I've given a lot of thought to how to deal with symptoms caused by bad bacteria in the small bowel (commonly referred to as SIBO) when one also has a susceptibility to Candida.

Gastroenterologists generally treat SIBO with Antibiotics . Sometimes they are lucky and the problem is resolved with a 7 day course of Rifaxamin. However it is very common for the patient to relapse. For those who don't have a problem with Candida, this is annoying, but not always a major drama. For those with an immune system that cannot control Candida, using Antibiotics can be an utter disaster, potentially setting the person up for a lifetime of misery.

The reason Antibiotics taken for SIBO are rarely (if ever) helpful for those with candidiasis, is that by killing the small intestine bacteria, you decrease the competition for Candida. So by inhibiting one pathogen, you are making another more dominant. And every time Candida takes over new bowel territory, it is very reluctant to ever let go. Every time I have used antibiotics my health has inevitably deteriorated.

The other main way to treat SIBO is with probiotics. The strategy is to 'crowd out' the bad bacteria by swallowing probiotic bacteria that compete well with the pathogenic bacteria. Now you might think this is very inefficient, because there are 100 trillion bacteria in the average person's bowels, so the probiotics are hugely outnumbered. However it isn't as hopeless as one might think. Only a small fraction of the GI tract's bacteria are in the small intestine. So any probiotic bacteria are going to have 100x more effect on bacteria in the small bowel than the colon. This is very good news.

Most leaky bowels and Candida overgrowths are also located in the small intestine, so are also potentially treatable by probiotics. Another consideration is that I suspect most people with intestinal candidiasis also have some degree of SIBO. The bottom line is that I consider probiotic treatment to be essential for anyone who suffers from bad bacteria and Candida in their small bowel. That may be most people in this forum.

So, which probiotics? I think two of the best are Saccharomyces boulardii and Bacillus subtilis. SB is actually a yeast, and competes very well with both Candida and bacteria. However if you are allergic to yeast, as many of us are, its use is problematic. Bacillus subtilis is a soil based organism used in some of the more successful probiotics. It seems to be effective against both bacteria and Candida. IMO it is the most important bacteria in both Threelac and Primal Defence. People like myself who are very allegic to yeast may not tolerate Threelac too well, but there is a very similar product called Symbion which does not contain yeast.

In this post I have really only outlined some of my thinking in recent days regarding my own situation. I may continue with my plan to take antifungals like Sporanox and Lufenuron to try to eradicate the Candida causing my leaky bowel, however my current priority is to treat my SIBO with probiotics. Symbion will be the core product I will use, but I will also take a good local acidophilus/bifido probiotic too.