Evidence supporting the use of: Lactobacillus
For the health condition: Small Intestinal Bacterial Overgrowth

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Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Lactobacillus species have been investigated for their potential role in managing Small Intestinal Bacterial Overgrowth (SIBO), primarily based on their probiotic properties. The rationale for their use is that certain Lactobacillus strains can help restore a healthy balance of gut microbiota, compete with pathogenic bacteria, and modulate immune responses and intestinal motility. Several small clinical studies and case series have examined probiotics, including Lactobacillus, in SIBO patients. Some studies suggest that probiotic supplementation may reduce SIBO symptoms, improve breath test results, and decrease recurrence rates, particularly when used adjunctively with antibiotics. However, the overall quality of evidence is low due to small sample sizes, heterogeneity in probiotic strains and dosages, and lack of large, well-controlled randomized trials specific to SIBO.

A handful of studies (e.g., Khalighi et al., 2014; Gatta et al., 2017) have shown symptom improvement and normalization of breath tests with probiotics that include Lactobacillus strains, but these studies often combine multiple probiotic species, making it difficult to isolate the effect of Lactobacillus alone. Furthermore, systematic reviews note that while probiotics may offer benefit for some patients, the evidence remains preliminary and insufficient for strong recommendations. Current guidelines from gastroenterological societies do not universally endorse probiotics, including Lactobacillus, as a primary therapy for SIBO. In summary, there is some scientific investigation supporting the use of Lactobacillus for SIBO, but the evidence is weak to moderate, with further robust research needed.

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