{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T17:20:36Z","timestamp":1793726436049,"version":"4.6.1"},"reference-count":100,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Irritable bowel syndrome (IBS) and small intestinal bacterial overgrowth (SIBO) share symptoms such as abdominal pain, bloating, and altered bowel habits. Both are linked to dysbiosis and gut\u2013brain axis dysfunction. IBS is a multifactorial disorder characterized by abnormal motility, visceral hypersensitivity, low-grade inflammation, and alterations in the microbiota. In contrast, SIBO is defined by excessive bacterial colonization of the small intestine that can mimic or worsen IBS symptoms. Gut microbes and their metabolites influence motility, immune activation, barrier integrity, and gas production; methanogen overgrowth is associated with constipation-predominant presentations, while hydrogen- and hydrogen sulfide-related pathways may contribute to diarrhea and bloating. Because recurrent or empiric antibiotic use is common\u2014particularly in suspected SIBO\u2014yet carries risks of resistance, microbiome disruption, and relapse, there is a strong rationale to prioritize effective non-antibiotic strategies. Accordingly, this review synthesizes current evidence on IBS\/SIBO pathophysiology and microbiota interactions. It evaluates non-pharmacological interventions including dietary approaches, probiotics\/prebiotics, herbal therapies, and mind\u2013body treatments (e.g., cognitive behavioral therapy and gut-directed hypnotherapy). We emphasize an integrative framework that supports symptom control and quality of life while helping reduce unnecessary antibiotic exposure.<\/jats:p>","DOI":"10.3390\/antibiotics15030251","type":"journal-article","created":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T15:52:38Z","timestamp":1772207558000},"page":"251","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["IBS and SIBO: Gut Microbiota, Pathophysiology, and Non-Pharmacological Interventions"],"prefix":"10.3390","volume":"15","author":[{"given":"Jelena","family":"\u0160uran","sequence":"first","affiliation":[{"name":"Apiotix Technologies d.o.o., Hrvojeva 12, 21000 Split, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3452-389X","authenticated-orcid":false,"given":"Nikola","family":"Pavlovi\u0107","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia"},{"name":"Laboratory for Cardiometabolic Research, University of Split School of Medicine, 21000 Split, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1634-0635","authenticated-orcid":false,"given":"Jo\u0161ko","family":"Bo\u017ei\u0107","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia"},{"name":"Laboratory for Cardiometabolic Research, University of Split School of Medicine, 21000 Split, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9696-3359","authenticated-orcid":false,"given":"Marko","family":"Kumri\u0107","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology, University of Split School of Medicine, 21000 Split, Croatia"},{"name":"Laboratory for Cardiometabolic Research, University of Split School of Medicine, 21000 Split, Croatia"},{"name":"Department of Cardiovascular Diseases, University Hospital of Split, 21000 Split, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2182-2890","authenticated-orcid":false,"given":"Katarina","family":"Vukojevi\u0107","sequence":"additional","affiliation":[{"name":"Department of Anatomy, Histology and Embryology, University of Split School of Medicine, 21000 Split, Croatia"},{"name":"Mediterranean Institute for Life Sciences, University of Split, 21000 Split, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8943-4109","authenticated-orcid":false,"given":"Natalija","family":"Filipovi\u0107","sequence":"additional","affiliation":[{"name":"Department of Anatomy, Histology and Embryology, University of Split School of Medicine, 21000 Split, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo\u017eo","family":"Radi\u0107","sequence":"additional","affiliation":[{"name":"Apiotix Technologies d.o.o., Hrvojeva 12, 21000 Split, Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1393","DOI":"10.1053\/j.gastro.2016.02.031","article-title":"Bowel Disorders","volume":"150","author":"Lacy","year":"2016","journal-title":"Gastroenterology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1038\/s41575-020-0286-8","article-title":"Global Burden of Irritable Bowel Syndrome: Trends, Predictions and Risk Factors","volume":"17","author":"Black","year":"2020","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"165","DOI":"10.14309\/ajg.0000000000000501","article-title":"ACG Clinical Guideline: Small Intestinal Bacterial Overgrowth","volume":"115","author":"Pimentel","year":"2020","journal-title":"Am. J. Gastroenterol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1038\/ajg.2017.46","article-title":"Hydrogen and Methane-Based Breath Testing in Gastrointestinal Disorders: The North American Consensus","volume":"112","author":"Rezaie","year":"2017","journal-title":"Am. J. Gastroenterol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1111\/j.1572-0241.2007.01072.x","article-title":"The Degree of Breath Methane Production in IBS Correlates with the Severity of Constipation","volume":"102","author":"Chatterjee","year":"2007","journal-title":"Am. J. Gastroenterol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"190","DOI":"10.14309\/ajg.0000000000000504","article-title":"Small Intestinal Bacterial Overgrowth in Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis of Case-Control Studies","volume":"115","author":"Shah","year":"2020","journal-title":"Am. J. Gastroenterol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1136\/gut.2006.108712","article-title":"Small Intestinal Bacterial Overgrowth in Patients with Irritable Bowel Syndrome","volume":"56","author":"Posserud","year":"2007","journal-title":"Gut"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e075777","DOI":"10.1136\/bmj-2023-075777","article-title":"Non-Pharmaceutical Treatments for Irritable Bowel Syndrome","volume":"387","author":"Wang","year":"2024","journal-title":"BMJ"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1172\/JCI76304","article-title":"Gut\/Brain Axis and the Microbiota","volume":"125","author":"Mayer","year":"2015","journal-title":"J. Clin. Investig."},{"key":"ref_10","first-page":"203","article-title":"The Gut-Brain Axis: Interactions between Enteric Microbiota, Central and Enteric Nervous Systems","volume":"28","author":"Carabotti","year":"2015","journal-title":"Ann. Gastroenterol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1136\/gut.47.6.804","article-title":"Increased Rectal Mucosal Enteroendocrine Cells, T Lymphocytes, and Increased Gut Permeability Following Acute Campylobacter Enteritis and in Post-Dysenteric Irritable Bowel Syndrome","volume":"47","author":"Spiller","year":"2000","journal-title":"Gut"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1778","DOI":"10.1053\/gast.2002.33579","article-title":"Activation of the Mucosal Immune System in Irritable Bowel Syndrome","volume":"122","author":"Chadwick","year":"2002","journal-title":"Gastroenterology"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1111\/j.1365-2036.2007.03399.x","article-title":"Systematic Review and Meta-Analysis: The Incidence and Prognosis of Post-Infectious Irritable Bowel Syndrome","volume":"26","author":"Thabane","year":"2007","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1042","DOI":"10.1053\/j.gastro.2016.12.039","article-title":"Prevalence, Risk Factors, and Outcomes of Irritable Bowel Syndrome After Infectious Enteritis: A Systematic Review and Meta-Analysis","volume":"152","author":"Klem","year":"2017","journal-title":"Gastroenterology"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"3503","DOI":"10.1111\/j.1572-0241.2000.03368.x","article-title":"Eradication of Small Intestinal Bacterial Overgrowth Reduces Symptoms of Irritable Bowel Syndrome","volume":"95","author":"Pimentel","year":"2000","journal-title":"Am. J. Gastroenterol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1293","DOI":"10.1007\/s10620-024-08279-y","article-title":"Influence of Helicobacter pylori Infection and Eradication on Small Intestinal Bacterial Overgrowth and Abdominal Symptoms","volume":"69","author":"Wang","year":"2024","journal-title":"Dig. Dis. Sci."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Takakura, W., and Pimentel, M. (2020). Small Intestinal Bacterial Overgrowth and Irritable Bowel Syndrome\u2014An Update. Front. Psychiatry, 11.","DOI":"10.3389\/fpsyt.2020.00664"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"G1089","DOI":"10.1152\/ajpgi.00574.2004","article-title":"Methane, a Gas Produced by Enteric Bacteria, Slows Intestinal Transit and Augments Small Intestinal Contractile Activity","volume":"290","author":"Pimentel","year":"2006","journal-title":"Am. J. Physiol. Gastrointest. Liver Physiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"196","DOI":"10.5009\/gnl16126","article-title":"Small Intestinal Bacterial Overgrowth and Irritable Bowel Syndrome: A Bridge between Functional Organic Dichotomy","volume":"11","author":"Ghoshal","year":"2017","journal-title":"Gut Liver"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1056\/NEJMoa1004409","article-title":"Rifaximin Therapy for Patients with Irritable Bowel Syndrome without Constipation","volume":"364","author":"Pimentel","year":"2011","journal-title":"N. Engl. J. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"19","DOI":"10.5056\/jnm20149","article-title":"Gut Microbial Dysbiosis in the Pathogenesis of Gastrointestinal Dysmotility and Metabolic Disorders","volume":"27","author":"Singh","year":"2021","journal-title":"J. Neurogastroenterol. Motil."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1016\/j.dld.2017.01.142","article-title":"Altered Molecular Signature of Intestinal Microbiota in Irritable Bowel Syndrome Patients Compared with Healthy Controls: A Systematic Review and Meta-Analysis","volume":"49","author":"Liu","year":"2017","journal-title":"Dig. Liver Dis."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/imm.13749","article-title":"Gut Microbiota and Intestinal Immunity\u2014A Crosstalk in Irritable Bowel Syndrome","volume":"172","author":"Chen","year":"2024","journal-title":"Immunology"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"S56","DOI":"10.1097\/MCG.0000000000000418","article-title":"The Intestinal Microbiota and Irritable Bowel Syndrome","volume":"49","author":"Ringel","year":"2015","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"12693","DOI":"10.1038\/srep12693","article-title":"Reduction of Butyrate- and Methane-Producing Microorganisms in Patients with Irritable Bowel Syndrome","volume":"5","author":"Pozuelo","year":"2015","journal-title":"Sci. Rep."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1053\/j.gastro.2025.07.016","article-title":"Low Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols Diet Improves Colonic Barrier Function and Mast Cell Activation in Patients with Diarrhea-Predominant Irritable Bowel Syndrome: A Mechanistic Trial","volume":"170","author":"Gao","year":"2026","journal-title":"Gastroenterology"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"100139","DOI":"10.1016\/j.medmic.2025.100139","article-title":"Short-Chain Fatty Acids (SCFAs) in Gut Health: Implications for Drug Metabolism and Therapeutics","volume":"25","author":"Sankarganesh","year":"2025","journal-title":"Med. Microecol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1093\/advances\/nmz127","article-title":"Tryptophan metabolism: A link between the gut microbiota and brain","volume":"11","author":"Gao","year":"2020","journal-title":"Adv. Nutr."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1097\/j.pain.0000000000002438","article-title":"Visceral sensitivity modulation by faecal microbiota transplantation: The active role of gut bacteria in pain persistence","volume":"163","author":"Lucarini","year":"2022","journal-title":"Pain"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1044","DOI":"10.1111\/apt.15001","article-title":"Systematic Review with Meta-Analysis: The Efficacy of Prebiotics, Probiotics, Synbiotics and Antibiotics in Irritable Bowel Syndrome","volume":"48","author":"Ford","year":"2018","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1136\/gutjnl-2019-319630","article-title":"Efficacy of Faecal Microbiota Transplantation for Patients with Irritable Bowel Syndrome in a Randomised, Double-Blind, Placebo-Controlled Study","volume":"69","author":"Hatlebakk","year":"2020","journal-title":"Gut"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/S2468-1253(17)30338-2","article-title":"Faecal Microbiota Transplantation versus Placebo for Moderate-to-Severe Irritable Bowel Syndrome: A Double-Blind, Randomised, Placebo-Controlled, Parallel-Group, Single-Centre Trial","volume":"3","author":"Johnsen","year":"2018","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Wielgosz-Grochowska, J.P., Domanski, N., and Drywie\u0144, M.E. (2022). Efficacy of an Irritable Bowel Syndrome Diet in the Treatment of Small Intestinal Bacterial Overgrowth: A Narrative Review. Nutrients, 14.","DOI":"10.3390\/nu14163382"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1053\/j.gastro.2013.09.046","article-title":"A Diet Low in FODMAPs Reduces Symptoms of Irritable Bowel Syndrome","volume":"146","author":"Halmos","year":"2014","journal-title":"Gastroenterology"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1016\/S2468-1253(24)00045-1","article-title":"A Low FODMAP Diet plus Traditional Dietary Advice versus a Low-Carbohydrate Diet versus Pharmacological Treatment in Irritable Bowel Syndrome (CARIBS): A Single-Centre, Single-Blind, Randomised Controlled Trial","volume":"9","author":"Nybacka","year":"2024","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Bertin, L., Zanconato, M., Crepaldi, M., Marasco, G., Cremon, C., Barbara, G., Barberio, B., Zingone, F., and Savarino, E.V. (2024). The Role of the FODMAP Diet in IBS. Nutrients, 16.","DOI":"10.3390\/nu16030370"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Bogdanowska-Charkiewicz, D., G\u00f3rski, P., Jurkowska, G., \u015aroda, R., \u015awidnicka-Siergiejko, A., D\u0105browski, A., and Daniluk, J. (2026). Effectiveness of the low FODMAP diet in patients with irritable bowel syndrome and small intestine bacterial overgrowth syndrome. Front. Nutr., 13.","DOI":"10.3389\/fnut.2026.1725524"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1007\/s11306-023-02083-x","article-title":"Exploration of Differential Responses to FODMAPs and Gluten in People with Irritable Bowel Syndrome\u2014A Double-Blind Randomized Cross-Over Challenge Study","volume":"20","author":"Nordin","year":"2024","journal-title":"Metabolomics"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Velasco-Aburto, S., Llama-Palacios, A., S\u00e1nchez, M.C., Ciudad, M.J., and Collado, L. (2025). Nutritional Approach to Small Intestinal Bacterial Overgrowth: A Narrative Review. Nutrients, 17.","DOI":"10.3390\/nu17091410"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1017\/S0007114525000868","article-title":"Effects of dietary FODMAP content on the faecal microbiome and gastrointestinal physiology in healthy adults: A randomised, controlled cross-over feeding study","volume":"134","author":"Murtaza","year":"2025","journal-title":"Br. J. Nutr."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1111\/jgh.13687","article-title":"Re-Challenging FODMAPs: The Low FODMAP Diet Phase Two","volume":"32","author":"Tuck","year":"2017","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"17","DOI":"10.14309\/ajg.0000000000001036","article-title":"ACG Clinical Guideline: Management of Irritable Bowel Syndrome","volume":"116","author":"Lacy","year":"2021","journal-title":"Am. J. Gastroenterol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1000","DOI":"10.1111\/j.1365-2036.2010.04436.x","article-title":"Clinical trial: The combination of rifaximin with partially hydrolysed guar gum is more effective than rifaximin alone in eradicating small intestinal bacterial overgrowth","volume":"32","author":"Furnari","year":"2010","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"343","DOI":"10.5217\/ir.2016.14.4.343","article-title":"Symptomatic Improvement with Gluten Restriction in Irritable Bowel Syndrome: A Prospective, Randomized, Double Blinded Placebo Controlled Trial","volume":"14","author":"Zanwar","year":"2016","journal-title":"Intest. Res."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1023\/B:DDAS.0000011605.43979.e1","article-title":"A 14-Day Elemental Diet Is Highly Effective in Normalizing the Lactulose Breath Test","volume":"49","author":"Pimentel","year":"2004","journal-title":"Dig. Dis. Sci."},{"key":"ref_46","first-page":"32","article-title":"Homemade Elemental Diet to Treat Intestinal Methanogen Overgrowth: A Case Report","volume":"20","year":"2021","journal-title":"Integr. Med."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"a2313","DOI":"10.1136\/bmj.a2313","article-title":"Effect of Fibre, Antispasmodics, and Peppermint Oil in the Treatment of Irritable Bowel Syndrome: Systematic Review and Meta-Analysis","volume":"337","author":"Ford","year":"2008","journal-title":"BMJ"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1016\/S2468-1253(20)30056-X","article-title":"Heat-Inactivated Bifidobacterium Bifidum MIMBb75 (SYN-HI-001) in the Treatment of Irritable Bowel Syndrome: A Multicentre, Randomised, Double-Blind, Placebo-Controlled Clinical Trial","volume":"5","author":"Andresen","year":"2020","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1111\/j.1365-2036.2008.03750.x","article-title":"Review Article: Probiotics and Prebiotics in Irritable Bowel Syndrome","volume":"28","author":"Spiller","year":"2008","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"e46","DOI":"10.1017\/jns.2025.10021","article-title":"Randomised Controlled Trial: Nutritional Supplements to Relieve Irritable Bowel Syndrome Symptoms by Targeting the Gut Microbiota","volume":"14","author":"Liu","year":"2025","journal-title":"J. Nutr. Sci."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Li, E., Wang, J., Guo, B., and Zhang, W. (2025). Effects of Short-Chain Fatty Acid-Producing Probiotic Metabolites on Symptom Relief and Intestinal Barrier Function in Patients with Irritable Bowel Syndrome: A Double-Blind, Randomized Controlled Trial. Front. Cell. Infect. Microbiol., 15.","DOI":"10.3389\/fcimb.2025.1616066"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Zhang, T., Zhang, C., Zhang, J., Sun, F., and Duan, L. (2022). Efficacy of Probiotics for Irritable Bowel Syndrome: A Systematic Review and Network Meta-Analysis. Front. Cell. Infect. Microbiol., 12.","DOI":"10.3389\/fcimb.2022.859967"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1097\/MCG.0000000000000814","article-title":"Probiotics for Preventing and Treating Small Intestinal Bacterial Overgrowth: A Meta-Analysis and Systematic Review of Current Evidence","volume":"51","author":"Zhong","year":"2017","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1007\/s12602-018-9401-3","article-title":"Effect of a Preparation of Four Probiotics on Symptoms of Patients with Irritable Bowel Syndrome: Association with Intestinal Bacterial Overgrowth","volume":"11","author":"Leventogiannis","year":"2019","journal-title":"Probiotics Antimicrob. Proteins"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"ofz266","DOI":"10.1093\/ofid\/ofz266","article-title":"Increased Fecal Lactobacillus Is Associated with a Positive Glucose Hydrogen Breath Test in Bangladeshi Children","volume":"6","author":"Donowitz","year":"2019","journal-title":"Open Forum Infect. Dis."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1186\/s12986-016-0070-5","article-title":"Randomized clinical study: Partially hydrolyzed guar gum (PHGG) versus placebo in the treatment of patients with irritable bowel syndrome","volume":"13","author":"Niv","year":"2016","journal-title":"Nutr. Metab."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Skrzyd\u0142o-Radoma\u0144ska, B., Prozorow-Kr\u00f3l, B., Cicho\u017c-Lach, H., Majsiak, E., Bier\u0142a, J.B., Kosikowski, W., Szczerbi\u0144ski, M., Gantzel, J., and Cukrowska, B. (2020). The Effectiveness of Synbiotic Preparation Containing Lactobacillus and Bifidobacterium Probiotic Strains and Short Chain Fructooligosaccharides in Patients with Diarrhea Predominant Irritable Bowel Syndrome\u2014A Randomized Double-Blind, Placebo-Controlled Study. Nutrients, 12.","DOI":"10.3390\/nu12071999"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"2","DOI":"10.4082\/kjfm.17.0064","article-title":"A Randomized Clinical Trial of Synbiotics in Irritable Bowel Syndrome: Dose- Dependent Effects on Gastrointestinal Symptoms and Fatigue","volume":"40","author":"Lee","year":"2019","journal-title":"Korean J. Fam. Med."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1111\/j.1365-2036.1988.tb00677.x","article-title":"The actions of peppermint oil and menthol on calcium channel dependent processes in intestinal, neuronal and cardiac preparations","volume":"2","author":"Hawthorn","year":"1988","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"Vermeijden, N.K., van der Feen, C., Groeneweg, M., Hummel, T., Zagers, D., Bertrams-Maartens, I., van Wering, H., Hurkmans, P., Stapelbroek, J., and Sauv\u00e9, I. (2026). Peppermint Oil and Sweets in Pediatric Irritable Bowel Syndrome and Functional Abdominal Pain: A Randomized Trial. Clin. Gastroenterol. Hepatol, ahead of print.","DOI":"10.1016\/j.cgh.2026.01.014"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"16","DOI":"10.7453\/gahmj.2014.019","article-title":"Herbal Therapy Is Equivalent to Rifaximin for the Treatment of Small Intestinal Bacterial Overgrowth","volume":"3","author":"Chedid","year":"2014","journal-title":"Glob. Adv. Health Med."},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Guo, H., Lu, S., Zhang, J., Chen, C., Du, Y., Wang, K., and Duan, L. (2023). 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). Front. Pharmacol., 14.","DOI":"10.3389\/fphar.2023.1121435"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"346","DOI":"10.3748\/wjg.v20.i2.346","article-title":"Complementary and Alternative Medicines in Irritable Bowel Syndrome: An Integrative View","volume":"20","author":"Grundmann","year":"2014","journal-title":"World J. Gastroenterol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1002\/1099-1573(200102)15:1<58::AID-PTR805>3.0.CO;2-R","article-title":"Artichoke Leaf Extract Reduces Symptoms of Irritable Bowel Syndrome in a Post-Marketing Surveillance Study","volume":"15","author":"Walker","year":"2001","journal-title":"Phytother. Res."},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Alammar, N., Wang, L., Saberi, B., Nanavati, J., Holtmann, G., Shinohara, R.T., and Mullin, G.E. (2019). The Impact of Peppermint Oil on the Irritable Bowel Syndrome: A Meta-Analysis of the Pooled Clinical Data. BMC Complement. Altern. Med., 19.","DOI":"10.1186\/s12906-018-2409-0"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1002\/fsn3.807","article-title":"Ginger in Gastrointestinal Disorders: A Systematic Review of Clinical Trials","volume":"7","author":"Maleki","year":"2019","journal-title":"Food Sci. Nutr."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"105","DOI":"10.3748\/wjg.v17.i1.105","article-title":"Effect of Ginger on Gastric Motility and Symptoms of Functional Dyspepsia","volume":"17","author":"Hu","year":"2011","journal-title":"World J. Gastroenterol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"436","DOI":"10.1097\/MEG.0b013e3282f4b224","article-title":"Effects of Ginger on Gastric Emptying and Motility in Healthy Humans","volume":"20","author":"Wu","year":"2008","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"996","DOI":"10.1136\/gutjnl-2017-315136","article-title":"Randomised Placebo-Controlled Trial of Dietary Glutamine Supplements for Postinfectious Irritable Bowel Syndrome","volume":"68","author":"Zhou","year":"2019","journal-title":"Gut"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1002\/jgh3.12463","article-title":"Effect of Lactase on Symptoms and Hydrogen Breath Levels in Lactose Intolerance: A Crossover Placebo-Controlled Study","volume":"5","author":"Baijal","year":"2021","journal-title":"JGH Open"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"187","DOI":"10.2174\/138920021702160114150137","article-title":"Digestive Enzyme Supplementation in Gastrointestinal Diseases","volume":"17","author":"Ianiro","year":"2016","journal-title":"Curr. Drug Metab."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1038\/ajg.2012.66","article-title":"Acupuncture for Irritable Bowel Syndrome: Systematic Review and Meta-Analysis","volume":"107","author":"Manheimer","year":"2012","journal-title":"Am. J. Gastroenterol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"860","DOI":"10.7326\/0003-4819-134-9_Part_2-200105011-00010","article-title":"Health-Related Quality of Life and Health Care Costs in Severe, Refractory Irritable Bowel Syndrome","volume":"134","author":"Creed","year":"2001","journal-title":"Ann. Intern. Med."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"1441","DOI":"10.1136\/gutjnl-2020-321191","article-title":"Efficacy of Psychological Therapies for Irritable Bowel Syndrome: Systematic Review and Network Meta-Analysis","volume":"69","author":"Black","year":"2020","journal-title":"Gut"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"1232","DOI":"10.1016\/S0140-6736(84)92793-4","article-title":"Controlled Trial of Hypnotherapy in the Treatment of Se-Vere Refractory Irritable-Bowel Syndrome","volume":"324","author":"Whorwell","year":"1984","journal-title":"Lancet"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/S2468-1253(18)30310-8","article-title":"Efficacy of Individual and Group Hypnotherapy in Irritable Bowel Syndrome (IMAGINE): A Multicentre Randomised Controlled Trial","volume":"4","author":"Flik","year":"2019","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_77","doi-asserted-by":"crossref","unstructured":"H\u00e4user, W. (2024). Gut-Directed Hypnosis and Hypnotherapy for Irritable Bowel Syndrome: A Mini-Review. Front. Psychol., 15.","DOI":"10.3389\/fpsyg.2024.1389911"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1007\/s12529-012-9241-6","article-title":"Mindfulness-Based Stress Reduction for the Treatment of Irritable Bowel Syndrome Symptoms: A Randomized Wait-List Controlled Trial","volume":"20","author":"Zernicke","year":"2013","journal-title":"Int. J. Behav. Med."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1111\/apt.14400","article-title":"Randomised Clinical Trial: Yoga vs a Low-FODMAP Diet in Patients with Irritable Bowel Syndrome","volume":"47","author":"Schumann","year":"2018","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1038\/ajg.2010.480","article-title":"Physical Activity Improves Symptoms in Irritable Bowel Syndrome: A Randomized Controlled Trial","volume":"106","author":"Johannesson","year":"2011","journal-title":"Am. J. Gastroenterol."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1038\/s41395-018-0222-5","article-title":"Effect of Antidepressants and Psychological Therapies in Irritable Bowel Syndrome: An Updated Systematic Review and Meta-Analysis","volume":"114","author":"Ford","year":"2019","journal-title":"Am. J. Gastroenterol."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1016\/S2468-1253(25)00051-2","article-title":"Efficacy of Gut\u2013Brain Neuromodulators in Irritable Bowel Syndrome: An Updated Systematic Review and Meta-Analysis","volume":"10","author":"Khasawneh","year":"2025","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"1548","DOI":"10.3748\/wjg.15.1548","article-title":"Efficacy of Tricyclic Antidepressants in Irritable Bowel Syndrome: A Meta-Analysis","volume":"15","author":"Rahimi","year":"2009","journal-title":"World J. Gastroenterol."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"23723","DOI":"10.1038\/s41598-024-71571-4","article-title":"New Connections of Medication Use and Polypharmacy with the Gut Microbiota Composition and Functional Potential in a Large Population","volume":"14","author":"Larsson","year":"2024","journal-title":"Sci. Rep."},{"key":"ref_85","doi-asserted-by":"crossref","unstructured":"Rukavishnikov, G., Leonova, L., Kasyanov, E., Leonov, V., Neznanov, N., and Mazo, G. (2023). Antimicrobial Activity of Antidepressants on Normal Gut Microbiota: Results of the in Vitro Study. Front. Behav. Neurosci., 17.","DOI":"10.3389\/fnbeh.2023.1132127"},{"key":"ref_86","doi-asserted-by":"crossref","unstructured":"Aumpan, N., Chonprasertsuk, S., Pornthisarn, B., Siramolpiwat, S., Bhanthumkomol, P., Issariyakulkarn, N., Gamnarai, P., Bongkotvirawan, P., Wongcha-um, A., and Mahachai, V. (2025). Efficacy of Encapsulated Fecal Microbiota Transplantation and FMT via Rectal Enema for Irritable Bowel Syndrome: A Double-Blind, Randomized, Placebo-Controlled Trial (CAP-ENEMA FMT Trial). Front. Med., 12.","DOI":"10.3389\/fmed.2025.1648944"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.14309\/ajg.0000000000000198","article-title":"Efficacy of Fecal Microbiota Transplantation in Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis","volume":"114","author":"Xu","year":"2019","journal-title":"Am. J. Gastroenterol."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1111\/apt.17703","article-title":"Randomised Clinical Trial: Faecal Microbiota Transplantation for Irritable Bowel Syndrome with Diarrhoea","volume":"58","author":"Yau","year":"2023","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"e0202324","DOI":"10.1128\/mbio.02023-24","article-title":"The Impact of Small Intestinal Bacterial Overgrowth on the Efficacy of Fecal Microbiota Transplantation in Patients with Chronic Constipation","volume":"15","author":"Wang","year":"2024","journal-title":"mBio"},{"key":"ref_90","doi-asserted-by":"crossref","unstructured":"Xu, F., Li, N., Wang, C., Xing, H., Chen, D., and Wei, Y. (2021). Clinical Efficacy of Fecal Microbiota Transplantation for Patients with Small Intestinal Bacterial Overgrowth: A Randomized, Placebo-Controlled Clinic Study. BMC Gastroenterol., 21.","DOI":"10.1186\/s12876-021-01630-x"},{"key":"ref_91","first-page":"131","article-title":"Efficacy of the Low FODMAP Diet for Treating Irritable Bowel Syndrome: The Evidence to Date","volume":"9","author":"Nanayakkara","year":"2016","journal-title":"Clin. Exp. Gastroenterol."},{"key":"ref_92","doi-asserted-by":"crossref","unstructured":"Altobelli, E., Del Negro, V., Angeletti, P.M., and Latella, G. (2017). Low-FODMAP Diet Improves Irritable Bowel Syndrome Symptoms: A Meta-Analysis. Nutrients, 9.","DOI":"10.3390\/nu9090940"},{"key":"ref_93","first-page":"369","article-title":"Probiotics in Irritable Bowel Syndrome\u2014Is the Quest for the Right Strain over? Rapid Review of Existing Guidelines and Recommendations","volume":"16","author":"Marlicz","year":"2021","journal-title":"Prz. Gastroenterol."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"3631","DOI":"10.1097\/JS9.0000000000000658","article-title":"Probiotics for the Management of Irritable Bowel Syndrome: A Systematic Review and Three-Level Meta-Analysis","volume":"109","author":"Chen","year":"2023","journal-title":"Int. J. Surg."},{"key":"ref_95","doi-asserted-by":"crossref","unstructured":"Dale, H.F., Rasmussen, S.H., Asiller, \u00d6.\u00d6., and Lied, G.A. (2019). Probiotics in Irritable Bowel Syndrome: An up-to-Date Systematic Review. Nutrients, 11.","DOI":"10.3390\/nu11092048"},{"key":"ref_96","doi-asserted-by":"crossref","unstructured":"Fernandes, A.J.T., Farrell, A.L., Naveh, S.V., and Chakraborty, S. (2024). Stress Reduction and Psychological Therapy for IBS: A Scoping Review. Front. Gastroenterol., 3.","DOI":"10.3389\/fgstr.2024.1342888"},{"key":"ref_97","doi-asserted-by":"crossref","unstructured":"Hinse, M., Thronicke, A., Bergh\u00f6fer, A., and Matthes, H. (2022). New Multimodal Intervention to Reduce Irritable Bowel Syndrome (IBS) Severity Symptoms-Pilot Study with a 12 Month Follow-Up. PLoS ONE, 17.","DOI":"10.31234\/osf.io\/3a82h"},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"2031","DOI":"10.1111\/j.1572-0241.2008.02030.x","article-title":"Small Intestinal Bacterial Overgrowth Recurrence after Antibiotic Therapy","volume":"103","author":"Lauritano","year":"2008","journal-title":"Am. J. Gastroenterol."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"1901","DOI":"10.14309\/ajg.0000000000002862","article-title":"A Multicenter Randomized Controlled Trial of Microbiome-Based Artificial Intelligence-Assisted Personalized Diet vs Low-Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols Diet: A Novel Approach for the Management of Irritable Bowel Syndrome","volume":"119","author":"Tunali","year":"2024","journal-title":"Am. J. Gastroenterol."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"1162","DOI":"10.1016\/S2468-1253(24)00245-0","article-title":"Personalisation of Therapy in Irritable Bowel Syndrome: A Hypothesis","volume":"9","author":"Black","year":"2024","journal-title":"Lancet Gastroenterol. Hepatol."}],"container-title":["Antibiotics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-6382\/15\/3\/251\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T05:10:45Z","timestamp":1772341845000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-6382\/15\/3\/251"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,27]]},"references-count":100,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["antibiotics15030251"],"URL":"https:\/\/doi.org\/10.3390\/antibiotics15030251","relation":{},"ISSN":["2079-6382"],"issn-type":[{"value":"2079-6382","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,27]]}}}