The Relationship Between Gut Bacteria and Multiple Sclerosis

Cathy Chester avatar

by Cathy Chester |

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treating MS holistically

This year, I wrote several articles about gut health because, in addition to MS, that’s what I’m currently battling. Writing is cathartic, so when an issue hits close to home, pouring words onto paper … er, a laptop, is a godsend. It’s like having a built-in therapist. After successive clicks, a sentence is finished and an emotional issue may sting a little less. Reading study after study increases my knowledge on a topic, with each conclusion adding another nugget of useful information.

I was recently diagnosed with SIBO. What’s that, you may ask? SIBO is an acronym for small intestinal bacterial overgrowth. If you have never heard of it don’t worry. Neither did several doctors I’ve seen since my diagnosis. That’s a tricky game when doctors are in the dark about a patient’s illness.

Basically, SIBO is when bacteria normally found in the large intestine proliferate and spill over into the small intestine, a place where they don’t belong. It may be caused by a dysfunction of intestinal nerves or muscles or some sort of abnormality of the intestine.

Symptoms can include abdominal bloating, diarrhea, constipation, gas, joint pain, abdominal pain, vitamin and mineral deficiencies, and weight loss.

After two rounds of expensive antibiotics to kick the bad bacteria out of my small intestine, my stomach once again felt normal. My gastroenterologist sent me happily on my way with one piece of advice: Eat more fruits, vegetables, and whole grains.

How naive I was to think I was cured. Unfortunately, SIBO is chronic and must be managed carefully. I began eating healthier meals, including whole grains, which resulted in frantic, painful trips to the bathroom. I quickly learned that gluten, sugar, and dairy were the culprits because they bind themselves to bacteria, overloading my system and sending me over the excruciating cliff.

As I began reading up on SIBO, I found growing evidence about a relationship between gut bacteria and multiple sclerosis.

According to research led by Harvard Medical School investigators at Brigham and Women’s Hospital:

“Bacteria living in the gut may remotely influence the activity of cells in the brain involved in controlling inflammation and neurodegeneration. Using preclinical models for multiple sclerosis and samples from MS patients, the team found evidence that changes in diet and gut flora may influence astrocytes (a star-shaped glial cell in the brain and spinal cord) in the brain, and, consequently, neurodegeneration, pointing to potential therapeutic targets. The team’s results were published in Nature Medicine.”

“‘For the first time, we’ve been able to identify that food has some sort of remote control over central nervous system inflammation,’” said corresponding author Francisco Quintana, HMS associate professor of neurology and the Ann Romney Center for Neurologic Diseases at Brigham and Women’s.

“What we eat influences the ability of bacteria in our gut to produce small molecules, some of which are capable of traveling all the way to the brain. This opens up an area that’s largely been unknown until now: how the gut controls brain inflammation,” he said.

Now I know I’m on the right path to use food as medicine. But it’s going to be a circuitous path because my SIBO continues to act up. I’ve eliminated anything tasty from my diet and my MS reminds me daily that it’s listening.

I’ve asked for a second opinion from a world-renowned facility with learned specialists in digestive disorders, functional medicine (looking at the whole person), and complementary treatments. I’m praying for guidance for my SIBO along with the other three digestive orders I received this year. I want to avoid a full-blown exacerbation because my MS is getting angry with my digestive system. I’d like to stay in remission. We shall see.   

NOTE: Take a look at this small study titled, “Prevalence of Small Intestinal Bacterial Overgrowth in Multiple Sclerosis: a Case-Control Study from China,” reported by the National Institutes of Health. I hope it’s another step forward to solving a piece of the SIBO-multiple sclerosis puzzle. 


Note: Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Multiple Sclerosis News Today or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to multiple sclerosis.


Gwen Halcyon avatar

Gwen Halcyon

Thank you for this. Do you know if there is a recommended probiotic we should be taking to "re-balance the gut" bacteria? I take nature plus ultra probiotic and also VSL3 combination probiotic...I've no idea if it's doing any good though. I've upped my intake of fruit and veg too - slowly but steadily, it can have unfortunate side effects (urgently needing the loo) if you change your diet too quickly.

Cathy Chester avatar

Cathy Chester

Hi Gwen~

That's a great question Gwen but unfortunately one I can't answer. First, since I am not a medical person I can't give recommendations, and also there are so many probiotics on the market it's difficult to know which one to try.

Current research shows the benefits as well as some difficulties with probiotics. I would suggest googling articles or reading websites such as Dr. Josh Axe who delves into SIBO.

If you feel better after taking your current probiotic I'd say stay with it, and if not change to another brand. Talk to someone knowledgeable at a local health store - I've found they can be quite helpful.

Good luck with your search. I think we are all different, as in MS, and what works for one person may not work for another.

Best to you and happy holidays, Cathy

Folake Taylor, MD, FACP avatar

Folake Taylor, MD, FACP

Hi! I am an internist with PPMS. Based upon my positive response to VSL#3, I now prescribe it to patients with GI issues. I also take another regular probiotic daily, just in case I forget to reach into the refrigerator and grab the VSL#3. I either take Innovix Labs probiotic or Naturewise Time Release probiotic. They are the same medication, but Naturewise costs more! My mood, my bowel regularity, and my weight control are linked to how healthy my gut is with a good balance of greens, probiotics, infused water, and even Vitamin D. When I can do aerobic exercise, it’s even better. But since the last time I had a worsening lumbar herniation in my right L5S1 10 weeks ago, I have not been able to do any targetted aerobic exercise without a flare up of back pain.
But yeah, VSL#3 it is for me. I believe it’s the ultimate so far for autoimmune disease, though formulated for Ulcerative Colitis (UC), its effect is not limited to UC. Hope that helps.

francesco paolo ruggieri avatar

francesco paolo ruggieri

from Italy, Google translation
  for your lumbar hernia in my right L5S1, an effective remedy, function hernia size, is the application of Cladodi Cactus indica, cut in half and applied, inside mucilaginous green on hernia area, through adjustable panciera and, in general, after 15 -30 days, it should be disinfammable and disappear-return completely! . A friend of mine, had a lumbar hernia of 16 mm, fully returned, with the aforementioned application in about 30 days. With the cladodes, fat leaves on which the fruit of the prickly pear is born, fresh and not the Nopal on the market, used in salad, it improves-heals from hiatal hernia, esophageal reflux, gastritis and applied on deep wounds, stops the spill blood and heals the wound, without scar formation. ;

Italy : per la tua ernia lombare nella mia destra L5S1 , un rimedio efficace, funzione grandezza ernia, è la applicazione di Cladodi Cactus indica, tagliata a metà ed applicata, parte interna verde mucillaginosa su zona ernia , tramite panciera regolabile e, in genere, dopo 15-30 gg, dovrebbe disinfiammarsi e sparire-rientrare in toto ! . Un mio amico, aveva una ernia lombare di 16 mm , rientrata in toto, con la suddetta applicazione in 30 gg circa. Con i cladodi, foglia grassa sulla quale nasce il frutto del fico d'india, fresca e non il Nopal in commercio, utilizzati in insalata, si migliora-guarisce da ernia iatale, reflusso esofageo, gastrite e applicata su ferite profonde, blocca la fuoriuscita sangue e guarisce la ferita, senza la formazione di cicatrice.

Haidy Sharawy avatar

Haidy Sharawy

Thank you so much for all that information.
Do you recommend multi-grain for MSers. If so, can you give me some examples.
Thank you.

Cathy Chester avatar

Cathy Chester

I am not a medical person but if you want to avoid gluten because of gut issues I'd recommend taking a look at the FODMAP diet. In general many grains contain gluten so do you homework such as taking a look at this website. Good luck, Cathy

Folake Taylor, MD, FACP avatar

Folake Taylor, MD, FACP

No. The less gluten the better for MS. Until March of this year, there was no medication for PPMS. So I had to avoid gluten like the plague. It made me have pins and needles under my entire skin if i ate gluten. No celiac, just severe gluten sensitivity. Dairy wasn’t so bad for me. Please get this book, The Wahls Protocol and the cookbook that goes with it. Terry Wahls is a fellow MD who was in a zero gravity wheelchair until she studies functional medicine and turned her disease course around with diet. She’s not on MS meds and and barely takes supplements. She grows her own food. She also has TED Talks on YouTube. Amazing lady.
I started Ocrevus infusions (the new med) in August so it modified my food sensitivities and has helped with how bad I feel when I feel bad. I’m still partially disabled, but I am hoping Ocrevus has at least slowed down my disease course. I’m still able to see patients in the morning and for that, I am thankful.
Terry Wahls recommends avoiding all grain but for me, gluten was the real trigger, especially gluten from the United States. It’s interesting but I can go to Japan and Europe and the Caribbean, and their gluten did not cause inflammation in my body. Go figure.

Ian Smythe avatar

Ian Smythe

Yes I've been this food program for 10 months,professor George Jelineck Australia,is my hero

Laura Drake avatar

Laura Drake

In 2001 I started with uncontrollable diarrhea and abdominal pain 24/7. After every gastrointestinal test possible an Octreoscan was ordered and that also was normal, except that my brain lit up. They found gliosis and demyelination. I was not, however, officially diagnosed with MS until 2012. The diarrhea stopped on it's own with no changes to anything I ate, or medications I took. The diarrhea returned and a new testing was done. An MRCP showed all of my gastrointestinal organs were normal, but a fecal elastase test showed my pancreas was not producing the enzymes I needed for proper digestion. I was put on pig enzymes (Creon) and I have never had a bout of diarrhea or abdominal pain since. I also take an over the counter probiotic made under the Walgreen's name, a 5 billion count strength. I will need those 2 drugs the rest of my life. They believe I had a single MS exacerbation in 2001 that went into remission and later returned as Secondary Progressive MS. MS can attack internal organs and create havoc. Non-textbook symptoms makes it very difficult for doctors to diagnosis diseases. I also have a Neurogenic bladder from the MS and fight constant urinary tract infections. That's under control with a low dose muscle relaxer and low dose maintenance antibiotic. This is my experience with abdominal pain and symptoms very similar to yours. I cannot offer medical advice but wanted to share the journey I took to healing. I love fruits and vegetables, but eat just normal servings. I am VERY cautious with my fiber intake.

Julianne avatar


Check out The Wahls Protocol - book and several YouTube videos. Or go to She is a physician with MS who reversed her own progressive form of MS. She is currently doing research regarding diet and healing the gut for MS and other neurologic pathologies. She even landed a grant from the National MS Society to study diet and MS.

Cathy Chester avatar

Cathy Chester

Thank you. I interviewed her a few years ago and I know her work. I look forward to hearing what she finds about MS & the gut relationship.

Dawn avatar


Many people, including myself, are controlling our MS symptoms with the Wahls Protocol. It is strict and takes work, but really works so much better than the drugs for me. Check out:

Rich avatar


I have had zero flare ups and no new lesions in 14 moths since the moment I removed all grains from my diet. I know that everyone is different but I feel so blessed to have learned about the “gut-brain” connection.

Alex avatar


Hello Cathy,

Have you ever considered getting an FMT?

It's where they transplant the microbiota from a healthy person to an ill person, in an effort to cure the illness.

I suffer from IBS, which possibly is misdiagnosed SIBO, and I am strongly considering it as an option.

Judy lynn avatar

Judy lynn

Coincidence, I was just diagnosed with SIBO myself last month. I did not want to do the antibiotics because of side effects, so I’m on an herbal protocol from the naturopath. It’s shown good results but usually requires a couple of rounds. High doses of Berberine, Allicin, and a few other ingredients. You might ask about trying any of these to prevent recurrence.
Wishing us luck!!

Cari avatar


I have heard about a link to antibiotics for colds or mononucleosis killing off all good bacteria.
I always need a prescription to take after a round of antibiotics to prevent/treat yeast infections.

Lynne Roso avatar

Lynne Roso

Presently on the Ketos diet. No sugar, GF & maximum of 20 grams carbs. Am 62 y/o female 37 years with RRMS & this is a life changing way of eating for me. Very similar to Dr. Terry Whals diet, but I found lots of support groups & recipe web sites help me stay on program.

Don Senger avatar

Don Senger

Hi Cathy,
I am writing in the hope of encouraging you and your readers to learn about the Nrf2 Cell Defense Pathway. This internal defense pathway is the body’s natural defense against oxidative stress, and poor Nrf2 function has been linked to a multitude of health problems that include neurodegeneration. In particular, the relationship between oxidative stress and MS was highlighted recently in an article published in MS News Today:
And an earlier MS News Today article reported on “Antioxidant Therapies Seen as Promising Approach in Treating MS and Like Diseases”:

There are thousands of research publications on the Nrf2 Cell Defense Pathway, but unfortunately it hasn’t yet made it into mainstream consciousness. Nonetheless, there are clear connections between oxidative stress and MS.

There are also direct connections between Nrf2 function, the modern diet, and bacteria – particularly the plant lactobacilli that our ancestors got from traditionally fermented foods and beverage. These natural probiotics produce Nrf2 activators that strongly support Nrf2 function. But they are no longer available in modern foods like those in a typical Western diet. The absence of these natural probiotics in our modern diet has profoundly negative consequences for Nrf2 activation, resulting in increased oxidative stress and a variety of potential health problems. For published research on how our modern diets have “starved” Nrf2 and our best defense against oxidative stress see:

Finally, an approved drug used in treatment of MS has been shown to be an Nrf2 activator, although not a natural one like those produced by the lactobacilli found in traditionally fermented foods. See:

Diane avatar


Hello, I was diagnosed with SIBO in June, 2019 and following a low FODMAP diet, no fructose (including no fruit), no gluten, dairy, or sugar and certainly no alcohol. With this change plus my functional medicine nurse practitioner's plant-based anti-microbial protocol, SIBO is controlled. However, I am having neurological symptoms which may be connected to MS or other neurological auto-immune disease. If anyone has a recommendation for the best doctor for me to see for a diagnosis, I would appreciate it. I find it difficult to find any doctors who get beyond the basics of the diagnostic process and most do not seem to be problem solvers. I am in Michigan but will travel anywhere in the country for the right doctor. Thank you.

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