Comments on: Small Intestinal Bacterial Overgrowth (SIBO)

By: Ashley

Ashley — Thu, 30 Oct 2014 01:36:55 +0000

Kate
Thank you so much for responding! After so many doctors with no real help, it’s so comforting to talk to someone with knowledge about this subject.
If you don’t mind, I have just a couple follow up questions from your reply.
I can’t get into a new GI for months and the only real help the current one has done is to prescribe the xifaxan. I am planning on :
– xifaxan for two weeks, with a balanced diet ( should I take the Gluatmine while on antibiotic or start after? )
-GI said probiotic only option for after, so discouraging her lack of knowledge or help. I was trying to find a non prescription prokinetic and Iberogast sounds promising.Have you ever heard of this herbal alternative? Again, start after antibiotic.
-my only other question upon starting treatment is the use of HCL for low stoamch acid, do you have any opinions?

Again I understand that you can’t give medical direction, but being able to ask questions to someone who understands this is helpful and comforting beyond words. Thank you again for your thoughts.

By: katescarlata

katescarlata — Wed, 29 Oct 2014 23:44:28 +0000

In reply to Ashley.

Ashley–You might want to find another GI doctor that has better knowledge of SIBO. The majority of my SIBO clients have been helped with use of the pro kinetics post antibiotic therapy. I have mixed feelings about using a probiotic in a patient that is likely not cleansing their small bowel efficiently…which led to their developing SIBO. Most SIBO patients have less cleansing waves–due to the SIBO or due to having a motility disorder that contributed to the advent of SIBO. I often recommend l-glutamine in powdered form for patients with low grade inflammation or long term GI issues to help heal the gut. But l-glutamine is contraindicated in patient’s with bi-polar disorder. It is so important to find a dietitian that is well versed in digestive health and a GI doctor that enjoys working with SIBO and functional gut disordered patients.

By: Ashley

Ashley — Tue, 28 Oct 2014 23:58:41 +0000

Hi Kate,
My GI just prescribed xifaxan 550mg twice a day for fourteen days, after months of sudden ibs and acid reflux problems.Ive been trying to educate myself on the subject of bacteria overgrowth and to be honest I’m overwhelmed. I have a few questions that I was hoping you could share your thoughts on…probiotics seem to be up in the air, to use or not to use.I think the basis behind not doing so have some merit, what do you think? My GI doesn’t seem to eager to help me get best possible outcome, when I asked about prokinetics she said there is nothing to do after taking the xifaxan except probiotics and yogurt. If she won’t prescribe one, is there some otc or natural prokinetic to keep things moving? One last question, I was reading about glutamine and how it repairs, should I take this?

I know you can’t give medical direction, but I’m young, 28, and feel like I’m going into this blind.any thoughts would be greatly appreciated.Thank you for your time .

By: katescarlata

katescarlata — Mon, 27 Oct 2014 11:26:29 +0000

In reply to Tammy.

Tammy, typically I recommend small amounts of FODMAPs during antibiotics–perhaps 1/2 apple and some garlic–I don’t typically push fermentable carbs to induce terrible symptoms. Some people feel lousy during the antibiotic phase and then start to feel better with in the week of stopping the antibiotic–but I find it varies person to person.

By: Tammy

Tammy — Mon, 27 Oct 2014 03:22:06 +0000

I have been tested positive for SIBO. I am being seen at Cedar Sinai with a doctor working with Mark Pimentel. The physician did not really discuss diet treatment with me. I have been on a low FODMAP diet for over a year. I have been prescribed a 10 day treatment of rifaxim and neomycin (which I am taking now day 4). Following, I will take 3 months of a prokinetic called prucalopride. I noticed in your article that Dr. Pimentel recommends eating a high fermentable diet while taking the antibiotics. I have been doing this, but my stomach has been so bloated. How high FODMAP do you recommend to eat? Do you know long it takes for some type of symptom relief to come? You stated that you had SIBO in the past. Did you follow a high fermentable eating protocol while you were on antibiotics?

By: Colette Binger

Colette Binger — Tue, 21 Oct 2014 16:39:18 +0000

Hi Kate- Thank you for this site and be dedicated to SIBO research. I was diagnosed in July with SIBO, am currently on my 4th course of antibiotic first however of Xifaxan and Neomycin (high in methane- and unfortunately, don’t have a dr/gi here that knew to treat with both earlier). First course, Flagyl, then two of xifaxin alone- now this. Dropped 40 pounds since April, when this all began and have been terribly ill. Have done 100’s of hours of research, phone consult with Dr. Keller (one of A. Siebecker’s partner’s in crime from Oregon), and have an appt with Weinstock in St Louis in 6 weeks. Here is my question and issue. This dose of meds is making me have explosive diarrhea, and feel worse, I have heard this can be common- thoughts? I am feeding the bacteria, do you have suggestions of how (I am lactose intolerant for sure). Protocol suggests doing a repeat breath test 5-14 days after meds (Pimentel/Siebecker)…do you know have suggestions after this if my levels are still higher than they should be? Vivonex? Which I hear makes people vomit? HELP? Frustrated and weak- feeling this week may be another weight loss week and just not up for that. :/
C

By: suzanne

suzanne — Sun, 19 Oct 2014 22:15:26 +0000

Hi Kate,
I had a LACTULOSE breath test which showed a classic sharp rise within 20 mins. I then had a course of Doxycycline.
Since then Ive had another Lactulose breath test and even though I strictly followed the preparation diet, my baseline for the test was a high reading with a slow gradual incline.
Because of this my holistic doc has suggested i may still have SIBO.
Is there another reson i may have had the high baseline? Many Thanks Suzanne.

By: April Ogden

April Ogden — Sun, 19 Oct 2014 00:59:27 +0000

In reply to katescarlata. I'm in the same boat and my doc is working with me but is not real knowledgable on Sibo. What would be included in a good work up to determine why the bacteria are growing in the small intestine. He will order any tests I want but I need to know what to ask for. Thanks April

By: katescarlata

katescarlata — Sat, 18 Oct 2014 20:28:37 +0000

In reply to Phil Paroian.

Hey Phil,
I would check out Alison Siebecker on siboinfo.com–in Portland, Oregon or Adam Rinde at http://www.soundintegrative.com/blog/–outside of Seattle– both are naturopaths with great background in SIBO care. Meal spacing is very important and modifying diet too. Proper antibiotic therapy and follow up with a prokinetic such as low dose erythromycin -50 mg at night can help reduce reoccurrence. And remember SIBO is not an end of the road diagnosis–it is a SYMPTOM of something else going on. Try to get a good work up to determine why bacteria are growing in your small bowel.

By: Phil Paroian

Phil Paroian — Sat, 18 Oct 2014 18:36:57 +0000

Hi Kate;
I live on Olympia WA, about half-way between Seattle and Portland OR. I was diagnosed with probably SIBO, did a course of Xifaxcin, and just got the results of a breath test done 3-4 weeks after the antibiotics finished. That showed results that even more strongly confirmed SIBO. My local GI doc and I are trying to sort out treatment options, and with his full support, I was wondering if you knew of any SIBO experts in either Portland or Seattle that you’d recommend for a second opinion/consult? Thanks!

Cheers,
Phil