Probiotics are actually a mixed bag with SIBO because
SIBO often involves an overgrowth of D-lactate-producing probiotic species, and that causes a buildup of D-lactate in the gut, and a lot of the symptoms associated with SIBO are caused by that. So, you want to avoid in many cases taking any probiotics that have D-lactate-forming species like Lactobacillus acidophilus, which is, of course, one of the most common probiotics that people take. There’s a D-lactate-free product sold by Custom Probiotics that’s helpful.
I’ve also found soil-based organisms to be helpful when SIBO is present, and the one that I like the most right now is called Prescript-Assist...I’ve actually had a lot of success with it myself and with my patients in my practice....A few months ago, I started doing some research about it. There’s one study that was double-blind, placebo-controlled that lasted for quite a long time, especially for probiotics. A lot of the studies are pretty short in duration. And essentially the theory behind it is that we evolved in an environment where we were continually exposed to these soil-based organisms. Our ancestors were not scrubbing their vegetables and fruits before they ate them. They were taking them out of the ground and maybe wiping them off a little bit and eating them. They weren’t buying them in the store after they had been scrubbed, and they weren’t scrubbing them themselves. And the other thing is that the soil diversity and quality has changed a lot since the industrialization of agriculture, and so we’re just not exposed to the same number and types of soil-based organisms to the same extent that we probably were for most of our evolutionary history. And as we’re going to discuss in a lot more detail in a later question, there’s a lot of evidence that these soil-based organisms have profound immunoregulatory effects. In other words, we evolved with them over a long period of time, and our immune systems have a symbiotic relationship with them and function much better in their presence. And so the soil-based organisms are a different approach than the lactic acid-forming types of probiotics, and I’ve found that they’re better tolerated in people with SIBO. As a fairly unrelated side note, they tend to work better for constipation than a lot of other probiotics. Oftentimes, probiotics can make constipation worse, so the soil-based organisms and Prescript-Assist, I think, is a really good choice for people with SIBO.
And then another probiotic that can be helpful with SIBO is
Saccharomyces boulardii, which is a beneficial strain of yeast, and I’ve had some success with that as well. [
LINK]