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  • SIBO: excess bacteria in small intestine, causing IBS-like symptoms.
  • Herbal therapies such as oregano and garlic may show similar effectiveness to antibiotics.
  • Breath tests diagnose SIBO; herbal options exist for antibiotic alternatives.


Small intestinal bacterial overgrowth, or SIBO, is a commonly underdiagnosed condition in which abnormally large numbers of commensal bacteria are present in the small intestine.

In a healthy gut, ‘friendly’ bacteria are found mostly in the large intestine, yet in cases of SIBO, they start to proliferate in the small intestine where they ferment food, causing unwanted symptoms such as gas (belching and flatulence), bloating, pain, diarrhoea and constipation.

SIBO symptoms mirror those typical of IBS. In fact, SIBO is now considered to be an underlying cause of IBS in at least 50% and perhaps as many as 84% of IBS cases.

Breath testing for hydrogen and methane levels is the most common method used to diagnose SIBO. While conventional treatments involve antibiotics, many people are now exploring SIBO natural treatments as an alternative approach.

Can herbal therapies be as effective as conventional SIBO treatment?

Can Herbal Therapies Be as Effective as Conventional SIBO Treatment?

A 2014 study, carried out by Gerard Mullin MD and his colleagues at John Hopkins and the University of Pittsburgh, explored the effectiveness of SIBO herbal treatment compared to commonly prescribed antibiotics. The study, published in Global Advances in Health & Medicine, evaluated the results of using herbal therapies in treating SIBO versus the antibiotic rifaximin, which is the most studied and commonly used antibiotic for the condition.

104 study participants who tested positive for newly diagnosed SIBO by lactulose breath testing (LBT) were offered either rifaximin (1200mg daily) or comprehensive herbal therapy (A range of herbal extracts including berberine, oregano and garlic). Those who didn’t respond to rifaximin were then offered either triple antibiotics or herbal rescue therapy at that point.

Results showed that SIBO is widely prevalent in gastroenterology practice and that herbal therapies are at least as effective as rifaximin for resolution of SIBO diagnosed by LBT.

The findings revealed that SIBO natural treatment using herbal therapies was at least as effective as rifaximin in resolving SIBO diagnosed by breath testing. Additionally, herbal therapy was also as effective as triple antibiotic therapy for individuals who did not respond to rifaximin.

These results highlight the potential of SIBO herbal treatment as an alternative to antibiotics, particularly for those who do not respond to conventional therapy or prefer a more natural approach.

Key takeaways on SIBO natural treatment

• Herbal therapies could be an effective alternative antibiotics for treating SIBO.
• Common herbal treatments for SIBO include berberine, oregano, and garlic extracts.
• Breath testing is the most widely used diagnostic tool for SIBO.
• Dietary and lifestyle changes, alongside herbal therapies, may further support SIBO management.

Herbal SIBO therapy also appears to be as effective as triple antibiotic therapy for SIBO when treating rifaximin non-responders.

While conventional antibiotics remain a primary treatment for SIBO, research suggests that SIBO natural treatment using herbal therapies offers a promising alternative. If you suspect SIBO, consult your healthcare practitioner to explore your best treatment options, including herbal remedies for SIBO.

References:
Mullin GE, Chedid V et al.  Herbal therapy is equivalent to rifaximin for the treatment of small intestinal bacterial overgrowth.  Global Advances in Health & Medicine.  2014 May; 3(3): 16-24.  Published online 2014 May 1. Doi: 10.7453/gahmj.2014.019

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