Gut Maintain (IBS-D)
The step that decides whether your Gut Repair-4 IBS-D result lasts. A daily probiotic and therapeutic-yeast pack designed to be taken for a minimum of 6 months after the 28-day Repair-4 program — because supplemented probiotic strains begin to decline within 7–10 days of cessation, and the IBS-D pattern (low diversity, barrier dysfunction, pathogen overgrowth) reasserts itself without ongoing support. Built to be reordered every 2 months, no thought required.
Eradication is half the job. Maintenance is the other half.
Gut Repair-4 IBS-D clears the pathogens, calms the barrier, and reseeds the diversity your gut was missing. It cannot, in 28 days, make those colonisations permanent. Research consistently shows that supplemented probiotic strains begin to decline within 7–10 days of cessation — and the IBS-D pattern (low diversity, barrier dysfunction, pathogen overgrowth) is the steady state your gut returns to without ongoing support.
Daily maintenance is the difference between rebuilding and rebuilt. Diet alone does not provide the concentration of beneficial organisms required to hold the gains made in Phase 2 — and the IBS-D barrier needs continuous support while it heals. Daily targeted supplementation bridges that gap until the microbiome and the barrier are self-sustaining, which takes months, not weeks.
Gut Maintain IBS-D is built to be the easy answer: a high-strength daily probiotic plus a therapeutic yeast, reordered every two months for at least six months. Nothing to think about, nothing to deviate from.
Two daily components. One ongoing routine.
High-Strength Daily Probiotic
Lactobacillus + Bifidobacterium species (30 capsules — 2-month supply, dose per Microbiome Doctor's protocol)
A high-strength daily multi-strain probiotic chosen for the IBS-D terrain — Lactobacillus and Bifidobacterium species that have demonstrated stool-form normalisation, urgency reduction, and barrier support in controlled trials. Holds the rebuilt diversity in place after the more intensive Phase 2 dosing.
Daily — keep the right bugs where the wrong ones used to dominate.
Therapeutic Yeast
Saccharomyces boulardii (60 capsules — 1 per day for 2 months)
Saccharomyces boulardii is a non-colonising therapeutic yeast with a specific evidence base in diarrhoea-predominant gut conditions — it competes with diarrhoea-driving pathogens, supports the gut barrier, and modulates the local immune response. Used continuously through Maintain to hold the conditions established in Repair-4.
Daily — protect the barrier and crowd out pathogens.
Maintain the Conditions That Worked
Continued GutBiome Restore Diet principles + adequate hydration + steady meal timing
Probiotics need substrate, and the IBS-D barrier needs time to recover. Continue the dietary and meal-timing patterns established in Repair-4 — staged fibre reintroduction, sustained hydration to replace fluid losses, and consistent meal spacing. Reintroduction of restricted foods happens gradually, under your Microbiome Doctor's oversight.
Daily — feed the flora and protect the barrier.
Why six months is the minimum.
From Repair-4 to durable remission.
Transition straight into Maintain.
Order at the start of Week 3 of Gut Repair-4 IBS-D so the first 2-month pack arrives before Phase 2 ends. The handover should be seamless — no gap, no waiting for symptoms to nudge you back.
Daily dosing + dietary continuity.
Take the high-strength probiotic per your Microbiome Doctor's protocol and one Saccharomyces boulardii capsule per day, with food. Continue the GutBiome Restore Diet™ principles, staged fibre reintroduction, and the meal-timing patterns from Repair-4. Reintroduction of restricted foods happens gradually under clinical oversight.
Re-test your gut microbiome.
Repeat your gut microbiome test at the 6-month mark to validate diversity improvements, confirm pathogen levels have returned to within reference range, and decide — with your Microbiome Doctor — whether to step down, continue, or extend Maintain further.
Questions, answered.
Do I have to finish Gut Repair-4 IBS-D before starting Maintain?
Yes. Gut Maintain is designed as the step that follows the full 28-day Repair-4 program — Phase 1 eradication + Phase 2 rebuild. Starting Maintain without first clearing pathogens and reseeding diversity means dosing daily probiotics into a microbiome that's still dominated by the wrong organisms. Complete Repair-4 first, then transition directly into Maintain at the end of Phase 2 with no gap.
Why six months minimum? Can I stop earlier if I feel fine?
Feeling fine is not the marker — sustained microbial diversity and barrier integrity are. Supplemented probiotic counts begin declining within 7–10 days of cessation, and the IBS-D pattern (low diversity, barrier dysfunction) can re-establish before symptoms return. The 6-month minimum exists because that's the timeframe over which the rebuilt diversity consolidates and the gut barrier heals to a self-sustaining baseline. Stopping earlier is the most common cause of recurrence we see in clinic.
How do I take the two components each day?
Take the high-strength multi-strain probiotic per the dose specified by your Microbiome Doctor, and one Saccharomyces boulardii capsule per day, with food. Most patients dose both with breakfast for consistency. Your digital Maintenance Guide includes a worked daily schedule plus hydration and fibre-reintroduction prompts.
When should I order my next 2-month pack?
Order your next pack 1–2 weeks before your current supply runs out so there's no gap. The product is set up to be reordered every 2 months across the 6-month minimum maintenance window — three packs back-to-back. Most patients set a calendar reminder at week 6 of each pack.
Are there any allergens or precautions I should know about?
The therapeutic yeast (Saccharomyces boulardii) is a live yeast — generally well tolerated, but it should not be used in patients who are severely immunocompromised, who have a central venous catheter, or who have a documented yeast allergy. Discuss any of these with your Microbiome Doctor before starting. The probiotic capsules are dairy-free; review allergen labels before starting.
Can I take this if I'm pregnant or breastfeeding?
Discuss with your Microbiome Doctor before continuing in pregnancy or breastfeeding. The probiotic strains in this maintenance pack are generally considered well-tolerated, but supplementation in pregnancy should be supervised — and dietary support alone may be the more appropriate approach during this window. Do not start or continue without clinical clearance.
What about diet during Maintain?
Continue the GutBiome Restore Diet™ principles from Repair-4 — staged fibre reintroduction, adequate hydration to replace fluid losses, and the meal-timing patterns established in the program. Reintroduction of any foods restricted during Phase 1 happens gradually under your Microbiome Doctor's oversight, usually beginning after the 6-month re-test.
Should I re-test at 6 months?
Yes. A repeat gut microbiome test at the 6-month mark objectively validates diversity improvements, confirms whether pathogen levels have returned to within reference range, and decides whether to step down, continue Maintain, or extend further. Symptoms alone are an unreliable guide — testing is the only way to know.
Important — general advice only. Information presented on this page is general health information and is not personal medical advice. Always consult your treating practitioner before starting any new supplement, particularly if you are pregnant, breastfeeding, immunocompromised, or taking prescription medications.
Therapeutic yeast precautions: The Saccharomyces boulardii capsule is a live yeast and should not be used in severely immunocompromised patients, patients with a central venous catheter, or those with a documented yeast allergy. Consult your Microbiome Doctor if any of these apply.
These products are listed complementary medicines and are not intended to diagnose, treat, cure, or prevent any disease. The Microbiome Clinic has no commercial affiliation with any specific supplement brand included in this protocol — supplements are selected on the basis of clinical evidence alone, in line with the Microbiome Clinic Independence Guarantee.