I’ve been taking Flagyl for months but I think I might be experiencing early symptoms of neuropathy, so I stopped the medication. I’m on Xifaxan now, and it isn’t doing anything for my symptoms! I’m being treated for SIBO so I don’t know why Xifaxan does not work and why Flagyl does. Is this normal? Or does this mean that I might not have SIBO but something else?

You'll find a lot of conflicting information and scare tactics about Xifaxan and people pushing "natural" treatments for SIBO, so you'll have to do your own research. I also don't want to run afoul of the proponents for natural supplements.

I will say I did a lot of research on my own and concluded that Xifaxan and Neomycin was the best route for me. This helped put things into context: https://health.usnews.com/health-news/blogs/eat-run/articles/facts-about-sibo-the-internet-keeps-getting-wrong. You can take it or leave it. I find this dietician to be very evidence-based as well as Kate Scarlata, who had SIBO herself. Another consideration is that the natural supplements are also very expensive on their own and don't have as much high-quality research to back up the efficacy.

To answer your question, I did get over SIBO with Xifaxan and neomycin. I did a SIBO breath test and it was actually negative, but they don't always exclude SIBO. Because of my symptoms (and we ruled out everything else), my doctor agreed to treat it empirically.

From my understanding, Xifaxan is more specific to the gut, so it's far less likely to impact antibiotic resistance and the risk of causing C. Diff is extremely low. I'm not totally clear on why this is, but I recall finding many sources online that explained why. But they need to include that risk on any label, including topical antibiotics. I had very few qualms about taking Xifaxan, except the risk of side effects affecting how I felt.

Neomycin is a different story--do you have a diagnosis of methane dominant SIBO? It's usually only indicated for methane-dominant SIBO. My symptoms were consistent with methane-dominant SIBO, which is more challenging to diagnose. While I tolerated Xifaxan okay, the neomycin caused me nausea I was able to manage by making sure to always take with food. It's not something you'd want to take unless you have to, and not something you'd want to repeat, whereas Xifaxan can in some cases be repeated if you have an occurrence.

I also took Florastor, upon recommendation of my doctor, which is the only evidenced-based probiotic shown to help prevent C. Diff and survive the environment in the gut when you're also taking an antibiotic. The first time I took Xifaxan without it and I immediately noticed the difference when I took Florastor. It's also pricey, but worth it to me for the peace of mind.

It is expensive if your insurance won't cover it--thankfully my insurance was willing to cover it, twice.

I haven't had a recurrence, but I took steps to improve my motility as much as I could--did pelvic PT to learn about abdominal massage, I take Iberogast which can act as a prokinetic, make sure to move around after I eat, practice diaphragmatic breathing, to try to prevent a recurrence.

I've been battling SIBO for 4 years. First 2 times with Xifaxan alone, but the DR.s I had didn't know much about SIBO. So 3rd time Xifaxan + Neomycin 14 day program killed the SIBO. The hardest part for me is the special certain foods you have to eat. Natural cures. Please read about these Wild Oregano Oil, Berberine, Neem, Triphala, Also Sibo will deplete certain Vitamins. VIT. ADK, Iron, Magnesium, D3. It's a year or so long if you do everything right. Good luck, it drains your energy too.

Sorry, no success story from me. I tested positive, "off the chart" with SIBO and I think I've been suffering from birth with it. But the Xifaxan (which cost me $1,900) didn't work for me at all. (The Florastor didn't work either.) As I heard someone here on this site say, the Xifaxan doesn't get at the cause of the SIBO so it comes right back as soon as you stop the Xifaxan. And last I heard, they still don't know what causes the SIBO, so no wonder there doesn't seem to be a cure for it.

Yes, the test showed both methane and hydrogen. My doctor called in both Xifaxan and Neomycin. He also said I could look up SIBO diet on Dr. Google. Thank you to emo too. Good to know I may need to take the Neomycin with food. Keeping my fingers crossed.

Xifaxan is a treatment for symptoms of SIBO. Every time I went off it, my symptoms returned. It’s not enough to take any pharmaceuticals or natural supplements without also changing your diet. My doctor has a dietitian that helped with kinds of foods to eliminate for a period of time to be reintroduced later one at a time until my gut healed.
There’s also a great book - SUPER GUT - you can order on Amazon that’s really helpful on foods that are gut healing, includes easy recipes. It’s worth checking out.

Take Dysbiocide and FC-Cidal, from Biotics Research from Amazon. I took it I think for 6 weeks per doctor's instruction and my Sibo never returned.

Dont eat sweets while trying to heal.

I came across success stories using celery juice. Anyone else? My 7 yo daughter has hydrogen SIBO (2nd time). The first time, she did low FODMAP diet, a round of flagyl (didn’t help), then a round of rifaximin (helped a good bit). 6 months later, we’re here again and the rifaximin is on backorder. Think we’re going to try the celery juice… will report back.

After a few rounds of SIBO, in which Xifaxin helped get me out of a couple of episodes, I realized that improper diet was the problem, causing relapses. Try the diet by Dr. Mark Pimentel of Cedars Sinai hospital. Sugar and sweeterners are one culprit, as are beans. Not a hard diet to stay on.

Canada has xifaxin for ! $100 give or take -google it!