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

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Synopsis

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

Lactobacillus plantarum has some scientific evidence supporting its use in the management of Small Intestinal Bacterial Overgrowth (SIBO), though the evidence base is limited and not definitive. L. plantarum is a probiotic bacterium that is well-studied for general gut health and has shown antimicrobial properties in vitro, including the ability to suppress pathogenic and fermentative bacteria that may be overrepresented in SIBO. Some small clinical studies and case series have reported improvement in gastrointestinal symptoms and hydrogen breath test results in SIBO patients treated with multi-strain probiotics containing L. plantarum. However, these studies are often of low quality, have small sample sizes, or use multi-strain formulations, making it difficult to attribute effects specifically to L. plantarum.

There is biological plausibility for its use: L. plantarum can produce bacteriocins and lower intestinal pH, both of which may inhibit typical SIBO-associated bacteria. Additionally, its role in restoring gut barrier function and modulating local immune responses may provide indirect benefits. However, as of 2024, there are no large, high-quality randomized controlled trials (RCTs) that specifically evaluate L. plantarum as a monotherapy for SIBO. Most clinical guidelines recommend antibiotics as first-line therapy, with probiotics considered adjunctively and with caution due to insufficient robust evidence. In summary, while there is some scientific rationale and early clinical support, more high-quality research is needed to firmly establish the efficacy of L. plantarum for SIBO.

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