Research has shown that natural antimicrobial treatments can be helpful both in SIBO and irritable bowel syndrome. While it’s possible that either diet or antimicrobial supplements alone could be enough, I believe that combining the two will give you better results:
- Faster resolution when you tackle the problem from 2 sides.
- Antimicrobials can kill some pathogens that might take longer to starve out, such as Candida.
- On the other hand, bacteria cannot develop resistance to starvation. Diet can reduce pathogens that have developed resistance to antimicrobials.
- Antimicrobial treatments alone will only cure about 50% of the people.
Herbal antimicrobial blends
A study published in 2014 tested herbal antimicrobial blend against the antibiotic Rifaximin. Rifaximin is the current standard prescription treatment for SIBO. Unfortunately, it’s prohibitively expensive, with 2-week treatment setting you back over $500.
Here are the cure rates for both groups:
- Rifaxamin: 34%
- Herbal antimicrobials: 46%
While this study showed better results with herbal treatment, we should keep in mind this was a relatively small study (only 37 patients in the herbal treatment group). There were also some other reasons why we shouldn’t draw too many conclusions based on this study. Other studies have shown better cure rates with Rifaxamin alone or in combination with other antibiotics.
We can say that herbal treatments seem a promising alternative to prescription antibiotics. Especially when considering that herbs often have several antimicrobial effects; meaning that the bacteria are less likely to develop resistance to them. In the above study, 14 of the people who didn’t get results from Rifaxamin were given the herbal antimicrobial treatment. The herbal treatment cured 8 of the 14 (57%).
The researchers used two different herbal antimicrobial combinations in this study (they didn’t mention whether one combination was more effective than the other):
Dose and treatment duration
- Dose: 2 capsules of each product twice a day for the total of 8 capsules a day.
- Treatment duration: 4 weeks
Unfortunately, that’s the only scientific study on herbal treatments for SIBO. Dr. Allison Siebecker, a naturopathic doctor and one of the leading experts on SIBO, says her clinic uses the following herbs:
- Allicin (from garlic): 450mg 2-3 x day
- Oregano: 100mg 2 x day
- Berberine (found in Goldenseal, Oregon grapes, Barberries): 5g (in split dose) 1 x day
- Neem: 300mg 3 x day
- Cinnamon (higher end of the label dosage)
The authors of herbal antimicrobial study also mention that the following herbs have been shown to have antimicrobial properties against gut pathogens:
- Oil of oregano
- Horsetail (Equisetum arvense)
With so little reliable information to go by I can’t make good product recommendations.
I used these two products:
From what I can tell, the combination of those 2 worked well for me. Since taking them, I have much, much less gas and don’t get constipated even if I eat some onions or other FODMAP foods; suggesting they cleared methane producing bacteria from my gut. I can’t guarantee they’ll work for you as everyone has somewhat different gut bacteria.
I chose those 2 products because they seemed to have a nice combination of antimicrobial herbs. They should also clear Candida overgrowth in the gut. And they are more affordable than the product combinations used in the above study.