1
|
Redondo-Cuevas L, Belloch L, Martín-Carbonell V, Nicolás A, Alexandra I, Sanchis L, Ynfante M, Colmenares M, Mora M, Liebana AR, Antequera B, Grau F, Molés JR, Cuesta R, Díaz S, Sancho N, Tomás H, Gonzalvo J, Jaén M, Sánchez E, Garayoa A, Moreno N, Gallén A, Cortés-Castell E, Cortés-Rizo X. Do Herbal Supplements and Probiotics Complement Antibiotics and Diet in the Management of SIBO? A Randomized Clinical Trial. Nutrients 2024; 16:1083. [PMID: 38613116 PMCID: PMC11013329 DOI: 10.3390/nu16071083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 04/01/2024] [Accepted: 04/03/2024] [Indexed: 04/14/2024] Open
Abstract
Small intestinal bacterial overgrowth (SIBO) arises from dysbiosis in the small intestine, manifesting with abdominal symptoms. This study aims to assess the efficacy of combined antibiotic therapy, herbal supplements, probiotics, and dietary modifications in SIBO management. A total of 179 SIBO-diagnosed patients underwent clinical evaluation and breath testing. Patients were categorized into hydrogen (H2-SIBO) and methane (CH4-SIBO) groups. The control group received standard antibiotic therapy and a low-FODMAP diet, while the intervention group received additional herbal antibiotics, probiotics, and prebiotics. After treatment, both groups exhibited reduced gas levels, particularly in CH4-SIBO. Clinical remission rates were higher in the intervention group, especially in CH4-SIBO cases. Logistic regression analysis showed gas concentrations at diagnosis as significant predictors of treatment success. In conclusion, adjunctive herbal supplements and probiotics did not significantly impact gas levels, but showed potential for clinical improvement, especially in CH4-SIBO.
Collapse
Affiliation(s)
- Lucia Redondo-Cuevas
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (L.R.-C.); (L.B.); (M.Y.); (M.C.); (A.R.L.); (F.G.); (J.R.M.); (N.S.); (M.J.); (X.C.-R.)
| | - Lucia Belloch
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (L.R.-C.); (L.B.); (M.Y.); (M.C.); (A.R.L.); (F.G.); (J.R.M.); (N.S.); (M.J.); (X.C.-R.)
| | - Vanesa Martín-Carbonell
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (L.R.-C.); (L.B.); (M.Y.); (M.C.); (A.R.L.); (F.G.); (J.R.M.); (N.S.); (M.J.); (X.C.-R.)
- Digestive Section, Hospital de Sagunto Internal Medicine Service, 46520 Valencia, Spain; (I.A.)
| | - Angela Nicolás
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (L.R.-C.); (L.B.); (M.Y.); (M.C.); (A.R.L.); (F.G.); (J.R.M.); (N.S.); (M.J.); (X.C.-R.)
| | - Iulia Alexandra
- Digestive Section, Hospital de Sagunto Internal Medicine Service, 46520 Valencia, Spain; (I.A.)
| | - Laura Sanchis
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (L.R.-C.); (L.B.); (M.Y.); (M.C.); (A.R.L.); (F.G.); (J.R.M.); (N.S.); (M.J.); (X.C.-R.)
- Digestive Section, Hospital de Sagunto Internal Medicine Service, 46520 Valencia, Spain; (I.A.)
| | - Marina Ynfante
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (L.R.-C.); (L.B.); (M.Y.); (M.C.); (A.R.L.); (F.G.); (J.R.M.); (N.S.); (M.J.); (X.C.-R.)
| | - Michel Colmenares
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (L.R.-C.); (L.B.); (M.Y.); (M.C.); (A.R.L.); (F.G.); (J.R.M.); (N.S.); (M.J.); (X.C.-R.)
| | - María Mora
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (L.R.-C.); (L.B.); (M.Y.); (M.C.); (A.R.L.); (F.G.); (J.R.M.); (N.S.); (M.J.); (X.C.-R.)
| | - Ana Reyes Liebana
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (L.R.-C.); (L.B.); (M.Y.); (M.C.); (A.R.L.); (F.G.); (J.R.M.); (N.S.); (M.J.); (X.C.-R.)
| | - Beatriz Antequera
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (L.R.-C.); (L.B.); (M.Y.); (M.C.); (A.R.L.); (F.G.); (J.R.M.); (N.S.); (M.J.); (X.C.-R.)
| | - Francisco Grau
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (L.R.-C.); (L.B.); (M.Y.); (M.C.); (A.R.L.); (F.G.); (J.R.M.); (N.S.); (M.J.); (X.C.-R.)
| | - José Ramón Molés
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (L.R.-C.); (L.B.); (M.Y.); (M.C.); (A.R.L.); (F.G.); (J.R.M.); (N.S.); (M.J.); (X.C.-R.)
- Digestive Section, Hospital de Sagunto Internal Medicine Service, 46520 Valencia, Spain; (I.A.)
| | - Rubén Cuesta
- Digestive Section, Hospital de Sagunto Internal Medicine Service, 46520 Valencia, Spain; (I.A.)
| | - Samuel Díaz
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (L.R.-C.); (L.B.); (M.Y.); (M.C.); (A.R.L.); (F.G.); (J.R.M.); (N.S.); (M.J.); (X.C.-R.)
| | - Noelia Sancho
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (L.R.-C.); (L.B.); (M.Y.); (M.C.); (A.R.L.); (F.G.); (J.R.M.); (N.S.); (M.J.); (X.C.-R.)
| | - Héctor Tomás
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (L.R.-C.); (L.B.); (M.Y.); (M.C.); (A.R.L.); (F.G.); (J.R.M.); (N.S.); (M.J.); (X.C.-R.)
| | - José Gonzalvo
- Digestive Section, Hospital de Sagunto Internal Medicine Service, 46520 Valencia, Spain; (I.A.)
| | - Mercedes Jaén
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (L.R.-C.); (L.B.); (M.Y.); (M.C.); (A.R.L.); (F.G.); (J.R.M.); (N.S.); (M.J.); (X.C.-R.)
- Digestive Section, Hospital de Sagunto Internal Medicine Service, 46520 Valencia, Spain; (I.A.)
| | - Eva Sánchez
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (L.R.-C.); (L.B.); (M.Y.); (M.C.); (A.R.L.); (F.G.); (J.R.M.); (N.S.); (M.J.); (X.C.-R.)
- Digestive Section, Hospital de Sagunto Internal Medicine Service, 46520 Valencia, Spain; (I.A.)
| | - Ana Garayoa
- Digestive Section, Hospital de Sagunto Internal Medicine Service, 46520 Valencia, Spain; (I.A.)
| | - Nadia Moreno
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (L.R.-C.); (L.B.); (M.Y.); (M.C.); (A.R.L.); (F.G.); (J.R.M.); (N.S.); (M.J.); (X.C.-R.)
| | - Ana Gallén
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (L.R.-C.); (L.B.); (M.Y.); (M.C.); (A.R.L.); (F.G.); (J.R.M.); (N.S.); (M.J.); (X.C.-R.)
| | - Ernesto Cortés-Castell
- Department of Pharmacology, Pediatrics and Organic Chemistry, Miguel Hernández University of Elche, 03550 Elche, Spain;
| | - Xavier Cortés-Rizo
- Valencian Digestive Institute (IVADI), 46021 Valencia, Spain; (L.R.-C.); (L.B.); (M.Y.); (M.C.); (A.R.L.); (F.G.); (J.R.M.); (N.S.); (M.J.); (X.C.-R.)
- Digestive Section, Hospital de Sagunto Internal Medicine Service, 46520 Valencia, Spain; (I.A.)
| |
Collapse
|