ArticleGlobal advances in health and medicine2014
Herbal therapy is equivalent to rifaximin for the treatment of small intestinal bacterial overgrowth.
Article in Global advances in health and medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07768267 (A Pilot Study of the Role of an Antimicrobial Herbal Formulation), which is not on this map. Cited by 33 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Pilot Study of the Role of an Antimicrobial Herbal Formulation (Biocidin REMOVE) for the Management of Small Intestinal Bacterial Overgrowth (SIBO) in Patients With Irritable Bowel Syndrome (IBS)
Who cites it
33 citing papers in PubMed, 3 syntheses or guidelines pooled it, 73 citations in OpenAlex.
- Antibiotic therapy for small intestinal bacterial overgrowth: a systematic review of comparative efficacy, clinical-test discordance, and pediatric evidence gaps.Frontiers in pharmacology · 2026Pooled it
- Relationship between small intestinal bacterial overgrowth and irritable bowel syndrome and the efficacy of rifaximin intervention: a systematic review and meta-analysis.Frontiers in microbiology · 2026Pooled it
- Systematic review with meta-analysis: rifaximin is effective and safe for the treatment of small intestine bacterial overgrowth.Alimentary pharmacology & therapeutics · 2017Pooled it
- An Oral Botanical Supplement Improves Small Intestinal Bacterial Overgrowth (SIBO) and Facial Redness: Results of an Open-Label Clinical Study.Nutrients · 2024Trial
- Do Herbal Supplements and Probiotics Complement Antibiotics and Diet in the Management of SIBO? A Randomized Clinical Trial.Nutrients · 2024Trial
- Targeted antibiotic and dietary approaches in managing small intestinal bacterial overgrowth across irritable bowel syndrome subtypes.Internal and emergency medicine · 2026Review
- Small Intestinal Bacterial Overgrowth in the Pediatric Population: A Review of Pathophysiology, Diagnosis, and Management.Current gastroenterology reports · 2026Review
- Treatment of Small Intestinal Bacterial Overgrowth (SIBO) in Gastrointestinal, Hepatic, Endocrine, Neurological, and Postoperative Diseases: A Comprehensive Narrative Review.Medical sciences (Basel, Switzerland) · 2026Review
- Evaluating the Risk ofJournal of clinical medicine · 2026Article
- Exploring effectiveness of Metronidazole, Bismuth, and Rifaximin in treating small intestinal bacterial overgrowth and irritable bowel syndrome: A systematic review.World journal of methodology · 2026Article
- IBS and SIBO: Gut Microbiota, Pathophysiology, and Non-Pharmacological Interventions.Antibiotics (Basel, Switzerland) · 2026Review
- Article
- Review
- Should We Treat SIBO Patients? Impact on Quality of Life and Response to Comprehensive Treatment: A Real-World Clinical Practice Study.Nutrients · 2025Article
- Integrative Approaches to Managing Gut Health.Current gastroenterology reports · 2024Review
- Effect of Trimebutine and Rifaximin on Breath Hydrogen and Methane by Glucose Breath Test in Patients With Functional Bloating: A Randomized Double-blind Clinical Trial.Journal of neurogastroenterology and motility · 2024Article
- Nutritional Strategies for the Management of Type 2 Diabetes Mellitus: A Narrative Review.Nutrients · 2023Review
- Current and Future Therapeutic Options for Irritable Bowel Syndrome with Diarrhea and Functional Diarrhea.Digestive diseases and sciences · 2023Review
- Diagnosis by Microbial Culture, Breath Tests and Urinary Excretion Tests, and Treatments of Small Intestinal Bacterial Overgrowth.Antibiotics (Basel, Switzerland) · 2023Review
- Berberine and rifaximin effects on small intestinal bacterial overgrowth: Study protocol for an investigator-initiated, double-arm, open-label, randomized clinical trial (BRIEF-SIBO study).Frontiers in pharmacology · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivePatients with small intestine bacterial overgrowth (SIBO) have chronic intestinal and extraintestinal symptomatology which adversely affects their quality of life. Present treatment of SIBO is limited to oral antibiotics with variable success. A growing number of patients are interested in using complementary and alternative therapies for their gastrointestinal health. The objective was to determine the remission rate of SIBO using either the antibiotic rifaximin or herbals in a tertiary care referral gastroenterology practice.
designOne hundred and four patients who tested positive for newly diagnosed SIBO by lactulose breath testing (LBT) were offered either rifaximin 1200 mg daily vs herbal therapy for 4 weeks with repeat LBT post-treatment.
resultsThree hundred ninety-six patients underwent LBT for suspected SIBO, of which 251 (63.4%) were positive 165 underwent treatment and 104 had a follow-up LBT. Of the 37 patients who received herbal therapy, 17 (46%) had a negative follow-up LBT compared to 23/67 (34%) of rifaximin users (P=.24). The odds ratio of having a negative LBT after taking herbal therapy as compared to rifaximin was 1.85 (CI=0.77-4.41, P=.17) once adjusted for age, gender, SIBO risk factors and IBS status. Fourteen of the 44 (31.8%) rifaximin non-responders were offered herbal rescue therapy, with 8 of the 14 (57.1%) having a negative LBT after completing the rescue herbal therapy, while 10 non-responders were offered triple antibiotics with 6 responding (60%, P=.89). Adverse effects were reported among the rifaximin treated arm including 1 case of anaphylaxis, 2 cases of hives, 2 cases of diarrhea and 1 case of Clostridium difficile. Only one case of diarrhea was reported in the herbal therapy arm, which did not reach statistical significance (P=.22).
conclusionSIBO is widely prevalent in a tertiary referral gastroenterology practice. Herbal therapies are at least as effective as rifaximin for resolution of SIBO by LBT. Herbals also appear to be as effective as triple antibiotic therapy for SIBO rescue therapy for rifaximin non-responders. Further, prospective studies are needed to validate these findings and explore additional alternative therapies in patients with refractory SIBO.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.