Almost 60 – 80% of people suffer with IBS have SIBO as an underlying issue. So, this states that studies conducted on IBS are also applicable for SIBO. According to a study published in World Journal of Gastroenterology, 14 patients were given 65ml of Yakut (probiotics) for 6 weeks. 64% of the patients have shown a positive result. (2)
3. In a study, 30 patients (with positive hydrogen breath test and abdominal pain) were divided into 2 groups. One group was given Lactol for 15 days and others were not. After 6 months, test results confirmed that people who took lactol had a better response and breath test turned negative 93% of time. This is indeed an interesting study because Lactol contains FOS (prebiotic) which is actually not recommend for SIBO (3)
So finally, though there are fewer clinical studies, most of them proved that probiotics has an impact in treating SIBO and related issues.
Which Probiotic Strains are considered to be good for SIBO?
Actually our small intestine is divided into 3 parts:
- The Duodenum – food from the stomach is emptied into this part of the small intestine.
- The jejunum and ileum – this part empties the undigested food into colon or large intestine.
When it comes to small intestine, the most dominant flora in duodenum and jejunum is – Lactobacilli. While most dominant flora in ileum is – bifidobacterium.
SIBO is caused due to imbalance in gut flora (dysbiosis) and dysfunctional gut lining in small intestine. So, replenishing lactobacilli and bifidobacteria should be the main part of the treatment.
What is the Appropriate Way to Consume Probiotics for SIBO?
Actually, if probiotics are consumed in a proper way then it will improve gut health and immune system, especially in people with SIBO. Though several studies have shown to efficiency of probiotics, but it is still unclear which ones are specifically the best.
This is because, SIBO represents bacterial overgrowth in the intestines but we are not aware which type of species. So, it is important to listen to your body for symptoms and iterate the treatment according to it. Remember that, just because certain probiotic products have worked some people doesn’t mean it will work for you.
So when treating yourself for SIBO, you have to ask yourself few questions to understand the problem accurately. Here are the questions…
- Did this probiotic formula or product make me feel better?
- Did it reduce my symptoms?
- Or did it increase my symptoms?
In most of the cases, taking probiotics should not increase the symptoms. However, if you are experiencing an increase then you have to decrease the dosage or switch to another probiotic supplement that has different bacterial strains.
As probiotics are too case-sensitive, gastroenterologists and SIBO specialists have recommended to follow certain guidelines that include…
- Analyse and evaluate after 2 weeks of taking the probiotic supplements. After this period, you will be able to clearly tell if there is any reduction or aggravation in symptoms.
- It is better to test one brand or strain at a time. This helps you understand which strain is working for you and which one is not.
- Make sure to start with a slow dosage. Usually, probiotics contain millions or billions of microorganisms in each dose. If you are taking probiotics for the first time then start with millions range. You can also open up the capsules and take a small amount of it in the initial days. As SIBO patients are sensitive, they will be able to tell if the reaction is negative or not (even with small dosage).
- Usually, if there is any negative reaction then you can see it within 3 hours of taking the supplements. So, stay aware and if you experience negative symptoms then stop taking it further. You can try any other supplement with a different strain.
- Some of the SIBO patients may not tolerate the probiotic supplements in the initial days of the treatment or when their gut is too sensitive. So, if you are one of them then you have to first get your gut under control and increase gut motility before you test again.
Are Soil Based Probiotics Safe to Take for SIBO?
Yes, soil based probiotics are considered to be safe and effective in relieving the symptoms of SIBO. Unlike other probiotics, they have a seed like structure which makes it harder. So, they have a high capacity of surviving the harsh stomach conditions, even if they are taken in a very small quantity.
This is possible because of their endospore formation which can handle stomach acid, bile salts, pancreatic enzymes and other harsh conditions that would normally kill the bacterial strains.
And moreover, soil based organisms stay in their spore state until they consider the environment is safe. This amazing property makes them more effective option for treating SIBO – because they don’t contribute the bacterial overgrowth, instead of it they populate the large intestine, promoting vibrant health.
These types of probiotics are also proven to be effective in dealing with auto-immune diseases – because SIBO and immunity are closely linked to.
Soil-based probiotics have a specific strain which aids in immunoglobulin A (IgA) production which plays an important role in maintaining a strong immune system. It also helps in restorting gut lining, repairing pathways – this helps in preventing the microbes, toxins and food particles from entering the blood stream and trigger an immune response.
As per a double-blind clinical study – patients with IBS were given soil-based probiotics for 2 weeks. The results have shown that they have observed a significant reduction in IBS symptoms. As 80% of IBS patients deal with SIBO as well, soil-based probiotics can helpful for that too. (4)
What Strains are Effective in Soil-based Probiotics?
Below are some of three important bacterial strains of soil-based probiotics and their individual benefits…
1. Bacillus clausi – Also represented as B. Clausii
- It is beneficial in modulating immune response.
- Encourages production of bactarin which acts as a good weapon against pathogens.
- Helps in IgA synthesis.
- It is anti-biotic resistant so can be used in combination with SIBO treatment.
2. Bacillus Coagulans – Also represented as B. Coagulans
- It is considered as a potent immune stimulator.
- It has been long studied in terms of ulcertative colitis, IBS and Crohn’s.
- Enables the good bacteria to colonize the gut.
3. Bacillus Subtilis – Also known as B. Subtilis
- Increases IgA and butyrate in order to support gut repair.
- Stimulates 12 antibiotics.
- Safe and effective.
- Has shown a positive impact on auto-immune and inflammatory markers.
- It helps in fermenting vitamin K which is very important for repair and growth.
Apart from these benefits, the seed like structure make them resistant with oxygen, light, heat and other harsh conditions in the GI tract. And moreover soil-based probiotics do not require refrigeration and stay alive until they reach the intestines.
What is the Relationship between IBS and SIBO?
IBS or Irritable Bowel Syndrome is a common gastrointestinal condition which causes abdominal pain, bloating, gas, bowel alterations, constipation or diarrhoea. This condition stays long term and its symptoms can vary over months and years.
Usually, it is diagnosed based on tests and typical symptoms that include tissue inflammation, obstruction, ulcer, infection and others.
The symptoms of SIBO and IBS are quite similar. And moreover, SIBO can be responsible for some of the symptoms in patients with IBS. Both these conditions can be diagnosed with hydrogen breath test. People with IBS have experienced symptoms relief after taking antibiotics – which is the primary treatment for SIBO.
We hope the information provided in this article has clarified your doubts regarding whether probiotics are suitable for SIBO patients or not. Even if you are still in doubt, we recommend trying probiotic supplement once to know how you react to it. If you observe any negative reactions, then stop taking them. If they are positive, you can continue. The best time to take probiotics is after completing the antibiotic treatment of SIBO.
If you still have any doubts of queries, write to us in the comment section below. We are happy to clarify your queries.