![]() Symptoms suggestive of SIBO included abdominal discomfort, cramping, bloating, flatulence, eructation, diarrhea, symptoms worsened via food consumption, and low serum B12. In this retrospective case review, 104 individuals with SIBO symptoms and diagnosis via a positive LBT were treated for SIBO, including a post-treatment LBT. 3 Many individuals with IBS seek integrative treatment options, but the use of botanical antimicrobials and other oral supplements is common yet not well studied for effectiveness. 2 Rifaximin, an antibiotic with little to no systemic absorption, is the most commonly used antibiotic for the treatment of SIBO. The amount of gas produced can be measured by a lactulose breath test (LBT) and is a common procedure for diagnosis of small intestinal bacterial overgrowth (SIBO). Lactulose is not absorbed or used by the gastrointestinal tract in humans, and is metabolized by bacteria into hydrogen and methane gas. 1 The population of microbiota in the small intestine creates gas as a byproduct of fermentation, leading to typical IBS symptoms, and may activate host mucosal immunity, leading to a wide array of systemic symptoms. The expansion of intestinal microbiota from the predominant location in the colon to the small intestine has been studied as one cause of irritable bowel syndrome (IBS). Herbal antimicrobial combination therapies were similarly effective to triple antibiotic therapy in resolving rifaximin-refractive SIBO.Īdverse effects were more common and severe in individuals treated with rifaximin. A retrospective chart review of 104 patients undergoing treatment for small intestinal bacterial overgrowth (SIBO) with a 30-day course of rifaximin or herbal antimicrobials found that herbal treatments were at least equally effective to rifaximin for the treatment of SIBO. ![]()
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