The Best Supplements for Treating SIBO

Small intestinal bacterial overgrowth (SIBO) is a digestive condition that occurs when bacteria migrate from the large intestine and start growing in the small intestine.

It can cause numerous symptoms, including abdominal pain, bloating, diarrhea, and sometimes constipation.  

If antibiotic therapy has been unsuccessful, or you’re experiencing recurrent SIBO, you may wonder if any supplements can help.

Continue reading to learn more about evidence-based supplements for managing SIBO. 

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Benefits of Taking Supplements for SIBO

The first line of treatment for small intestinal bacterial overgrowth (SIBO) is antibiotic therapy, which targets the harmful bacteria present in the small intestine.

While this treatment can be highly effective in relieving digestive symptoms, around 40% of SIBO patients don’t experience an improvement following antibiotic therapy. 

In addition, many people experience a recurrence of SIBO after it has been treated. The best way to prevent recurrence is to identify and treat the underlying cause of the SIBO.

However, this is not always simple, and many people turn to supplements to help treat and manage their SIBO in the meantime. 

Several supplements are evidence-based for treating SIBO or managing digestive symptoms.

In many cases, these are used alongside antibiotic therapy to increase the efficacy of the treatment. 

It’s important to use caution when taking SIBO supplements because many claims online are not evidence-based, and some supplements may make SIBO worse. 

Types of Supplements for SIBO 

There are a few different types of supplements that can be used to manage SIBO. 

• Some are herbal supplements that have antimicrobial action and can help kill harmful bacteria. 
• Others target gastrointestinal symptoms that may accompany SIBO, like abdominal pain, bloating, and diarrhea. 
• SIBO is associated with low levels of certain vitamins and minerals, so part of managing this condition often includes supplements to resolve these nutritional deficiencies. 
• Lastly, supplements can also help improve overall gut health, which may help prevent the recurrence of SIBO. 

The Best Supplements For SIBO Treatment 

The treatment approach will vary based on the type of SIBO you have, your medical history, and your symptoms.

Talk to your doctor before trying any supplements to ensure it aligns with your treatment plan. 

Berberine

Berberine is a natural compound derived from several medicinal plants, and it has been shown to improve the health of the gut microbiota and reduce inflammation of the digestive tract. It also has antibacterial qualities. 

A 2014 study found that an herbal supplement containing berberine (along with other herbal ingredients) was just as effective as antibiotic treatment for SIBO. 

Partially Hydrolyzed Guar Gum

Partially hydrolyzed guar gum (PHGG) is a prebiotic supplement known to help boost intestinal motility. 

A study from 2010 found that SIBO patients treated with antibiotics and PHGG experienced greater eradication of harmful bacteria than those treated with only antibiotics.

The supplement group also experienced a more significant improvement in digestive symptoms. 

Iberogast

Iberogast is a supplement containing a combination of different herbal extracts.

Though it is commonly recommended for SIBO treatment, it has been primarily studied in patients with irritable bowel syndrome (IBS). 

Iberogast has been shown to improve IBS-related symptoms (including abdominal pain) and increase intestinal motility, which are common issues in SIBO. 

Peppermint Oil 

Enteric-coated peppermint oil capsules are another supplement commonly used in the management of IBS and have been proven effective for improving overall digestive symptoms.

Because peppermint oil also has antimicrobial properties, it’s hypothesized to be effective for treating SIBO as well. 

However, the research on peppermint oil and SIBO is very limited.

One case study from 2002 did show significant improvement in symptoms and hydrogen production in a person with SIBO who took peppermint oil supplements, but larger studies are needed

Oil of Oregano

Oil of oregano is an herbal supplement that has strong antimicrobial activity.

A study from 2014 found that an herbal supplement containing oil of oregano as one of the active ingredients was just as effective at treating SIBO as antibiotic therapy. 

Probiotics 

There’s mixed evidence regarding the use of probiotics for managing SIBO.

Some studies show that probiotic supplementation can reduce bacteria growth in the small intestine and improve symptoms in people with SIBO.

Probiotics may even make antibiotic treatment more effective when used in combination. 

However, other research has found that probiotics can make SIBO symptoms worse, and taking them may be a risk factor for developing certain forms of SIBO. 

Vitamins and Minerals

Studies show that SIBO can result in vitamin and mineral deficiencies because inflammation and damage to the digestive tract may sometimes impair nutrient absorption.

Talk to your doctor about possible deficiencies that may need to be treated with supplements, including:

• Vitamin A.
• Vitamin D.
• Vitamin K.
• Vitamin B12. 
• Zinc.

Key Considerations When Taking Supplements For SIBO 

A major consideration is that there is limited data for supplement use in managing SIBO.

Many supplement recommendations online will extrapolate data from IBS studies to claim the supplement is effective for managing SIBO. 

SIBO and IBS are very closely related.

They present with similar symptoms, and many IBS patients also have SIBO. However, they are different conditions that often require different treatment considerations.

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Side Effects and Risks

SIBO is a complex condition to manage, and the best treatment for you will depend on the type of SIBO you have, along with other factors like your medical history. 

It’s important to talk to your doctor before starting any supplements for SIBO because some options may worsen your symptoms or cause other side effects. 

For example, probiotic supplements may amplify SIBO symptoms in people with methane-dominant SIBO.

Though peppermint oil capsules may help relieve SIBO-related digestive symptoms, they can also worsen pre-existing acid reflux. 

Tips For Choosing The Right Supplement 

Not all supplements are created equal. It’s important to understand that supplements are not regulated by the FDA the same way food and drugs are. This means a few things:

• A supplement may not contain the ingredients it says it does. 
• Supplements can be contaminated with unsafe compounds like heavy metals. 
• Health claims on supplement labels may not be proven. 

To find high-quality supplements, look for brands that a third-party organization, such as Consumer Lab, NSF, and USP, has tested. A logo on the supplement container will typically indicate this. 

When To See a Doctor About Your SIBO Symptoms

It’s important to talk to your doctor if you experience chronic gastrointestinal symptoms, such as: 

• Abdominal pain. 
• Bloating. 
• Gas. 
• Diarrhea. 

These symptoms overlap with many digestive diseases, including SIBO, and receiving the correct diagnosis is the best way to ensure your condition is treated properly. 

Takeaway

Though antibiotic therapy is the first-line treatment for SIBO, some supplements may help treat SIBO, manage digestive symptoms, improve gut health, and resolve nutritional deficiencies. 

It’s important to always talk to your doctor before starting any supplements to manage SIBO, as some options can worsen your symptoms depending on your medical history.

Be mindful of the quality of the supplements you purchase, as they are not regulated by the FDA. 

How a Dietitian Can Help

In addition to supplements, dietary changes may improve treatment outcomes for SIBO.

If you feel unsure how your food choices impact your symptoms, a SIBO dietitian can help you identify possible trigger foods and help you find the best eating plan for you. 

Find a dietitian near you that accepts insurance using Nourish.

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