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Permanent SIBO due to removal of ileocecal valve
Digestive Health | Last Active: Apr 2 6:54am | Replies (191)Comment receiving replies
Hi all. I had a right hemicolectomy 9 years ago for colon cancer. I understand now that this procedure generally removes the ileocecal valve, much of the ileum as well as the cecum. While I had more gas than normal I didn't have full sibo symptoms until 1+ years ago. A diligent primary care provider got my insurance to approve a round of treatment with Xifaxan. And it did absolutely nothing for me. In looking for answers online I happened to stumble across a GI Dr website that suggested Atrantil. I tried it and it worked. But then I dropped to the maintenance dose (or less) and it came back. I happened to be rx'd Cephalexin because of a mole removal and took the treatment dose of Atrantil along with it and this was far more effective than just Atrantil by itself. I had no gas for a couple weeks - none. But of course it came back. I've been able to mostly control it with Atrantil but this time it seems to not be working as well/quickly, and so I found this discussion while looking for ideas. For now I'm looking to combine antimicrobials (Berberine, oil of oregano) w/ Atrantil and possibly use Allicin (garlic extract) as an alternative to Atrantil to change things up. To prevent recurrence I see so much discussion on improving motility, but for those of us without the ileocecal valve, the missing valve is the issue, not motility. Perhaps digestive enzymes might help with prevention?
Replies to "Hi all. I had a right hemicolectomy 9 years ago for colon cancer. I understand now..."
I can truly relate to what you are saying. I also had the gas symptoms first before I got the real SIBO symptoms but that was about 2 years after my right hemicolectomy. I also am in search for the ideal treatment. When I find it I will post it. I had written an earlier post on what I have done so far but have not found anything that truly maintains the situation yet. I am also in agreement with you on the motility issue. I don't think we have the same problem as others with SIBO do in that area.
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Hi Azdon,
So weird that you had no symptoms for 8 years and then they appeared. For the sake of curiosity, was there any specific "event" that you think caused them, or was it just a gradual onset?
Although it is not great that you have not achieved "permanent" remission, the fact that your situation does, in fact, respond to antibiotics and antimicrobials should offer you hope that you are barking up the right tree, as it were.
I was prescribed several rounds of conventional oral anti-biotics like flagyl and doxycline for 10 days. Each time I briefly achieved remission but the condition came back. I even tried to use atrantil to extend remission - as you yourself described! - but in the long run this was not successful. What finally worked for me was doing a 28 day regiment of neomycin. I have been symptom free for more than 4 weeks now, which is longest I have felt good in almost 3 years.
What was your dose of rifaximin - was it 3 pills of 550mg daily for 14 days? When you said it did nothing, do you mean you absolutely had no response?
If I were you, I would next try 28 days of neomycin (2x daily 500mg), or whatever your doctor felt comfortable prescribing for you. Neomycin can damage kidneys and hearing, so you got to watch out. But the formula seems simple, get rid of your current "infection" and maybe get 8 years of "normalcy". Fingers crossed good luck.