Observational studyClinical and translational gastroenterology2018
Brain fogginess, gas and bloating: a link between SIBO, probiotics and metabolic acidosis.
Observational study in Clinical and translational gastroenterology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 77 papers, 3 of them syntheses that pooled it.
What it found
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
77 citing papers in PubMed, 3 syntheses or guidelines pooled it, 157 citations in OpenAlex.
- European Consensus on Malabsorption-UEG & SIGE, LGA, SPG, SRGH, CGS, ESPCG, EAGEN, ESPEN, and ESPGHAN. Part 1: Definitions, Clinical Phenotypes, and Diagnostic Testing for Malabsorption.United European gastroenterology journal · 2025Guideline
- Clinical trials targeting the gut-microbiome to effect ocular health: a systematic review.Eye (London, England) · 2023Pooled it
- Show Me What You Have Inside-The Complex Interplay between SIBO and Multiple Medical Conditions-A Systematic Review.Nutrients · 2022Pooled it
- Effect of probiotics on length of hospitalization in mild acute pancreatitis: A randomized, double-blind, placebo-controlled trial.World journal of gastroenterology · 2021Trial
- Gut bacteria and their metabolites may influence our decisions, intelligence, cognition, and consciousness.Gut microbes · 2026Review
- Validation and Application of Quantitative Methods for D-Lactic Acid and L-Lactic Acid Determination in Lactic Acid Bacteria.Foods (Basel, Switzerland) · 2026Article
- Nutritional Approaches to Managing Brain Fog: Insights Into Neuroinflammation, the Gut-brain Axis, and Sleep.Current nutrition reports · 2026Review
- Unraveling the Complexities of Small Intestinal Bacterial Overgrowth.Medicina (Kaunas, Lithuania) · 2026Review
- Synergistic Effects of Plant Polysaccharides and Probiotics: A Novel Dietary Approach for Parkinson's Disease Intervention.Pharmaceuticals (Basel, Switzerland) · 2026Review
- Small intestinal microbiome, the underrated maestro of SIMO disease.FEMS microbiology reviews · 2026Review
- The algorithmic epistemic inversion in gastroenterology: how social media and psychological vulnerability fuel secondary risks in IBD and IBS management.Frontiers in public health · 2026Article
- Heyndrickxia coagulans LMG S-24828 Is a Safe Probiotic Strain Capable of Germinating in the Human Gut.Probiotics and antimicrobial proteins · 2025Article
- Glymphatic System Dysregulation as a Key Contributor to Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.International journal of molecular sciences · 2025Review
- All That Glitters Ain't Gold: The Myths and Scientific Realities About the Gut Microbiota.Nutrients · 2025Review
- Gut Microbiome as a Source of Probiotic Drugs for Parkinson's Disease.International journal of molecular sciences · 2025Review
- From Bacillus Criminalis to the Legalome: Will Neuromicrobiology Impact 21st Century Criminal Justice?Brain sciences · 2025Article
- Article
- Role of Probiotics in Depression: Connecting Dots of Gut-Brain-Axis Through Hypothalamic-Pituitary Adrenal Axis and Tryptophan/Kynurenic Pathway involving Indoleamine-2,3-dioxygenase.Molecular neurobiology · 2025Review
- Small Intestinal Bacterial and Fungal Overgrowth: Health Implications and Management Perspectives.Nutrients · 2025Review
- Ketogenic Diet and Gut Microbiota: Exploring New Perspectives on Cognition and Mood.Foods (Basel, Switzerland) · 2025Review
17 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundD-lactic acidosis is characterized by brain fogginess (BF) and elevated D-lactate and occurs in short bowel syndrome. Whether it occurs in patients with an intact gut and unexplained gas and bloating is unknown. We aimed to determine if BF, gas and bloating is associated with D-lactic acidosis and small intestinal bacterial overgrowth (SIBO).
methodsPatients with gas, bloating, BF, intact gut, and negative endoscopic and radiological tests, and those without BF were evaluated. SIBO was assessed with glucose breath test (GBT) and duodenal aspiration/culture. Metabolic assessments included urinary D-lactic acid and blood L-lactic acid, and ammonia levels. Bowel symptoms, and gastrointestinal transit were assessed.
resultsThirty patients with BF and 8 without BF were evaluated. Abdominal bloating, pain, distension and gas were the most severe symptoms and their prevalence was similar between groups. In BF group, all consumed probiotics. SIBO was more prevalent in BF than non-BF group (68 vs. 28%, p = 0.05). D-lactic acidosis was more prevalent in BF compared to non-BF group (77 vs. 25%, p = 0.006). BF was reproduced in 20/30 (66%) patients. Gastrointestinal transit was slow in 10/30 (33%) patients with BF and 2/8 (25%) without. Other metabolic tests were unremarkable. After discontinuation of probiotics and a course of antibiotics, BF resolved and gastrointestinal symptoms improved significantly (p = 0.005) in 23/30 (77%).
conclusionsWe describe a syndrome of BF, gas and bloating, possibly related to probiotic use, SIBO, and D-lactic acidosis in a cohort without short bowel. Patients with BF exhibited higher prevalence of SIBO and D-lactic acidosis. Symptoms improved with antibiotics and stopping probiotics. Clinicians should recognize and treat this condition.
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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.