In our Undoctored approach for SIBO and SIFO, we address undesirable bacterial and fungal species that have proliferated and ascended up the length of the gastrointestinal (GI) tract using herbal antibiotics and a variety of antifungal agents. We have not relied on probiotics to eradicate SIBO or SIFO, as they have only partial suppressive effects and do not typically achieve full eradication. High H2 breath readings, food intolerances, and fibromyalgia, for instance, usually persist despite probiotics.
This should come as no surprise, as conventional probiotics are created haphazardly without attention to choosing species/strains for specific SIBO-eradicating effects such as bacteriocin production or upper GI-colonizing properties, aspects that have potential for advantage in a SIBO management program. We therefore resort to either conventional treatments such as rifaximin or the two herbal antibiotic regimens that have been shown to match or exceed the efficacy of rifaximin. Neither conventional nor herbal antibiotics are 100% successful, typically generating successful responses in 35-70% of people and often requiring repeated courses, as well as additional strategies such as addition of a biofilm disrupter to increase bacterial susceptibility.
Most commercial probiotics are created by combining several bacterial species that have been shown to be individually beneficial. Limited evidence has suggested moderate effects of such products on reducing SIBO and levels of breath hydrogen (H2) gas. Can we improve on partial responses by choosing our species/strains more deliberately?
What are the characteristics of probiotic species/strains that have SIBO-eradicating potential? Among the characteristics of microbial species/strains that would potentially yield SIBO-eradicating benefits are:
- Colonization of the upper GI tract—since SIBO, of course, is largely a small intestinal process
- Production of bacteriocins—i.e., production of natural peptide antibiotics produced by selected bacterial species/strains, especially those effective against the Gram-negative Proteobacteria/Enterobacteriaceae that dominate in SIBO, as well as some Gram-positive species such as Streptococcus and Enterococcus.
- Support the proliferation of other healthy bacterial species
- Suppression of methane-producing Archaea
- Suppression of fungal growth, especially Candida species
By identifying probiotic species/strains with such characteristics and combining them, can we increase the effectiveness of a probiotic effort to eradicate SIBO? Can we also exert suppressive effects on methanogenic SIBO and SIFO? Can we thereby avoid the use of antibiotics?
I believe it is indeed possible to curate a collection of bacterial species/strains with these characteristics that may stack the odds in favor of having a beneficial effect on SIBO. I have therefore posted the recipe and rationale for making what I call SIBO Yogurt in the Undoctored Inner Circle. Should you choose this option for managing SIBO, please share your before/after H2-breath readings by the AIRE device in the Undoctored Inner Circle Forum devoted to this project.
First of all, thank you Dr Davies for all your information, which I have been following for nearly 10 years now.
After hearing one your posts on silo and the possibility of making my own pro-biotic yogurt I couldn’t be happier with my result.
I combined portions of Life wayKefir, Green Valley Kefir and since I was unable to get unflavored Wallaby Kefir, I used a portion of cultured Goat Milk Kefir.
I combined all the above with a quart of 1/2 + 1/2 and inulin, fermented in the oven with only the oven light on for 36 hours.
Beautiful results and had practically immediately great relief from acid stomach, due, I believe from too much coffee in the morning.
Thanks again for all of your wisdom!
I’m 76 years old and in excellent health since I am on your program.
Irene
Correction : should read,
Your posts on SIBO
How about Lactobacillus gasseri LG-G12? Do you think this strain would have the same effect as BNR17? I know strain specifity is crucial. At the moment, this is the only gasseri strain that I can get hold of so I’m curious.
Dean wrote: «How about Lactobacillus gasseri LG-G12? »
I don’t know, and it may not be known. In any case, you’d be adding a new variable to what is already an exploration.
re: «At the moment, this is the only gasseri strain that I can get hold of so I’m curious.»
Here’s the source that most people are using to obtain BNR17: Gmarket; Item No.1830626470. The page is in English, but the product isn’t.
The AceBiome product, however, is just L.gasseri BNR17®. The wholesale samples so far prepared by the U.S. licensee also have DDS®-1 Lactobacillus acidophilus, which is a potential confounder.
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Hi Bob,
I don’t know if you remember but we’d talked about how I couldn’t find BioGaia Gastrus in Turkey. I found the product in Germany (ebay) and bought it through a relative. I’ll most likely get it at the end of this month.
At the moment, I’m making two different yogurts from B. coagulans GBI-30,6086 and mix culture (along with kombucha and fermented veggies). B. coagulans makes the most delicious and thickest yogurt I’ve ever had. I’ll probably ditch the mix culture and make reuteri yogurt instead.
I was also wondering is it possible to use acacia fiber when making the yogurt (or mix of a. fiber and inulin)? I would guess dissolving might be a challenge. I use inulin with success but I’m just curious since I’ve also got acacia fiber.
Sergen Tuncer wrote: «I was also wondering is it possible to use acacia fiber when making the yogurt (or mix of a. fiber and inulin)? I would guess dissolving might be a challenge. I use inulin with success but I’m just curious since I’ve also got acacia fiber.»
Almost any of the prebiotic fibers are worth a try, but I wouldn’t invest more than a litre/quart on any given experiment.
Considerations include: excess thickening, clumping, contamination, and perhaps more.
I tried glucomannan (konjac) powder once, and it was far too thickening at concentrations providing carbon substrate comparable to inulin. For someone desiring thicker progurt, adding a small amount of konjac to the main prebiotic could be useful.
I gave up on unmodified potato starch due to clumping.
Contamination can be managed by whisking in the prebiotic prior to re-pasteurization, but then the fiber needs to be one that is cooking-safe. Potato starch, for example, might largely depolymerize to glucose during re-pasteurization.
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How about using inulin prior to pasteurization or after when milk is still hot?
Sergen Tuncer wrote: «How about using inulin prior to pasteurization or after when milk is still hot?»
I whisk it in prior to re-pasteurization, and have been doing so for well over a year now, with great results in terms of consistency. As far as I know, inulin is heat tolerant up to 212°F/100°C, and I don’t take much above 185°F/85°C for 10 minutes or so.
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Thank you, Bob. You’ve been really helpful. Bacterial Count Amplification System is a really powerful tool. I’ve seen results with this tool. That was what I needed. I’m sure with reuteri yogurt I’ll get much more benefit.
Btw, this is the mix culture that I’ve been using (in addition to B. coagulans). https://www.bigjoy.com.tr/image/catalog/suda/fem-biotic-besin.png
Sergen Tuncer wrote: «…this is the mix culture that I’ve been using…»
Here’s the whole product page (from Istanbul): Suda Probiotic Fembiotic
That Lactobacillus reuteri LR92 appears to be DSM 26866, for purposes of searching on trial data (and there is some). For English speakers, “milyar” is billion, so the CFUs (“kob”) are decent for use as a starter.
The normal considerations would apply for a fermented food based on a mixed-culture probiotic:
• what common substrate?
• what common temperature?
• what common duration?
• relative growth rates?
• bacteriocins & other competition?
• palatability of result?
The species and strains in most probiotics are likely cultivated and prepared separately, being joined only at final packaging.
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According to a study, Lactobacillus reuteri DSM 26866 is a promising strain for the production of reuterin.
Mix culture has its own problems and raises some questions, for sure. I couldn’t find kefir without fungal species so I chose this product instead. I ferment it between 100°F-103°F. It makes delicious and thick yogurt (it’s not as thick as yours because half-and-half is not a thing here).
In a few days, I’m going to make reuteri yogurt (finally got it).
Thanks again, Bob. You are a big help.