This is a guest post written by Amy Nett, MD.
The normal small bowel, which connects the stomach to the large bowel, is approximately 20 feet long. Gut microbiome bacteria are normally present throughout the entire gastrointestinal tract, but in varied amounts. Relatively few bacteria normally live in the small bowel (less than 10,000 bacteria per milliliter of fluid) when compared with the large bowel, or colon (at least 1,000,000,000 bacteria per milliliter of fluid). And, the types of bacteria normally present in the small bowel are different from those in the colon.
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Why You Should Thank Your Small Bowel and the Beneficial Bacteria That Live There
The small bowel plays an important role in digesting food and absorbing nutrients. It is also an important part of the immune system, containing an impressive network of lymphoid cells (cells of the immune system that help fight infections and regulate the immune system).
Are you at risk for small intestinal bacterial overgrowth? Find out what the most common risk factors and symptoms are.#SIBO #SIBOsymptomps
The normal (beneficial) bacteria that are an essential part of the healthy small bowel also perform important functions. These beneficial microorganisms help protect against bad (i.e. pathogenic) bacteria and yeast that are ingested. They help the body absorb nutrients, and also produce several nutrients (such as short chain fatty acids) and vitamins like folate and vitamin K. These bacteria help maintain the normal muscular activity of the small bowel, which creates waves that move the contents of the intestine, like food, through the gut.
What Is SIBO?
SIBO, small intestinal bacterial overgrowth, is defined as an increase in the number of bacteria, and/or changes in the types of bacteria present in the small bowel. In most patients, SIBO is not caused by a single type of bacteria, but is an overgrowth of the various types of bacteria that should normally be found in the colon (1). Less commonly, SIBO results from an increase in the otherwise normal bacteria of the small bowel.
SIBO has been shown to negatively affect both the structure and function of the small bowel. It may significantly interfere with digestion of food and absorption of nutrients, primarily by damaging the cells lining the small bowel (the mucosa). Additionally, this damage to the small bowel mucosa can lead to leaky gut (when the intestinal barrier becomes permeable, allowing large protein molecules to escape into the bloodstream), which is known to have a number of potential complications including immune reactions that cause food allergies or sensitivities, generalized inflammation, and autoimmune diseases (2).
These pathogenic bacteria, whether too many or the wrong types, can lead to nutritional deficiencies on top of those due to poor digestion or malabsorption. In particular, the bacteria will take up certain B vitamins, such as vitamin B12, before our own cells have a chance to absorb these important nutrients. They may also consume some of the amino acids, or protein, that we’ve ingested, which can lead to both mild protein deficiency and an increase in ammonia production by certain bacteria. (We normally produce some ammonia daily from normal metabolism, but ammonia requires detoxification, so this may add to an already burdened detoxification system.) The bacteria may also decrease fat absorption through their effect on bile acids, leading to deficiencies in fat soluble vitamins like A and D.
What Causes SIBO?
The body has several different ways of preventing SIBO. These include gastric acid secretion (maintaining an acidic environment), waves of bowel wall muscular activity, immunoglobulins in the intestinal fluid, and a valve that normally allows the flow of contents into the large bowel but prevents them from refluxing back into the small bowel. (This is called the ileocecal valve because it’s located between the ileum, or terminal end of the small intestine, and the cecum, a pouch forming the first part of the large bowel.)
The cause of SIBO is usually complex, and likely affects more than one of the protective mechanisms listed above. A number of risk factors for SIBO have been identified, with some of the more common risk factors listed below. For a more complete discussion of associated diseases and risk factors check out this study and this study.
Risk Factors for SIBO
- Low stomach acid
- Irritable bowel syndrome
- Celiac disease (long-standing)
- Crohn’s disease
- Prior bowel surgery
- Diabetes mellitus (type I and type II)
- Multiple courses of antibiotics
- Organ system dysfunction, such as liver cirrhosis, chronic pancreatitis, or renal failure
Moderate Alcohol Consumption and Oral Contraceptive Pills (OCPs) Also Increase the Risk for SIBO
Heavy alcohol use has long been recognized in association with SIBO (3). This study also found an association between SIBO and moderate alcohol consumption, defined as up to one drink per day for women and two drinks per day for men. Alcohol appears to have effects on several of the normal protective mechanisms, including causing injury to the small bowel mucosal cells, contributing to leaky gut, and decreasing the muscular contractions. Additionally, alcohol may “feed” a few specific types of bacteria contributing to overgrowth (4).
Overall there appears to be a moderate association between OCPs and inflammatory bowel disease (IBD) such as Crohn’s disease (5). Though no studies to date specifically correlate the use of OCPs with SIBO, given the known relationship between IBD and SIBO, it is likely that this association holds true for SIBO as well. However, once patients stop taking OCPs, this risk appears to reverse.
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How Do You Know If You Have SIBO?
The number of people with SIBO in the general population remains unknown. Some studies suggest that between 6 to 15% of healthy, asymptomatic people have SIBO, while up to 80% of people with irritable bowel syndrome (IBS) have SIBO (6).
Complicating this, the most commonly used tests (breath tests measuring levels of hydrogen and methane gas) still have fairly high rates of false negatives (meaning the test results come back as negative but you actually do have the disease) (7).
The most common symptoms of SIBO include:
- Abdominal pain/discomfort
- Bloating and abdominal distention
- Diarrhea
- Constipation (generally associated with methanogens as Chris discussed in his recent podcast)
- Gas and belching
- In more severe cases, there may be weight loss and symptoms related to vitamin deficiencies.
Is SIBO Contagious?
Unlike many other bacterial infections of the gastrointestinal tract, SIBO is not contagious, and there is no evidence that exposure to any single microorganism increases the risk for developing SIBO. SIBO occurs due to a complex interplay of many different factors and is not passed on between individuals. However, some evidence suggests that there is an association between Helicobacter pylori and methane production, suggesting that H. pylori plays a role in gut dysbiosis. (8)
Why SIBO Can Be Difficult to Treat
Antibiotics are often used to treat SIBO. However, studies show that despite treatment with antibiotics, recurrence develops in almost half of all patients within one year. One study comparing treatment with rifaximin (the most commonly used antibiotic for SIBO) and botanical antimicrobials showed slightly better outcomes with the botanical protocol, but still with successful treatment in close to only half of all patients after one course of treatment.
These finding suggests that treatment of the overgrowth alone is not enough for most people. An additional piece of successful treatment must include addressing the underlying cause, or predisposing factor.
Though there are many identified associations between SIBO and other diseases as described above, abnormalities in gut motility are recognized as one of the most common associations. One study published this month demonstrated that patients with SIBO do have significant delays in small bowel transit time (the amount of time it takes something to move through the small bowel). This finding suggests that patients with SIBO, who do not recover after a standard course of antibiotics, or botanical antimicrobial protocol (which we prefer), may benefit from the addition of a prokinetic agent, which increases the muscular contractions of the small bowel. Octreotide and low dose naltrexone are two such options that are being investigated, and may help treat some cases of SIBO that don’t respond to antimicrobials alone. Other options may include prucalopride and low-dose erythromycin, as well as lubiprostone. (9)
As research into SIBO continues, we are increasingly understanding the complexity of this disease, and how treatment must be tailored to each individual to maximize success.
If you need support in dealing with SIBO, consider working with the California Center for Functional Medicine. CCFM offers a membership-based health transformation service that excels at helping people with chronic conditions make the changes necessary to reclaim their health. Find out more about what CCFM has to offer.
About Amy: Amy Nett, MD, graduated from Georgetown University School of Medicine in 2007. She subsequently completed a year of internal medicine training at Santa Barbara Cottage Hospital, followed by five years of specialty training in radiology at Stanford University Hospital, with additional subspecialty training in pediatric radiology.
Along the course of her medical training and working through her own personal health issues, she found her passion for Functional Medicine. She works with patients through a Functional Medicine approach, working to identify and treat the root causes of illness. She uses nutritional therapy, herbal medicine, supplements, stress management, detoxification and lifestyle changes to restore proper function and improve health.
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Melvin:
I have made a list of what all I need to buy to follow your suggestions. I am confused about the following. Could you please clarify?
1. You wrote Aliverex on one post and Oliverex on another. Is this a typo? If so, which is correct? I cannot find any of these yet??? Are these pills and what are they for?
2. You said 2 scoops of L-Glutamine. Did you start that immediately? And what was this one for? Also, do you feel the pills will work just as well? I’m not sure I will do OK with powder? I found the Biocidin drops on Ebay for $40 and the Klaire Labs Plus 100 Capsules Vital-Dophilus Plus on elbay for $23.00. Are these the correct ones? Do the prices seem corrct to you? I want to make sure I get it right. I’m at the end of my rope with living like this. Thanks so much! I appreciate all of your responses.
Tiffany,
Its called Oliverex, Biocidin and Klaire Labs Interface Plus. Oliverex is about $36, Biocidin $60 and Klaire about $32. Please note that Glumanice is really helpful in repairing your intestines. You can also take in conjunction with Zinc Vitamin for better results and digestive enzymes to help release vitamins from the food you eat so that it doesnt stay long or undigested and eaten by the bacteria. You will see great results.
Melvin….do you believe that the Biocidin pills will be just as effective as the drops? Thank you, again!
Tiffany,
If you read the label and ingredients for Biocidin capsules or drops, they are identical so no need to feel that one will work better than the other.
Melvin:
I have been following the diet to a T and have had a very good week. I ordered all of the medications that you suggested. My Klaire Labs Interface Plus came in yesterday. I took 2 today 2 hours after my lunch. It made me super nauseus and I was swollen within 15 minutes. Did this happen to you? Thank you, again, for everything.
Hi Tiffany,
I didn’t experienced any nausea while taking Klaire Labs InterFace Plus. However, I did have some die off symptoms, including fatigue,, sluggish feeling, itchy skin and achyness as if I was coming down with the flu. This is only the beginning, continue your diet and supplements, especially the diet after completing your regimen and you will notice the difference. Another thing, take a liver detox to mop away the mess from dead cells/bacteria. You will start recovering soon.
Melvin
Melvin….I am doing GREAT so far! THANK YOU X 1,000,000,000. One more question….all of the things I am taking are a cleanse right???? Biocidin, Oliverex, Klaire Labs. I still need to buy a probiotic correct? None of those are probiotics…correct? I am also on the digestive enzymes.
I’ve had chronic nausea my entire life, which is worse in the mornings and during stress. About 5 years ago I got an H. Pylori infection and went thru the traditional treatment of antibiotics. I ate the typical American diet, except when restricted by my nausea at which point I didn’t eat at all. I never completely recovered from the H. pylori and started changing my lifestyle. I cut out all processed foods, sugars etc. But my problem is that I have sensitivity to vegetables. So although I ate eggs, fruit, whole wheat flour, potatoes, agave nectar, etc, I still ate too many sugars and carbs. After lots of tests, I now have been diagnosed with SIBO, although my symptoms are a little different including nausea, upper abdominal pain, and constipation. I only recently started feeling bloated, fatigued, and am having weight loss. I’m starting a diet low in carbs, sugars, and dairy and am praying the sensitivity to vegetables is a symptom of the SIBO that will go away. Because the list of foods I cant eat at this point is so much longer than the ones I can eat, it’s no fun!
Everyone, PLEASE listen to me. I was diagnosed with SIBO, Leaky Gut and Candida (YES, all three it was a tornado). I was experiencing all kind of symptoms from fat malabsorption, gas, bloating, cramps, mucous in stools, loose stools or diarrhea, fatigue, depression, weight loss, muscle ache, post-nasal drip, sore tongue, undigested food in stools and so many others. Note that toxic metabolic substances produced by the bacteria may injure intestinal cells and impair absorption, resulting in nutrient deficiencies, food allergies and intolerances, and impaired digestive enzyme activity, which was exactly what I was experiencing. My primary doctor conducted some blood tests and the results indicated vitamin B12 and vitamin D deficiency. My gastroenterologist did a endoscopy and colonoscopy which resulted with erosive gastritis and chronic esophagitis. I was desperate and sought help with a functional medicine doctor. Please listen to me, this doctor did a stool test that indicated that my body was not producing digestive enzymes and was depleted of friendly bacteria and was being overrun by candida instead. So, the first step to heal your gut and get rid of the bacteria was changing my diet, no dairy, no gluten, no corn, no soy and no eggs for 6 weeks. Please note that you cannot drink soda, juices or eat processed food as well. Bacteria and Fungi have a biofilm that protects them from antibiotics or anything that would kill them so I took Klaire Labs Interface Plus to tackle shield from the bacteria and a natural antibiotic called Biocidin. In addition, I was taking Digestive Enzymes, B Complex, Methyl Vitamin B12 (which are easily absorbed), Vitamin D, Omega 3 (fish oil) to reduce inflammation caused by the bacteria, 50 Billion CFU’s probiotic (daily) and L-Glutamine (2 scoops about 10 grams). Please be patient and do not cheat on your diet, you will definitely see results. I am completely SIBO and Candida Free. I have gained weight and my health is back to normal. I feel completely energized and brand new. Note you will start seeing results after 6 weeks of following the diet and taking the supplements. If you follow this protocol, you will be SIBO free and you can obtain optimal health again. I did it so can you!!!
Wow! Thanks Melvin for sharing. This gives me renewed hope. I am going to follow this regiment. Cheers!
Hi Melvin,
I was wondering if Biocidin was the only herbal you took. I took it for 4 wks at 5 drops 3 xday. I stopped and the got C back. What was your dosage and how long were you on it for? and it was the only herbal?
Hi Kristin,
I took klaire labs InterFace enzymes to break the biofilm from the bacteria in conjunction with Biocidin and Oliverex to ease the die off symptoms along with all the other natural supplements. Now, Biocidin was 2 drops 3 times a day for 3 days, increasing to 6 drops 3 times a day for a week and finally 10-12 drops 3 times a day for two weeks. Let me know how it goes and i hope you feel better.
Thanks Melvin! I’m actually already on the supplements that you are on minus the interfase. How many months did you do the herbal procotol? (and you only did the herbals biocidin & oliverex?)just 6 weeks? I’m gonna try Allicin and oregano oil and see if that can get rid of the rest or I’ll go back on Biocidin. I feel much better but still some C and bloating..way better than before. You are symptom free? no C at all? I’m very good about my diet besides a bowl or 2 of crispy brown cereal..but I think its better digested than regular rice and I need some carb as I still need to gain weight..any food ideas? I pretty much eat fish, coconut oil, olive oil, chicken, some cooked veggies, banana, almond butter,a little bit of peanut butter,eggs, turkey bacon.. only drink water
Kirsten,
After taking the biocidin and aliverex, you will continue the diet up to 3-4 months to get rid of the bacteria for good. I am currently symptom free and i am again regular like before. Of course, I still eat healthy and I refuse to go back to my old ways.
In good health
Melvin
Melvin,
I also wanted to take fish oil but I’m currently on 5,000 iu day of D3(Iwas low too) didnt know if adding fish oil would be too much. How much D and fish oil do you take? Hpefully when spring or summer comes I can ease off the D and just have fish oil.
Kirsten,
Please not that I took fish oil and vitamin D at the same time and it didn’t affect me in any way. Vitamin D of 2000 (one or twice a day). Vitamin B12 of 5000 (onnce a day).
Stay Healthy, MG
Hi Melvin,
What brand/type of probiotics did you take and how much? Thanks for sharing your protocol. It’s what we all need – specifics!
Jean
Hello Jean,
Probiotics are so hard to decide but make sure you use a well known company. Inmy case i used Klaire Labs 50 Billion CFU’s and Health Origins 30 Billion CFU’s (two pills at night). However, i am currently taking a soil based probiotic after many research which appears to be more promising especially for those suffering from SIBO or Candida, its called Prescript-Assist.
Thanks so much, Melvin, and pre-apologies for being a pest.
I continue to have confusion regarding probiotics. I’ve been told and read that pre-biotics feed the SIBO bacteria. I really had to wonder about this as Prescript is recommended by Chris Kresser and it is also pre-biotic. If you have been told or read different research, I’d like to check it out.
Did you switch because the first two probiotics weren’t helping?
I’ve been following the Specific Carbohydrate Diet protocol (http://www.breakingtheviciouscycle.info/p/about-the-diet/ and also through Dr. Allison Siebecker’s site: http://www.siboinfo.com/diet.html)
A nutritionist gave me a copy of the FODMAP diet which seems similar to SCD.
I’m so happy you are sharing your experience.
Thx,
Jean
Jean,
Regarding probiotics, please note that Klaire Labs and Health Origins worked wonderfully for me and I am not sure if prebiotics are not well tolerated by individuals with SIBO because I didn’t have any adverse results. Keep in mind that is always good to retotate your probiotics, especially those with different strains to give your body additional beneficial bacteria. Once you start feeling better, you can decrease your dosage to a cheaper one but never go below 50 Billion for the first 2 months.
Hi All,
The only probiotic that I know of is Progurt that is only human bacteria and not made from bovine or porcine sources. Pricey tho and actually probiotics made my system go into a tizzy, so gonna wait a bit on that.
April
Melvin,
What was your dosage of the Interphase?
Hello Phil,
InterFace Plus is great to break dowm the biofilm that protects these pathogens. My naturalist recommended 4 pills per day. So, you will take 2 pills either 1 hour before eating or two hours after eating in order to tackle the shield that protects the bacteria. You will do this twice a day for 30 days until you finish the entire bottle.
Cheers and good health.
Hi Melvin,
How long were you on the herbals for? You said you started feeling better after 6 wks but how long did you stay on them for? Also how many bottles should I buy of biocidin and oliverex to cover the time needed? Thnx so much !
Kirsten,
I took the entire bottle of Biocidin, Oliverex and Klaire Labs and then a detox to clean out any toxic waste from the liver to give it a break.
Kirsten,
I took the entire bottle of Biocidin, Oliverex and Klaire Labs InterFace Plus and then a detox to clean out any toxic waste from the liver to give it a break.
Hi Melvin. Thank you for sharing everything. I am going to try to piece all of the information together from the various questions and follow what worked for you. I was diagnosed 2 years ago at the Mayo Clinic and am nowhere near symptom free. I’ve had many rounds of antibiotic treatments. I follow the FODMAP diet, which was given to me by my Mayo doctor. Over the last few weeks of research, it seems that should have following a more strict diet at the beginning…or at least at some point. Mayo only told me about FODMAP. Now, 2 years later, I am only at 50%. Someone from the site said that I may also have Candida since I swell immediately from fruit. I followed the FODMAP diet tonight for my dinner and ate without incident. However, I was then hungry after a little bit, ate a banana, and was swollen within 2 minutes. 🙁 If you happen to have everything all together in one shot..your diet, exactly what you took and how much of it/for how long (I’m a bit confused about he drops??), would you mind posting it all together on one post…everything that I need to follow in your footsteps with this? If that is too much to ask, I will try to piece all of the comments together. I pray for the day I can make your statement of being symptom free and healthy again. 🙁 I just want to make a list of what worked for you, go purchase it, and start immediately! Was it you that also said MMS? If so, what is that? THANK YOU SO MUCH for sharing.
Hi Tiffany,
I am so sorry that you have not been feeling better despite of your 2 year treatment. Please note that your diet should be rule number 1, avoid dairy, gluten, soy, corn, eggs(if allergic) processed food and sugar, no juices of any kind. If you can tolerate fruits, i would highly recommend strawberries, cherries, apples and blueberries. You can have small bowl of brown rice or quinoa once a day, but the majority of your diet should be 70-80% of vegetables and meats. If you noticed that you are loosing too much weight like in my case, feel free to add good fats like avocado, extra virgin coconut oil (my favorite and kills bacteria and parasites), walnut oil, flaxseed, avocado oil, grapeseed, extra virgin olive oil ect and you can mix with your vegetables or salads or even cooking they are delicious and very healthy. Once you start your diet, start taking Klaire Labs InterFace Plus to attack the biofilm of the bacteria or funji 4 times a day (two in the morning 1 hr before or 2 hours after eating and two more in the pm). Wait at least 2-3 days and then you can start taking Biocidin either through pills or liquid as the esrlier post mentioned, along with oliverex to avoid or decrease die off Symptoms. These will work with individuals that have SIBO or candida and leaky gut. I would highly recommend that you take a good multivitamin with b complex, vitamin b12 and vitamin D and Glutamine two scoops per day. Note that DGL are also very good to protect the lining of the intestines while it heals. In addition, YOU may want to get a good probiotic at least of 50 billion cfu or 100 cfu to repopulate your gut with friendly bacteria. I used to have 3 meals per day along with healthy snacks such as almonds and walnuts with no sugar or anything added. Be patient and i hope you feel better, dont give up and keep fighting.
In good health,
Melvin
Thank you, Melvin. I appreciate all of the information. My body cannot tolerate fruit, besides strawberries. Apples, adovado, etc. are a no no on the FODMAP diet and are high in fructose. I can literally get sick from one single bite of an apple. I am not sure how you were able to eat those items. I am going to print out your herbs/medicine suggestions and get started! Thank you so much.
Tiffany, I was wondering sense the bloating coincided with the menstral cycle of our hormones are making it worse in some way. I don’t use birth control and don’t want to but my doc recommended since it always happen the same time ever month.
Tiffany2….When all of this happened my Gyno found some research 2 years ago that birth control can slow down your “gut,” so I got off of the pills. 2 weeks later I was so much better and thought I had found the culprit of all of this. However, it just came back. However, being on the pills made it much worse. I am not on any medications except allergy medicine. 🙁 My Mayo doctor said that birth control pills are just an “aggravating factor” to my condition. So…I would most definately tell you NOT to get one them. I was much worse on the pill. There is research to support this. When I told my Mayo doctor about how my cycle changes it, he just said, “That doesn’t surprise me.” Other than that, I have no explanation.
I just seen your message, my email is elliotttiffany@att@AT&T.net
Hi Tiffany,
I’m the same with my cycles .. My cycles started to get really bad a year ago and then got sibo. I also have severe endometriosis but I had different side effects with sibo during my cycle. I just had endo removed from my colon but still having sibo symptoms .. I did make lots of progress with my last herbal treatment but still having lots of bloating in the evening and some constipation. How have you done treatment? Abx or herbals ? Other things should be ruled out too.
Kirsten…From the MAYO clinic, I have had 7 or 8 rounds of antibiotic treatment over the past 2 years and then was told to follow the FODMAP diet. That has been the extent of my treatment thus far. It took me over a year and 5 or 6 doctors to even be diagnosed. I had every medical test you could probably name…including exploratory surgery at MAYO clinic.
Tiffany.. Did you get any progress from abx? Which dr diagnosed you with sibo ? Was it a conventional dr?
I am basically just figuring out that SIBO is what I have been fighting for the last 15 years. 2020 hindsight… I did best after I took a course of MMS and ate a high protein diet. Recently I switched back to a diet much lower in protein and higher in grains and have had a flair up. In my experience, high sugar consumption makes it worse. Eating out causes flare ups likely by exposure to new bacteria and/or digestion altering food additives or low quality foods and oils. Foods that suppress gut function, like cold foods such as ice cream, and most processed foods, which also contain sugar and chemicals that alter gut function, make it worse.
The symptom I have that is most distressing is large amounts of protein in my urine which is usually accompanied by a sort of tiredness that feels like I took a Dramamine. I imagine it’s the result of poor protein digestion, leaky gut, or kidney inflammation from bacteria overgrowth.
MMS works like a charm. I took herbs for many years that where supposed to kill harmful gut bacteria but they didn’t work. Whatever the strains are that cause my symptoms they needed something stronger. After that it’s a matter of what I eat. Any sugar binging is asking for trouble. Apparently high grain consumption, basically a high carb intake, is also an issue.
I started mountain biking 3 days a week during this last flare up. I lost 20 pounds from all the calorie burning and muscle building I am doing. It seems like the flare up I’m having currently is somehow related although I’m not sure why. It might be the diet high in grains that started about the same time.
TO EVERYONE ON THIS SITE WITH SIBO…..I am VERY curious to know if any of you were on the Body By Vi Visalus Shakes when you got SIBO???? Three people that have developed SIBO, including myself, were taking this shake. I really and curious to find out if there is a correlation or if this is just a coincidence!!!!????!!!!!! Two of my friends are drinking Visalus now, and I don’t wish this upon anyone. I have urged them to stop taking it until I ask around and find out. Anyone? Thank you! I’m SO GLAD to find other people that actually understand what I am going through.
Crazy you mention this! My symptoms got so severe when I bought these shakes from a friend. I assumed it was all the dairy–the whey protein in the mix and then the milk I mixed it with. I don’t really think it was the shake, just the shake unmasking my issues?! But because of this shake, I discovered a whole new lifestyle (for the better–but still can’t shake SIBO).
I have had SIBO for about 3 years. The FODMAP diet has helped me. However, I still have about 2 bad weeks a month…regardless of what I eat. I started Plexus, Plexus BioCleanse, and Plexus ProBio 5 on Christmas Day at the recommendation of a friend. They say it will get worse before it gets better and may take 4 months to see improvement. Has anyone else tried this? I am not getting any better and am wondering if I should discontinue using it. Anyone??? I called my DR at Mayo Clinic, but they said he probably wouldnt’ give me an opinion if I did not come in/pay for another visit since I haven’t been in a while. Thank you!
I am so thankful I found this website and read your experience!! I have been going through the same thing for 4 yrs. I get bloated so bad that I can’t breath effectively and it always starts two wks before my menstrual cycle. This past summer it lasted for two months and in the fall it did it again for over 2 months. I am going to. GI specialist this week to have test done because something is causing the SIBO. I’m a runner and eat a lot of carbs so I’m thinking I have a food intolerance. I’m soooooo over this! I’m tired of looking pregnant and feeling horrible.
Tiffany 2….Mine is most definitely related to my cycle as well. It is like clockwork. I can expect 2 bad days a month…regardless of how well I follow the diet. Are you on the FODMAP diet? If you, you NEED to be. It really does help. Don’t get me wrong; it won’t cure you. Nothing really does. I was at Mayo for about a year and my doctor told me to “find ways to manage it.” But the diet does make a huge difference. I have had 4 or 5 round of antibiotic treatment. If you haven’t had that, it does help tremendously. But again, it will not completely stop it. It just becomes much less severe. (ie…you not being able to breath and the feeling of so much extreme pressure after you eat)
I feel your pain. I get congratulated on my baby all the time, because without swelling I am a size 2…so it is very obvious when I swell. 🙁 I’m also thankful that I found this site.
Tiffany, thank you so much for sharing!! I told my husband that a girl named tiffany is going through something just like me! I am normally a size 0 and tonight I look 6 months prego. I told my son, which is 4 yrs old, tonight I’m having a boy and he said take him out, lol. I relied, only if I could! I started looking into the fodmap diet TODAY. I will be investing in it. Any website you suggest or anything about the lifestyle change, please let me know.
Tiffany 2…I know EXACTLY what you are talking about! Feel free to send me your email or phone number. I, too, and glad to find other people like me. I felt like I was the only once since it took about 6 or more doctors to figure out what was wrong with me! I also use the FODMAP Apps on my phone to help me figure out what NOT to eat.
Thanks Amy, this is really helpful. I actually just sent off a Genova SIBO lactulose breath test because it’s something I’ve suspected for quite a long time. You mentioned that these tests aren’t very accurate; what leads you to believe that? Is it because you’ve had patients with negative test results but still responded to the treatment & dietary protocols? Any idea of the false negative rate?
Thanks!
Can medical doctors test and treat for SIBO?
Yes, I was diagnosed by my gastroenterologist. You need to do a hydrogen breath test and then if its positive than can prescribe rifaxin
The breath test also tests for methane gas, for those who have constipation instead of diarrhea.
Any Long Island or NYC doctor to recommend?
Maybe the Hoffman Center in NYC? Ronald Hoffman is an integrated MD and may be your best bet. He has a podcast online as well.
The Kellman Center in NYC. They are wonderful and diagnosed me with SIBO. Totally integrative practice. Life saving.
Do you have pain 24/7 in lower right intestine? Can this be caused by sibo? What was your treatment for sibo?
My husband is dealing with SIBO at age 64, which seems to have been present most of his life. Many factors, esp slow gut syndrome contributing. So far, just finished Rifaximin/Neomycin rx, hasn’t helped much. The prior FODMOP diet for 2 months helped more, but not perfect. Miralax adds to his constipation, as do most laxatives. (not sure if this is because of this being a form of complex carbo or not). We’ve always eaten semi-vegetarian, whole-foods, organic, and now he has to cut out mushrooms, apples, broccoli, beets, and all that healthy stuff, (not to mention high in fiber), but can eat white sugar, which we NEVER do, (sigh); it’s ridiculous that he can’t eat the most nutritious anti-oxidants; he’s lost way too much weight, was just right before, though he keeps running for the opiods. Has anyone out there tried Reglan for a pro-kinetic? I know about the EPS side-effects, but you could stop taking it if that occurs. It raises serotonin in the gut, and we’ve used it for breastfeeding moms for many years without a problem.I’m reluctant to try Naltraxone, b/c of the anti-opiod effect, which might increase his rectal pain. He needs to touch bases with his GI doc this week, who is in Kirkland, about 2 hours from here, and the only one in Washington state that treats this. He is not very open to alternatives outside his own protocol, which I can understand. But am looking for some ongoing treatment for the underlying problem.
Hi, I have a friend who is afraid to tell her doc that she believes she has SIBO. She lives in Spokane. Could you please tell me what clinic or doctor your husband sees in Kirkland? Thanks!
Amy, can someone start the protocol without going on the antibiotics I do not want to go through any testing want to try something natural to see if improvements could be seen Any suggestions would help…thanks Aidan :)’s
Try the low-FODMAP diet. I’ve had IBS for 15 years and last summer was diagnosed with SIBO. I had to take 2 rounds of Xifaxan and I still have trouble, but my symptoms are greatly controlled with this diet and Culturelle daily. My GI doc recommended it, and that helps me more than anything.
Casie, I am struggling with this fairly new diagnosis & am currently on Xifaxan 550mg 2x/day. I can hardly believe that my GI doc never mentioned any dietary changes or herbal treatments.
Do you know if you have wait till the antibiotic is completed to start any of the herbals or do you not take the herbals?
Thank you
Sorry, just saw this.
I was instructed not to take the probiotics till the Xifaxan was complete – which wipes out both good and bad bacteria, before taking Culturelle to re establish the good bacteria. I also took oregano oil to help kill the bad bacteria, and switched to a low-formal diet immediately to give bacteria less to feed on.
Do any of you consume alcoholic beverages?? And do you get these symptoms only after consuming adult beverages?
Have had ibs for 43 years. Having breath test in a couple of weeks. I hope someone will respond to me for support. Have had several Gi docs and find them and their staff SO cold. Working with people with chronic conditions I would think staff including Drs would be supportive and available. I have a masters yet feel treated like I am an idiot. Anyone else feel this way?
Just did the breath test last week and found out today that it’s positive for SIBO. My follow up appointment is not for another 3 weeks to discuss treatment options. I suffered for 17 years till I found that a low fodmap diet made me feel better at which point my naturopath sent me for the SIBO test. Good luck to you. I’m looking forward to not being bloated EVERy day:)
Keep me posted on the treatment. Good luck to you too!
Has anyone been diagnosed with orthostatic hypotension in addition to their SIBO?
Yes, I have. I am learning a lot about the interplay between gut motility dysfunction, dysautonomia (OI), and Hashimoto’s. It’s a tough nut to crack, and seems like it is taking me forever to feel better.
I was diagnosed with SIBO last year after finally finding a naturopath that understood what I was going through. She had me go on a strict diet and take several supplements. I did it for 3 months and it helped me tremendously! I felt better for 6 months, but now am having issues again. I don’t understand why it comes back and what the root cause of it is? Sounds like antibiotics are not the answer.
Hi Lisa
Which naturopath that you went to and what was the medicines/ supplements that you took to get better? Thanks!
Check out this podcast: http://chriskresser.com/answers-to-your-burning-questions-about-digestion
Chris says: “So, what I’m saying is that what I’ve seen is that if somebody goes on the GAPS diet for a while and they reach a point where Kaitlyn’s reached or I’ve reached and they start adding starch back in, that can sometimes be helpful, and I think one of the reasons behind that is that when you only eat the single-molecule sugars, the monosaccharides, then in addition to starving the bad gut flora, you can also end up starving the good gut flora.”
That seems ignorant for him to say, because the whole premise of Gaps diet is adding beneficial bacteria back in with fermented foods so they overpopulate the bad guys.
Hi Everyone
Anyone got breath test done at Mayo clinic before? I live in AZ and no doctor does breath test except Mayo. However when I spoke to Mayo this morning, the girl in the office said that their breath test is for ppmH 2, fructose intolerant. I ask if they will test for methan or ppmCH4, the girl said she does not know. All of what she saw on the lab list is ppmH 2. Does it mean they test for hydrogen only, not methane????
I have had not had one done at Mayo Clinic, but I have had one done in Buffalo, NY. In Buffalo, they did test for both hydrogen and methane, so I would assume that the Mayo Clinic would definitely test for both. Best of luck
Thank you! I wonder if the lab might put only ppmh 2 but they test for both. The girl at the front desk has no idea and does not know who to ask for!
Where in buffalo did u go ? I live in buffalo to. Email me Anderson.m6812@gmail
Hey Geoff. I’m getting a breath test done may 5 in buffalo. Email me [email protected]. I’d like to know where u went and what your symptoms were and protocol
My doctor sent me an at-home hydrogen breath test. Genova is the company. I’m in Colorado and when I wanted a follow up I called all the GIs in Denver (Boulder area didn’t have any breath test machines) and finally found that Rose Medical Center had one. Call around if you want to go somewhere to do it, but if you are very diligent about following directions and watching the video on exactly how to do the at-home test, it could work out for you. Your doctor will have to order it for you. The people at Rose had me on a stricter diet than the Genova instructed for me to do. So as strict as you can handle will give you the best results. You could even call Rose Medical Center in Denver, CO and ask to speak to the person who administers the test there. I can’t think of her name right now, but I remember her being very helpful and guiding me.
Thank you! I wish there Is a way to find out if mayo do that test so they can treat me also.
I did a breath test at home that I ordered on line. The naturopath Dr. I went to had me order it. I don’t think they’re that accurate though.
I had a breath test for SIBO at Mayo a few weeks ago. They test for various conditions based on your symptoms and medical history.
Thanks, Nancy! Could you please let me know their breath test are for both hydrogen and methan or just hydrogen only? I am at the end of the rope now and can’t even walk any more because of sibo. I am trying to find a place that do both hydrogen and methan. Thanks!
I had a test done at mayo in AZ and they tested both methane and hydrogen.
Thank you, Dave! Were you positive with hydrogen or methan? Did you get treatment from Mayo for sibo?
My husband was just diagnosed with SIBO yesterday-we live in Phoenix and he went to doctor Laurie Peterson- http://www.arizonadigestivehealth.com/providers/laurie-peterson-pa-c/
He had to drink lactulose then do the breath tests-thats all I know
Brennan,
She is PA. I did the breath test there and she treated me for SIBO. I had very bad experience with her and Denise (her assistance) and I will never go there again. They don’t have any knowledge about methane or treating methane. They test and treat hydrogen only. I learned it the hard way. I was almost death.
Would you mail me the word document. I am on second round of anti Biotics herbal from Biotics, worked the first time. Looking for preventative. Had the smart pill an it was determined my digestion was slow. No pro kinetics were given to me. Are there herbal pro kinetics? What do you know about acupuncture for motility?
I took the breath test at UCLA medical center it came back positive. The doctors at UCLA are great. My first visit with my gastroenterologist and he set up the breath test. Now waiting for my insurance to approve the antibiotic he prescribed. It has taken 3 years to get to this point. Had to change medical groups and finally got the right group of doctors. After reading up on SIBO it looks like it may be a life long struggle, Definitely will need to change my eating. I hope the antibiotic works.
I am in Tucson and their is a great naturopath here that does test or SIBO. check with the naturopath college of medicine in PHX (forget the name of it, but their are only 4 in country)
Would you mind sharing the name of the naturopath in Tucson? Thanks!
I had the breath test done at Mayo clinic and was diagnosted with SIBO after the breath test. Hope that helps Mia. My Dr. is Dr. Lange. I was treated with antibiotics and have now had 4 rounds of treatment. I am on the FODMAP diet. Although I am so much better than I was before, I still have issues….even watching what I eat. I can look at pasta and almost get sick.
Tiffany,
I was treated with xifaxan for a month with az digestive health but had no improvement. I changed to AZ Mayo and diagnostics with sibo again through a breath test last week. I was prescribed xifaxan twice a day for 10 days. I am on day 3 now. I hope it works this time. You have had 4 rounds of Xifaxan or different kind of a antibiotic each round? What is your dose for xifaxan? Would you like to give me a little bit detail please? I have a lot of gas pain especially at high upper abdominal up to the stomach that I can’t eat any more and loss 1/4 of my body weight. I tried to eat but everything gave me gas pain. Thanks!
Mia….I hope this helps. Mayo put me on the FODMAP diet to “live with it’ and “manage it.” Before that, this was my treatment. Hope this helps.
Diagnosed May 2013. I took 2 antibiotics in May 2013. I’m sorry I didn’t write those down. One was beginning of May. I saw much improvement, but needed another by the end of May. August I needed more….Noroxin 400 MG 2x a day for 7 days. This didn’t work for me. September 250 mg of Metronidazole (Flagyl) 4x a day. It worked, but after 2 days of being off the medicine, it came right back. October I took Noroxin 400 mg 2 x per day for 10 days. Worked…but eventually came back. This was the longest stretch that worked for me. May 11, 2014…again took Norovan 400 mg 2x a day. It did not work. So….May 18, 2014 I started XiFaxan 550 mg for 3x a day. It did not work that well. They all made my situation more “livable” that before…where I was at least able to function after I ate. But still, nothing every cures and STAYS. It is all about diet at this point.
Thanks, Tiffany!
Hey Mia,
I live in Tucson and went to AZ Gastroenterology where I saw a great NP, Nikki Deuel. The first thing they did was 3 breath tests: fructose, lactose, and the bacteria one. I was negative for the first two and positive for the third – but knowing that really helped me to adjust my diet without it being SO restrictive. She also recommended the low-FODMAP diet, which I otherwise follow and that has helped me a great deal. She also said, when I told her I ate 6 small meals a day, that some evidence suggests that by doing so, it interrupts the gut’s natural cleansing process, which might cause further disturbances (she clarified that the jury is still out on this, but it is suspect, so I changed that to 3 meals instead). Hope this helps!
Tiffany,
I was treated with xifaxan for a month with az digestive health but had no improvement. I changed to AZ Mayo and diagnostics with sibo again through a breath test last week. I was prescribed xifaxan twice a day for 10 days. I am on day 3 now. I hope it works this time. You have had 4 rounds of Xifaxan or different kind of a antibiotic each round? What is your dose for xifaxan? Would you like to give me a little bit detail please? I have a lot of gas pain especially at high upper abdominal up to the stomach that I can’t eat any more and loss 1/4 of my body weight. I tried to eat but everything gave me gas pain. Thanks!
Casie
I live in Chandler. Did you try any antibiodic? What help you most? I can’t eat because of the gas pain and loss so much weight. I can’t eat anything. My upper abdominal is full of gas all of the time. If I don’t eat I still have gas pain just less than if I eat. Thanks!
I did one round of Xifaxan, which helped immediately – but as soon as the 10 day treatment was over, it came back with a vengeance. I did one more round of Xifaxan, and thereafter have been able to manage my symptoms.
How soon after finishing the first round did you start the second?
I need to have surgery for breast cancer. Six weeks ago I turn a little corner on the SIBO – gained about 6 lbs and my thyroid numbers (with thyroid meds) stabilized. I want to do anything I can to prevent a relapse as they will have to use antibiotics during the surgery, along with anethesia, and pain meds. Any suggestions are appreciated if anyone has had surgery with SIBO.
does anybody know a practitioner or dr that treats sibo and severe ibs. I live in northeast philadelphia. Someone in the holistic field. Near buckscounty and Huntington va.
still looking for some one to treat sibo in my area. Northeast Philadelphia or bucks county
I just watched a YouTube video with Datis Kharrazian who said, among a ton more, that the simple act of gargling plain water 3 times a day greatly improved gut motility. I’ve been doing it for several days, and I swear to you I have less burping and gas. The gargling stimulates the part of the brain that affects digestion.
Cheryl, could you provide that YouTube link?
TIA
https://m.youtube.com/watch?v=Am7kr-vP0Ys
Sorry, I just saw the message! Here you go.
Thanks Cheryl, really appreciate it-love his work!
Thank you so much for this video link – it explains so much. I can’t wait for his latest book.
In his Brain book, Datis also says that singing loudly and stimulating the gag reflex will improve gut motility. (Improving an impaired vagus nerve and gut-brain axis – Chapter 9).
I have been dx’d with SIBO and have taken several rounds of Xifaxan over the last year, to no avail. As soon as the antibiotics would end, the symptoms and pain come right back. For the last 3 years, every aspect of my life has revolved around my gut.
I am seriously considering a trip to the Mayo Clinic.
I am going for a breath test in 2 weeks at IU. I work there in GI/ERCP and know we have some of the best docs in the country. I’m going to see Dr Woo. I explained my symptoms to his nurse and right away she suggested SIBO where no doctor ever did. They all said it was my diet acid reflux, which my symptoms where way beyond that. I feel hopeful that I will get some relief at least for the methane smell when I eat certain foods. It’s so embarrassing I don’t even want to leave my house in fear that it might start in public.
Liz….I was at the Mayo Clinic for over a year before being disgnosed with SIBO. All they will do is give you antibiotic and put you on the FODMAP diet. I wish I had better news, but I’m trying to save you the trip and the money. The doctor told me I needed to find ways to change my diet and learn to “manage it.”