As I explained in a previous post, I got diagnosed with SIBO in December 2017 after years of not knowing what was wrong with me. Now, I’m going to tell you exactly how I treated my SIBO, how things are going six months after treatment, and what I would do differently.
Medications I Used When I Treated My SIBO
Depending on who you ask (doctor, naturopath, or dietician) you may get some very different answers for how to treat SIBO. There are pharmaceutical antibiotics, natural antibiotics, or the elemental diet. Not to mention countless other supplements, diets, or protocols that people swear by.
My gastroenterologist trained under Dr. Mark Pimentel, one of the foremost SIBO experts, at Cedars-Sinai Hospital in Los Angeles. His approach basically mimics what Dr. Pimentel recommends. I had read up on this protocol beforehand, so I was pleased when my doctor recommended it without me having to educate him.
My doctor prescribed me a 14 day course of the antibiotics Rifaximin and Neomycin. My breath test showed both hydrogen and methane, and this combination is very effective when treating both. Using Metronidazole instead of Neomycin also been shown to be effective.
I took the Rifaximin three times a day in 550mg doses for a total of 1,650mg per day. The Neomycin I took twice a day (morning and evening), in doses of 500mg for a total of 1,000mg per day.
I set a timer on my phone to remind me to take them, because it’s a lot of medication to be taking all the time! I also found it pretty annoying to have to remember to take the bottles with me when I went to work.
Supplements I Used During Treatment
During the antibiotic phase, I only used one additional supplement, a prebiotic called Partially Hydrolyzed Guar Gum or PHGG.
Prebiotics are starches and fibers that act as food for the bacteria living in our intestines. PHGG, made from guar beans, mainly consists of a starch called glucomannan.
While “partially hydrolyzed” makes it sound a little scary, this process means that unlike normal guar gum, PHGG is much less gummy. This makes it easier to digest and won’t block you up like some other fibers.
I was very nervous about taking a prebiotic fiber because I haven’t had good experiences with fiber before. As I’m sure some of you know, they can make you very gassy and uncomfortable and either slow things down or speed them up too much!
However, I read a study of SIBO patients comparing those solely taking Rifaximin with those taking Rixfaximin and PHGG. The study found that patients who took 5g of PHGG had a higher rate of eradicating SIBO than those solely taking Rifaximin. The group taking Rifaximin and PHGG eradicated SIBO in 87.1% of cases, while only 62.1% of patients taking only Rifaximin eradicated their SIBO.
That’s a pretty big difference in success! I really, REALLY wanted my SIBO to go away, so I decided to take the PHGG. I figured I would just endure whatever unpleasant symptoms it might cause temporarily while I treated my SIBO.
As it turns out I tolerated it very well. PHGG mixes super easily into either hot or cold drinks with no grit or taste. I just mixed it into my tea and didn’t have any side effects. In fact I think it actually helped my digestion a little!
You can find PHGG very easily on Amazon. This is the one I took as it specifically said it’s ok for SIBO, but you can also find others on Amazon.
What I Ate During Antibiotic Treatment
Often people ask if they should be on a low FODMAP diet while taking antibiotics for SIBO. NO!
As Dr. Pimentel and other experts have explained, antibiotics work best when the bacteria are actively replicating. This is when the medicine enters the bacteria to destroy them.
So, you want to keep the bacteria happy and well fed while you’re on antibiotics. This means continuing to eat FODMAP containing foods like bread, fruits, etc. Don’t go crazy and eat donuts all week, but continue to eat a balanced, healthy, FODMAP-full diet.
My doctor told me that after I had completed the antibiotics, I needed to follow the low FODMAP diet for six weeks. So I was more than happy to enjoy FODMAPs while I still could.
How I Felt During Antibiotic Treatment
I had read a lot of scary stories about how terrible people felt on antibiotics while treating their SIBO. As it turns out, I had a relatively easy time on the antibiotics.
The first few days I was very gassy and my stomach felt pretty rumbly. It kind of felt like I had indigestion for a few days, basically. I also noticed that overall I felt a little tired and out of it.
After the first few days though, I started feeling better and better. Before the treatment, I had gotten so used to my stomach being bloated for years that I had apparently forgotten what I looked like when not bloated!
My digestion also became lot more regular. I thought, is this what having a normal digestive system is like?! It had been ten years since I had developed SIBO, so I’d forgotten what that felt like before I treated my SIBO.
I was almost sad to finish the course of antibiotics because I felt so great.
I also knew that the next phase of treatment involved eating a low FODMAP diet for six weeks. I’d done the diet before and knew how restrictive it was, so I was sad to stop cramming my face full of carbs and yummy FODMAP foods. But once I treated my SIBO, I wanted it to stay away…far, far away.
My Post-Antibiotic Diet
After the antibiotics, I did (and still continue to do) several things to try and keep the SIBO from returning.
First, like I just said, I followed a low FODMAP diet for six weeks. I followed it fairly strictly although I did drink moderate amounts of wine and beer. I really dislike the diet because it makes socializing so difficult, but I endured.
Fortunately the diet only lasted six weeks.
Long term, I continue to follow a number of maintenance tactics to hopefully keep me from relapsing.
Long Term: Prokinetics
Right after finishing the antibiotics I started taking a prokinetic. Prokinetics drugs stimulate the migrating motor complex to do its job properly and clean the bacteria out of the small intestine.
I take a low dose of Erythromycin. Erythromycin, you say? Isn’t that an antibiotic?
Yes, but it doesn’t have antibiotic properties at such a low dose (I take 62mg, which means I cut up the 250mg tablets into four!). Other prokinetics include Low Dose Naltrexone and Resolor. Resolor supposedly works very well, but isn’t available in the U.S.
In addition to Erythromycin, I also take an herbal prokinetic, Iberogast, that my doctor ok’d. Iberogast is a mixture of 9 herbal extracts that acts as prokinetic. I’ve found it seems to help with nausea and indigestion as well. I take 20 drops of it in the morning and at night.
Iberogast tastes slightly medicinal, and I don’t like to put it in water for that reason. I prefer to mix it into my ginger tea. For some reason the ginger masks the flavor of the Iberogast really well. As a bonus, ginger also works as a natural prokinetic and digestive aid.
I order my Iberogast from Amazon as it’s the cheapest place I’ve seen it for sale.
So, how am I doing six months after I treated my SIBO?
So far, I’ve been really pleased at my improvement so far. While it’s not like my digestive system returned to “normal,” it is significantly better.
I don’t expect I will ever feel 100% “cured” but I have only had a couple bad days since taking the antibiotics. I’ve only taken Imodium twice and haven’t felt like I needed it at all otherwise.
The thing that feels least improved is that I sometimes still get cramping stomach pains. In particular, this tends to happen after I haven’t had a good night of sleep. I recently wrote about how I’ve improved my sleep, and you can read about it here.
As for diet, I mostly eat whatever I want now. However, I avoid beans and legumes out of an abundance of caution. I avoid artificial sweeteners when possible as I’ve heard they impair the migrating motor complex. I tend to avoid gluten when practical, but I definitely eat it sometimes.
I have not redone a breath test since treatment, as my doctor prefers to go by symptomatic improvement instead. If I had to guess, I think I probably still have some inappropriately located bacteria, because my initial levels were super high. But given my improvement, there’s not enough reason to warrant more treatment right now.
My plan is to continue taking a prokinetic, probably forever, as there doesn’t seem to be any downside. I am interested in switching to Low Dose Naltrexone as it has immune system benefits, but I haven’t done that yet. Has anyone had experience with LDN? If so I’d love to hear about it in the comments.
Last Words
Given that I’d had digestive problems for a decade with no answers or improvement, I consider myself extremely fortune that I accidentally found a doctor who knew the favored protocol for treating SIBO.
I’m also very fortunate I tolerated the antibiotics so well and that they seem to have largely worked.
Of course, I’m aware that often SIBO comes back and generally is a chronic condition. While I still manage mine on a daily basis, right now it feels like largely preventative measures. Hopefully it stays that way!
Do you have any questions about how I treated my SIBO? What have you tried to treat your SIBO? Let me know in the comments!
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Could you write what you ate for a typical day’s meals for breakfast, lunch, dinner, etc? What were good things to eat?
Hi Sue, you can read more about the low FODMAP diet online (just google low FODMAP to get ideas for shopping lists, foods, etc.). Generally, I would eat eggs, bacon, and hash browns for breakfast, or a low FODMAP cereal (like Mesa Sunrise or Gorilla Munch) with low FODMAP fruit like tangerines or strawberries. For lunch and dinner I would usually have some kind of protein like chicken or fish, sometimes rice, salad, or greens like kale or swiss chard. Here is a good resource for learning more about what foods are low FODMAP: https://www.monashfodmap.com/i-have-ibs/starting-the-low-fodmap-diet/
Hope that helps! Good luck!
Did you take the partially hydrolyzed guar gum at the same time as your meal? This is how my ND said to do it but I feel super full even before I take a bite of food. And on the package it says to take 2 hours apart from any medications. I am on Rifaxamin and Neomycin. Thank you.
Hi Fabian, if my memory is correct I took one dose in the morning shortly before breakfast and the other one sometime before bed. I didn’t specifically attempt to take them with meals although I probably ended up taking them around breakfast and dinner anyways.
I’m dealing with the same thing pending confirmation although my symptoms match M- Sibo , I think it’s called something else now idk. 1) how are you doing now? 2) have you ever used ATRANTIL? My thoughts on this condition are there is no such thing as a quick fix, that said that particular nutraceutical supposedly preformed very well in 2 clinical trials including one where the criteria to participate was multiple failed therapies. Most of these folks had the harder to treat Methane version although the bacteria that produce methane consume hydrogen then convert it to methane. I surmise anyone with Methane sibo also has hydrogen overgrowth to one degree or another. Hope you are doing well
How long did you take the ethromycin for?
Has anyone tried probiotics after taking Rifaximin? I’ve just finished my first 14 day course and still having diarrhea and I usually take a 50 billion culture probiotic but I got a 100 billion one to try after treatment. Does anyone know if they recommend taking these for sibo or will some good old fashioned yogurt a couple times a day do the trick and help get things balanced better again. Thanks. Marie
Marie, check out my post on probiotics and SIBO. They may do more harm than good. I would ask your doctor about them.
Very interesting
No! No! No! Most probiotics contain the causative bacteria (lactobacillus and bifidus, most commonly) for SIBO. Unless it’s an SBO (Soil Based Probiotics), avoid it! Look for probiotics with ONLY the following: bacillus clausii, bacillus longum, bacillus coagulans, bacillus subtilis. Other strains do more harm than good by populating the problem-causing bacteria. The goal is to eliminate the problem NOT increase their population!
I just watched a video conference with Shivan Sarna and Kiran Krishnan. He recommends soil or spore based probiotics after having SIBO. I always thought probiotics were good but apparently it depends on what is in them as some can make SIBO worse. You should Google him, He’s an expert. Maybe see if you can check this out. https://wellnessmama.com/podcast/219/#:~:text=Kiran%20Krishnan%20is%20undisputedly%20one%20of%20the%20world%E2%80%99s,dozens%20of%20human%20clinical%20trials%20and%20human%20nutrition.
Marie,
Saccharomyces boulardii is a probiotic yeast used to treat and prevent diarrhea associated with gastrointestinal disorders and antibiotic treatments.
No prescription needed. It can be purchased over the counter. Medical doctors have been recommending the Brand Florastor that has the probiotic saccharomyces boulardii. Here is a link below that gives more details:
https://www.medicinenet.com/saccharomyces_boulardii/article.htm
Marie,
Bismuth is in the brand of Kaopectate and Pepto Bismol that kills the bacteria that causes diarrhea.
If you are sensitive to dyes and other ingredients, Kaopectate in pill form is best because it does not have the pink dyes like Pepto Bismol. Also, if you are very sensitive to other ingredients you can have a compounding pharmacy formulate it for you with less ingredients.
Hi Emily!
Would you be able to share the name of your Dr.? I’ve been struggling with Sibo, on so many different diets and antimicrobials that aren’t working. It’s so demoralizing. I’d love to talk to your Dr. as I’m in SF as well and see if the route you took would work for me.
~Leanne
Hi, I think I may have sent you an email but in case I didn’t – Dr. Nikhil Agarwal, at Sutter health is great.
If you are worried that SIBO can come back you need to take a course of biofilms. Biofilms will dissolve the outer thin layers of hidden bacteria or microbes that they were resistant to the antibiotics and slowly starts to eliminate the bacterial debrese.
Thank you. Great info
Thanks for reading!
Do you mind me asking who your doctor was and where he/she is located?
I go to Dr. Nikhail Agarwal, in San Francisco. So far so good with him!
Did you take Glutamine after your treatment to heal your gut?
I had tried Glutamine before I learned I had SIBO (when I thought I had IBS and didn’t know what the problem really was). It didn’t seem to do anything for me then. I haven’t tried it since.
Hi, Thank you so much for posting this!!! So you took the Iberogast at night and morning. Did you take the Erythromycin at a specific time?
Hi Inna, I just took it before bed, not at any specific time. Same with the iberogast, I just put it in my evening up of ginger tea. Thanks! Hope it helps.
Hi, Thank you for posting this!!! So you took 50mg of the Iberogast at morning and night. Was there a specific time you took the Iberogast?
I’m confused. I have hydrogen dominant SIBO, with occasional urgent diarrhea. I haven’t quite figured out about prokinetics. I’ve been enjoying my morning ginger/peppermint tea, but if ginger is a prokinetic, a motility encourager, perhaps I shouldn’t be drinking it in the morning when my symptoms are worse. Prokinetics for SIBO with constipation?
So, prokinetics do not cause diarrhea any more than they cause constipation really. They are not the same as laxatives. Prokinetics help restore the normal smooth muscle contractions than SIBO messes up, which causes both constipation and diarrhea. My understanding is that the difference between constipation and diarrhea is caused more by the type of bacteria that is overgrowing. So, prokinetics should not make it worse. I drink ginger tea with Iberogast pretty much every morning!
I appreciate you taking the time to tell us your story. So many of us are suffering and I’m sure this has helped many. Thanks.
I hope it helped or at least made you feel like you’re not so alone! Thank you!
This is so helpful, thank you Emily. How much of the guar gum do you take daily and when? Thanks!
Thanks So much. I am starting Xifaxan for 14 days on Monday. When and how much PHGG did you take? I have read to take 5grams daily for 10 days, but they never say what time of day or whether to take it with an xifaxan dose or not. Also what times of day did take the Xifazan? Thanks again I’m trying so hard to get this right and get my life back.
I took 5 grams of PHGG, divided up into 2 doses, one in the morning and one at night. No particular reason I took them in the AM or PM though, I’m sure you could take it all at once probably. I don’t recall what time of day I took the Xifaxan, I want to say it was divided up into a morning, afternoon, and evening dosage. Best of luck!
Thanks for your blog. The two foremost SIBO experts are Siebecker and Pimentel. Siebecker has a great site with lots of information and guidance and can be found at siboinfo.com. You got lucky that your doctor studied under Pimentel. I end up with some putz so I ended up treating myself. What low fodmap diet did you follow? Was it Pimentel’s Cedars-Sinai SIBO Diet?
Thanks again.
Ray
Yeah, unfortunately most doctors just aren’t up on the latest SIBO information, if they have even heard of it it at all. I followed the normal FODMAP diet, not Dr. Pimentel’s. I’m not sure which is better or if there is any advantage of one or the other though. I think as long as you stay away from high-fermentation foods for a while that’s the main goal, and there are likely many ways to achieve this.
How are you doing now? What do you do to prevent relapse of Sibo?
I am still doing pretty well, although some recent medication changes have been affecting my stomach lately. I will be doing a more thorough post on how I’m doing soon so look for that! To prevent relapse I take prokinetics (Iberogast and erythromycin) and try to avoid things that trigger my digestion, which isn’t a lot (coffee / caffeine, ice cream, fried stuff).
Is it good to take a prokinetic while taking xifaxan or after I am done with it? I’ve been reading conflicting things about this.
I took one after. I don’t think there’s any harm in taking one during your antibiotic treatment though. I would check with your doctor to be sure.
Good luck!
Hi thank you 🙏🏻 so much for wonderful information. I have sibo/ dirreha for last seven years, I am on erythromycin they are many things I can’t eat I get relapses in between the treatments, I was wondering the prebiotic PHGG you mentioned is good for my condition?my concern is don’t want to have more dirreha.
Thank you so much.
Good, basic, simple information. Thank you! There is so much on FB and on line. Gets VERY confusing. I’ve done similar things and I am better and as you say, not perfect, but have been able to add so much back into my diet.
You’re welcome! I’m glad you found it useful and have been able to expand your diet.
Do you take PHGG at the same time? Because it says on the product to not take it until 2 hours before or after medication.
Ralf did you ever find out the answer to this?
First, I want to thank you for sharing your story and yes for letting us know we are not alone, but more importantly giving us hope that there can be a light at the end of the tunnel. SO THANK YOU! Last year, I was diagnosed with SIBO methane dominant. From everything I have read either you experience diarrhea or constipation. Mysteriously, I have experience neither. Regular bowel movements ever sense the diagnosis from another practitioner that it was methane dominant SIBO. While I am thankful to experience neither, I am confused as to why neither symptom is experienced. However, I do experience bloating, gas, bad breath, and occasional slight burning below middle of ribcage. My first indication of SIBO was after eating a breakfast sandwich from local diner. Since then, I have had the symptoms. I’ve read SIBO can be brought by food poisoning. Subsequently, I had two unsuccessful treatments with Xifaxin. I later found out that Xifaxin does to work on SIBO methane dominant, neither did my old practitioner. New practitioner gave me a choice herbal or prescription antibiotics. I have been on herbal antibiotics for 16 days with another 14 days left. Sometimes I feel better other times it feels the same. I keep hearing herbal take longer. If this does not work I will take the combination of Xifaxin and Neomycin followed up by LOWFOD MAP Diet for a minimum of 2 weeks. My new practitioner has not said anything about Prokinetics, but I am definitely going to mention them, and ask when I can take them. My main concern is that SIBO is the secondary issue and if I do not get to the root cause of the condition, I will be constantly trying to stop reoccurrences. I have read that if a slower motility is the causes that it can be improved with prokinetics.
Hi Theo, I also never experienced a change in bowl movements – just gas and bloating, but my breath test results sure did show methane dominant SIBO!
Hi Mallory,
Thanks for the response. The herbal antibiotics are wearing me out. I have 10 more days of taking 14 pills a day. Not feeling much better. Most likely I will have to take Xifaxin and Neomycin. it sounds like you took both for 14 days. My doctor prescribed14 days Xifaxin and 10-14 days for Neomycin. Prior to successful treatment, did you have any discomfort, like slight radiating below the middle of your ribcage? CAT SCANS with and without contrast and Ultrasounds were negative. Blood test for celiac and thyroid issues were negative. It is that same feeling I felt when after eating the infamous sandwich that lead to the onset of what turned out to be SIBO. But its always in the same location. right underneath ribcage (middle). I am wondering if there is a correlation between this feeling and the onset of SIBO,,,, Also, while my doctor has not mentioned prokinetics, I agree there are benefits particularly for improving motility. So, I am going let my doctor know that I plan to take them while on low fodmap diet and then she can let me know if she prefers that I not take them and explain why. Again, thank you for sharing your story. I pray that I, too, can get to the other side like you.
I
I’ve had a similar problem in the middle area. There or further to the right. I suspect it’s bacterial, as when I started antibiotics, it went away, plus I’ve also had suspicions (as my doctors looked stupid) that somehow I had some sort of “infection” in my bile ducts, something else that’s stopped! One word of advice. Don’t let your doctor decide too much. Get educated in every way you can. You know your body. Follow your instincts or, duh, “go with your gut.” I’ve had a lot of practitioners, if they aren’t fully educated on something, who simply say “Don’t do that.”
Hi,
Thank you for the response. I agree with you. I suspect that it is the bacteria from gut as well. My physician said that that area is where the stomach meets the small intestine. That makes sense given SIBO is in the small intestine. You are right, we have to go with our GUT. Some doctors really do not know and will subject patients to whatever treatment and procedure that comes in their head, with nothing to support it. I am on herbal antibiotics and now have whats called black tongue. I have gone to my general practitioner and he said its nothing serious and could be related to the herbals. Immediately contacted my GI said she never had anyone have that side effect. I go on line, and it says that some herbal antibiotics can cause black tongue. I have an appt with Ears, Nose and Throat doc next week. What’s crazy is that it brushes off the tongue with a toothbrush.
Theo
Hi Theo,
Sorry to hear your herbal protocol is not helping, but it definitely sounds like you have other good treatment options to try. I do not experience pain below my rib cage or elsewhere in my stomach really.
I have not yet been treated successfully for SIBO. Like you, my doctor didn’t know that Xifaxin + Neomycin is the best way to treat methane SIBO. I underwent Xifaxin-only with lackluster results. I’ve since found a doctor who at least knows that there are different ways to treat SIBO based on whether you are a methane-producer. Hoping he will prescribe me Xifaxin and Neomycin next week!
Hi Mallory
Interesting that you have no pain, or discomfort below your rib cage in the middle. Mine is not all the time. A couple other folks that post on the site, stated they experienced the same discomfort in that area, but once prescribed the right meds, the discomfort, cramping, bloating went away. I guess symptoms can be different depending on the individual. I hope you are prescribed what will heal you. Thank you for the response.
Theo
Hi Mallory, I hope your new doctor has prescribed you the right antibiotics that will help you! Keep a positive attitude and let us know how it goes. Best of luck and I hope you feel better.
I also have that feeling in the middle under the rib cage, I describe as a thumping, beating, happens when something goes in or at any time of day. You are first that has mentioned it. I don’t have a movement issue, normal no D or C, have done the Xifax. and herbal and am not better, going again to see GI, ready to try ED but too thin. Have you gotten and answer to that Feeling?
the anonymous message sent on April 10, 2019 at 1:42 is from Theo to Mallory
Theo
Mallory,
Did you ever have a comprehensive stool test performed for parasites?
Theo
Thank you so! You cannot imagine how valuable your words are in aligning my universe! I’m, literally, DECADES (broken medicine) into undiagnosed bacterial overgrowth–a duh, considering most of my childhood NON-STOP on antibiotics–and your experience is so valuable. How do I find a Pimental-trained doctor in my area? New Mexico,
I do not personally know of Pimental-trained doctors in New Mexico, but I haven’t looked either. I have seen a list someone put together of SIBO doctors, I will have to see if I can find it again.
Great question Kathleene. So, how do I also find a Pimental trained doctor in my area? Maryland
Theo
You will probably have to fly to Beverly Hills to see him or you can fly to Oregon to see Siebecker who treats the same way. Other than those 2 it will be hard to find some one competent.
Thanks for the information.
Theo
Hi Ray,
Thanks for the response. After reading your response, I called Dr. Primental Office and got a recording stating that he is not taking any new patients. I heard this same response from another leading SIBO GI doctors on the east coast. Its tough finding a GI that even bring up the possibility of SIBO being the cause of discomfort let alone knows how to best treat it. You are right, it is extremely hard to find someone competent. I hope you and everyone on this blog get well and STAYS WELL!!!
Theo
I’ve been good for about 4 months now but won’t be in the clear until the 12 month mark as SIBO has a high relapse rate the first 1yr. I ended up treating myself as the two main doctors were not accepting new patients. I gathered enough information from these two doctors from online sources and created a treatment plan for myself. I flew down to San Diego, went over into TJ and got 2 rounds of meds (4 weeks total). Before my 1st round my numbers were at 28 hydrogen and 13 methane. After the 1st round I took a breath test that I purchased online for $300.00 (it was home kit) and a week later I got my results. Hydrogen was now down to 12 and methane at 8 but still had some mild diarrhea but no high fodmap symptoms. I waited 4.5 weeks (during which I was on a low fodmap diet) and did the second round. After the second round my numbers were 7 hydrogen and 2 methane which is considered a negative test result for SIBO. I don’t recommend this route to anyone but I was desperate and there was no way I was going to live like that. Plus during my research I learned that the longer you have SIBO the more damage it does to the lining of your small intestine to the point that you may never recover. There was no way I was going to let that happen and I already had SIBO for 9 months….too much to risk. I received no help from my gastro doc as he didn’t know much about SIBO. I was skeptical about the quality of the Mexican drugs but the box stated the Rifaximin was made in Italy and the Neomycin was made in Mexico but the Mexican drug company had been around since 1965. I felt confident about the quality so bought them for about $350 for the two rounds. And luckily it worked out. I’m taking a prokinetic now (ginger capsules) and 3 more months on this and I will be done. I can totally empathize with everybody here and I feel your pain. I wish you all luck on your healing efforts.
I commend you for taking matters into your own hands. It appears we have to be our biggest advocates and some cases only advocate. I just finished 30 days on herbal antibiotics (14 pills a day). This is a brutal regime. I do not have to be a doctor to know it’s harsh on a lining that was already compromised before ingesting the herbal antibiotics. What’s crazy is that for first three weeks still felt bloated, full, and gassy after only eating dinner. Did not experience symptoms after breakfast and lunch after the first week on herbal antibiotics, just after dinner. Then last three days on treatment, I stopped feeling bloated and full after dinner, almost forgot what it felt like to feel good. But I qualify this statement by saying my stomach still feels sensitive/raw from, what I believe is taking over 400 herbal capsules. Next step now is low fodmap diet for at least 2 weeks then retest breath. If I still have it I will opt for pharma meds you took for 14 days. My doc said NOTHING about Prokinetics even after I asked via email. But like you, all the research leads me to believe they are a must after treatment. Particularly given that the majority of SIBO suffers underlying causes is attributable to slowed or impaired motility, which can be improved/repaired. Reading your story has encouraged me tremendously and thank you for sharing alternative sources for getting the meds. Hang in there, and everyday you wake up feeling better is a day closer to the 12 month mark, which you will achieve!!!
Theo
I tried the herbal route 1st for 3 months. I took something like 40 pills a day to no avail. They were really hard on my intestines and it was really hard to finish the program. Wasted 500 dollars and 3 months time. I could have been healed that much sooner if I had went straight to GI doc first. Most of the doctors out there pushing the herbal method of treatment are usually chiropractors and thus they are not able to prescribe medication so they tell you they can heal you on antimicrobials. I haven’t heard about 1 person being successfully healed by using antimicrobials and I’ve done over 150 hours of research and read 6 books on stomach/intestinal problems. That doesn’t mean they are not out there, I just haven’t seen it. I hope it works for you but I had no luck with it. Good luck with everything and try to heal yourself as fast as possible because the longer you have SIBO the probability of never fully getting rid of it increases.
Ray
Hi Ray, sorry to hear that herbals didn’t work for you, I hope you managed to find a SIBO literate GI who was able to successfully help you with antibiotics or otherwise. There are several peer reviewed clinical studies showing that herbals can be as effective as pharmaceutical antibiotics, however like you said, not everything works for everyone! Another aspect is that a lot of the time, repeat courses are needed (of either herbals or pharmaceuticals) to eradicate SIBO. I hope you are healing well and thanks for reading!
Hi Theo, thank you for reading and I hope your regime was successful. I definitely believe (just my opinion – I’m not a doctor however) that evidence and research shows that prokinetics are crucial for maintaining motility after the bacterial overgrowth is eradicated. The nice thing about prokinetics is that if your doctor refuses to prescribe one there are non-pharmaceutical options. I myself rotate between low dose erythromycin, which is prescribed, and iberogast, which is not prescription but does have research backing it as a motility agent. I rotate because erythromycin I have been told loses its efficacy after a while, so you have to take “vacations” from taking it so that it is effective again. So during those “vacations” I take Iberogast, or just when I’m feeling bloated / gassy as Iberogast tends to help with that. I hope you feel better!
Hey Ray, I hope you are still doing well as you get closer to the 12 month mark. I took your advice got the same round of antibiotics you used to get it out of me quickly. Be Well!!!
Theo
Theo,
Glad you were able to get a hold of some. This is guaranteed to work but you need to feed the bacteria with high fodmaps while you are on the meds. I was eating high fodmaps at every meal and by the time i was about 10days into it I noticed that I was no longer having reactions to the high fodmaps (meaning that the meds were working). I was eating the most powerful high fodmaps there are…raw garlic and raw onions. Rest assured you will be healed quite quickly. If you have any questions let me know. Good job.
Ray
Hi Ray,
I pray I have the same results. I am eating high fodmap meals with ingredients such as garlic and raw onions. Eating everything high fodmap to keep the little buggers happy and exposed. I am extremely happy you are still feeling well!!!! Are you taking any supplements, prokinetics and/or probiotics? I am still trying to find out what caused it. I am getting a number of test performed to try and narrow it down. If its something like low stomach acids, then I know I need to take HCL supplements. But I won’t know until I get tested. Want to be in count down mode like you..Counting the months till 12 months…Keep it going! Again, I very happy you are still feeling well!!!! As we have said before we have to be our biggest advocates . Thanks for offering to answer any questions I may have; much appreciated.
Theo
Theo,
Yes, I’m taking probiotics in the form of trader joes sauerkraut (in the refrigerated section) and master miso (also refrigerated section). Prebiotics I’m eating apples and oatmeal. I’m still taking 1000mg of ginger as a prokinetic and I have a couple of months left on that. You definitely need to find out what caused your SIBO otherwise it may keep coming back. Make that a priority. From what I read its mostly due to food poisoning (auto immune response), intestinal surgery, low acid production, ppi use, and an Ileocecal valve that is no longer functioning properly which allows bacteria to flow from the large intestine into the small intestine. Make sure you find out the cause of your SIBO. You should be feeling well before the end of your round of meds and make sure you get a breath test done within 5 days of ending your meds and make sure you are off prokinetics 2 days prior to the test as they can skew the results of the test.
Best of luck and feel well again.
Ray
Are you better now on Aug 19? after all this?
Ray, did you have to have prescriptions to get your meds in Mexico???
Yes, but from a Mexican doctor which are everywhere. I paid the doc 3 bucks, told him my symptoms showed him my breath test and told him what I wanted and he wrote the Rx. It’s been 18 months and I’m SIBO free and I stopped the prokinetics last December. The Neomycin was like 30 bucks and the other one was 300 bucks. Way cheaper than U.S. prices. Good luck to you.
Hi Ray. Your story is so inspiring. THANK YOU for sharing and empowering us all. Can I ask when you tried your 2nd round of antibiotics, did you go back to a high formal diet. It looks like you did very high fodmap for 1st round. then took a 4 week break and did low fod map diet and then did another antibiotic round..with high or low fodmap diet??
Did you take pro kinetics when you were on antibiotics or during your 4 week break?
THANK YOU again.
Theo, you may want to ask to speak with those doctors (or their staff) who are not taking patients and see if they can recommend another GI doctor for SIBO. They will often know of who else in the area is SIBO-literate.
Hello Ray, I just start my antibiotic treatment (Rifaxamin & Metronidazole) an hour ago. Can you share with me your time schedule for when you took the antibiotics? I’ve read previous studies where they took them at 8:00 am, 2:00 pm and 8:00 pm but the antibiotics state to take them every 8 hours? Just curious at what times you took them? Also, I am researching a prokinetic for after I finish my treatment. I read that you took 1000 mg of Ginger. Did you take that once a day? What time? Did you take any other prokinetics with it? Lastly, do you mind sharing the brand you purchased? Different brands have different quality controls and such, I want to make sure I get one that works well. How long did you take the prokinetic? Thanks!
Hi Lynn,
I took 550mg Rifaxamin 3x/day at 5am, 11am and 5pm. The Neomycin 500mg I took 2x/day at 5am and 5pm. I did this for 2 weeks then took almost 3 weeks off and then did another cycle because my test still showed 11 hydrogen and 7 methane. The hydrogen was normal but the methane needed to be below 3. For a prokinetic I took Natures Way Ginger Root 1100mg at night before I went to bed(comes in 550mg capsules). I was on the ginger root for 1yr after my last med cycle. While on this treatment I also ate tons of high fodmap foods. The strongest ones are raw onions and raw garlic which I ate at every meal. I immediately started having reactions to the fodmaps but I kept with the program. After about 1.5 weeks into the first cycle I was no longer having reactions to the fodmaps which told me that the meds were working. That was the last time I had a reaction to high fodmaps and I still did the second cycle to just to get my methane under 3. So its been almost 2 yrs being SIBO free and I honestly don’t even think about it anymore and would like to forget about those days. I only had SIBO for 11 months before I killed it. I’ve read stories where people have had it for 7-10 yrs before they are diagnosed. By this time its too late as the SIBO does damage to the lining of the small intestine which ends up causing the SIBO to reoccur thus you really never get rid of it and just have to manage it some how. Luckily I caught mine early and hopefully you caught yours early. Good Luck.
Hi Lynn,
i forgot to mention that the whole reasoning behind taking high fodmaps while on the meds that you want the bacteria active so the medicine can get to them and kill them. If you are feeding them high fodmaps then they are active but if you are starving them of high fodmaps then they go into hibernation and the meds won’t be able to kill them.
Ray
Hi Ray, I can’t thank you enough for your timely and informative response! I read your message on the 25th and have been eating garlic and onions with every meal. I now have developed a gag reflex when I smell onions! haha I am on day 9 and have noticed less bloating today. However, I still have to complete the 14 day course of antibiocs and then continue on with the prokinetic. I may also get retested to see if this first round eliminated the Sibo. I have also ordered the Nature’s Valley Ginger you mentioned. I have had Sibo longer than you did so this may or may not help. However, I would do just about anything because I want things to get better. Thanks again, and have a great weekend!
I hope the info helps you. If you get retested make sure to do it within 5 days of your last day on the meds….this is per Siebecker’s protocol. And if you do get retested make sure you are off the prokinetic for 3 days prior or it will skew the test results…this is also per Siebecker’s protocol. Happy 4th and stay safe out there.
Hi Ray, So I’ll order an additional test tonight to retest. This is my first day off of the meds. I don’t think I got it all but I will retest. I had a quick question. Did you take the ginger supplements right after dinner? Or did you wait a few hours and take them right before going to sleep?
I took mine right before I went to bed…If I recall correctly, you have to make sure that when you take them that you haven’t eaten for the prior 1.5hrs or something like that. Hope you are feeling better.
Also you must take the ginger with a full glass of water rather than a couple of sips otherwise it has a tendency to not dissolve properly and you end up burping up ginger and it burns your throat. I ended up pulling the pill apart and dissolving it in 4oz of water then drinking it and had no problems.
Has anyone experienced black tongue as result of being on herbal antibiotics?
Theo
Theo,
How are you doing? Haven’t seen you on this board for a while. How are you stomach issues doing? Hope you are doing well.
Ray
Emily,
Again, thank you for sharing your story. How are you feeling now?
Theo
Hi Theo! I’m doing pretty well. I don’t think I will ever be totally “normal” or 100% but maybe no one’s digestion is ever 100% all the time. I’m going to do an update soon about how I’m doing and what I eat now, what I take, etc, to keep an eye out for that! Thank you for asking and reading. Are you doing better yourself at all?
Hi Emily,
Glad to read you are still doing well. Very encouraging! After 30 days on three different herbal antibiotics the methane levels went down, but still registered as SIBO. The herbal were tough, 14 pills a day. WOW. Although, I will say less bloating and cramping but still had a gnawing feeling from time to time. However, now I am taking Neo and Xif for 14 days. After this will start lowfod:, probiotics and prokinetics (so many choices, confusing). Look forward to your future post.
Theo
Hi Ray,
I glad you mentioned fermented foods such as sauerkraut and miso as probiotics. I was planning to include them, plus kimchi and kefir as a probiotic to rebalance the gut. Exactly when did you start taking the probiotics (i.e., sauerkraut and miso)? Was it immediately after finishing the antibiotics ? Or did you start a low fodmap diet after the antibiotics and at that time include the probiotics? In terms of motility, my doctor told me to use Motli Pro, which I found contains ginger. Are you taking straight ginger capsules or something else similar to Molti Pro that has ginger in it? I have seen ginger capsules. If so, I will take the ginger capsules instead. You are right on point about finding the cause. I am taking a test next week to check for the CdtB and Vinculin antibodies in my blood. Next week going to ask doctor to order tests to check pancreas enzymes and liver enzymes, and the Heidelberg stomach HCL Test. Doctor said, the ileocecal value looked normal on CAT Scans and Ultrasound. Looking and functioning are two distinctly different things. Also, I need to find out why I am still feeling a dull burning or slight gnawing sensation right below my ribcage. Earlier this year doc said maybe its the gallbladder, although CAT Scans and Ultrasound showed it look structurally fine. He order HIDA Gallbladder test. The HIDA Gallbladder test showed my gallbladder bile production and flow are normal. So, it’s not the gallbladder. The feeling is the exact feeling I had when I first starting experiencing the SIBO symptoms a year ago. Fortunately, during that time I had already scheduled a colonoscopy and endoscopy. Colonoscopy was fine. The endoscopy, however, showed acute gastritis. First time ever having anything show up an endoscopy. Now, its been a year and I am still feeling this dull, gnawing sensation. I feel it when I eat and when I am not eating anything. The area is where the stomach meets the duodenum. I am hoping its part of my small intestine that will be treated with the antibiotics. I am still going to ask a different GI to perform an endoscopy to see what, if anything is going on. I’ve read that gastritis can be associated with low stomach acid, which can lead to SIBO. The stomach’s HCL controls and kills bad bacteria in the gut. If low, the bad bacteria can then travel to other areas of the GI Tract, such as the small intestine. So, Ray you are absolutely right that getting to the root cause is a priority. Have to get to the root to avert a reoccurrence after treatment. Thank you and I appreciate your insight. The best to you, continue feeling well and I know you will meet and exceed your 12 month mark!!!!
Theo
Theo,
I’m taking ginger root capsules 1000mg/day as a prokinetic. Most of the other herbal prokinetics out there like Iberogast have ginger root as the main ingredient so I might as well just take the capsules. Plus Siebecker lists ginger root as an alternative to rx for prokinetic use. My problems started in late 2015 when I got gastritis which lead to an ulcer which I cured with ppi use (had 1 relapse). The ppi use led to SIBO which I just cured. Its been a long 3yr journey for me (now just turned 50 y.o.). I think what happened is that my body is just getting older and my stomach could no longer handle what I was putting in it. I just got my stomach and digestion back to normal except this time around I’m extremely careful with what I put in my mouth–everything in moderation. I had to give up coffee(caffeine) as that now seems to bother my intestines but It’s such a small sacrifice to get my health back. The gnawing feeling you are having sounds like an ulcer which is exactly what I experienced. But I could be wrong as I’m not a doctor. But those are the same feelings I had when my ulcer started. But for me the pain was in my upper rib cage as that is where the stomach is located. This was a peptic ulcer. There is also something called a duodenal ulcer which you might want to research. I didn’t start the probiotics until after I finished my second round of meds and even then I waited 4 weeks after that 2nd round to start it as I wanted to make sure the SIBO was completely gone and I was just basically following the Siebecker and Pimentel protocol to the T. Sounds like you might have something else going on in addition to SIBO. Stay on top of it, find out what it is and cure it. It might be causing your SIBO and it might need to be eliminated before you can move on to tackling SIBO. You seemed determined so I’m sure you’ll get control of it. Make it your number one priority, everything else is secondary.
Best of luck and keep me apprised.
All the best,
Ray
Hi Ray,
Thanks for your advice, it is very insightful and resonates with tons of info I read about SIBO.
Could you let me know where to find the Siebecker and Pimentel protocol?
I had my 1st round of Rifaximin, but was not told to be on High FODMAP by my consultant, which now explains why I felt some improvement but not great.
I am pretty sure I will need the 2nd round and I want to do it right this time.
I live in London and I do not think our GIs are up to speed with how to treat this condition.
Many Thanks,
Julia
Hi Julia,
Siebecker’s site has her protocol listed. Her site is http://www.siboinfo.com. Pimentel’s protocol is the same but he didn’t have a site at the time. I found his protocol on various video interviews he did on youtube and facebook. I hope you are able to defeat this disease.
Best of luck,
Ray
Hi Ray,
Thank you for a quick response. Just one more thing.
Is it important to wait 3/4 weeks between 1st and 2nd round of meds? Can the 2nd one be repeated after 1 week of the first one if SIBO is still there.
My Consultant suggested to take digestive enzymes (as well as pro kinetics, Iberogast) straight after the meds treatment. But with everything I read on the subject I didn’t come across the enzymes. Have you seen Siebecker or Pimentel recommending to take them?
And the last thing, I wanted to thank you so much for sharing your experience and wish I came across it earlier. I’m kicking myself that I wasted the 1st round of Rifaximin simply because I was not advised by any of my consultants the importance of High Fodmaps during the med treatment.
Best Wishes,
Julia
Hi Julia,
I waited about 3.5 weeks based on what the doctors recommended and because Neomycin is hard on the system. I also got retested within 5days of the end of my first cycle. I didn’t take any enzymes and if I recall correctly Siebecker nor Pimental didn’t recommend them. Taking the high fodmaps is critical during the treatment. I was eating them at every meal and by my 10th day on my first round I stopped have reactions to them and that was the last time I had reactions to high fodmaps. Most doctors don’t give any advice on food, they just dish out prescription (and ususally the wrong ones). You really have to be your own doctor when it comes to sibo unless you are going to Siebecker or Pimentel. After that I did one more cycle because my methane was still at 7 and it needs to be 3 or below. My hydrogen returned to normal after 1 cycle.
Good luck,
Ray
Hi Ray,
Thank you for your reply. Good to hear that there some positive cases, which means there is light at the end of the tunnel!
You are right about Consultants – I learnt that you need to check every word they say! I still in disbelieve that London’s most well known clinics are so backward on this.
Because of that, like yourself, I wasted lots of time and money on the wrong treatment.
Have you been taking the Partially Hydrolyzed Guar Gum or PHGG with the meds?
Best Wishes,
Julia
Hi Julia,
I haven’t had Sibo for 2.5yrs so I don’t give much thought to it anymore. You need to find out what the root cause was and if it was simple like mine(acid reducing medication) then it can be easily cured if you catch it quick enough. The longer you have it then the more damage it can do to the lining of the small intestine and at that point Sibo may become irreversable. When I started the meds I was taking Guar Gum but then realized that it’s just a High Fodmap like the raw onions and raw garlic I was eating with the meds and they both serve the same purpose. You can do one or the other but no need to do both. More wasted money on my part. I hope you can get it under control.
Ray
Hi Ray,
Thanks for all the info. It all makes sense, just need to put into practice. Such a relieve for you to be able to get rid of it. You hear a lot of scary stories from people, but I guess everyone is different and it seems that underlying causes can play a big part in this.
Thank you once again.
Julia
Theo,
How are you doing buddy? Here is a series partly on SIBO that starts tonight. You can register here and it’s free. I’m symptom free from SIBO but I may still watch it. https://digestionsos.com/gift/?affiliate=190
Hope you are doing well.
Ray
I am learning so much from this series, but no mention of the under the rib cage
can it just be small pressure from gas?
Ray,
I agree, I am going to follow the Seibecker and Pimentel protocol for prokinetics (1000mg ginger capsule per day at bedtime). Plus drink 2-3 cups of ginger tea, made with the root. Thank you for reinforcing the protocol. I also think after being on the lowfod map diet for 2 to 3 weeks, i’ll then start introducing fermented foods (i.e., sauerkraut, kimchi, kefir, and mosi). This should give my gut time to heal before introducing them. This goes counter to what my doc recommended. She said take probiotics while on lowfod map diet for at least 2 weeks. Then add the fermented probiotics during the food challenge phase of the low fodmap diet. Truth be told, it was my idea not hers to add the fermented foods. She so by the book, its scary. I really do not have a lot of confidence in her. To the point, I am switching to another doc on Wednesday, despite her prescribing the antibiotic treatment. She just not responsive. This other GI is very responsive and I recently found out he is very familiar with treating SIBO. The one thing I can say about the occasional gnawing feeling is that it has not increased in intensity; not gotten worse since last year’s endoscopy. Which make me feel (hope) it is not an ulcer. You felt something in the upper ribcage. Interesting. Mine is below ribcage, center. Its definitely not constant. I hoping as someone on this site posted that they felt the same feeling in the same area and it went away after the antibiotic(Neo and Xif) treatment. Right, I did read that PPI use can lead to SIBO and that gastritis can lead to it as well. Vicious cycle. But you beat BOTH!!! I also had to give up coffee, and occasional beer and other foods. I agree small sacrifices to make to get back a healthy gut. I should also mentioned that around 8 years ago I had and was successfully treated for H. Pylori. Which I recently found out can lead to SIBO as well. I recently tested (breath and stool) negative for H. Pylori. But who is to say it did not start the process of gut damage back then which lead up to this point. I am in my late 50s and agree that age might have contributed to me not being able to no longer tolerate certain food and habits which lead to SIBO. I honestly believe I got it from going through a stressful period, and skipping meals. There are many SIBO symptoms I do not like but the one I really dislike is the robbing of your nutrients. This makes me weak. I have a family member and a friend who had SIBO both said they felt tired all the time from SIBO. For me, I also think the previous round of herbal antibiotics ( in late March 2019) made me tired as well. Heard they can have that effect. So a double dipper for me. Did you ever feel tired? Continue to be well and keep on counting!!!! I will keep you apprised and please do the same. I am very encouraged by your success!!!!
Theo
Next week I am starting the exact same protocol as you did and have already purchased my PHGG because I also read the study where patients had greater success when taking it with their xifraxin and neomycin. I’m excited to start the antibiotics but worried about getting my hopes up. My main symptoms have been constipation and bloating. It’s wonderful to read about your positive results. Thank you for sharing.
I hope it goes well for you! My symptoms were different, but hopefully you’ll get some relief as well. I will say that during the antibiotic phase I did have a lot of discomfort, gas, bloating etc. So don’t expect to feel better right away. Let me know how it goes 🙂 sending good vibes your way!
Thanks for sharing your experience! I’m on my second round of antibiotics and trying the guar gum this time. Did you stop taking it the last day of the antibiotics? Glad you’re feeling well!
Emily, I just found your site, and have looked up your Dr. in SF, since I am about 4 hrs away, he will be on my list of next to try after one more visit to my GI, am hoping he is better informed a yr later. Have tried a MD RD but the herbs did not work for me. Want to thank you for your information. It is helpful, and so is the current Docseries by SIBOSOS running currently
Good luck! I Hope he can help you. SIBO can be such a frustrating condition.
Thank you for sharing! Quick question: is it ok to take a small amount of prokinetic WHILE taking Rifaximin & PHGG? I’m taking Iberogast (20 drops) just one time per day. (Before starting the antibiotic I was taking it 3 times per day, but I’m worried it will move the antibiotic through too quickly).
My GI had noticed while doing tests to diagnose Sibo, the scan showed a small stomach aorta enlarged, just repeat with a scan every two years. That is what both the GI and IN, which are both thin, say I am feeling, the center under rib cage pulsing. I am 96 lbs ,5’31/2. It is very annoying, and I thought it was pressure from the Sibo gas. Was told it may never get any larger and may never need any surgery
Your website is amazing. I am looking forward to the future.
Thank you so much! It makes me really happy that I can hopefully help someone out there or at least give a bit of hope. 🙂
Hi Emily
Thank you for all the wonderful information that you have put together to help others.
I have a question which I wonder if you may know the answer to. If I combine Rifaximin with Allimed then what would the duration of the two be? 2 weeks for Rifaximin and 4 weeks for Allimed? In other words of you combine pharma-antibiotics with herbals do you know what the guidelines are for duration of treatment with both?
Thank you.
Imran
I’m so glad it has been helpful! Unfortunately, I’ve never seen an answer to that question of how to combine pharmaceutical antibiotics with herbals. I am not a practitioner, but my inclination would be to just do the full course of both, because I believe that’s how it works with taking different courses of antibiotics and Allimed is essentially an antibiotic. But that’s just my guess. If you have a doctor or naturopath you can ask, I would do that. Good luck!
Thank you, Emily.
I cured my SIBO completely by doing a low oxalate diet. And the dysbiosis, leaky gut, haemorrhoids, all digestive issues basically. Oxalate accumulation in the body is the root cause, that’s why I have perfect health now while you haven’t. I bet your issues will eventually return in full force, because the bacterial overgrowth is a symptom of another problem, not a problem in itself. So many people struggle with this issue because they don’t understand what’s going on. It seems that the body actually deliberately lets those bacteria overgrow so that they produce hydrogen sulphide gas to make up for an underlying sulphate deficiency, and by killing them off you aren’t doing yourself a favour.
Hi Anna, I have SIBO Methane dominant, but the hydrogen is also high. Thank you for sharing your story. When you say a low oxalate diet, do you mean a temporary or permanent diet change? Also, did you test yourself for SIBO, before and after or did you base it on symptoms? How long did it take to heal your SIBO on the low oxalate diet? Thank you.
Hey Emily,
Thanks for the interesting post.
I have a question though. It sounds as if you had to take the Rifaximin and the Neomycin away from each other and not at the same time. Is that correct? Thanks a lot.
Alex
I took them on the same day, but do not recall if I took them at different times of day. I don’t think it mattered from what I recall, but of course consult your doctor.
Hi Emily, I have methane dominant SIBO, the recommended treatment is 550 Rifaximin+ 250mg Metronidazole (Flagyl). I’ve read the the Rifaximin basically just affects the small intestine, but the Flagyl is systemic. As it is I have dysbiosis and was wondering if the Flagyl will have a major effect on my microbiome? Thank you for sharing your story.
Hi Emily
Have you done any: EDTA , DMSA | DMPS challenges to see if you have a high toxic metal load ( Lead, cadmium, Mercury, etc..) in your bodies fat stores? Toxic Load is one likely cause of SIBO. Read the Book: “The Devil In The Garlic” by Dr. Greg Nigh. Hes onto this sibo like no other Dr’s. One of the theories now is: your body prioritizes storing Sulfur, but the body does not have enough for your load, so the body prioritizes the production of Hydrogen Sulfite by raising your blood sugar to grow its own sulfur by fostering the growth of sulfur producing bacteria. Its an adaptation, thats what it wont just go away. We can also have sulfur oxidation issues, from Roundup, the end resulting illness is similar. Liver impairment from various issues can cause it. Lead is the worst metal to have, all the other metals seems simple to get rid of. Long and tedious, but simple compared to lead.
Hi CJ – I have had Sibo for at least 2 years, as well as erosive gastritis and I am regularly in pain with epigastric burning.
Your post regarding sulphur is exactly what I’m dealing with right now. I’ve just been told I have an extremely high mercury level and a calcium shell. I have high blood sugar but no diabetes. I also cannot handle fats except oils. I’m on a low sulphur diet because my latest specialist thinks I might have a sulphur issue although I’ve yet to do a TN1TN2 test (I think it’s called). The new diet initially made me more comfortable but I’m now struggling with the gastritis that I know the Sibo is affecting. My illness has completely and utterly taken over my life, it’s badly affected my whole family and I had to leave my job as it was making me worse. Any help or advise you or indeed Emily can give me I’d be forever grateful for.
Thank you,
Dawn
I don’t see any basis for that cause in the scientific research. The cause of my SIBO was very clearly food poisoning, which is a common cause for SIBO and well grounded in the accepted scientific research.
Hi there ! Did you continue the PHGG after antibiotics ? And did you take any herbals as well along with the antibiotics ? Thank you !
I have high hydrogen SIBO (diagnosed by a breath test). I have tried two rounds of antibiotics – Rifaximin and Flagyl – and had no improvement whatsoever. I have a terrible, bitter, rancid taste in my mouth 24/7 and feel sick to my stomach most of the time, especially after I eat. I have to force myself to eat 2 small meals a day. I have severe constipation and have lost almost 40 lbs. I am getting desperate. I have read that prebiotics are bad for SIBO, so I’m not sure about your recommendation. I have also read that soil-based probiotics can help. My doctors are at a loss.
Yes! SBOs are the only probiotics recommended. Look for probiotics containing (Bacillus subtilis, Bacillus coagulans, Bacillus clausii). Avoid any probiotics containing Lactobacillus and bifidus, even if it contains the forementioned! Also, stick to leafy greens and lean meat (zero fat). Avoid all fruits high in frictose (stick to green bananas, a little strawberry and blueberry from time-to-time). Avoid fiber, sugar, carbohydrates (bacteria feeds on this through fermentation which causes the pain due to the production of excessive gases) and fats (fat malabsorption is a symptom of sibo, so avoid ingesting fats & oils as much as possible). Avoid tomatoes, peppers, carbonated drinks (soda) etc. Avoid gluten (wheat, rye, barley, malt, kamut, spelt), nuts (including tree nuts), fish (wild and fresh water) and lactose (milk) as well. Read ingredient labels carefully because a lotta sweeteners contain these in disguise (anything which is SWEETENED is NOT for you)!
This is terrible advice! No fish? What the heck is a person supposed to eat? You can def have fish and lactose free milk.
Go read Pimental’s book where he says what to eat and not eat. you CAN eat carbs on a low-fermentation diet. Just specific ones.. Geez!
Thanks, Chelita. I will try the soil-based probiotics. I can’t follow that strict diet. Can’t eat meat – it makes me even sicker, and if I couldn’t eat dairy, There would be just about nothing I could eat. I don’t eat sweets or bread, so that at least is doable. I feel pretty hopeless..
Hi Everyone,
Im happy I found this thread. I was diagnosed with SIBO combo of both hydro/meth. I have been suffering with this for almost 10 years now. My main and only real symptoms are extreme stomach bloating/distension 24/7. I cant really do the low FODMAPS diet because I dont eat meat…so thats been discouraging knowing its part of the process, it just not realistic for me. Currently, I am taking three pills of Atrantil with ADP oil of oregano three times a day. I have not seen or felt any change and its been just about a month. I was hoping doing the herbal antibiotics might help me? Because of covid, my dr cant fit me in to see them until next month to (hopefully) get referred to a gastro dr. I was also trying to watch suggestions on Youtube and I saw people recommending a product/treatment called “canXida” and was wondering if anyone else has had any success with it?
Anyway, im desperate to feel relief and to have this bloating be gone. it looks like im pregnant. It feels like someone stuck an air hose in my bellybutton and filled it up, its miserable. At this point I just feel so hopeless and defeated..
Any help/support would be so appreciated.
Thank you for reading
Hi! I was treated for hydrogen/methane with antibiotics Rifaximin and neomycin and that worked. I did relapse but only hydrogen, methane never returned so mention that to your practitioner. Those two work for methane
I have to wait until next month to see my Dr and hopefully get referred to a gastro Dr. I will definitely bring those meds up. Did you change anything else? diet, other supplements? did you suffer from bloating? That is my main symptom.
Thank you 🙂
I sure did ! And after completing that treatment I immediately felt better. My stools were more formed, no bloating etc I just didn’t follow the diet strictly and relapsed. I’m actually starting Rifaximin soon again but this time no neomycin since I only have hydrogen. So I’d suggest antibiotics and following the low fodmap diet strictly for the next 6 weeks or so. That’s what I plan to do this time around. Keep us posted how it goes 😊
what symptoms came back when you relapsed? Thats what concerns me, is the low FODMAP diet. I dont eat meat so its pretty unrealistic for me to follow. I know its crucial, but Im just being honest with myself.
I hope that you have success! thank you for your response
It didn’t let me reply on the bottom anymore haha. But I think as long as you introduce slowly prebiotic foods once you confirm you are sibo free you should be good to go. Even if you’re vegan or vegetarian. I’ve read that’s even better to heal your gut
You need to see Pimentel or Siebecker.
Michelle, if you have tested positive for Covert91, you have exozomes that have broken free from your cells and are circulating. The covid test is the 1960 PCD test, all it does is find your very own exozomes floating in your blood, the DNA in them is you. Every cell in your body has an exozome within it. This means that your cells trash removers (exozomes) are greatly overloaded. Exozomes are the cells way of expelling toxic metals and stored chemical poisonings (toxic load). If you have Covid you need to detox in every way you can. SIBO Drs, the sharp ones, are figuring this out and talking about it. Every health issue is a Detox issue. Do you live in a home with old lead based paint? Drink tap water? Have a mold issue with you home? HVAC problems?
I have extremely high hydrogen plus high methane SIBO, and I have tried 2 weeks of Rifaximin followed by 10 days of Flagyl. Neither antibiotic did any good whatsoever. I am about to start the probiotic Visbiome. Has anyone had any success with that?
You’re supposed to drink at the same time
Jennifer I put my recent SIBO experience (which has progressed to SIBO and UC) on a forum here it is: https://www.healingwell.com/community/default.aspx?f=38&m=4225070#gsc.tab=0
I have same story of a long food poisoning followed by a shorter one about 9 months later, after which I started having similar problems, and am diagnosed with IBD now. Curious to try the PHGG, but the Amazon link is dead… Could you update it and send me an e-mail?
You can get 60 550 mg tablets of rifaximin antibiotics through Offshore Cheap Meds at https://www.offshorecheapmeds.com/ UNDER $65
rifaximin is the generic for XIFAXAN
What is the best prokinetic if you have acid reflux and just completed xiflaxin
Best cort
I tried Atrantil and it didn’t help in the slightest.
Hi! Thanks so much for this info! I was on Xifaxin in July and started with a prokinetic after (Motegrity). Was doing amazing, until I had a relapse after a course of steroids’.. so back on the Xifaxin now. Were you instructed to stop your prokinetic until after the Xifaxin was done, or could you take both at the same time? Also did you take the guar gum more than once a day? Thank you!!
Hi Jill, I believe I took guar gum 2x a day but I do not remember totally. I took a prokinetic for quite some months after I was done with the Xifaxin – maybe even a year? Hope this helps and good luck 🙂
Hi, just curious, after you finish the antibiotics do you stop the PHGG? Thanks very much.
I very good information!
had severe bloating with and without food. Tried AIP diet. Ended up in hospital with severe pain center under rib cage. Suspected gallbladder. Found inflamed duodenum with endoscopy. Slow gallbladder ejection rate from HIDA scan. Which is non-conclusive to diseased gallbladder. Gastroenterologist referred me to Naturopath for SIBO breath test came back 45% Hydrogen! Never have diarrhea only constipation for years! Naturopath helped me order Rifaxamin through Canada with great savings. Took 500 mg 3X day 21 days along with Metrondazole. Using MONASH Diet app for all meals religiously. Completed 1.. Antibiotic/Eradication Phase. Now in 2. Correcting factors Phase. Iberogast 20 drops after each meal. Lots of ginger tea evening. 3-4 hour spaced meals to allow MMC to operate. Supplementing with B-12 injections, B-Complex, D3 & K2, Choline 500 mg with each meal. Peppermint oil capsules if needed. Teaspoon of powdered magnesium, selenium, some others. Recommend you watch Dr Berg. SIBO Steals Your Nutrients. I did have about 80% improvement in BM’s and bloating. After 30 days of Stage 2 I will move into Stage 3 Relapse prevention. Iberogast, Ginger, maybe Low dose Erythromycin, and a Megaspore Probiotic and slowly add back in foods like an elimination diet the MONASH Diet app helps with that. Really hoping this works completely. It’s been a 30 battle.
Thanks for sharing. Can I ask how long did you take the PHGG for afterwards?
I just took it until I was done with the Rifaximin.
Hello people please do NOT take Metronidazole! Ever! I’m in a support group of thousands of Flagyl drug injured men and women. This antibiotic has ruined our lives and now I have some form of SIBO and am getting zero help with any doctors around here. Do not take this drug or you will become a member of our group: Metronidazole Central Nervous System Toxicity on Facebook.
Jodi. I have just started metronidazole and have never heard of this. I will take a look at the Facebook page. Wondering if anyone else has heard of Metronidazole toxicity? My GI doctor did not want to put me on neomycin but I can try to switch over to that. I have Methane SIBO and need to take the Rifaximin with either metronidazole or neomycin.
Jodi. There is no Facebook group that I can find titled ‘Metronidazole Central Nervous System Toxicity’. Can you clarify please? Thank you
Bonjour Emily! Sibo/IMO have just started to being taken seriously in France. I have IMO, low grade but still there after one round of antibiotiques. We’re now searching for the cause before trying the natural way. What was your cause ? I understood that treating wasn’t enough, WE had to fond thé base of thé problème (probably gastroparesis for me, but causes it?… Neverending story).
I went on the low fodmap diet for 10 days (90% compliant) when doctor suggested I might have sibo and I was having terrible pain and bloating for months. Then i took the sibo breath test and it came back negative. Can i start introducing foods and see if i can tolerate them? (My situation is complicated by having dormant Crohn’s. I thought initially this was a flare and ate exactly the wrong thing for weeks–lots of refined carbohydrates. Also by the fact I take low dose morphine to deal with another health issue which slows motility.). I responded to the diet quickly with reduced bloating and no pain if I am very religious about following the diet.)