Sibo treatment Rifaxamin and Neomycin
I have been diagnosed with SIBO and am being advised to take Rifaxamin 3x a day and Neomycin 2x a day for 14 days. I have many concerns about the Neomycin due to the ototoxicity. I have a bit of tinnitus already the think that may make me more vulnerable to a possible problem. The idea of taking something that might hurt my hearing even more is concerning. Any thoughts about the Neomycin in this context? I would like to hear about the research and if genetics can be determined to see if this would be safe for me to take.
Also, does anyone have any recommendations for a Dr. at Mayo/ Scottsdale who treats SIBO? I would like to coordinate care with my other doctors at Mayo as I think this is going to be essential to getting a handle on this.
Much gratitude in advance for this supportive community.
Take care,
Jaki
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@eileen57 - I wanted to let you know I moved your post here to this existing discussion where the original poster, @azj, also was talking about the same medications for SIBO:
- Sibo treatment Rifaxamin and Neomycin https://connect.mayoclinic.org/discussion/sibo-treatment-rifaxamin-and-neomycin/
You also mentioned something about flimsy US food labeling. I think perhaps you are talking about something like what is described in this National Science Foundation 2025 article https://www.nsf.org/news/americans-demand-greater-clarity-standardization-food-labeling. However, will you talk more about any concerns you have with food labeling and how that affects you as a patient with SIBO?
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1 Reaction@gboi that is incredible and thank you for sharing. Would you mind sharing if you were able to return to a normal diet, or how you managed the sibo afterwards?
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1 ReactionI had tinnitus before treatment. I took both antibiotics and lasted 5 days due to stomach upset. That was a couple months ago. Same diagnosis as yours. You may tolerate it better. I don’t think my tinnitus is any worse. What symptoms do you have or had that led to the breath test?
@eileen57 best of luck to you. I took both meds for 5 days and stopped. My stomach was too upset. Everyone is different. I have IBS too. I took a blood test through IBS SMART and it was positive. Meaning I have IBS due to an infection at some point. I’ve had IBS all my life so I don’t know what and when. What were your SIBO symptoms? Hope you’re feeling better.
@katnewton
I had nausea, fatigue and constipation. I just restarted Rifaximin and will take with the antimicrobial Allicin 450 mg. I hope to be able to get up to 450 3 times a day. I will start with once daily to see how I can tolerate it. My breath test revealed both hydrogen and methane. I so hope this treats my symptoms. I pray you find relief, as well
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2 Reactions@agb461 best of luck to you. I hope this combo works. I feel the natural supplements are a great plan with the Rifaximin. For nausea I use Gas X because the gas seemed to be causing my nausea. You might consider that if you have nausea. Also there’s wrist bands for nausea on Amazon.
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3 Reactions@katnewton
Thanks so much for the suggestions. I will definitely try gas x, as the nausea is the worst part. Leads to feeling so depressed. It’s good to know I’m not alone
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2 Reactions@marcconley I'm currently taking rifaximin and neomycin for IMO. I'm having several days of watery diarrhea during the last half of the 14 day course of treatment.
I don't know if this is normal or not. I seem to have a dud for a gastroenterologist.
I went through multiple Rifaxin/Neomycin treatments and at first they seem to help but then the problem is back. After researching and talking to a couple doctors plus dietitian I realized the Archaea in my small intestine was a symptom, not the problem (IMO). I started taking antomicrobials (Atrantil, emulsified oregano oil, neem oil and alicin to fight the archaea. I took some gut health drugs and some to help my motility (Ginger, artichoke/ginger, iberogast). Look-up MMC (natural cycle in your body that has to do with timing). Remember, different people have different triggers/problems, not a single problem for everyone. Suggestions other than the alternate solution to antibiotics include: 1- Water, hydration (I do 64 oz /day), 2- Chew food very well, helps digestion, 3- Three meals / day with no snacking, keeping the time separation 4-5 hours between meals, nothing in-between having calories as that upsets the MMC. 12 hours between meals fasting ie. 6PM to 6 AM allows the body to clear out the system. 4- No antacids (stomach acid is part of the operation of your system) and when your motility gets rights you should not need them. 5- Follow a low FODMAP diet while you fight this problem.
I had the SIBO / IMO problem for a few years. Once I started on this, it took about 4 months and now I’m low gas, no pain and a regular BM schedule. I found that my body is low in producing some enzymes and now, I take no supplements other than enzymes es to have normal digestion. Good luck! - Chatbots were very helpful for me but remember that they are helpful but not always right. (Suggestion: Cross check a second BOT).
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4 ReactionsEveryone is different and awesome enzyme production for you started some.