Probiotics for SIBO and Other Gut Disorders
To probiotic or not to probiotic … that is the question. Given the sheer number of probiotic supplements filling the store shelves, it seems like the smart thing to do, especially if you have a gut disturbance like diarrhea, irritable bowel syndrome (IBS) or small intestinal bacterial overgrowth (SIBO).
But is this really true? Are we throwing money down the drain or perhaps … gasp … making things worse?
Let’s look at what probiotics are, when they should be used, and if we should consider probiotics for SIBO or other special digestive issues.
What are probiotics?
To put it simply, probiotics are live, microbial strains that researchers have found to be beneficial to human health. In some cases they help improve the diversity of the bacteria in our digestive system, aka the gut microbiome, and in other cases they can help replenish strains that may have been depleted.
Numerous studies have shown that having healthy bacteria in our gut is crucial for optimal health. When we wipe out or decrease good gut bugs with antibiotics, stress and poor diet habits, our health suffers.
In fact, many common digestive issues such as diarrhea, IBS and SIBO are linked to an unhealthy balance of bacteria in the gut. So naturally this begs the question, would probiotics for SIBO and other gut ailments be the answer?
But before we answer that, let’s discuss what probiotics actually do. This may help you better understand if and how probiotic foods or supplements are right for you.
What do probiotics do?
When considering if probiotics for SIBO, IBS and other digestive concerns would be appropriate, let’s first understand how our beneficial gut flora help us.
Digestion
First off, the bacteria in our gut help us digest. Bifidobacteria, lactobacillus, and many other strains of probiotics inhabit our gut and help break down many of the indigestible fibers we consume. What we can’t digest makes perfect fuel for our gut bugs. What a great partnership!
If we lack these beneficial strains, food can travel further down the digestive tract undigested. This may lead to unpleasant symptoms such as excessive gas, diarrhea, and even in some cases, constipation.
In fact, studies have shown that while using antibiotics, which can deplete both good and bad bacteria, can cause some people to have diarrhea, adding probiotics can help reduce this significantly. This is just one example of how adding bacteria back to our gut can help improve digestion and restore balance.
“Postbiotic” Production
Pathogenic bacteria are known to produce toxins as byproducts which can make us very sick. Beneficial bacteria, on the other hand, make byproducts that support our bodies.
In the process of breaking down the fibers that our digestive enzymes are unable to, beneficial bacteria are able to synthesize short-chain fatty acids, a variety of vitamins, and even antioxidants. We call these components “postbiotics.”
Our bodies then use these postbiotics for our own good. They nourish our intestinal cells, enhance our immune systems, and help replenish vitamin stores.
Additionally, some beneficial bacteria can even produce byproducts that act as natural antibiotics. Their postbiotic output actually neutralizes pathogenic bacteria and maintains a healthy balance.
In many ways, a healthy microbiome is the gift that keeps on giving!
Immune Function
Did you know that the bacteria in our gut can help our immune system function better? Indeed. Beneficial bacteria help stimulate immune cells in the intestines and improve their ability to locate and fight more dangerous bacteria.
Part of this is due to healthy gut bacteria keeping the gut lining healthy, which is where most of the intestinal immune system resides.
Addtionally, the immune cells are reinforced by many of the byproducts that our beneficial bacteria produce, including short-chain fatty acids, antioxidants and certain vitamins.
An unbalanced microbiome, on the other hand, can weaken our immune system and make it easier for invading pathogens to get a foothold.
Mind Body
Our gut health has also been strongly linked to mood and brain health. The gut-brain axis is controlled by a complex hormone signaling system, and it appears that our microbiome can actually speak into this system and help to regulate interactions.
It is still not entirely clear how all of this occurs, but studies show that a healthy and diverse microbiome strengthens this system and improves human health, while low diversity and higher prevalence of pathogenic bacteria deteriorate aspects such as mood regulation, appetite signals, sleep, and stress response.
Overall Bacterial Balance
An abundance of healthy bacteria in our gut helps keep everything in check. Basically, the more beneficial bugs we have, the less of the bad stuff can take root.
Even if pathogens enter the digestive tract and try to gain foothold, they are less likely to find a comfortable home if the environment around them is taken up by the good stuff.
And as mentioned before, some of these strains even produce their own types of antibiotic byproducts, further reducing the chance that a pathogen can take over. The more types and abundance of good bacteria we have, the better our overall health.
In fact, research suggests that better microbial balance may help prevent the development of more serious intestinal diseases such as Crohn’s and ulcerative colitis.
Probiotics for SIBO
Given this preponderance of positive evidence, the question remains, would using probiotics for SIBO and other gut imbalances be a prudent choice?
To put it simply, yes, but the type and timing matters.
Testing, Testing, Testing
First, if you have the ability, microbiome testing can really help. These stool tests can assess the overall diversity of your gut, identify strains that might be low or missing, and show the prevalence of pathogens that may have taken root.
Some tests can even assess gut permeability (aka leaky gut) and inflammation levels.
A few common microbiome tests on the market include:
I always recommend testing if someone has the means so we can target the right type of probiotics, if appropriate.
But, these tests are expensive and not always easily accessible.
In the absence of testing, practitioners can make their best assessment of the situation based on what has worked for patients with similar diagnoses and symptoms. A skilled healthcare provider can usually provide a good recommendation that will work well, even in the absence of testing.
Type
The type of probiotic matters. Period. Grabbing the first thing off the drugstore shelf is not the best idea. All probiotics are not created equal.
Some brands are single-strain and for specific uses only. Others are multi-strain and claim to target a number of health conditions. Some are third-party tested and contain the active live cultures they claim …. and some don’t. Dosages vary widely as well.
In all honestly, probiotics are still a bit of the wild, wild west in terms of quality, consistency, and reliability.
So before you grab a probiotic supplement for SIBO or any health condition, consult a health practitioner that specializes in digestive health. They can suggest an effective and high-quality supplement that may be a great fit for your health concerns.
Timing
Once you decide on the perfect probiotic choice, timing is also key. If using probiotics for SIBO, it’s often recommended to avoid using probiotics until after the SIBO treatment is completed. This varies based on the protocol, however.
If it’s recommended to take a probiotic during the treatment period, tak it hours apart from the treatment. Whether it’s Rifaxminin or some other herbal antibiotic product, do not take probiotics at the same time unless instructed to do so.
For example, if you take your treatment dose in the morning, consider taking your probiotic at night.
If not on a SIBO treatment or if the treatment has finished, adding probiotics may be a great next step. The goal is to get the good stuff back in there and keep the bad guys from moving back in.
Timing does not matter as much at this stage. Take probiotics for SIBO at a regular and consistent time, such as morning or evening, just for consistency.
How do you know if it’s working?
As with any supplement, it is hard to know if probiotics for SIBO or other digestive issues are actually working.
First make sure you are taking the right type of probiotic for your condition. If unsure, talk with a healthcare provider that specializes in gut health.
Then, give it time. Probiotics do not change symptoms overnight. It can take weeks if not a month or more to notice symptoms improve. Be patient and keep up with healthy diet and lifestlye practices in the meantime.
What about using probiotics if you don’t have digestive issues?
Here’s my philosophy: If it ain’t broke … don’t fix it.
If you have “healthy” digestion, and by that I mean normal bowel movements, no abdominal pain or bloating, no reflux, and basically a care-free life when it comes to your digestion, you don’t need probiotics.
If this is you, say a “Thank you Jesus,” and consider yourself extremely fortunate. Don’t mess with a good thing. Instead, add more probiotic foods and fiber to maintain your gut health for the long term.
*Please note, I don’t want to suggest that probiotics may not be helpful for other conditions such as obesity, metabolic disease, autoimmune disease, and other health disorders, however, that discussion is outside the scope of this article.
In summary
Using probiotics for SIBO and other digestive concerns is often a wise choice to help improve the overall microbiome and regain healthy balance and diversity. The type of probiotic matters, and there may be timing considerations to make sure it has the intended effect.
But before you grab that probiotic off the shelf, talk with a healthcare provider that specializes in gut health first. Not only can choosing the wrong probiotic be a waste of money, but it may also delay you feeling better.
And remember, if you do not have digestive issues, you probably do not need to be taking a probiotic. Instead, consider adding probiotic foods and lots of fiber to keep your gut robust and strong.
A healthy gut is the key to health. Probiotics may be one tool to get you on your way to optimal digestion.
