Small Intestinal Bacterial Overgrowth (SIBO) has a prevalence of 56% among patients with irritable bowel syndrome. Over the years, this condition was only treated with antibiotics, with a variable success rate. Consequently, patients have developed an interest in natural and sustainable herbal treatments to reverse bacterial overgrowth. The growing prevalence of this condition and the shift of the medical environment has raised the interest in using herbal therapy for Small Intestinal Overgrowth.
Table of Contents
What is Small Intestinal Bacterial Overgrowth
Small Intestinal Bacterial Overgrowth or SIBO is an increased concentration of bacterial of more than 1000 000 colony-forming units per mL located in the jejunal fluid. Furthermore, its presentation varies widely from a mild gastrointestinal disturbance and escalates to a full-blown enteropathy. Consequently, SIBO can overlap with IBS and is associated with malabsorption and malnutrition, potentially triggering celiac disease.Â
SIBO associated triggers and mediators:
- Achlorhydria (autoimmune, surgical, iatrogenic)
- Motor abnormalities.
- Diabetic enteropathy.
- Vagotomy.
- Abnormal communication between the colon and small bowel.
- Gastrointestinal fistulas.
- Resection of the ileocecal valve.
- Systemic and intestinal immune deficiency states.
- Scleroderma.
On the other hand, we can account for several protective mediators against small intestine bacterial overgrowth. Indeed, a regular gastric acid release, along with the proper function of pancreatic enzymes and bile acid, can protect against SIBO. In addition, different motility factors such as the migrating motor complex contribute to the adequate bacterial distribution.
Furthermore, there are additional extrinsic factors that might contribute to the gut’s microbiota alterations. These factors are mainly environmental such as following a FODMAP’s (fructooligosaccharides, saccharides, monosaccharides, and polyols) dietary pattern. Also, the use of drugs that may alter gastric function, such as proton pump inhibitors, antibiotics, and anti-motility agents to treat diarrhea. Nevertheless, the current use of probiotics, accompanied by fiber and prebiotics, are essential factors contributing to the colonization and growth of certain bacterial strains.Â
Antibiotics vs. Herbal therapy
The use of herbal therapy has been tested with similar results as the current SIBO antibiotic treatment. Indeed, after testing positive for SIBO by lactulose breath testing (LBT), the following step is to treat this condition with a 10-14 day course of rifaximin.
Nevertheless, the population’s need for an alternative and sustainable treatment has led to herbal components as contributors to SIBO. Chedid et al. designed a study to test the combination of specific herbal ingredients against antibiotic therapy with positive results.
In this study, three-hundred and ninety-six patients underwent LBT for suspected SIBO, of which two-hundred and fifty-one turned positive. Following these results, these patients decided between being treated with 1200mg of rifaximin daily or herbal therapy for four weeks. Of the patients who received herbal treatment, 46% had a negative follow-up LBT against 34%of rifaximin users.
Some of the combinations used in this study were:
FC CidalÂ
DysbiocideÂ
Candibactin-ARÂ
Candibactin-BR
Comprehensive stool testing
Getting to the root cause of the condition is the main focus of any functional medicine treatment. Indeed, in El Paso Functional Medicine we focus on treating the gut with the use of comprehensive, state-of-the-art- art testing.
In conclusion, this study determined that herbal therapy was as effective as the use of antibiotics for SIBO. In addition, this alternative treatment was recommended for those patients who used antibiotics without positive results. Furthermore, from an economic point of view, herbal therapy serves as a sustainable alternative to treat this ever-growing condition. – Ana Paola RodrÃguez Arciniega, MS
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Professional Scope of Practice *
The information herein on "Herbal Therapy for Small Intestinal Bacterial Overgrowth: A Healthy Alternative" is not intended to replace a one-on-one relationship with a qualified health care professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional.
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Dr. Alex Jimenez DC, MSACP, APRN, FNP-BC*, CCST, IFMCP, CFMP, ATN
Email: coach@elpasofunctionalmedicine.com
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Education:
Graduate with Honors: ICHS: MSN-FNP (Family Nurse Practitioner Program)
Degree Granted. Master's in Family Practice, MSN Diploma (Cum Laude)
Dr. Alex Jimenez, DC, APRN, FNP-BC*, CFMP, IFMCP, ATN, CCST
(Board Certified: Family Practice Nurse Practitioner—Multistate)*
(Licensed Nurse Practitioner & Chiropractor - Multistate)*
Clinical Director
DC & FNP License (Review Above)
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NPI: 1205907805
Dr. Maria Cardenas, MD
(Board Certified: Internal Medicine)
(Licensed Medical Doctor)
Medical Director, Clinical Director & Collaborative Physician
NPI # 1164426748
MD License #: J2933
Licenses and Board Certifications:
MD: Medical Doctor
DC: Doctor of Chiropractic
APRNP: Advanced Practice Registered Nurse
FNP-BC: Family Practice Specialization (Multi-State Board Certified)
FNP-BC: Family Practice Across Life Span (Neonatal to Geriatrics)
RN: Registered Nurse (Multi-State Compact License)
CFMP: Certified Functional Medicine Provider
MSN-FNP: Master of Science in Family Practice Medicine
MSACP: Master of Science in Advanced Clinical Practice
IFMCP: Institute of Functional Medicine
CCST: Certified Chiropractic Spinal Trauma
ATN: Advanced Translational Neutrogenomics
Family with Primary Care Focus (Family Nurse Practitioner or FNP)
- The Family Nurse Practitioner (FNP) promotes, maintains, and restores health for individuals and families across the lifespan. FNPs also identify health risks, promote wellness, and diagnose and manage acute and chronic illness.
- The FNP focuses on comprehensive primary care, promoting healthy lifestyles for patients across the lifespan in settings such as private practice, physician offices, and community health centers.
Memberships & Associations:
TCA: Texas Chiropractic Association: Member ID: 104311
TNA: Texas Nurse Association: Member ID: 06458222
TNP: Texas Nurse Practitioner Association ID: 2025091511
AANP: American Association of Nurse Practitioners: Member ID: 2198960
ANA: American Nurses Association: Member ID: 06458222 (District TX01)
| Primary Taxonomy | Selected Taxonomy | State | License Number |
|---|---|---|---|
| No | 111N00000X - Chiropractor | NM | DC2182 |
| Yes | 111N00000X - Chiropractor | TX | DC5807 |
| Yes | 363LF0000X - Nurse Practitioner - Family | TX | 1191402 |
| Yes | 363LF0000X - Nurse Practitioner - Family | FL | 11043890 |
| Yes | 363LF0000X - Nurse Practitioner - Family | CO | C-APN.0105610-C-NP |
| Yes | 363LF0000X - Nurse Practitioner - Family | NY | N25929 |
| Yes | 363LF0000X - Nurse Practitioner - Family | NM |
90560 |
| Yes | 363LF0000X - Nurse Practitioner - Family | GA | GAA-NP005701 |
Dr. Alex Jimenez, DC, APRN, FNP-BC*, CFMP, IFMCP, ATN, CCST
(Board Certified: Family Practice Nurse Practitioner—Multistate)*
(Primary Care Across Lifespan—Neonatal / Pediatric / Adult / Geriatrics)
(Licensed Nurse Practitioner & Chiropractor - Multistate)*
Clinical Director
Digital Business Card
NPI: 1205907805
Dr. Maria Cardenas, MD
(Board Certified: Internal Medicine)*
(Licensed Medical Doctor)*
Medical Director, Clinical Director & Collaborative Physician
NPI # 1164426748
MD License #: J2933
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