In a study conducted by the Medical College of Georgia at Augusta University researchers have discovered a significant accumulation of bacteria in the small intestine from probiotic use which can result in disorientating brain fogginess and rapid, severe belly bloating. The study was conducted on 30 patients with 22 of them reporting problems with difficulty concentrating and confusion. They also reported bloating and gas.

The researchers found large colonies of breeding bacteria in the patient’s small intestines and also high levels of D-lactic acid which was being produced by the bacteria lactobacilus fermentation of sugars in the food they consumed. D-lactic acid can be temporarily toxic to brain cells which can interfere with thinking, sense of time and cognition. Some of the patients in the study showed two to three times the normal amount of D-lactic acid in their blood. Most of the patients said the brain fogginess they were experiencing lasted from half an hour to several hours after eating and some reported that the fogginess was so severe they had to quit their job.

This is the first time the connection has been made between bacterial overgrowth in the small intestine, high levels of D-lactic acid in the gut, and brain fogginess associated with probiotic use. Probiotic bacteria has the capacity to break down sugar and produce D-lactic acid. If the small bowel is inadvertently colonized with probiotic bacteria then the stage has been set for potentially developing lactic acidosis and brain fogginess. Probiotics can be very beneficial in some scenarios such as restoring gut bacteria after taking antibiotics, but with excessive or indiscriminate use complications such as noted in the study can arise. The researchers warn that probiotics should be treated as a drug rather than as a food supplement.

The patients in the study who experienced brain fogginess took protiotics and small intestinal bowel overgrowth (SIBO) was more common in this group (68% compared to 28%),. The patients with brain fogginess also showed a higher prevalence of D-lactic acidosis (77% compared to 25%). When the patients experiencing the brain fogginess stopped taking the probiotics and took a course of antibiotics, their brain fogginess resolved. The actual movement of food in the gastrointestinal tract was slow in one third of the patients with brain fogginess and one fourth in the other group. Slower passage of food can increase the chance of SIBO.

Normally the small intestines do not make much D-lactic acid. SIBO appears to change that by causing bacteria to go into a feeding frenzy which ferments sugars resulting in methane and hydrogen gas that causes bloating. When probiotics are added to that the acid gets absorbed in the blood and can reach the brain.

By identifying the problem, it can be treated. Diagnosis includes urine, blood and breath tests to detect lactic acid and an endoscopy which examines fluid from the small intestine can identify the specific bacteria and antibiotic treatment can be administered.

In the study, the patients with brain fogginess, SIBO and/or D-lactic acidosis were asked to discontinue probiotic products and were given antibiotics which were targeted to their bacterial population. Those patients who did not exhibit SIBO were asked to stop probiotics and stop eating yogurt. Those patients with SIBO and D-lactic acidosis but no brain fogginess were also administered antibiotics. After treatments, 70 percent of patients reported significant improvements in their symptoms. 85 percent of patients reported their brain fogginess had disappeared. Those patients with SIBO and high levels of D-lactic acid and no brain fogginess reported significant improvement in regards to cramping and bloating with three months.

All patients who participated in the study had extensive examination of the gastrointestinal tract which included a motility test to rule out any other potential causes of their symptoms. Questionnaires were filled out which included questions about symptoms such as belching, gas and abdominal pain along with other related issues about antibiotic and probiotic use and food fads and consumption of yogurt.
Patients were given carbohydrates which were followed by metabolic testing to see the impact of things like insulin and blood glucose levels. Levels of D-lactic acid and L-lactate acid were also measured as these acids which result from muscle use of glucose as energy can also cause muscle cramps.

Probiotics are meant to work in the colon and not in the stomach or small intestines. However, people with motility issues, those taking opioids and proton pump inhibitors, can result in issues with probiotic bacteria reaching the proper place. Other problems from use of antidepressants and minerals like iron and people with diabetes, can also slow movement and increase the change that probiotics will remain too long in the upper intestine where they can cause harm.

For many people probiotics can help especially in those suffering from gastroenteritis or stomach flu where diarrhea and other problems from antibiotic use can wipe out natural gut bacteria. This is when probiotic use is beneficial in building up the bacterial flora. Good sources of probiotics are sauerkraut, yogurt, kefir, kimchi and dark chocolate. These are all generally safe due to their small amounts of bacteria. Helpful gut bacteria or microbiome are essential to a well functioning immune system and general health overall.

Future studies will include following patients for longer periods of time to ensure problems remain resolved. Some of the patients in the current study required two rounds of antibiotics.

To view the original scientific study click here: Brain fogginess, gas and bloating: a link between SIBO, probiotics and metabolic acidosis.

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