SIBO (small intestinal bacterial overgrowth), does anyone have any experience of this!

[TheWholeShackShimmies]

After decades of suffering digestive issues such as excessive gas, burping, acid, pain, bloating, excessive gurgling, diarrhoea to constipation and back to diarrhoea and never feeling well throughout my digestive system, I tested positive for SIBO 6 months ago and have been very much struggling ever since.

My gastro just handed me a prescription for Rifaximin and said she'd see me in a year for a follow up and that was that!

I took the Rifaximin for a couple of days but felt worse so stopped. I know that's not long but I seriously can not afford to feel worse, I have a very stressful life helping care for my mum who has dementia and breast cancer as well as having my own family and a part time job which I don't get paid sick as I'm self employed. I have endometriosis too which I wonder is the cause of the sibo but not sure as no one on the NHS seems to know much about this condition.

I have tried so many diets and foods to help (currently low fodmap and only drink water). I have spent so much money seeing nutritionists and functional practitioners but they all advise something different. I have fallen down so many rabbit holes joining endless FB, IG and Reddit SIBO support groups and again they all have conflicting advise.

I'm slowly losing my mind over it all. Does anyone know how to treat this successfully without feeling worse than before?

My son was advised to do FODMAP and take symprove. Garlic and onion were the culprits. Once he cut them out he had no further issues. After a couple of years he reintroduced both in small quantities and is usually ok. He accepts that the occasional take away curry may leave him doubled up. If you need to cut out onion, asafoetida in tiny quantities is your friend

My relative did low fodmap and it really helped. Not sure how quickly. It wasn't instant, but I'd say a month or two.

They also found they were deficient in several vitamins as they hadn't been absorbing them. They found the spray ones, that you spray on your cheek, best. B12 and D.

Thanks chesterlestreet & Frowningprovidence
I've been low fodmap for quite some time but it's not helping the symptoms at all (or maybe they'd be even worse if I wasn't on it?).

Frowningprovidence I had a full blood test recently but everything has come back as normal.

Have you figured out any problem foods from the low fodmap?

It may be that you’re not eating enough variety to repopulate your gut bacteria.

I know! I know! Whatever one expert tells you to do, there’s another telling you the exact opposite,

My issues are different to yours but in the same ballpark. I’m very wary of additives and emulsifiers, trying to eat clean, and adding in more fermented foods, and a lot more fibre.

Intermittant fasting seems to be helping too - I vary it with my cycle, and it’s only 12 hours, but that has helped regulate my system.

It just feels like a guessing game.

It's such a hit and miss guessing game at times, isn't it?

I have kept a food diary for ages. Garlic, onions, dairy and quite a few fruit and veg are big triggers. Artificial sweeteners give me grief and high fat and sugar foods too. I have awful issues with most fibres, I have been advised to take psyllium but am really apprehensive to do that given my poor history with fibres. I have to eat very basic foods which I agree with you, are not helping my microbiome at all. I have endometriosis and am in perimenopause which certainly isn't helping.

I eat from around 11am to 7pm but not sure if that's a really helping for the longer I go without food the more gassy and bloated I get.

I feel like a jigsaw and several pieces have gone missing. It's a long haul hunt to track those missing pieces down.

I have. I have IBS due to radiotherapy and at times I get a sibo flare up. It's really important to take the antibiotics as they are helping stop the bad bacteria. I also take a probiotic after the antibiotics have finished. I also avoid certain foods, so legumes, pulses and whole wheat. With me it's not always fodmap foods but can be anxiety etc that are triggers

I find oats are usually ok so eat porridge etc

Yes it’s an overgrowth of bacteria so antibiotics really do help, I would ask for metronidazole and take two weeks worth then start a probiotic. Diet etc never made any difference.

Btw used to alternate antibiotics to avoid the bacterial resistance. So would alternate rifaximin and metronidazole, but metronidazole worked best. Then would alternate with probiotics. Maybe see a gastroenterologist if you are getting worse.

Ring the gastro secretary and get an appointment do not wait a year.

I would second a two week course of metronidazole. It can give you a horrible metallic taste in your mouth, and it's the one antibiotic you can't drink on as it'll make you vomit, but if you see out the two weeks it will make a massive difference.

I tested negative for SIBO but I've a rather altered GI system and a stoma, so talking to a surgeon friend he suggested a 2 week course of metronidazole and low and behold it really worked.

Thanks everyone, I'll try and contact my gastro and see if she can prescribe the metronidazole.

Hi TheWholeShackShimmies

Did you get to see/talk to the gastro about the alternative antibiotic metronidazole? Did you try either antibiotic again?

I'm in a similar position to you. Have had SIBO for years and it is managed rather than eliminated as I can never tolerate the natural antibiotics (oil of oregano, berberine, etc) to get rid of the excess bacteria. Never tried pharma antibiotics or seen anyone from NHS about it as they didn't believe it existed 20 years ago so I was laughed out the door. So I did my own thing with nutritionists and I don't have too many big symptoms but it does need addressing still. So I'm interested to see if antibiotics do work and whether they are more tolerable than the natural antimicrobials.

My workarounds (not cures) that have helped are: digestive enzymes, pepsin HCl (breakdown the food fully so there's less undigested stuff for bacteria to feed on), ginger capsules or fresh tea (helps with motility, also slightly antimicrobial and is anti-inflammatory and anti-histamine, and helps with nausea too). An anti-histamine probiotic called Hstamine x probiota (mast cells and histamine release can be issues too sometimes). And a low-ish FODMAP diet.

I also have endometriosis, and my hunch is that the lesions/scar tissue have attached at some point in my GI tract and are restricting normal motility. Taking NAC and a good dose of Omega 3 oil helped with inflammation. And DIM to keep estrogen levels lower. That seems to keep a lid on it (so I don't collapse and vomit with pain).

I also have hyper-mobility which also doesn't help with gut motility keeping things moving in the right direction at the right time.

So my SIBO has come from possibly endometriosis and hyper-mobility. Another culprit may be the mercury fillings I've had (11 fillings starting from a very early age). So as these need replacing anyway as they're so old, I'll be subbing them with white ones as and when they need doing. Mercury does, in minute amounts, come off because of abrasion when eating and hot drinks vaporise some. It's not crazy amounts but if you've got 11 and you've had a small dose of mercury for most of your life it's going to have an effect. So that's a background job. There's a lot of debate about mercury fillings I understand people say they are completely safe. But it is mercury and there's no dressing it up, mercury is toxic. I hope this isn't relevant to you anyway.

If anyone has any good strategies that have helped their SIBO it would be great to hear. Thanks.

Hi everyone, first time poster just looking for any help with my partners SIBO diagnosis.
Deb has MS but has also struggled for the last six years with an undiagnosed gastric issue.
She was recently scheduled to take the hydrogen breath test, but was too ill to attend.
The consultant decided that it was likely enough to be SIBO, to treat it as such even without a definitive diagnosis.
She was prescribed Rifaximin 400mg 3 x daily.
All the data on Rifaximin suggests that she should start to feel better after a day or two. She’s on day four and if anything, she feels worse.
Is this normal? What are other peoples experiences?
It’s probable that the MS slows her motility, is this likely to delay the effects of the Rifaximin?
She’s really suffering and we thought, where do you go for sensible advice? We thought of you guys.
Any insights or advice would be greatly appreciated.

I haven’t been diagnosed but believe I have SIBO. Only thing that’s got rid of my symptoms is decimating my gut biome with antibiotics. You don’t want your gut bacteria thriving too much because the point of SIBO is that it’s overgrown.

Thanks TheGreatWesternShrew, do you recall what antibiotics they were?

SIBO a bi product of diabetes for me, Metronidazole and a small time (12-18 hours) of starvation can help me. Be careful of pulses and grains plus slow release carbs as they can exacerbate your SIBO.