Americans spent $1.43 million on over-the-counter laxatives in 2019 . When you consider that chronic constipation negatively impacts social functioning and quality of life [2 Trusted SourcePubMedGo to source], it’s clear that a lot of people suffer in silence with this condition.
Chronic constipation is a common digestive disorder, affecting up to 27% of the population . And while constipation can affect anyone, it is more common among women and adults over 65 years of age .
Constipation is officially defined as having fewer than 3 bowel movements per week and/or having hard stool that is difficult to pass. However, in functional medicine, having 1-3 healthy bowel movements per day is one of the benchmarks of good digestive health.
Laxatives are fine for occasional constipation. However, for chronic conditions, it’s best to address the root causes. Probiotics help to correct the bacterial imbalances that underlie many cases of constipation.
Constipation and Gut Dysbiosis
For some people, overcoming constipation is simply a matter of making better food choices. If your diet is high in processed foods, adding fiber-rich whole foods and drinking enough water may be all that’s needed.
But fiber can be a double-edged sword if your constipation is caused by gut dysbiosis, an imbalance of the microorganisms in the digestive tract. Fiber feeds your gut bugs. Eating more fiber may make constipation, bloating, and abdominal pain worse [4 Trusted SourcePubMedGo to source, 5 Trusted SourcePubMedGo to source], particularly if you have an overgrowth of harmful bacteria.
Chronic constipation and gut dysbiosis can be a self-perpetuating cycle. As fecal matter sits immobile in your digestive system, it encourages more growth of harmful bacteria and yeast, creating more constipation. Digestive system overgrowths can also cause inflammation and leaky gut, which can lead to other symptoms like fatigue, brain fog, food sensitivities, itchy skin, and more.
Probiotics can be very helpful in breaking the cycle of chronic constipation.
Research shows that the beneficial bacteria in probiotic supplements can help with chronic constipation. Several systematic reviews and meta-analyses (the highest quality of research) have shown that probiotics:
One meta-analysis of 15 clinical trials showed that multi-strain probiotics were more effective than single-strain probiotics for increasing stool frequency, improving stool consistency, and reducing bloating [11 Trusted SourcePubMedGo to source]. Similar results have been found when comparing multi-strain and single-strain probiotics for treating irritable bowel syndrome (IBS) [26 Trusted SourcePubMedGo to source, 27 Trusted SourcePubMedGo to source].
I’ve seen similar results using probiotics for constipation in my clinic. Many people don’t seem to achieve balance in their gut microbiome with just one strain of probiotic. For many patients who have tried probiotic supplements without much success in the past, a multi-strain approach makes all the difference. For this reason, I recommend a comprehensive approach that includes all three categories of probiotics.
Probiotic Triple Therapy
You don’t need to try every different probiotic strain on the market, hoping to find the right one. Probiotic Triple Therapy is a comprehensive approach and eliminates the guesswork of choosing probiotic products.
Nearly every probiotic product can be classified into one of three categories . When following the Probiotic Triple Therapy protocol, you’ll pick one quality supplement from each category.
Lactobacillus & bifidobacterium species predominated blends
Saccharomyces Boulardii (a healthy fungus)
Soil-Based Probiotics using various Bacillus species
These are the most well-researched, with well over 500 trials assessing their validity. These live microorganisms are also known as lactic-acid producing probiotic bacteria. They include a large number of well-known probiotic species, such as: ⚫️ Lactobacillus acidophilus, ⚫️ Lactobacillus Plantarum, ⚫️ Lactobacillus casei, ⚫️ Lactobacillus reuteri, ⚫️ Bifidobacterium lactis, ⚫️ Bifidobacterium longum, ⚫️ Bifidobacterium infantis
The second most researched probiotic, with more than 100 studies. Saccharomyces boulardii (S. Boulardi for short) is not a normal part of human gut microbiota, meaning it does not colonize us but does improve the health of the host.
Monitor your symptoms for 3-4 weeks. If you’re improving, stay on the Probiotic Triple Therapy protocol until your improvements have plateaued.
Once you’ve seen your maximum improvement (you’ve plateaued), stay on the protocol for about a month to allow your system to calibrate to these new improvements. Then, reduce your dose and find the minimal effective dose. Stay on the minimal effective dose.
If you haven’t noticed any change in your symptoms after 3-4 weeks, you can stop taking probiotics and feel confident that you have fully explored probiotic therapy. There’s no need to shop for other strains of probiotics.
Rachel came to see me after reading my book, Healthy Gut, Healthy You. She had IBS-C and only went to the bathroom once every 5-6 days. Her struggle with constipation was lifelong, and she had tried many different natural treatments with little success.
With my support, Rachel started using Probiotic Triple Therapy. Within 48 hours, her lifelong constipation normalized. She also noticed that her mood was better. Rachel continued to take probiotics and was able to reduce her dose over time.
Not everyone enjoys the benefits of probiotics as quickly as Rachel. Allow at least three weeks to see if Probiotic Triple Therapy works for you. Even small improvements in your symptoms should be taken as a good sign that probiotics are working to restore your gut health.
Additional Treatments for Constipation
For some patients, probiotics offer a partial solution, improving but not eliminating symptoms. If this is your experience, you may benefit from these additional treatment options:
Prokinetic agents are drugs or natural supplements that help increase the strength and coordination of your migrating motor complex (MMC). The MMC is a complex system of nerves, muscles, and neurotransmitters that moves waste through the gastrointestinal tract. Prokinetic agents aren’t harsh like most laxatives and are better suited for long-term use.
It’s very important to keep waste moving through your gut. When fecal matter becomes trapped in your digestive tract, harmful bacteria thrive. Poor gut motility contributes to SIBO and other conditions of bacterial overgrowth.
A recent meta-analysis compared 36 clinical interventions for chronic constipation [34 Trusted SourcePubMedGo to source]. Probiotics combined with a prokinetic agent was found to be the most effective treatment.
MotilPro is an effective natural prokinetic agent. There are also a number of prescription options for prokinetic agents. A recent meta-analysis reviewed 33 clinical trials involving 17,214 patients to determine which drug was most effective for constipation [35 Trusted SourcePubMedGo to source]. While prucalopride was not the most effective initially, it ranked as the most effective after 12 weeks of therapy.
Low Fiber Diet
Fiber consumption works well for some, however it can be very counterproductive for others with functional constipation [36 Trusted SourcePubMedGo to source]. That’s because fiber may feed the gut bugs that cause constipation.
If you’ve tried high-fiber diets without success, it may be time for a different approach. One clinical trial found that a low- or no-fiber diet significantly improved constipation and bloating . In the study, 41 patients who completely stopped fiber intake increased bowel movement frequency from once every 3.75 days to once per day.
Antibiotic therapy may be needed to reduce harmful gut bacteria if other treatments aren’t successful. Research shows that antibiotic treatment with Rifaxamin eliminates SIBO for 67% of patients [44 Trusted SourcePubMedGo to source].
Herbal antimicrobials have beneficial side effects and fewer risk factors when compared to antibiotic treatment. They are anti-inflammatory and possibly antidepressant [47, 48]. They can be effective for eliminating bacteria, fungi, and protozoa while antibiotics mostly work against bacteria [49 Trusted SourcePubMedGo to source].
Some SIBO patients relapse after antimicrobial and antibiotic therapy. For many patients, ongoing management of digestive function with probiotics, prokinetic agents, and/or a low fiber diet can help to prevent relapse.
Set Yourself Free from Constipation
Constipation is uncomfortable, frustrating, and can be a lifelong struggle without the right advice. Many patients haven’t found much support in the conventional medical system, beyond the faulty advice to consume more fiber.
Your health depends on good elimination. Treatment of long-term, chronic constipation is possible. Start with the beneficial effects of probiotics and consider additional treatment recommendations if needed.
Trads M, Pedersen PU. The association between constipation and quality of life, health related quality of life and health status in adults: a systematic review protocol. JBI Database System Rev Implement Rep. 2015 Jul 17;13(6):45-55. doi: 10.11124/jbisrir-2015-1760. PMID: 26455744. Trusted SourcePubMedGo to source
Sanchez MI, Bercik P. Epidemiology and burden of chronic constipation. Can J Gastroenterol. 2011 Oct;25 Suppl B(Suppl B):11B-15B. doi: 10.1155/2011/974573. PMID: 22114752; PMCID: PMC3206560.
Müller-Lissner SA, Kamm MA, Scarpignato C, Wald A. Myths and misconceptions about chronic constipation. Am J Gastroenterol. 2005 Jan;100(1):232-42. doi: 10.1111/j.1572-0241.2005.40885.x. PMID: 15654804. Trusted SourcePubMedGo to source
Gonlachanvit S, Coleski R, Owyang C, Hasler W. Inhibitory actions of a high fibre diet on intestinal gas transit in healthy volunteers. Gut. 2004 Nov;53(11):1577-82. doi: 10.1136/gut.2004.041632. PMID: 15479674; PMCID: PMC1774297. Trusted SourcePubMedGo to source
Leblhuber F, Steiner K, Schuetz B, Fuchs D, Gostner JM. Probiotic Supplementation in Patients with Alzheimer’s Dementia – An Explorative Intervention Study. Curr Alzheimer Res. 2018;15(12):1106-1113. doi: 10.2174/1389200219666180813144834. PMID: 30101706; PMCID: PMC6340155. Trusted SourcePubMedGo to source
Wang F, Feng J, Chen P, Liu X, Ma M, Zhou R, Chang Y, Liu J, Li J, Zhao Q. Probiotics in Helicobacter pylori eradication therapy: Systematic review and network meta-analysis. Clin Res Hepatol Gastroenterol. 2017 Sep;41(4):466-475. doi: 10.1016/j.clinre.2017.04.004. Epub 2017 May 25. PMID: 28552432. Trusted SourcePubMedGo to source
García-Collinot G, Madrigal-Santillán EO, Martínez-Bencomo MA, Carranza-Muleiro RA, Jara LJ, Vera-Lastra O, Montes-Cortes DH, Medina G, Cruz-Domínguez MP. Effectiveness of Saccharomyces boulardii and Metronidazole for Small Intestinal Bacterial Overgrowth in Systemic Sclerosis. Dig Dis Sci. 2020 Apr;65(4):1134-1143. doi: 10.1007/s10620-019-05830-0. Epub 2019 Sep 23. PMID: 31549334. Trusted SourcePubMedGo to source
Greco A, Caviglia GP, Brignolo P, Ribaldone DG, Reggiani S, Sguazzini C, Smedile A, Pellicano R, Resegotti A, Astegiano M, Bresso F. Glucose breath test and Crohn’s disease: Diagnosis of small intestinal bacterial overgrowth and evaluation of therapeutic response. Scand J Gastroenterol. 2015;50(11):1376-81. doi: 10.3109/00365521.2015.1050691. Epub 2015 May 19. PMID: 25990116. Trusted SourcePubMedGo to source
Wen Y, Li J, Long Q, Yue CC, He B, Tang XG. The efficacy and safety of probiotics for patients with constipation-predominant irritable bowel syndrome: A systematic review and meta-analysis based on seventeen randomized controlled trials. Int J Surg. 2020 Jul;79:111-119. doi: 10.1016/j.ijsu.2020.04.063. Epub 2020 May 6. PMID: 32387213. Trusted SourcePubMedGo to source
Zhang C, Jiang J, Tian F, Zhao J, Zhang H, Zhai Q, Chen W. Meta-analysis of randomized controlled trials of the effects of probiotics on functional constipation in adults. Clin Nutr. 2020 Oct;39(10):2960-2969. doi: 10.1016/j.clnu.2020.01.005. Epub 2020 Jan 14. PMID: 32005532. Trusted SourcePubMedGo to source
Miller LE, Ouwehand AC, Ibarra A. Effects of probiotic-containing products on stool frequency and intestinal transit in constipated adults: systematic review and meta-analysis of randomized controlled trials. Ann Gastroenterol. 2017;30(6):629-639. doi: 10.20524/aog.2017.0192. Epub 2017 Sep 21. PMID: 29118557; PMCID: PMC5670282. Trusted SourcePubMedGo to source
Kang S, Park MY, Brooks I, Lee J, Kim SH, Kim JY, Oh B, Kim JW, Kwon O. Spore-forming Bacillus coagulans SNZ 1969 improved intestinal motility and constipation perception mediated by microbial alterations in healthy adults with mild intermittent constipation: A randomized controlled trial. Food Res Int. 2021 Aug;146:110428. doi: 10.1016/j.foodres.2021.110428. Epub 2021 May 19. PMID: 34119240. Trusted SourcePubMedGo to source
Kommers MJ, Silva Rodrigues RA, Miyajima F, Zavala Zavala AA, Ultramari VRLM, Fett WCR, Balogun SO, de Oliveira RG, Fett CA. Effects of Probiotic Use on Quality of Life and Physical Activity in Constipated Female University Students: A Randomized, Double-Blind Placebo-Controlled Study. J Altern Complement Med. 2019 Dec;25(12):1163-1171. doi: 10.1089/acm.2019.0134. Epub 2019 Oct 29. PMID: 31657615. Trusted SourcePubMedGo to source
Martínez-Martínez MI, Calabuig-Tolsá R, Cauli O. The effect of probiotics as a treatment for constipation in elderly people: A systematic review. Arch Gerontol Geriatr. 2017 Jul;71:142-149. doi: 10.1016/j.archger.2017.04.004. Epub 2017 Apr 14. PMID: 28467916. Trusted SourcePubMedGo to source
Gomes DOVS, Morais MB. GUT MICROBIOTA AND THE USE OF PROBIOTICS IN CONSTIPATION IN CHILDREN AND ADOLESCENTS: SYSTEMATIC REVIEW. Rev Paul Pediatr. 2019 Nov 25;38:e2018123. doi: 10.1590/1984-0462/2020/38/2018123. PMID: 31778407; PMCID: PMC6909257. Trusted SourcePubMedGo to source
Jin L, Deng L, Wu W, Wang Z, Shao W, Liu J. Systematic review and meta-analysis of the effect of probiotic supplementation on functional constipation in children. Medicine (Baltimore). 2018 Sep;97(39):e12174. doi: 10.1097/MD.0000000000012174. PMID: 30278490; PMCID: PMC6181519. Trusted SourcePubMedGo to source
Wegh CAM, Benninga MA, Tabbers MM. Effectiveness of Probiotics in Children With Functional Abdominal Pain Disorders and Functional Constipation: A Systematic Review. J Clin Gastroenterol. 2018 Nov/Dec;52 Suppl 1, Proceedings from the 9th Probiotics, Prebiotics and New Foods, Nutraceuticals and Botanicals for Nutrition & Human and Microbiota Health Meeting, held in Rome, Italy from September 10 to 12, 2017:S10-S26. doi: 10.1097/MCG.0000000000001054. PMID: 29782469. Trusted SourcePubMedGo to source
Bures J, Cyrany J, Kohoutova D, Förstl M, Rejchrt S, Kvetina J, Vorisek V, Kopacova M. Small intestinal bacterial overgrowth syndrome. World J Gastroenterol. 2010 Jun 28;16(24):2978-90. doi: 10.3748/wjg.v16.i24.2978. PMID: 20572300; PMCID: PMC2890937.
Toribio-Mateas M. Harnessing the Power of Microbiome Assessment Tools as Part of Neuroprotective Nutrition and Lifestyle Medicine Interventions. Microorganisms. 2018 Apr 25;6(2):35. doi: 10.3390/microorganisms6020035. PMID: 29693607; PMCID: PMC6027349. Trusted SourcePubMedGo to source
Stenman LK, Lehtinen MJ, Meland N, Christensen JE, Yeung N, Saarinen MT, Courtney M, Burcelin R, Lähdeaho ML, Linros J, Apter D, Scheinin M, Kloster Smerud H, Rissanen A, Lahtinen S. Probiotic With or Without Fiber Controls Body Fat Mass, Associated With Serum Zonulin, in Overweight and Obese Adults-Randomized Controlled Trial. EBioMedicine. 2016 Nov;13:190-200. doi: 10.1016/j.ebiom.2016.10.036. Epub 2016 Oct 26. PMID: 27810310; PMCID: PMC5264483. Trusted SourcePubMedGo to source
Frei R, Akdis M, O’Mahony L. Prebiotics, probiotics, synbiotics, and the immune system: experimental data and clinical evidence. Curr Opin Gastroenterol. 2015 Mar;31(2):153-8. doi: 10.1097/MOG.0000000000000151. PMID: 25594887. Trusted SourcePubMedGo to source
Mujagic Z, de Vos P, Boekschoten MV, Govers C, Pieters HH, de Wit NJ, Bron PA, Masclee AA, Troost FJ. The effects of Lactobacillus plantarum on small intestinal barrier function and mucosal gene transcription; a randomized double-blind placebo controlled trial. Sci Rep. 2017 Jan 3;7:40128. doi: 10.1038/srep40128. PMID: 28045137; PMCID: PMC5206730. Trusted SourcePubMedGo to source
Sindhu KN, Sowmyanarayanan TV, Paul A, Babji S, Ajjampur SS, Priyadarshini S, Sarkar R, Balasubramanian KA, Wanke CA, Ward HD, Kang G. Immune response and intestinal permeability in children with acute gastroenteritis treated with Lactobacillus rhamnosus GG: a randomized, double-blind, placebo-controlled trial. Clin Infect Dis. 2014 Apr;58(8):1107-15. doi: 10.1093/cid/ciu065. Epub 2014 Feb 5. PMID: 24501384; PMCID: PMC3967829. Trusted SourcePubMedGo to source
Lamprecht M, Bogner S, Schippinger G, Steinbauer K, Fankhauser F, Hallstroem S, Schuetz B, Greilberger JF. Probiotic supplementation affects markers of intestinal barrier, oxidation, and inflammation in trained men; a randomized, double-blinded, placebo-controlled trial. J Int Soc Sports Nutr. 2012 Sep 20;9(1):45. doi: 10.1186/1550-2783-9-45. PMID: 22992437; PMCID: PMC3465223. Trusted SourcePubMedGo to source
American College of Gastroenterology Task Force on Irritable Bowel Syndrome, Brandt LJ, Chey WD, Foxx-Orenstein AE, Schiller LR, Schoenfeld PS, Spiegel BM, Talley NJ, Quigley EM. An evidence-based position statement on the management of irritable bowel syndrome. Am J Gastroenterol. 2009 Jan;104 Suppl 1:S1-35. doi: 10.1038/ajg.2008.122. PMID: 19521341. Trusted SourcePubMedGo to source
Ford AC, Quigley EM, Lacy BE, Lembo AJ, Saito YA, Schiller LR, Soffer EE, Spiegel BM, Moayyedi P. Efficacy of prebiotics, probiotics, and synbiotics in irritable bowel syndrome and chronic idiopathic constipation: systematic review and meta-analysis. Am J Gastroenterol. 2014 Oct;109(10):1547-61; quiz 1546, 1562. doi: 10.1038/ajg.2014.202. Epub 2014 Jul 29. PMID: 25070051. Trusted SourcePubMedGo to source
Ilinskaya ON, Ulyanova VV, Yarullina DR, Gataullin IG. Secretome of Intestinal Bacilli: A Natural Guard against Pathologies. Front Microbiol. 2017 Sep 1;8:1666. doi: 10.3389/fmicb.2017.01666. PMID: 28919884; PMCID: PMC5586196. Trusted SourcePubMedGo to source
Eskesen D, Jespersen L, Michelsen B, Whorwell PJ, Müller-Lissner S, Morberg CM. Effect of the probiotic strain Bifidobacterium animalis subsp. lactis, BB-12®, on defecation frequency in healthy subjects with low defecation frequency and abdominal discomfort: a randomised, double-blind, placebo-controlled, parallel-group trial. Br J Nutr. 2015 Nov 28;114(10):1638-46. doi: 10.1017/S0007114515003347. Epub 2015 Sep 18. PMID: 26382580; PMCID: PMC4657032. Trusted SourcePubMedGo to source
Yoon H, Park YS, Lee DH, Seo JG, Shin CM, Kim N. Effect of administering a multi-species probiotic mixture on the changes in fecal microbiota and symptoms of irritable bowel syndrome: a randomized, double-blind, placebo-controlled trial. J Clin Biochem Nutr. 2015 Sep;57(2):129-34. doi: 10.3164/jcbn.15-14. Epub 2015 Jun 30. PMID: 26388670; PMCID: PMC4566021. Trusted SourcePubMedGo to source
Cappello C, Tremolaterra F, Pascariello A, Ciacci C, Iovino P. A randomised clinical trial (RCT) of a symbiotic mixture in patients with irritable bowel syndrome (IBS): effects on symptoms, colonic transit and quality of life. Int J Colorectal Dis. 2013 Mar;28(3):349-58. doi: 10.1007/s00384-012-1552-1. Epub 2012 Aug 12. PMID: 22885882; PMCID: PMC3587687. Trusted SourcePubMedGo to source
Ringel-Kulka T, Palsson OS, Maier D, Carroll I, Galanko JA, Leyer G, Ringel Y. Probiotic bacteria Lactobacillus acidophilus NCFM and Bifidobacterium lactis Bi-07 versus placebo for the symptoms of bloating in patients with functional bowel disorders: a double-blind study. J Clin Gastroenterol. 2011 Jul;45(6):518-25. doi: 10.1097/MCG.0b013e31820ca4d6. PMID: 21436726; PMCID: PMC4372813. Trusted SourcePubMedGo to source
Shi Q, Tan L, Liu C, Wang H, Zhang J, Wang H, Zhai J. Comparative efficacy of pharmacological and nonpharmacological treatments for chronic idiopathic constipation in China: a Bayesian network meta-analysis. BMC Complement Altern Med. 2019 Nov 14;19(1):311. doi: 10.1186/s12906-019-2741-z. PMID: 31727037; PMCID: PMC6857160. Trusted SourcePubMedGo to source
Luthra P, Camilleri M, Burr NE, Quigley EMM, Black CJ, Ford AC. Efficacy of drugs in chronic idiopathic constipation: a systematic review and network meta-analysis. Lancet Gastroenterol Hepatol. 2019 Nov;4(11):831-844. doi: 10.1016/S2468-1253(19)30246-8. Epub 2019 Aug 29. PMID: 31474542. Trusted SourcePubMedGo to source
Eswaran S, Muir J, Chey WD. Fiber and functional gastrointestinal disorders. Am J Gastroenterol. 2013 May;108(5):718-27. doi: 10.1038/ajg.2013.63. Epub 2013 Apr 2. PMID: 23545709. Trusted SourcePubMedGo to source
Ho KS, Tan CY, Mohd Daud MA, Seow-Choen F. Stopping or reducing dietary fiber intake reduces constipation and its associated symptoms. World J Gastroenterol. 2012 Sep 7;18(33):4593-6. doi: 10.3748/wjg.v18.i33.4593. PMID: 22969234; PMCID: PMC3435786.
Mazzawi T, El-Salhy M. Changes in duodenal enteroendocrine cells in patients with irritable bowel syndrome following dietary guidance. Exp Biol Med (Maywood). 2017 Jul;242(13):1355-1362. doi: 10.1177/1535370217699537. Epub 2017 Mar 17. PMID: 28737477; PMCID: PMC5528200. Trusted SourcePubMedGo to source
Mazzawi T, Hausken T, Gundersen D, El-Salhy M. Dietary guidance normalizes large intestinal endocrine cell densities in patients with irritable bowel syndrome. Eur J Clin Nutr. 2016 Feb;70(2):175-81. doi: 10.1038/ejcn.2015.191. Epub 2015 Nov 25. PMID: 26603880; PMCID: PMC4744244. Trusted SourcePubMedGo to source
Mazzawi T, El-Salhy M. Effect of diet and individual dietary guidance on gastrointestinal endocrine cells in patients with irritable bowel syndrome (Review). Int J Mol Med. 2017 Oct;40(4):943-952. doi: 10.3892/ijmm.2017.3096. Epub 2017 Aug 11. PMID: 28849091; PMCID: PMC5593462. Trusted SourcePubMedGo to source
Gibson PR, Shepherd SJ. Evidence-based dietary management of functional gastrointestinal symptoms: The FODMAP approach. J Gastroenterol Hepatol. 2010 Feb;25(2):252-8. doi: 10.1111/j.1440-1746.2009.06149.x. PMID: 20136989. Trusted SourcePubMedGo to source
Gibson PR, Shepherd SJ. Food choice as a key management strategy for functional gastrointestinal symptoms. Am J Gastroenterol. 2012 May;107(5):657-66; quiz 667. doi: 10.1038/ajg.2012.49. Epub 2012 Apr 10. PMID: 22488077. Trusted SourcePubMedGo to source
Zahedi MJ, Behrouz V, Azimi M. Low fermentable oligo-di-mono-saccharides and polyols diet versus general dietary advice in patients with diarrhea-predominant irritable bowel syndrome: A randomized controlled trial. J Gastroenterol Hepatol. 2018 Jun;33(6):1192-1199. doi: 10.1111/jgh.14051. Epub 2018 Feb 21. PMID: 29159993. Trusted SourcePubMedGo to source
Gatta L, Scarpignato C. Systematic review with meta-analysis: rifaximin is effective and safe for the treatment of small intestine bacterial overgrowth. Aliment Pharmacol Ther. 2017 Mar;45(5):604-616. doi: 10.1111/apt.13928. Epub 2017 Jan 12. PMID: 28078798; PMCID: PMC5299503. Trusted SourcePubMedGo to source
Chen C, Tao C, Liu Z, Lu M, Pan Q, Zheng L, Li Q, Song Z, Fichna J. A Randomized Clinical Trial of Berberine Hydrochloride in Patients with Diarrhea-Predominant Irritable Bowel Syndrome. Phytother Res. 2015 Nov;29(11):1822-7. doi: 10.1002/ptr.5475. Epub 2015 Sep 24. PMID: 26400188. Trusted SourcePubMedGo to source
Chedid V, Dhalla S, Clarke JO, Roland BC, Dunbar KB, Koh J, Justino E, Tomakin E, Mullin GE. Herbal therapy is equivalent to rifaximin for the treatment of small intestinal bacterial overgrowth. Glob Adv Health Med. 2014 May;3(3):16-24. doi: 10.7453/gahmj.2014.019. PMID: 24891990; PMCID: PMC4030608. Trusted SourcePubMedGo to source
Rahimi R, Nikfar S, Abdollahi M. Induction of clinical response and remission of inflammatory bowel disease by use of herbal medicines: a meta-analysis. World J Gastroenterol. 2013 Sep 14;19(34):5738-49. doi: 10.3748/wjg.v19.i34.5738. PMID: 24039370; PMCID: PMC3769914.
Mechan, A., Fowler, A., Seifert, N., Rieger, H., Wöhrle, T., Etheve, S., . . . Mohajeri, M. (2011). Monoamine reuptake inhibition and mood-enhancing potential of a specified oregano extract. British Journal of Nutrition,105(8), 1150-1163. doi:10.1017/S0007114510004940
Banik GD, De A, Som S, Jana S, Daschakraborty SB, Chaudhuri S, Pradhan M. Hydrogen sulphide in exhaled breath: a potential biomarker for small intestinal bacterial overgrowth in IBS. J Breath Res. 2016 May 10;10(2):026010. doi: 10.1088/1752-7155/10/2/026010. PMID: 27163246. Trusted SourcePubMedGo to source
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