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  4. Is there any contraindication to a person with SIBO or pathogenic bacteria or yeast overgrowth taking prebiotics other than PHGG? I’m confused because in the past you mentioned that a person with SIBO should be cautious at this time. Should it just be used in the rebuild phase?

Is there any contraindication to a person with SIBO or pathogenic bacteria or yeast overgrowth taking prebiotics other than PHGG? I’m confused because in the past you mentioned that a person with SIBO should be cautious at this time. Should it just be used in the rebuild phase?

Chris Kresser:  The addition of PHGG is only for people who have SIBO and are doing a concurrent antimicrobial protocol. I wouldn’t still recommend prebiotics for someone who has SIBO who is not currently taking antimicrobials or post-treatment. For example, if we know that a patient has SIBO and they have had recurring SIBO and it tends to come back, then after the treatment I would tend to suggest that that person does avoid prebiotics if they have recurring SIBO until we can really get the situation under control and stop it from recurring, and they would just limit their use to the prebiotics on the protocol. If it’s on the protocol, I don’t think there’s anything magic, per se, about PHGG. It was just the one that was used in the study, and it tends to be better tolerated by people with SIBO because it’s partially hydrolyzed, which means it’s broken down and it’s a soluble fiber, which is better tolerated than FODMAPs, non-starch polysaccharides or resistant starch, in most cases. That’s why we recommend PHGG. I think I said this in the webinar or maybe the last Q&A, but the jury is still somewhat out on this. We have one study that said that antimicrobials worked better. We have a physiological mechanism that explains why that would make sense, but it could be that in the future we see other studies that show the opposite results, so we’ll just keep trying this out clinically and see where we get to.

 

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