Diet during antibiotics for SIBO

Posted by Twocoastsm @marlenec, Jul 13, 2023

I am about (pending insurance coverage for Xifaxin) to begin two weeks of Xifaxin and Neomycin prescribed my my GI due to SIBO test results. After a month on the low FODMAP diet I was feeling moderately better and had started gentle reintroduction but figured I should suspend that whilst on antibiotics. However, a dietician with whom I’ve consulted suggested “eating normally” whilst on the meds “so that the problematic pathogens are more active and more susceptible to elimination.” Thought I’d try to get some feedback from those of you with experience with SIBO treatment whilst waiting for (fingers crossed) insurance approval. My plan lists it as a Tier 2 drug but apparently the doc has to further justify its use. Been down this rabbit hole before with other situations and am cautiously pessimistic.

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As a longtime SIBO sufferer and frequent rifaximin (and one time neomycin user), the strategy of "eating food to make the bacteria flourish so you can kill them more readily" makes sense. Both of these antibiotics have the potential to mess up your digestion to begin with but stick with it. I would recommend 2-4 days of "eating normally" (what you consider normal right now) to let the antibiotics do some damage, and then switch to eating more "conventionally" "normally", or even going out of your way to eat specific foods that feed the bacteria, for the rest of the treatment. Maybe you already know which foods set you off the most so you can go and get those, but in my case and in many others, the "gum" additives found in most "processed" foods are the best/worst (guar gum and xanthum gum being the most noteworthy, and then carob bean gum). The product "Tomorrow's Nutrition, Sunfiber, Prebiotic Fiber Supplement for Digestive Health" which you can find on Amazon is pure guar gum, if you don't want to raid the cookie/icecream aisle at your grocery store (or do both since it's the middle of summer).

Good luck, hope you get your Rx filled.

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Rifaximin is expensive. My doctor at the time ordered it for me. While I was on it, I started to feel much better. Once off it in about 2 weeks, my symptoms returned. Again, these meds treat the SYMPTOMS, not the CAUSE. Antibiotics are not good for our digestive tract as they kill both the good and bad bacteria. (Don't misunderstand me - antibiotics have their place when it is in the right application.) You need the good bacteria and need it in the right place in the digestive tract. As it was explained to me, the bacteria feed on sugars. We have different bacteria in the upper digestive tract and lower digestive tract. When the upper digestive tract is weakened as in leaky gut, the lower digestive tract bacteria migrate to the upper digestive tract causing symptoms of gas, bloating, not digesting our food well, loosing weight, etc. The goal is to build the upper digestive tract mucous lining and get the bacteria that don't belong there back down to the lower digestive tract where they belong.
I cannot emphasize enough the need to find the CAUSE of your symptoms and NOT treat the SYMPTOMS or the symptoms return.

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Great info! Followed the same track as you, but did the fodmap diet along with meds. Had to work the system a little to get the meds.
Did tons of research during this period and learned about leaky gut at that time. Healing leaky gut is sooooo important! After
3-4 months of SIBO diet, started following a leaky gut diet. Ordered several small cookbooks online to know where to begin. Many foods are different from SIBO diet. I really worked on trying to stay away from Sibo triggers and follow the leaky gut diet. What a process!!! My life was focused on healing myself; no one can heal you but you with this type of illness.
Good luck…

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@gigi4

Rifaximin is expensive. My doctor at the time ordered it for me. While I was on it, I started to feel much better. Once off it in about 2 weeks, my symptoms returned. Again, these meds treat the SYMPTOMS, not the CAUSE. Antibiotics are not good for our digestive tract as they kill both the good and bad bacteria. (Don't misunderstand me - antibiotics have their place when it is in the right application.) You need the good bacteria and need it in the right place in the digestive tract. As it was explained to me, the bacteria feed on sugars. We have different bacteria in the upper digestive tract and lower digestive tract. When the upper digestive tract is weakened as in leaky gut, the lower digestive tract bacteria migrate to the upper digestive tract causing symptoms of gas, bloating, not digesting our food well, loosing weight, etc. The goal is to build the upper digestive tract mucous lining and get the bacteria that don't belong there back down to the lower digestive tract where they belong.
I cannot emphasize enough the need to find the CAUSE of your symptoms and NOT treat the SYMPTOMS or the symptoms return.

Jump to this post

So how is the cause identified?

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@gboi

As a longtime SIBO sufferer and frequent rifaximin (and one time neomycin user), the strategy of "eating food to make the bacteria flourish so you can kill them more readily" makes sense. Both of these antibiotics have the potential to mess up your digestion to begin with but stick with it. I would recommend 2-4 days of "eating normally" (what you consider normal right now) to let the antibiotics do some damage, and then switch to eating more "conventionally" "normally", or even going out of your way to eat specific foods that feed the bacteria, for the rest of the treatment. Maybe you already know which foods set you off the most so you can go and get those, but in my case and in many others, the "gum" additives found in most "processed" foods are the best/worst (guar gum and xanthum gum being the most noteworthy, and then carob bean gum). The product "Tomorrow's Nutrition, Sunfiber, Prebiotic Fiber Supplement for Digestive Health" which you can find on Amazon is pure guar gum, if you don't want to raid the cookie/icecream aisle at your grocery store (or do both since it's the middle of summer).

Good luck, hope you get your Rx filled.

Jump to this post

Thanks! Actually my label-reading has revealed that the gluten free and lactose free foods I’ve been consuming as part of a low FODMAP regimen - such as dairy free yogurt, cream cheese and even some GF carbs like bread and crackers- have xanthum gum and I see it as an ingredient in low FODMAP recipes as well.

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@marlenec

So how is the cause identified?

Jump to this post

I took a breath test that measures gases you breath out, done in the morning. It’s a home kit my doctor ordered. The results are sent to the doctor.

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There’s an excellent book SUPER GUT by Dr. William Davis that’s very helpful and informative in understanding what SIBO, foods definitely needed, plus recipes. You can purchase on Amazon.

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@marlenec

So how is the cause identified?

Jump to this post

I was diagnosed in my gastroenterologist’s office, with a breathing test. He also tested for gluten allergies and dairy.
Not at the same time…
I know there is a home test for SIBO, check with your doctor.

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@ch47

Great info! Followed the same track as you, but did the fodmap diet along with meds. Had to work the system a little to get the meds.
Did tons of research during this period and learned about leaky gut at that time. Healing leaky gut is sooooo important! After
3-4 months of SIBO diet, started following a leaky gut diet. Ordered several small cookbooks online to know where to begin. Many foods are different from SIBO diet. I really worked on trying to stay away from Sibo triggers and follow the leaky gut diet. What a process!!! My life was focused on healing myself; no one can heal you but you with this type of illness.
Good luck…

Jump to this post

Thanks. Sorry to be lengthy but I have some questions. First question is if you took neomycin did you have any hearing issues. I have very mild tinnitus but my hearing is just fine and I’m concerned after reading black box warnings and some posts on this site. Next I am a little confused about “cause.” I have taken the breath test and it’s positive for SIBO but why I have it other than having had IBS-D for years is a mystery. No anatomical cause as far as I know but I do have diverticulosis and have had bouts of diverticulitis. Finally I have a lot of info on FODMAP regimens as well as the Supergut book and I see foods that are not low FODMAP in the Supergut list - mushrooms for example. I will be working with a dietician who recommended eating some FODMAPS during the antibiotic course and who suggested waiting to start with her until after the course of meds is done.

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@marlenec

Thanks. Sorry to be lengthy but I have some questions. First question is if you took neomycin did you have any hearing issues. I have very mild tinnitus but my hearing is just fine and I’m concerned after reading black box warnings and some posts on this site. Next I am a little confused about “cause.” I have taken the breath test and it’s positive for SIBO but why I have it other than having had IBS-D for years is a mystery. No anatomical cause as far as I know but I do have diverticulosis and have had bouts of diverticulitis. Finally I have a lot of info on FODMAP regimens as well as the Supergut book and I see foods that are not low FODMAP in the Supergut list - mushrooms for example. I will be working with a dietician who recommended eating some FODMAPS during the antibiotic course and who suggested waiting to start with her until after the course of meds is done.

Jump to this post

My first Gastro rx’d the xifaxin, with no testing and just said SIBO diet, literally that is ALL he said. I did not take neomycin, just xifaxin, and had to fudge symptoms to get that. Insurance would not cover if I complained about my IBS-C…
I did do the diet while taking the Med. Don’t know if right or wrong, I had no guidance…
Switched Gastro after normal colonoscopy and my husband saw his bedside manner, rudeness etc.
Best thing I could have done!!!
Do not have IBS-D. And have had minor tinnitus forever.
As I understand, gut bacteria gets out of order, and travels to the small intestine. ( read the first post in this series, they did a great job explaining what happens. ) SIBO eats the foods that are sugar, or turn into certain sugars once digested. And swell up your upper intestines. And you know the rest…
As to leaky gut, can’t remember exactly how that happens, from swelling? Food? SIBO? You can look that up.
3-4 months on SIBO diet, totally strict, and had just started to introduce the least amount of fodmap foods I was missing, I started eating for leaky gut. Totally different from fodmap. That was interesting…🤣 trying to maintain some fodmap and leaky gut diet at same time.

Fodmap is not forever…

Food and beverage lifestyle changes, probably are forever for me, have helped my health. I will have most everything, but the “really bad” stuff is somewhat limited. It just becomes normal. I found other ways to make tasty food without a whole bulb of garlic 😂 (If someone has a homemade cookie, I’ll eat one and enjoy. If it comes out of a box, forget it. That’s my guide) I don’t want to do this again…

Good luck and great patience!!!

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