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.