I have a history of bacterial imbalance in the gut. Can you please help me out?

Q. Why do I struggle with gut dysbiosis and have bacterial imbalance in the gut?

Answered by
Dr. Ajeet Kumar
and medically reviewed by Dr. Infanteena Marily
This is a premium question & answer published on Feb 15, 2022

Hello doctor,

I have struggled with gut dysbiosis for over a decade. Whenever I take probiotics especially lactobacillus, it makes the heaviness even worse. I got a gut test done and it says that I am low in lactobacillus. I cannot figure out what I should do because I am afraid that taking it will make my issues flare-up. It also says that I am low in faecalibacterium, blautia, bifidobacterium, and akkermansia. The test said I am in a normal range for other beneficial bacteria, and did not find any unhealthy ranges of bad bacteria. Should I take the other four and avoid lactobacillus for now, then try adding it later or should I take all five of them together with probiotics? Can you please suggest on this? For the last ten years, I got rid of the worst symptoms by eating a healthy diet, but I still suffer from bloating and gas if I eat fibrous foods and especially if I have anything with live cultures like yogurt, or any supplement with lactobacillus in it. Whenever I try to eat vegetables or anything with live cultures, my symptoms increase. I do not have any issues with dairy or gluten, and it got worse when I tried to eat a FODMAP diet because I limited my diet extremely that it took years to be able to eat those foods again. I take a mediterranean diet, but cannot seem to incorporate whole vegetables. So, I consume vegetables in liquid form, other than lettuce and cooked greens.



Welcome to icliniq.com.

I understand your concern,

Although your gut microbiota may seem disturbed, but, as you see that most of the bacteria which are healthy and deficient in your gut are not commercially available. The only available ones are lactobacillus, fusobacteria and a few others. Actually, having dysbiosis and having its symptoms are two different things. All the symptoms that you have may not be due to dysbiosis, there are other potential factors that may be causing you gas and bloating. I suggest you to stop probiotic supplements for now. I suggest you start tablet Rifaximin 200 mg thrice daily for three weeks and tablet Levosulpiride 25 mg thrice daily half an hour before meals for two weeks.

You should be taking a low FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet only; it is good that you are already avoiding a high FODMAP diet. You should learn to practice diaphragmatic breathing. This is important, and you can learn it by seeing a video online. If your symptoms do not improve, we will need to modify your treatment, we can add some low-dose antidepressant medications, which would work to control the function of your gut.

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