TUDCA for Sibo

TUDCA for Sibo: Is It Effective?

TUDCA is a natural bile acid found in the livers of some animals. It is believed to have anti-inflammatory properties, inhibit bacterial effects, and stimulate bowel movements, making it a potential candidate for SIBO treatment.

This article will provide a comprehensive look at the role of TUDCA in treating SIBO, including relevant studies and evidence, helping readers gain the necessary information to make informed decisions.

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Key Takeaways

  • SIBO is a condition where the amount of bacteria in the small intestine exceeds normal levels, causing symptoms such as abdominal pain, bloating, diarrhea, constipation, and weight loss.
  • TUDCA is a bile acid metabolized from UDCA. It has positive effects on recovering from functional dyspepsia (FD) and supporting SIBO in humans.
  • In addition to using TUDCA, natural measures to prevent SIBO include healthy eating, reducing bad fats, increasing fiber and protein intake, and supplementing with Omega-3 and bile acids from dietary supplements.

Does TUDCA Help With SIBO?

Does TUDCA Help With SIBO

Yes, TUDCA (Tauroursodeoxycholic Acid), a bile salt produced naturally in the body, can help prevent the overgrowth of bacteria in the small intestine (SIBO).

A study published in 2020 showed that UDCA (Ursodeoxycholic Acid) improved symptoms of functional dyspepsia (FD) after two months of use [1]. FD is directly related to the overgrowth of bacteria in the small intestine (SIBO), and TUDCA is a metabolite of UDCA.

What is SIBO?

SIBO (Small Intestinal Bacterial Overgrowth) is the presence of excessive bacteria in the small intestine, causing an imbalance of gut microbiota and affecting normal digestive health.

Normally, less than 10 organisms/mL are found in the upper small intestine. However, SIBO patients often have bacterial populations in the small intestine exceeding 10³ - 10⁴ organisms/mL [3].

Excessive or inappropriate bacterial presence in the intestine can lead to discomforts such as chronic diarrhea, bloating, and malabsorption. Individuals with SIBO may experience sudden weight loss, nutritional deficiencies, and osteoporosis [2].

Bile's Role in SIBO

Bile's Role in SIBO

The gallbladder is a small pear-shaped organ on the right side containing bile. Bile is a complex mixture of organic and inorganic molecules stored in the gallbladder and released into the proximal small intestine when eating.

Bile is both an excretory fluid that helps eliminate cholesterol, bilirubin, and waste and a digestive fluid that promotes lipid absorption [5].

Produced by the liver, bile is essential in the digestive process, breaking down fats into fatty acids for energy metabolism, balancing gut microbiota, and regulating bacterial levels to prevent SIBO.

Bile acts as an antimicrobial agent with detergent properties that help dissolve bacterial cell membranes, reducing the absorption of harmful bacteria in the small intestine while promoting the diversity of healthy bacteria [4].

Adequate bile flow ensures the presence of antimicrobial agents, helping to control bacterial overgrowth. Bile also plays a role in regulating bowel movements, preventing the stagnation of food and bacteria in the small intestine.

How Does TUDCA Help With SIBO?

TUDCA is a bile acid (also known as bile salt) that acts as a major organic component of bile. Bile acids excel in dissolving polar lipids during digestion and enhance the inhibition of bacterial growth in the small intestine [5].

TUDCA benefits SIBO through specific mechanisms:

  • Antibacterial effect: TUDCA has antibacterial properties that help control bacterial levels in the small intestine. A study on how Gram-negative and Gram-positive bacteria counteract bile stress indicated differences in bile tolerance among bacterial strains, highlighting this function's potential benefits [6].
  • Regulating bowel movements: Bile acids have secretory, motor, and antibacterial functions in the intestine, reducing small intestinal motility while increasing large intestinal motility and effectively supporting intestinal transport disorders [7] [8].
  • Preventing leaky gut syndrome: Leaky gut is a condition associated with SIBO where gaps in the gut lining allow substances to leak into the bloodstream. TUDCA can prevent this, limiting intestinal barrier dysfunction and related conditions [9].
  • Migrating motor complex (MMC): The MMC process is often disrupted in SIBO patients, leading to bloating, abdominal pain, or indigestion. Research shows that TUDCA can trigger subsequent bile-emptying episodes with motilin release, and MMC can be maintained through this mechanism [10].
  • Digestion and nutrient absorption: Bile acids are essential for digesting and absorbing fats, lipids, and fat-soluble vitamins. Sufficient TUDCA supplementation helps digest fats effectively before reaching the small intestine, preventing bacterial overgrowth and causing SIBO [11].

How Much TUDCA Should You Use for SIBO?

tudca dosage for sibo

Currently, there is no definitive guideline on the dosage of TUDCA for SIBO.

However, in an experiment involving 24 patients diagnosed with FD and SIBO, participants were supplemented with 100 mg UDCA (a TUDCA metabolite) thrice daily for two months.

Results indicated significant improvement, with reduced methane gas levels indicative of indigestion [1].

According to one user's experience, consistent use of 250 mg TUDCA capsules each morning provided relief from bloating and indigestion..

What Otherwise Can You Do to Manage SIBO?

In addition to taking TUDCA, you can try the following methods to manage SIBO and enhance bile function:

  • Dietary changes: Adopt a fiber-rich, low-fat diet and include lean protein sources, nuts, and fruits. Consume healthy fats by using vegetable oils or canola oils. Avoid cholesterol-increasing culprits like fast food and junk food.
  • Omega-3 supplementation: Omega-3 supports cholesterol ratio and cardiovascular health, reduces bad fats, and limits negative impacts on the digestive system and other organs.
  • Bile acid supplementation: Providing the body with a sufficient amount of bile acids helps inhibit bacterial growth, thereby preventing SIBO risk. Animal liver, egg yolks, fatty fish, olive oil, probiotics, or TUDCA supplements can supplement bile acids.

FAQs

Does Lack of Bile Cause SIBO?

Yes, bile salts, a key component of bile, play a crucial role in regulating the movement of the small and large intestines. Therefore, a lack of bile can lead to gastrointestinal issues such as constipation, bloating, and diarrhea and can contribute to developing Small Intestinal Bacterial Overgrowth (SIBO).

Can You Take TUDCA With Digestive Enzymes?

There is no negative evidence regarding this combination, so you can use TUDCA with digestive enzymes. However, following the prescribed dosages and consulting a specialist is essential to ensure health safety.

Conclusion

TUDCA may be a potential option for SIBO patients, but more research is needed to confirm its effectiveness and safety. It's advisable to consult a doctor before using TUDCA and to maintain a healthy lifestyle and diet to avoid imbalances in the gut microbiota.

References

[1] Kim, Bom-Taeck, et al. "The Effect of Ursodeoxycholic Acid on Small Intestinal Bacterial Overgrowth in Patients with Functional Dyspepsia: A Pilot Randomized Controlled Trial." Nutrients, vol. 12, no. 5, 14 May 2020, p. 1410, https://doi.org/10.3390/nu12051410. Accessed 12 June 2020.
[2] Dukowicz, Andrew C., et al. "Small Intestinal Bacterial Overgrowth." Gastroenterology & Hepatology, vol. 3, no. 2, 1 Feb. 2007, pp. 112–122, www.ncbi.nlm.nih.gov/pmc/articles/PMC3099351/
[3] Isaacs, P. E., and Y. S. Kim. "Blind Loop Syndrome and Small Bowel Bacterial Contamination." Clinics in Gastroenterology, vol. 12, no. 2, 1 May 1983, pp. 395–414, pubmed.ncbi.nlm.nih.gov/6347463/. Accessed 24 May 2024.
[4] Urdaneta, Verónica, and Josep Casadesús. "Interactions between Bacteria and Bile Salts in the Gastrointestinal and Hepatobiliary Tracts." Frontiers in Medicine, vol. 4, 3 Oct. 2017, https://doi.org/10.3389/fmed.2017.00163..
[5] Hofmann, Alan F., and Lars Eckmann. "How Bile Acids Confer Gut Mucosal Protection against Bacteria." Proceedings of the National Academy of Sciences of the United States of America, vol. 103, no. 12, 21 Mar. 2006, pp. 4333–4334, www.ncbi.nlm.nih.gov/pmc/articles/PMC1450168/, https://doi.org/10.1073/pnas.0600780103.
[6] Begley, Máire, et al. "The Interaction between Bacteria and Bile." FEMS Microbiology Reviews, vol. 29, no. 4, Sept. 2005, pp. 625–651, https://doi.org/10.1016/j.femsre.2004.09.003.
[7] Ward, Joseph D, et al. The Bile Acid Receptor, TGR5, Regulates Basal and Cholinergic-Induced Secretory Responses in Rat Colon. Vol. 25, no. 8, 1 Aug. 2013, pp. 708–711, https://doi.org/10.1111/nmo.12148.
[8] Alemi, Farzad, et al. "The Receptor TGR5 Mediates the Prokinetic Actions of Intestinal Bile Acids and Is Required for Normal Defecation in Mice." Gastroenterology, vol. 144, no. 1, Jan. 2013, pp. 145–154, https://doi.org/10.1053/j.gastro.2012.09.055. Accessed 6 May 2023.
[9] Shi, Linsen, et al. "Bile Acids, Intestinal Barrier Dysfunction, and Related Diseases." Cells, vol. 12, no. 14, 19 July 2023, pp. 1888–1888, www.ncbi.nlm.nih.gov/pmc/articles/PMC10377837/, https://doi.org/10.3390/cells12141888. Accessed 24 May 2024.
[10] Hellström, P. M., et al. “Role of Bile in Regulation of Gut Motility.” Journal of Internal Medicine, vol. 237, no. 4, Apr. 1995, pp. 395–402, https://doi.org/10.1111/j.1365-2796.1995.tb01193.x. Accessed 18 June 2022.
[11] Staels, B., and V. A. Fonseca. "Bile Acids and Metabolic Regulation: Mechanisms and Clinical Responses to Bile Acid Sequestration." Diabetes Care, vol. 32, no. suppl_2, 29 Oct. 2009, pp. S237–S245, www.ncbi.nlm.nih.gov/pmc/articles/PMC2811459/, https://doi.org/10.2337/dc09-s355.
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Author

Ralph S. Albert, with over 10 years of expertise in nutrition and research, now heads the Research division at Vinatura Supplements. His dedication and extensive knowledge ensure top-quality articles on nutrition and health, collaborating with a skilled team. He has successfully completed The VINATURA Expertise Research Training Program, underscoring his commitment to Vinatura's mission. Ralph has also published numerous articles and conducted valuable research in the field, making him a trusted resource for individuals on their wellness journey.

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