Xifaxan for SIBO

@gigi4 I’ll check it out. Thanks!

You too!

Three rounds of Xifaxan, works for a little while but not a cure. It took me two years of careful monitoring and a very good, science-based dietician to zero in on my problem, which is inability to digest certain types of fats, esp long-chain fat digestion…. once you get to the root cause of your troubles, you can manage this. I was prescribed Zenpep, which is another very costly prescription, but I have been able to manage my symptoms with diet and with dietary enzymes from Pure Encapsulations, they make a cheaper version of the Zenpep. Dosage is not as high as Zenpep, but I can actually adjust as needed with 1, 2 or 3 pills if I’m going to eat something that might trigger symptoms. Hope this helps.

@dt61

This is my third time with SIBO. I've done extensive research to find the source of the problem. I encourage you to check out the following website https://sibosos.com. These practitioners really know it and they occasionally have a guest speaker, Dr. Mark Pimental, who is a SIBO specialist from Cedars Sinai. Xifaxan alone won't kill it. This time I took Biodisrupt first to eliminate the mucous that covers and protects the bacteria, followed by 2 weeks of Xifaxan, and now I'm on Atrantil for 7 weeks. At some point I will probable take a Prokinetic like Motility (I have methane dominant SIBO but I had Hydrogen dominant). I will then start to rebuild my microbiome using colostrum (you can get on without dairy) and probiotics. The only breath test worth taking is Gemelli Trio Smart. It is accurate for all 3 types of SIBO. You can now also take a test for IBS that Gemelli labs also makes called IBS Smart. I plan to take that. It will definitively show if my IBS and SIBO started with food poisoning. Most do and I'm convinced mine did too. If it did you need to be very vigilant following up treatment because 80% will have a relapse.
I hope you find a specialist in SIBO who can prescribe a protocol for your specific type. Not all GIs know SIBO. Mine doesn't and admits it. I finally found one who does. It's not easy.

thank you for your thoughts
i have posted previously the extent of my issues and personally (no offense meant) SIBO is a walk in the park.

Hi, you need to find a SIBO practitioner. The gold standard protocol to get rid of it is a course of anti-bacterial like berberine, a course of Rifaximin, a course of berberine, a course of Rifaximin and then a final course of berberine. SIBO is no joke and hard to get rid of. I had SIBO in 2017 and a relapse in 2020. MD's didn't know what it was back then. I had to find a SIBO naturopathic practitioner.

I got my Rifaximin from India via Canada. Much cheaper but that was before all the political ridiculousness. Price in the US was $2000 for one course. I got two courses for $70 from India/Canada.

@rpl55 - welcome to Mayo Clinic Connect. I'm glad you have a good, science-based dietician helping you with your SIBO. That is great.

That is too bad the pancrelipase (Zenpep) is so expensive. How are the enzymes working? What do your doctor who prescribed the pancrelipase (Zenpep) and the dietician say about taking them?

@gulfcoastwoman I got rid of SIBO (hydrogen only) by alternating anti-bacterials (berberine) with courses of Rifaximin (from India) AND I had to take a biofilm disruptor to get that the anti-bacterials/antibiotics to be effective. I still take LDN as my prokinetic. I agree you have to find a SIBO practitioner. Otherwise, you're wasting your time. I've used naturopaths because they were ahead the game when I had it in 2017 and relapsed in 2020.

@glennas I got my Rifaximin from India via Canada. This was 2020 and it cost me $70 versus $2K. I suggest getting a biofilm disrupter so the meds can really get to the bacteria overgrowth. I worked with a SIBO practitioner and successfully got rid of SIBO. Alternated Anti-bacterials with antibiotics. An antibacterial is berberine for example.

@lisalucier
My gastroenterologist approved the substitution but recommended I take the Zenpep when necessary (eating a Wagyu steak for example… which I would never do!)
Another recommendation made by both the doctor and the dietitian was to take a pill just before eating and to take another one about halfway through the meal. That recommendation has worked quite well with the enzymes. The dietitian had recommended Pure Encapsulations. I did a lot of research on my own - there are a lot of enzymes out there, but my Gastroenterologist agreed that these are very high-quality, in fact he recommended their vitamins too. It has taken years to get to the point where I feel like I am managing this extremely well now. Hyper awareness of what the triggering foods are and what the timing is has really helped.