SIBO probiotics to avoid

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SIBO probiotics to avoid

When it comes to probiotics, SIBO (small intestinal bacterial overgrowth) is a bit of a controversial issue. Certain studies propose that probiotics can assist in restoring a healthy microbial balance and decreasing bacterial overgrowth in the small intestine. However, others suggest that probiotics may worsen SIBO symptoms.

As a healthcare professional, I would like to emphasize that not all probiotics are identical, and different strains can have diverse impacts on SIBO. Consequently, it is important for individuals to be mindful when selecting which probiotic supplements they consume. 

With that said, my previous article has reviewed the best probiotics for SIBO.

So, today’s article will take a look at certain probiotics to be avoided in SIBO.

A quick review on SIBO

SIBO occurs when an excess of bacteria populates the small intestine instead of the colon. Common causes of SIBO include low stomach acid and impaired movement in the small intestine, as these factors prevent bacterial overgrowth in the small bowel. The abundance of these bacteria can disrupt gut function and lead to excessive gas production through increased fermentation.

SIBO patients may experience symptoms such as bloating, flatulence, changes in bowel habits (either constipation or diarrhea), fatigue, weight loss, difficulty concentrating (brain fog), and feelings of anxiety.

Can Probiotics Make SIBO Worse?

You might feel worse when you are taking the wrong kind of probiotics.

Some probiotics are helpful in treating bacterial overgrowth while others may cause SIBO.

What does research say?

📝 A meta-analysis of 18 studies suggested that probiotics are effective in reducing the bacterial burden in SIBO patients and alleviating their symptoms.

📝 In contrast, another study has shown that probiotics may provoke symptoms among SIBO patients including gas, bloating, and brain fogginess. In the study, probiotic cessation, and a course of antibiotics, resolved brain fogginess while improving other gastrointestinal symptoms.


These results suggest that probiotics can be both helpful and harmful when it comes to SIBO. The key, especially when it comes to treating SIBO with probiotics, is to choose the probiotics proven to help with SIBO and more importantly, to avoid those that may exacerbate symptoms.

Probiotics To Avoid: Which Ones Make SIBO Worse?

⚠️ Avoid the probiotic strains claimed to worsen SIBO in clinical trials

The effects of probiotic therapy in SIBO are strongly strain-dependent, and not all probiotics are equally effective. A study from 2018 showed that the majority of Lactobacillus and Bifidobacterium species tend to exacerbate the symptoms of SIBO. Therefore, if you are currently experiencing SIBO symptoms, it is advisable to avoid probiotics containing these particular strains.

⚠️ Avoid Probiotics with Prebiotics

Many probiotic formulas contain prebiotics. Although prebiotics are beneficial for various GI conditions, SIBO is an exception. This is because prebiotics can provide nourishment to the bacteria in the intestines, potentially exacerbating the condition.

If you come across terms like inulin, GOS (Galactooligosaccharides), or FOS (Fructooligosaccharides) on the ingredient list of your probiotic bottle, these are all examples of prebiotics. It might be necessary for you to temporarily avoid consuming products containing prebiotics in SIBO.

⚠️ Avoid Probiotics with Additives

SIBO patients are recommended to follow a low FODMAP diet. FODMAP stands for fermentable oligosaccharides, disaccharides, monosaccharides, and polyols, which are short-chain carbohydrates or sugars that the small intestine may find difficult to absorb. Consumption of these carbohydrates often leads to digestive discomfort in individuals with SIBO.

Certain probiotics may contain additives (e.g. lactose, starches, and soy) that are not suitable for those on a SIBO diet. Therefore, it is crucial to carefully check the contents of any probiotic supplements while dealing with SIBO.

Tips for Choosing the Right Probiotics for SIBO

  • Given that everyone is unique, what may be effective for one person may not yield the same results for you. Therefore, find a probiotic which makes you feel better and commit to it. As for professional guidance, you can check out my article: Best probiotics for SIBO.
  • Start small and see if you tolerate the probiotic. If you do, gradually increase it to the full dosage. If you have adverse reactions to the probiotic, stop taking it.
  • Consulting with a gastroenterologist or a healthcare professional can help clarify which probiotic may be helpful for you. 

The final say

Probiotics may be both a help and hindrance for SIBO depending on the specific probiotic used. Therefore, when dealing with SIBO, it is crucial to identify the probiotics that are beneficial and those that should be avoided. The probiotics mentioned earlier can potentially worsen the symptoms of SIBO, so it is advisable to steer clear of them. It is always important to seek guidance from a healthcare professional before beginning any probiotic treatment for SIBO.

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Dr Tun Min is s GP working in NHS UK and writing articles about supplements and vitamins based on personal clinical experience and clinical research.

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