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Natural Treatments for SIBO


Natural Support for Small Intestinal Bacterial Overgrowth with Scientific Studies

SIBO is the acronym for Small Intestinal Bacterial Overgrowth: a condition where there is an abnormal amount of bacteria and/or fungus taking residence in the small intestine (whether in total, or especially of certain types that are either usually largely confined to the colon, or are especially pathogenic).

It generally involves foods passing much slower through the small intestine than normal, which produces excess bacteria as the slow transiting foods get broken down by the digestive juices and get fermented by the other bacteria being encountered there.

Once those microorganisms get the opportunity to take root, this often causes bloating and diarrhea and may lead to unhealthy weight loss or even malnutrition.

Causes of SIBO & Standard Treatment

Although there are competing theories about its causes – candidates include structural problems or scar tissue in the folds of the intestine (whether genetically or introduced by abdominal surgery, food poisoning, or diseases); or a malfunction in the valve that separates the small and large intestine; or a problem with the 'pacemaker' cells that regulate the contractions of the smooth muscles in the intestine (the 'Interstitial cells of Cajal'); or even simply the chronic use of 'PPI' style heartburn or ulcer medications (Proton Pump Inhibitors) diluting the stomach acid too much – the standard initial course of treatment is broad spectrum antibiotics (accompanied by dietary changes to favour low fermentation foods).

However, those antibiotics can not only be quite expensive (particularly since this condition tends to recur) and not always that successful (especially once the bacteria get a chance to band together into biofilms that adhere to the intestinal walls better), but may also contribute to antibiotic resistance (depriving one of effective treatments for other infections).

Natural Dietary Support - Supplements for SIBO

Consequently Biotics Research has developed several nutritional supplements to help treat SIBO naturally with a blend or herbs and essential oils with anti-microbial properties to curtail the overgrowth, including BiomeBalance (formerly known as 'Dysbiocide'), FC-Cidal, and ADP Oregano Oil

Similarly, Metagenics has two supplements for this condition, as well: CandiBactin-AR and CandiBactin-BR.

Biotics Research Canada SIBO Protocol

Product Mechanism Dosage Food/Empty
A.D.P. Anti-Microbial 1-6 tabs TID Empty/Food
BiomeBalance Anti-Microbial 2 caps TID Empty/Food
Berberine HCl Anti-Microbial 1-3 caps TID Empty
S. boulardii Anti-Fungal 1-2 caps TID Empty
FC-Cidal Anti-Microbial 1-4 caps TID Empty

Dietary supplements are intended for use only as nutritional support and are not intended to diagnose, treat, cure or prevent any disease. Patients who may have medical conditions should consult their physician to ensure proper diagnosis and treatment.

Related Reading

Boosting Good Gut Microflora

IBS Sufferers Can Regain Their Quality of Life


Scientific Support

To help illustrate the extent of the scientific support for the efficacy of herbal support for SIBO, what follows is a series of scientific references to support this approach. This includes studies on the nature and suspected causes of the condition, and additional sources focusing on the antimicrobial properties of the ingredients for the BiomeBalance and FC-Cidal in particular.

Intestinal Tract

About Small Intestinal Bacterial Overgrowth and Its Causes

Ardatskaia, M D et al. [Syndrome of bacterial overgrowth in patients with the reduced stomach acid secretion: some aspects of the diagnosis] [Article in Russian] Eksperimental'naia i klinicheskaia gastroenterologiia = Experimental & clinical gastroenterology, 2014.

Chen, Binrui et al. “Reduced interstitial cells of Cajal and increased intraepithelial lymphocytes are associated with development of small intestinal bacterial overgrowth in post-infectious IBS mouse model.” Scandinavian Journal of Gastroenterology, 2017.

Dukowicz, Andrew C et al. “Small intestinal bacterial overgrowth: a comprehensive review.” Gastroenterology & Hepatology, 2007.

Ghoshal, Uday C et al. “Small Intestinal Bacterial Overgrowth and Irritable Bowel Syndrome: A Bridge between Functional Organic Dichotomy.” Gut and Liver, 2017.

Lewis, S J et al. “Altered bowel function and duodenal bacterial overgrowth in patients treated with omeprazole.” Alimentary Pharmacology & Therapeutics, 1996.

Lombardo, Lucio et al. “Increased incidence of small intestinal bacterial overgrowth during proton pump inhibitor therapy.” Clinical Gastroenterology and Hepatology, 2010.

Quigley, Eamonn M M et al. “AGA Clinical Practice Update on Small Intestinal Bacterial Overgrowth: Expert Review.” Gastroenterology, 2020.

Roland, Bani Chander et al. “Small Intestinal Transit Time Is Delayed in Small Intestinal Bacterial Overgrowth.” Journal of Clinical Gastroenterology, 2015.

Roland, Bani Chander et al. “Low ileocecal valve pressure is significantly associated with small intestinal bacterial overgrowth (SIBO).” Digestive Diseases and Sciences, 2014.

Roland, Bani Chander et al. “A Prospective Evaluation of Ileocecal Valve Dysfunction and Intestinal Motility Derangements in Small Intestinal Bacterial Overgrowth.” Digestive Diseases and Sciences, 2017.

Saffouri, George B et al. “Small intestinal microbial dysbiosis underlies symptoms associated with functional gastrointestinal disorders.” Nature Communications, 2019.

Sorathia SJ, Chippa V, Rivas JM. “Small Intestinal Bacterial Overgrowth.” [Updated 2022 Oct 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022.

Man with Abdominal Pain

Supporting Science References for Anti-Microbial and Antibiofilm Properties of Biotics Research Biome Balance Ingredients

Ajaiyeoba, EO, and HC Krebs. “Antibacterial and antifungal activities of Quassia undulata and Quassia amara extracts in vitro.” African Journal of Medicine and Medical Sciences, 2003.

Batiha, Gaber El-Saber et al. “Bioactive Compounds, Pharmacological Actions, and Pharmacokinetics of Wormwood (Artemisia absinthium).” Antibiotics (Basel, Switzerland), 2020.

Bazargani, MM et al. “Antibiofilm activity of essential oils and plant extracts against Staphylococcus aureus and Escherichia coli biofilms.” Food Control, 2016.

Castro, L M et al. “Antihelminthic action of the Anethum graveolens essential oil on Haemonchus contortus eggs and larvae.” Brazilian Journal of Biology, 2021.

Chedid, Victor et al. “Herbal therapy is equivalent to rifaximin for the treatment of small intestinal bacterial overgrowth.” Global Advances in Health and Medicine, 2014.

de Almeida, Luísa Maria Silveira et al. “Flavonoids and Sesquiterpene Lactones from Artemisia absinthium and Tanacetum parthenium against Schistosoma mansoni Worms.” Evidence-based Complementary and Alternative medicine: eCAM, 2016.

Mathlouthi, Ahmed et al. “Essential oils from Artemisia species inhibit biofilm formation and the virulence of Escherichia coli EPEC 2348/69.” Biofouling, 2021.

McMurray, R L et al. “Antibacterial Activity of Four Plant Extracts Extracted from Traditional Chinese Medicinal Plants against Listeria monocytogenes, Escherichia coli, and Salmonella enterica subsp. enterica serovar Enteritidis.” Microorganisms, 2020.

Negi, Bhawna Sunil, and Bharti P Dave. “In Vitro Antimicrobial Activity of Acacia catechu and Its Phytochemical Analysis.” Indian Journal of Microbiology, 2010.

Nickles, Melissa A et al. “Alternative Treatment Approaches to Small Intestinal Bacterial Overgrowth: A Systematic Review.” Journal of Alternative and Complementary Medicine (New York, N.Y.), 2021.

Saviuc, Crina-Maria et al. “Essential oils with microbicidal and antibiofilm activity.” Current Pharmaceutical Biotechnology, 2015.

Thompson, Aiysha et al. “Comparison of the antibacterial activity of essential oils and extracts of medicinal and culinary herbs to investigate potential new treatments for irritable bowel syndrome.” BMC Complementary and Alternative Medicine, 2013.

Villalva, Marisol et al. “Antioxidant, Anti-Inflammatory, and Antibacterial Properties of an Achillea millefolium L. Extract and Its Fractions Obtained by Supercritical Anti-Solvent Fractionation against Helicobacter pylori.” Antioxidants (Basel, Switzerland), 2022.

Wajima, Takeaki et al. “Oldenlandia diffusa Extract Inhibits Biofilm Formation by Haemophilus influenzae Clinical Isolates.” PloS one, 2016.

Yu, Zhihui et al. “The alarming antimicrobial resistance in ESKAPEE pathogens: Can essential oils come to the rescue?” Fitoterapia, 2020.

Zhang, Juan et al. “Major Constituents From Brucea javanica and Their Pharmacological Actions.” Frontiers in Pharmacology, 2022.

Zhang, Rui et al. “Isolation, purification, structural characteristics, pharmacological activities, and combined action of Hedyotis diffusa polysaccharides: A review.” International Journal of Biological Macromolecules, 2021.

Zhang, Tong et al. “Antibacterial constituents from Stemona sessilifolia.” Journal of Asian Natural Products Research, 2007.

Zhao, Huimin et al. “Insecticidal Endostemonines A-J Produced by Endophytic Streptomyces from Stemona sessilifolia.” Journal of Agricultural and Food Chemistry, 2020.

Zhu, JY and HF Yan. “Research status of Stemona alkaloid and its pharmacological function.” Journal of Shanghai Institute of Technology: Natural Science, 2010.

Supporting Science References for Anti-Microbial Properties of Biotics Research FC-CIDAL Ingredients

Amirinia, Fatemeh et al. “In Vitro Antimicrobial and Cytotoxicity Activities of Some Medicinal Plant Extracts against Oral Microbial Pathogens.” Folia Medica, 2021.

Arunachalam, Karuppusamy et al. “Tinospora cordifolia (Willd.) Miers: Protection mechanisms and strategies against oxidative stress-related diseases.” Journal of Ethnopharmacology, 2022.

Benli, Mehlika et al. “Screening antimicrobial activity of various extracts of Artemisia dracunculus L.” Cell Biochemistry and Function, 2007.

Ekiert, Halina et al. “Artemisia dracunculus (Tarragon): A Review of Its Traditional Uses, Phytochemistry and Pharmacology.” Frontiers in pharmacology, 2021.

Gupta, Sanjay Mohan et al. “Bioactive potential of Indian stinging plants leaf extract against pathogenic fungi.” Journal of Complementary & Integrative Medicine, 2018.

Kumar, Pradeep et al. “Tinospora cordifolia (Giloy): Phytochemistry, Ethnopharmacology, Clinical Application and Conservation Strategies.” Current Pharmaceutical Biotechnology, 2020.

Marcelino, Gabriela et al. “Effects of Olive Oil and Its Minor Components on Cardiovascular Diseases, Inflammation, and Gut Microbiota.” Nutrients, 2019.

Markin, D et al. “In vitro antimicrobial activity of olive leaves.” Mycoses, 2003.

Modarresi-Chahardehi, Amir et al. “Screening antimicrobial activity of various extracts of Urtica dioica.” Revista de Biologia Tropical, 2012.

Mojicevic, Marija et al. “Antifungal potential of bacterial rhizosphere isolates associated with three ethno-medicinal plants (poppy, chamomile, and nettle).” International Microbiology: The Official Journal of the Spanish Society for Microbiology, 2019.

Obistioiu, Diana et al. “Chemical characterization by GC-MS and in vitro activity against Candida albicans of volatile fractions prepared from Artemisia dracunculus, Artemisia abrotanum, Artemisia absinthium and Artemisia vulgaris.” Chemistry Central Journal, 2014.

Olivier, Rachel. “Select herbals proposed as beneficial in the eradication of small intestinal bacterial overgrowth.” The Original Internist, 2013.

Pallag, Annamaria et al. “Equisetum arvense L. Extract Induces Antibacterial Activity and Modulates Oxidative Stress, Inflammation, and Apoptosis in Endothelial Vascular Cells Exposed to Hyperosmotic Stress.” Oxidative Medicine and Cellular Longevity, 2018.

Park, Byeoung-Soo et al. “Antibacterial activity of Tabebuia impetiginosa Martius ex DC (Taheebo) against Helicobacter pylori.” Journal of Ethnopharmacology, 2006.

Park, Byeoung-Soo et al. “Selective growth-inhibiting effects of compounds identified in Tabebuia impetiginosa inner bark on human intestinal bacteria.” Journal of Agricultural and Food Chemistry, 2005.

Radulović, Niko et al. “Composition and antimicrobial activity of Equisetum arvense L. essential oil.” Phytotherapy Research: PTR, 2006.

Salehi, Bahare et al. “Thymol, thyme, and other plant sources: Health and potential uses.” Phytotherapy Research: PTR, 2018.

Verma, Deepak Kumar et al. “Unmasking the Many Faces of Giloy (Tinospora cordifolia L.): A Fresh Look on its Phytochemical and Medicinal Properties.” Current Pharmaceutical Design, 2021.

Zhou, Zuman et al. “Thyme (Thymus vulgaris L.) polyphenols ameliorate DSS-induced ulcerative colitis of mice by mitigating intestinal barrier damage, regulating gut microbiota, and suppressing TLR4/NF-κB-NLRP3 inflammasome pathways.” Food & Function, 2023.

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