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Confused about methane SIBO diagnosis + treatment plan
This may be long, but I am really looking for some insight from others (especially those who may have be in a similar situation).
I was recently diagnosed with SIBO and told I have methane-dominant SIBO, but looking at my test I am definitely Hydrogen dominant too plus IMO. My integrative doctor didn’t seem very confident with my treatment plan and that alone made me feel like this wasn’t a very individualized approach, ESPECIALLY in my complex case.
Here’s where I’m confused: My symptoms do NOT match what I’ve read about methane SIBO at all. I’ve had loose stools, urgency, and go to the bathroom up to 3–5 times a day for the past year or two. Definitely not constipated. Recently I started eating overnight oats, and it’s the first time in years I’m not running to the bathroom constantly. That seems… opposite of slow motility?
The protocol I was given is: Xifaxan, Neomycin, Nystatin, Digestive enzymes, Candibactin AR + BR, Low FODMAP diet (although my sheet is way more aggressive - no rice or potatoes - than actual Low FODMAP diets), cut out all current supplements I am on.
This feels super aggressive, especially all at once. I’m also really concerned about neomycin because of the black box warnings. I’ve seen a lot of people say it made them really sick too. On top of that, I have PCOS and suspected MCAS, long history of gut issues since childhood (food sensitivities, “candida,” etc.), chronic inflammation + nervous system dysregulation, recently developed random rashes that won’t go away, along with hormone imbalance since starting birth control in 2020.. I was NOT told to stop probiotics or berberine (or any of my supplements for that matter) before my SIBO test (which I’ve now read can affect results??) I’m also worried about doing an aggressive low FODMAP because of histamine issues.
Honestly, it feels like we’re jumping straight into “kill everything” without understanding the root cause. And my doctor already said I’d probably need to do the treatment twice, which doesn’t inspire confidence.
My questions:
Has anyone been diagnosed methane-dominant but had diarrhea/urgency instead of constipation?
Did anyone regret doing antibiotics vs going herbal route first?
Has anyone had false SIBO results from not stopping supplements beforehand?
If you have MCAS, PCOS, or hormone issues, did treating SIBO help or make things worse?
Would you pause and retest before starting something like this?
I’m not against treatment — I just want to make sure I’m not making things worse or missing something bigger without figuring out the true root cause.
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Yes what is an MMC?
@helenrose this is what I pulled from the internet: In gut health, MMC stands for the Migrating Motor Complex. It is a cyclical pattern of electrical and muscular contractions that moves through the stomach and small intestine during fasting periods between meals. Often called the gut's "housekeeper," its main job is to sweep away leftover food, waste, and bacteria.How the MMC WorksActs as a self-cleaning wave in the GI tract when it is empty.Activates roughly every 90 to 120 minutes.Pauses or resets whenever you eat food or snack.Takes about 1.5 to 3 hours to finish a full cycle.Why It MattersClears debris from the small bowel.Prevents harmful bacteria from building up.Reduces the risk of small intestinal bacterial overgrowth (SIBO).Helps minimize chronic bloating, gas, and digestive discomfort
I hope this helps. If anyone can tell me the dosage for herbal treatments for SIBO I’d be very grateful.
@annpeters very helpful. My nutritionist said I should be keeping meals at least 4 hours apart. Now I understand why.
@annpeters
I had IMO.- constipation. My findings are that the antibiotics fight the Achaea in the small intestine but this is a symptom, not a resolution of the problem. MMC is very important: let me suggest (i am not a doctor, but a patient):
1- Good hydration, drink plenty of plain water.
2- 3 meals / day with no snacking. Support a good MMC with meal spacing > 4 hrs.
3- Low FODMAP while you go through the cycle of fixing the IMO / finding the root cause.
4- My problem was that my body enzymes are low - including pancreatic Insufficiency + Lactose, Sucrose, and fructose. Get your doctor to prescribe a breathe test and fecal test to check your enzymes.
5- Get a good dietitian who knows SIBO (most don’t)
6-This is slow and will take time, be patient but dedicated to finding the root cause and fixing it.
7-I took supplements to a) kill the Archaea- Oil of Oregano, Allicin, Atrantil, neem oil etc, but the antibiotics can fit into this part of the problem solving b) Motility supplements- Iberogast, Magnesium Citrate, Ginger/Artichoke, Ginger, Miralax, Sunfiber, c) gut health - ginger, L-Glutamine, Zinc Carnosine (ask the dietitian for a list) - put together a plan.
8- Good exercise - help the body work.
9- I started taking B-12 in a spray form and Iron in a liquid form to get the body healthy without going through the infected intestine.
I found Chatgbt and Gemini to be very helpful.
Big issue for you is to find what is that root cause? - not the same for everyone. Antibiotics may make you feel better in the short term but I doubt that will fix your problem long term. These are all my opinions but patience, a good doctor that knows SIBO, IMO etc plus a good dietitian will hopefully get you there. - took me about 4 months to get to the 95% better spot.
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1 Reaction@marylandbob thank you for such a comprehensive response! I have a script for frayl However, I hesitate to take it due to bad reactions to antibiotics in the past. I think my root cause is slow motility but it’s just my best guess. I don’t have the best G.I. doctor. And I don’t have the opportunity to go to another one. I’m from Canada and if you have one Dr and request another, you are denied almost all of the time. I am seeing a Naturalpath and I am grateful for the improvement. I know I have a ways to go though. I’m so happy to hear that you’re 95% better. Wishing you 100% recovery quickly! thank you again for your response! May I ask what your dosage was on the antimicrobials?
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