Herbs for small intestinal bacterial overgrowth

Posted on Tue, 9 Sep 14

A new study has found that herbal treatment may be safer and more effective than antibiotics for small intestine bacterial overgrowth (SIBO). This is an important discovery for people with chronic digestive symptoms.

Small intestine bacterial overgrowth is a condition in which there is an overgrowth of bacteria, which are normally mostly in your large intestine, further up in your small intestine. Having bacteria where they are not supposed to be can be linked to bloating, flatulence, abdominal distention, abdominal pain, and diarrhea or irritable bowel syndrome (IBS).

Currently the most investigated treatment is the antibiotic rifaximin, but side effects, cost and concerns of antibiotic resistance limit the use of rifaximin and it is not currently approved for IBS treatment. Natural medicines are promising candidates for SIBO and a new study has shown that herbal therapy may be a better option that drug treatment.

In the study, people with SIBO who were treated with either herbal therapy (one of a number of different products*) or antibiotics (rifaximin) had their treatment results reviewed.

Successful treatment of SIBO, as confirmed with a follow-up breath test, was 46% in the herbal therapy group vs. 34% in those who received rifaximin. And people who did not respond to rifimaxin were offered either a stronger course of antibiotics or herbal therapy, which were equally effective at eradicating SIBO (both about a 60% successful treatment).

Adverse effects in those taking rifaximin were 1 case of anaphylaxis, 2 cases of hives, 2 cases of diarrhoea and 1 case of Clostridium difficile while only 1 case of diarrhoea was reported in those receiving herbal therapy.

“In summary, we conclude that in the setting of SIBO, patients can be given the choice of antibiotic or herbal therapy depending on their individual prefer­ence with similar response rates and safety profiles,” wrote the study investigators. “In addition, patients who are refractory to rifaximin can receive herbal therapy as a potential rescue therapy with equivalent results to triple antibiotics.”

*5 different (North American) products were used and each contained several anti-microbial herbs and extracts such as; Olive leaf (Olea europaea, leaf), Pau D’Arco (inner bark), Oregano (Origanum vulgare, essential oil), Thyme (Thymus vulgaris, essential oil), and Berberine sulfate.

Reference: 

Chedid V, Dhalla S, Clarke JO, Roland BC, Dunbar KB, Koh J, Justino E, Tomakin E, Mullin GE. Herbal therapy is equivalent to rifaximin for the treatment of small intestinal bacterial overgrowth. Glob Adv Health Med. 2014 May;3(3):16-24.