Novel Nutritional Formula Shows Promise in Treating Gut Microbial Overgrowth

Researchers at Cedars-Sinai have developed an innovative palatable elemental diet, named mBiota Elemental, which demonstrates effectiveness in reducing gut microbial imbalance and alleviating symptoms in patients suffering from small intestinal bacterial overgrowth (SIBO) and intestinal methanogen overgrowth (IMO). This new nutritional approach was evaluated in a recent clinical trial, revealing promising results.

The study involved a two-week course of the specially formulated diet, followed by a two-week phase of reintroducing regular foods. All 30 adult participants, diagnosed through lactulose breath tests, completed the trial without serious adverse effects. Breath tests showed significant normalization, with 73% of patients achieving results within the normal range, and 83% reporting symptomatic relief including reduced bloating, abdominal discomfort, and flatulence.

Biological assessments indicated substantial decreases in exhaled methane and hydrogen levels, critical markers in microbial overgrowth syndromes. The average maximum methane levels dropped from 41 to 12 parts per million (ppm), and hydrogen from 43 to 12 ppm. Notably, 92% of patients with detectable Methanobrevibacter smithii—an archaea associated with IMO—had reduced or undetectable levels after treatment.

Microbiome analysis supported these findings, demonstrating decreases in key bacterial groups like Prevotella_9 and Fusobacterium. Additionally, shifts in fermentation patterns were observed, suggesting alterations in gut microbial activity. Symptom improvements persisted across multiple domains, including gastrointestinal discomfort and systemic symptoms such as fatigue and brain fog.

Importantly, the diet was well tolerated, with mild side effects such as transient diarrhea, nausea, and cramps. Patients experienced an average weight loss of approximately 3 kg, mainly due to reductions in fat stores. Safety assessments confirmed normal electrolyte and glucose levels throughout the intervention.

This study indicates that a short-term course of the advanced, palatable elemental diet can serve as an effective non-antibiotic strategy for managing gut microbial overgrowth. The improved taste and texture appear to enhance adherence, overcoming previous barriers to elemental diet use. Further research is needed to evaluate long-term outcomes and deepen understanding of underlying mechanisms.

The findings, published in "Clinical Gastroenterology and Hepatology," suggest a promising avenue for patients with SIBO and IMO, offering a potential alternative or complement to traditional antibiotic therapies.