A bold new study examined the effectiveness of herbal therapy versus antibiotic therapy for the treatment of small intestinal bacterial overgrowth (SIBO). SIBO is prevalent among patients with irritable bowel syndrome (IBS) and is associated with a worsening of symptoms and quality of life. As many as 56% of patients with IBS test positive for SIBO using Lactulose Breath Testing (1).

SIBO and Fibromyalgia

Several studies suggest that SIBO may be the root cause of fibromyalgia symptoms. Up to 73% of fibromyalgia patients experience gastrointestinal symptoms related to dysbiosis—disrupted gut flora (2). If that is not surprising enough, a small study (n=42) at Cedars-Sinai Medical Center found that 100% of the fibromyalgia cohort studied had SIBO (3).  Left untreated, SIBO can lead to impaired bowel function, immune system activation, hypersensitivity (allodynia), and impaired skeletal muscle energy production (4).

SIBO Treatment

The FDA has not approved any medication for the treatment of SIBO. However, many gastroenterologists rely on antibiotics with mixed results. The most common antibiotic utilized is rifaximin 1200 mg taken over a period of 10-14 days. This medication is expensive and frequently not covered by many commercial health plans.

A downside of antibiotic treatment for SIBO is the potential for adverse effects. Some antibiotics may have adverse effects on the gut microbiome and the protective biofilm layer they create to maintain gut integrity. Antibiotic therapy may also lead to antibiotic resistance and destruction of beneficial species.

Herbal Therapy More Effective

In this comparative study, 104 patients who tested positive for newly diagnosed SIBO by lactulose breath testing were given either rifaximin 1200 mg daily or herbal therapy for 30 days. The herbal therapy treatment consisted of supplements that contained herbal microbials such as berberine, rhizome extract, and oils of oregano, thyme, and rosemary (1).

At the end of the study the herbal therapy treatment arm responded favorably as measured by a negative lactulose breath test. Those in the antibiotic treatment arm who did not respond to antibiotics were switched to the herbal therapy and responded positively. This study also indicated that side effects may occur with treatment with rifaximin—some subjects in the study experienced anaphylaxis, hives, diarrhea, or overgrowth of C. difficile. Only one case of diarrhea was experienced in the herbal therapy arm (1).

Berberine Complex contains extracts of barberry, Oregon grape, and goldenseal, all of which contain the alkaloid compound berberine. Berberine has been shown to exhibit activity in maintaining healthy intestinal flora. This formula supports the healthy balance of bacteria in the digestive tract.

Yeast Formula contains herbal oil extracts of oregano, thyme, peppermint, and goldenseal. These oils have a long history of use against microbial and yeast species in the gut. Taken together, these alkaloids have been shown to possess beneficial activities in support of immune function and stable flora throughout the body (5).

References

1  Chedid V., et al (2014) Herbal therapy is equivalent to rifaximin for the treatment of small intestinal bacterial overgrowth. Glob Adv Health Med. 3(3):16-24. doi: 10.7453/gahmj.2014.019. http://www.ncbi.nlm.nih.gov/pubmed/24891990

2  Wallace DJ, Hallegua DS. (2004) Fibromyalgia: the gastrointestinal link. Curr Pain Headache Rep. 8(5):364-8. http://www.ncbi.nlm.nih.gov/pubmed/15361320

3  Pimentel M., et al. (2004) A link between irritable bowel syndrome and fibromyalgia may be related to findings on lactulose breath testing. Ann Rheum Dis 63:450-452 doi:10.1136/ard.2003.011502. http://www.ncbi.nlm.nih.gov/pubmed/15020342  

4  Vasquez A. Fibromyalgia in a Nutshell: A Safe and Effective Functional Medicine Strategy. Portland, OR; Integrative and Biological Research and Consulting, LLC; 2012.

5  Braga PC, Culici M, Alfieri M, Dal Sasso M (2008) Thymol inhibits Candida albicans biofilm formation and mature biofilm. Int J Antimicrob Agents. 31(5):472-7. Epub 2008 Mar 10. http://www.ncbi.nlm.nih.gov/pubmed/18329858