24-Hour Yogurt for Intestinal Methanogen Overgrowth

by Anne Kessler, MScN

The bacterial strain Lactobacillus reuteri has been studied for its beneficial effects on constipation and in particular its effect on constipation resulting from intestinal methanogen overgrowth or IMO (pronounced “emo”).

IMO occurs when we have an overgrowth of methane producing organisms in either the small intestines, large intestines, or both. These organisms are classified as archaea, which are similar to but also very different from bacteria. Thus, if we have an overgrowth of methane producing archaea in the small or large intestines, we call this condition IMO. When we have an overgrowth of hydrogen or hydrogen sulfide producing bacteria, we call this condition Small Intestinal Bacterial Overgrowth or SIBO.

A clinical trial in 2017 found that individuals who supplemented with L. reuteri for 105 days had a significant improvement in their constipation resulting in a decrease in their time spent on the toilet, pain and straining, obstruction, abdominal discomfort and pain, and abdominal bloating. When compared to the placebo group, the individuals that supplemented with L. reuteri also had fewer instances of incomplete defecation, less abdominal discomfort and pain, less bloating, and needed to use significantly fewer laxatives (42% fewer individuals used laxatives while supplementing with L. reuteri).

A small study in 2017 specifically looked at the effect of L. reuteri on 20 individuals with functional constipation who had elevated methane levels on their lactulose breath tests (LBT). Individuals who supplemented with L. reuteri for 4 weeks saw their methane levels drop an average of 12ppm (from a group average of 20.8ppm to 8.9ppm). During the study, 11 of the 20 individuals had their methane levels drop below 5ppm.

We have found that some of our patients with IMO have experienced positive results from supplementing with L. reuteri, specifically from using the product BioGaia Gastrus. More recently, we have learned that Dr. William Davis has seen positive results using BioGaia Gastrus as the starter culture for 24-hour yogurt. The L. reuteri bacteria are more temperature sensitive than most conventional yogurt microorganisms though, and so special care must be taken not to ferment this yogurt above 100F (many yogurt makers have a presetting of 110F, so make sure that you are using an adjustable temperature-controlled yogurt maker or a basin-type sous vide).

And of course, make sure that you are fermenting your yogurt for at least 24 hours. During the fermentation process, the probiotic bacteria consume lactose turning it into lactic acid. Lactose is typically not well tolerated on a SIBO or IMO therapeutic diet because it is a preferred food for these bacteria and archaea and can result in an increase in your intestinal and other systemic symptoms. Conventional yogurts are only fermented for 6-8 hours, are typically not well tolerated by persons with SIBO/IMO, and contain significantly less beneficial probiotic bacteria. If you are sensitive and haven’t tried 24-hour yogurt before or if you haven’t tried 24-hour yogurt again since your SIBO/IMO symptoms began, start with a teaspoon or Tablespoon of yogurt and work your way up from there.

Lactobacillus reuteri 24-Hour Yogurt Recipe

Ingredients:

§  1 quart organic half and half (preferably using A2 milk from Guernsey cows, Jersey cows, goats, or sheep). Cream can also be used, but it may result in a very thick final product.

§  2 Tbs of prebiotic fiber such as inulin or raw potato starch

§  Yogurt starter: either 10 tablets BioGaia Gastrus or 2 Tbs previous batch of L. reuteri yogurt (whey or curds mixture of both)

Directions:

1.     Fill a shallow baking pan with ice cold water and set aside.

2.     In a saucepan over medium high heat, heat the half and half to 180F, measured with an instant read thermometer.

3.     Place the saucepan in the ice water until the half and half cools to 100F.

4.     Add 2 level Tablespoons of prebiotic fiber to a large bowl (ex: inulin or potato starch).

5.     Add your yogurt starter to the bowl: Use either 10 crushed tablets of BioGaia Gastrus (a mortar and pestle or rolling pin should do the trick) or use 2 Tbs of your previous batch of L. reuteri yogurt (whey or curds mixture of both).

6.     Add 2Tbs cooled half and half from your saucepan to the bowl and whisk well to combine.

7.     Add the remaining cooled half and half from your saucepan to the bowl and whisk to combine.

8.     Pour mixture into an adjustable temperature-controlled yogurt maker keeping the temperature right around 100F for 24-36 hours. The L. reuteri bacteria in BioGaia Gastrus are more temperature sensitive than most conventional yogurt microorganisms. Many yogurt makers including some Instant Pot models will only ferment yogurt at 110F or higher, but this will likely kill your L. reuteri bacteria. A basin-type sous vide device or stick sous vide may also be able to be used to maintain a temperature of 100F.

9.     Once fermentation is complete after 24-36 hours, refrigerate until firm, usually 8hrs or overnight.

Recipe inspired by: Nutritionist Kristy Regan’s “24-Hour Yogurt with Strawberry Compote” from her book The SIBO Diet Plan and Dr. William Davis’ blog post “How to Make L. reuteri Yogurt: A Step-by-Step Guide.”

References:

1.     Ojetti V, Petruzziello C, Migneco A, Gnarra M, Gasbarrini A, Franceschi F. Effect of Lactobacillus reuteri (DSM 17938) on methane production in patients affected by functional constipation: a retrospective study. Eur Rev Med Pharmacol Sci. 2017 Apr;21(7):1702-1708.

2.     Riezzo G, Orlando A, D'Attoma B, Linsalata M, Martulli M, Russo F. Randomised double blind placebo controlled trial on Lactobacillus reuteri DSM 17938: improvement in symptoms and bowel habit in functional constipation. Benef Microbes. 2018 Jan 29;9(1):51-60.

3.     Davis W. How to make L. reuteri yogurt: A step-by-step guide. Dr. William Davis. Published July 27, 2019. Accessed October 2, 2023. https://drdavisinfinitehealth.com/2019/07/how-to-make-l-reuteri-yogurt-step-by-step/

4.     Regan K. The SIBO Diet Plan. Rockridge Press; 2018.

Anne Kessler specializes in providing holistic nutrition therapy for patients with a widevariety of gastrointestinal conditions including IBS, SIBO, candida overgrowth and SIFO, GERD, IBD, diverticulosis, Celiac Disease, histamine intolerance and MCAS, as well as food allergies, sensitivities, and intolerances.

Anne earned a Master of Science in Nutrition from the National University of Natural Medicine and is presently a candidate for board certification as a Certified Nutrition Specialist. During her training at NUNM, she interned on Clinical Nutrition Shifts with Dulcie Childs, RD, and the GI Mentor Shift with Dr. Steven Sandberg-Lewis. She is certified through the Food as Medicine Institute as a Food as Medicine Everyday Educator.

Hive Mind Medicine blog posts are for educational purposes only and are not intended as medical advice. Please consult with your health care practitioner for personalized guidance.