How to manage SIBO symptoms?

Posted by jacque6977 @jacque6977, Feb 22, 2017

My wife, after years of suffering from debilitating nausea and fatigue, has finally been diagnosed with SIBO as confirmed by a hydrogen breath test. It is estimated the bacteria has had at least two years to grow and may be well established. She has started on Xifaxan, at $35 per pill, but it is estimated that elimination of the SIBO may take up to six months. Her day now starts with her waking up with nausea and when she has a cup of tea and toast in the morning she gets sick within fifteen minutes thereafter. Her sickness is accompanied by violent belching, and at times she regurgitates liquid vile. The only drug she has for nausea is Zofran which does nothing for her. Are there any other SIBO sufferers that are experiencing the same symptoms, and what are you taking to reduce the nausea?

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Profile picture for guerreraazul6 @guerreraazul6

Greetings SIBO community!
Despite having a gastroenterologist specialist & many chronic SIBO symptoms, the specialist never suggested possible SIBO . Only after viweing a post from someone I follow on social media (who battles another condition I have) I requested testing. POSITIVE!!! It was relieving to finally have an answer & confirming what was going on with my body.

From the extreme gas, extreme fatigue, bloating, oily & foul smelling stools, belching, indigestion, acid reflux, loss of appetite, extreme constipation (which I've had since my intestinal issue & surgery) & the CONFUSION!!! Something was off with this body. And the abnormal breath aroma no matter how often you brush your teeth, tongue, gargle & floss, it was there!

I've had multiple surgeries on my abdomen & a couple involving my intestines. I've also had several rounds of antibiotics. Presently my body is extremely sensitive to antibiotics & many other medications.

My most recent surgery, earlier this year, confirmed severe adhesions & just as I assumed & informed my specialists, I felt as if the adhesions were on my small bowels. This is what precisely is going on with my insides, a portion of my small bowels are entangled in dense adhesions. I was informed that they couldn't see where the bowels began & ended within the adhesions & to avoid a leak, they elected not to proceed with adhesiolysis.

I had a severe reaction to an antibiotic I had taken in the past prior to this surgery (Dec. 2020). My gut was never the same after this.

Previously I was in the medical field for over a decade however I'm not a physician, so please always consult your treating medical professionals & ADVOCATE for yourselves. If they don't listen, respectfully fire them. This is your body & your life. No one likes to start from square one but this is your life, we as patients, as human beings, deserve a physician(s) who actually have our best interests as a priority. It is my belief that patient & physician should work as a TEAM.

I knew something was wrong. I eventually researched SIBO diets & reviewed a food map chart. I was also prescribed an antibiotic that costs over $600 US dollars. I declined mainly due to medical research that displayed that antibiotics do not cure SIBO & it will more than likely return.

Apparently I'd been battling SIBO at least since 2015 & I had a major flare in 2021 until presently. It won't back down! I can say that avoidimg certain foods does help some but not enough.

From the medical research online from a renown medical website, SIBO usually initiates when your small intestine doesn't move food along the way it should. Bacteria grows & sticks around too long. If the “good” bacteria that helps you digest food cannot keep up with the harmful bacteria, the “bad” germs can multiply too fast, leading to an imbalance. This is precisely my issue & more than likely everyone with SIBO issue. My food sits in my small intestines. It's absolutely miserable.

I avoid white refined sugar & I even monitor how much fruit I consume. I used agave instead of sugar but I must be careful about that now. I also live on laxatives as I won't ever be able to "normally" defecate. I have to properly hydrate to avoid dehydration. Sometimes I miss a day or two of laxatives (you can imagine my life) & SIBO flares like a raging bull! I can't do this to often in order to avoid another NG tube placement (I've had bowel obstructions).

I'm concerned about the cons of persistent laxative use however I have no choice. I have to alternate what I use for my body. Miralax was the safest medical recommendation for my body. I alternate because these wonderfully made bodies of ours develop a tolerance. I used EXPERIENCE by pure trim as well as some teas & dulcolax when I must. I can't emphasize how crucial staying hydrated while using laxatives, whether it's daily use or not. I learned that spring water is full of minerals & is naturally alkaline so I choose to drink that most of the time when I'm able to.

I've personally learned that gut motility & good gut health is key. It's unfortunate for those of us with surgical histories that involve the gastrointestinal system & abdomen because we're prone to SIBO & other issues per my medical research & from personal experience.

Keep in mind that medicine is a science & it is a science that we all will need throughout our lives. I urge all in this community to learn how to manage your SIBO with a good medical professional(s). Remember, research PRIOR to consuming anything & YOU choose what treatment options are best & the most comfortable for YOU. I learned the hard may at the price of my health etc. from another ailment that was ignored by a past medical professional. Please ADVOCATE ADVOCATE ADVOCATE for your body, your health & for your life!!!

*I am not affiliated with the companies for the products I use for my SIBO treatment that are mentioned in this post. My personal health information regarding SIBO is shared for educational purposes for those in this SIBO community & does not amount to professional advice.

*I am not a physician. Consult a medical professional or healthcare provider if you are seeking medical advice, diagnoses, or treatment.

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Same issues, I had 2 surgeries. My kidney & Gallbladder. So of course prone to SIBO. Taking laxatives can be really BAD for gut health. I used to take miralax like crazy. What has helped and is gently but you’ll have 2-4 BM the morning after is magnesium oxide!!! Im telling you this stuff is magic!!! I have one kidney so I have to be careful with my magnesium but this is hardly absorbed throughout your body. Magnesium oxide causes the intestines to release water into the stool, which softens the stool and relieves constipation and irregularity. I had a colonic & the RN performing the colonic suggested it to me & I have never went back to laxatives, that’s what has helped me.

Where I live they don’t test for SIBO, I had to beg my GI doc to prescribed me medication for it. I had all the symptoms because I researched it. Today I start my Rifaximin. I know it doesn’t always work for people and it my SIBO can come back but my idea is, if I can just get it under control then work along a holistic herbalist to help as well & my IBS nutrients I can beat it. But again we have to find the root cause, which is the problem.

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Profile picture for jfar007 @jfar007

Update: I think I was lucky because I didn’t suffer with SIBO-M for more than a year, so the Rifaximin worked for me. I am now mostly following the F-Factor diet, which is basically low carb plus a very high fiber/low carb cracker. Constipation resolved completely, and distention slowly going away. I am trying to be very careful with avoiding sugar because this is known to come back. I haven’t thrown up since September.
Glad to hear I can use Canadian pharmacy if there is a relapse, this drug is horrendously expensive in US. I am off the Allicin because it made me worse. Doing Ginger capsules, 3 Berberine per day, and 2 Atrantil per day. So far most days I feel normal!

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Where do you get the Ginger capsules, Berberine Atrantil? Do you take this now so that the SIBO doesn’t come back ?

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Yes, after a lot of research, these natural ingredients can help stop a relapse. I got them all on amazon. Berberine turns out to help with several other factors as well, such as cholesterol, sleep, weight management. All have been easy for me to tolerate. The Allicin gave me severe symptoms.
It’s expensive to “treat” this but very much worth it.

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Profile picture for jfar007 @jfar007

Update: I think I was lucky because I didn’t suffer with SIBO-M for more than a year, so the Rifaximin worked for me. I am now mostly following the F-Factor diet, which is basically low carb plus a very high fiber/low carb cracker. Constipation resolved completely, and distention slowly going away. I am trying to be very careful with avoiding sugar because this is known to come back. I haven’t thrown up since September.
Glad to hear I can use Canadian pharmacy if there is a relapse, this drug is horrendously expensive in US. I am off the Allicin because it made me worse. Doing Ginger capsules, 3 Berberine per day, and 2 Atrantil per day. So far most days I feel normal!

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What dose of rifaximum? What pharmacy?

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I was taking 3 horse pills of Rifaximin a day. I’m with Kaiser and my co-pay was $650- yikes! But it was worth it for me

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Profile picture for jfar007 @jfar007

Update: I think I was lucky because I didn’t suffer with SIBO-M for more than a year, so the Rifaximin worked for me. I am now mostly following the F-Factor diet, which is basically low carb plus a very high fiber/low carb cracker. Constipation resolved completely, and distention slowly going away. I am trying to be very careful with avoiding sugar because this is known to come back. I haven’t thrown up since September.
Glad to hear I can use Canadian pharmacy if there is a relapse, this drug is horrendously expensive in US. I am off the Allicin because it made me worse. Doing Ginger capsules, 3 Berberine per day, and 2 Atrantil per day. So far most days I feel normal!

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Can you tell me which canadian pharmacy you use to get xifaxan? I live in the US and pay nearly 900.00/ month for 60 550mg tablets.
Thank you

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Our entire intestinal tract is filled with bacteria - good bacteria and not so good. My doctor explained my SIBO was caused by good bacteria in the lower intestines migrating to the upper small intestines to feed. That is due to not digesting food well in the small intestine to move it to the lower where these bacteria feed and causing problems like gas and acid reflux. I took prebiotics and probiotics for a period of time. When my symptoms subsided, I went off the prebiotic and continued with the probiotics. During this time I also made changes to my diet - omitted sugar (substituting stevia for tea and coffee) and sugar laden desserts, reduced alcohol, limited fruits to berries, and vegetables low in sugar. Bacteria like to feed on the sugars. So the goal was to get the lower intestinal bacteria back to the lower intestine by improving digestion in the upper small intestine. I also took 10 minutes before meals 2 pumps of bitters with water to get the digestive juices going, followed by a digestive enzyme after several bites of food.
Prior to all this, I took Rifaxamin for 6 weeks prescribed by a different doctor but once off it without the dietary changes, the symptoms returned.
I’m now symptom free which has benefited my heath in other ways as well.
In my humble opinion, a doctor should be open to both botanical, herbal supplements as well as a pharmaceuticals if that is the best way to treat and also test for vitamin and mineral levels to prescribe supplements to get the vitamins and minerals we may be low in that are critical to our well being.

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Profile picture for beanglow @beanglow

I haven't been diagnosed with SIBO but have all the symptoms. I'm going to be seeing my fourth GI at Mayo. I'm hoping to get a diagnosis of something. Everything I drink, even Boost causes terrible belching, bloating, distention, diarrhea or constipation and some nausea. My GI prescribed Xifaxan but my insurance would not cover it even with a very high co-pay. They said that since my diagnosis was not IBSD that I could not get it. My GI at the time would not even attempt an appeal on my behalf and told me that there was nothing else that she could do for me. Someone mentioned a SIBO test that was done at home. I was wondering if I could get the name of the site used. Also, does anyone know of anything that works for belching? This community has been so helpful. People here understand what you are dealing with. Trying to explain your condition to healthy people who can't understand what you are going through leaves you feeling isolated. Thanks to everyone who shares on the Mayo community.

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Search on breath test: "aerodiagnostics"
My insurance paid half. Blue Cross.
Look into "sibosos"
to get this resolved OR another, likely equally effective on line source, is "Dr Robillard"
Personally, I am working with a local dietician associated with a Chiropractor while considering one of these two to supplement my knowledge about SIBO.
I went to a ND(Naturopath) because I was disgusted with my local physician being dumb as a box of rocks and Gastro docs not being available and finding previous interactions indicating they were not knowledgeable. . . Long story short I quickly dumped the ND also! After test results showed I had SIBO(one good outcome of this intereaction) he wanted to sell me on 960 pills to take in one month of 7 different varieties!

This gastro stuff is a minefield with many doctors being obstructions around the mines. I am not happy with the allopathic professions. Good luck. Think for YOURSELF.

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Profile picture for gigi4 @gigi4

Our entire intestinal tract is filled with bacteria - good bacteria and not so good. My doctor explained my SIBO was caused by good bacteria in the lower intestines migrating to the upper small intestines to feed. That is due to not digesting food well in the small intestine to move it to the lower where these bacteria feed and causing problems like gas and acid reflux. I took prebiotics and probiotics for a period of time. When my symptoms subsided, I went off the prebiotic and continued with the probiotics. During this time I also made changes to my diet - omitted sugar (substituting stevia for tea and coffee) and sugar laden desserts, reduced alcohol, limited fruits to berries, and vegetables low in sugar. Bacteria like to feed on the sugars. So the goal was to get the lower intestinal bacteria back to the lower intestine by improving digestion in the upper small intestine. I also took 10 minutes before meals 2 pumps of bitters with water to get the digestive juices going, followed by a digestive enzyme after several bites of food.
Prior to all this, I took Rifaxamin for 6 weeks prescribed by a different doctor but once off it without the dietary changes, the symptoms returned.
I’m now symptom free which has benefited my heath in other ways as well.
In my humble opinion, a doctor should be open to both botanical, herbal supplements as well as a pharmaceuticals if that is the best way to treat and also test for vitamin and mineral levels to prescribe supplements to get the vitamins and minerals we may be low in that are critical to our well being.

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"2 pumps of bitters with water "
please explain. . . thanks.

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Profile picture for sarcomasurvivor @sarcomasurvivor

This is the best advice I've found after numerous visits to gastroenterologist, including Mayo. Mayo diagnosed me with SIBO twice. Two unsuccessful 2 week rounds of xifaxan. After extensive testing with no definitive answers for multiple gastro/neurological problems, I continue to have symptoms of IBS and SIBO. Nutrition was never raised. I've lost confidence in traditional medicine and have discovered through trial and error that I must follow the diet you describe. After being passed around to untold specialists, I feel like I've been dropped like a hot potato. Every time I see a Mayo TV ad, I cringe.

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likewise, I too have lost confidence in allopathic med docs. I have SIBO and am strongly considering the "elemental diet" as a means to make progress. I am presently in a queue to make an appt at Mayo, if they will condescend to allow me one. However, after hearing things that reinforce my experience so far and have heard elsewhere it will be hard to go down this additional rabbit hole.
My take: I believe antibiotics wrecked the microvilli and mucousal membrane in my intestines, causing the SIBO, maladsorbance in the small intestine, and migration of bad bacteria(citrobacter koseri) into it from the colon. The way to fix is to rest the entire system with the elemental diet. That is my plan. . . for now at least.

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