Berberine vs. Rifaximin for SIBO: What I Tell Clients
Quick answer: A 2025 network meta-analysis of 30 trials found berberine had the highest efficacy ranking of any single SIBO treatment, and an interim analysis of the first head-to-head trial (BRIEF-SIBO) found berberine was not inferior to rifaximin. In my practice, that means berberine is often my first move for uncomplicated hydrogen-dominant SIBO — but
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