What are your views on fermented foods for someone on a SIBO protocol and also once they’ve finished and had a clear test? Is it best to avoid for some time, or as probiotics are in the program, they’re okay as long as they’re tolerated.

Chris Kresser: Yes, it’s the latter actually. They’re okay as long as they’re tolerated, and that’s going to be determined by people’s ability to tolerate primarily when someone is not very tolerant of fermented foods. It comes down to histamine intolerance or intolerance of the specific bacteria if they’re sensitive to probiotics, but if they’re using probiotics in a SIBO protocol, and they’re fine with that, they probably won’t be sensitive to the probiotic bacteria, yeast, and fermented foods. If they don’t have a histamine intolerance issue, then there’s no reason to avoid fermented foods, and that could, in fact, support the protocol. We’re about to write an article soon on probiotics and prebiotics in the treatment of SIBO. There are some very interesting new research suggesting that probiotics and probiotics in various combinations can be as effective or more effective than conventional treatment. This is really interesting to me because I’ve argued for a long time that probiotics should be included in SIBO protocol, and as you know, they are in the protocol I’m teaching you in ADAPT, but the kind of party line within the SIBO community has been that probiotics and especially probiotics should be avoided by people with SIBO or at least certain types of probiotics. I always kind of wondered about that because there wasn’t any research that I can see that supported that, and the few studies that had been done on probiotics as a treatment for SIBO had yielded positive results. It’s good to see some light being shined on this now, and I think we’re going to, especially because of how often SIBO can recur, we’re going to be looking for strategies that can be employed multiple times over a person’s life or can be sustained over a long period of time to prevent recurrence.