Has anyone been cured of SIBO with Xifaxan.

Posted by p95 @p95, Jun 4 2:42pm

I need to hear some success stories. Everything I've read on the internet shows very poor efficacy of Xifaxan. My doctor has order 550 mg twice a day for 14 days along with Neomycin. Both are antibiotics. The Xifaxan is going to cost me $1,057.73. Also, I've read Xifaxan can cause C. Diff. (hospital acquired from spinal surgery) and after 3 years, I am still recovering from the damage that nasty bacteria left in my colon.

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You'll find a lot of conflicting information and scare tactics about Xifaxan and people pushing "natural" treatments for SIBO, so you'll have to do your own research. I also don't want to run afoul of the proponents for natural supplements.

I will say I did a lot of research on my own and concluded that Xifaxan and Neomycin was the best route for me. This helped put things into context: https://health.usnews.com/health-news/blogs/eat-run/articles/facts-about-sibo-the-internet-keeps-getting-wrong. You can take it or leave it. I find this dietician to be very evidence-based as well as Kate Scarlata, who had SIBO herself. Another consideration is that the natural supplements are also very expensive on their own and don't have as much high-quality research to back up the efficacy.

To answer your question, I did get over SIBO with Xifaxan and neomycin. I did a SIBO breath test and it was actually negative, but they don't always exclude SIBO. Because of my symptoms (and we ruled out everything else), my doctor agreed to treat it empirically.

From my understanding, Xifaxan is more specific to the gut, so it's far less likely to impact antibiotic resistance and the risk of causing C. Diff is extremely low. I'm not totally clear on why this is, but I recall finding many sources online that explained why. But they need to include that risk on any label, including topical antibiotics. I had very few qualms about taking Xifaxan, except the risk of side effects affecting how I felt.

Neomycin is a different story--do you have a diagnosis of methane dominant SIBO? It's usually only indicated for methane-dominant SIBO. My symptoms were consistent with methane-dominant SIBO, which is more challenging to diagnose. While I tolerated Xifaxan okay, the neomycin caused me nausea I was able to manage by making sure to always take with food. It's not something you'd want to take unless you have to, and not something you'd want to repeat, whereas Xifaxan can in some cases be repeated if you have an occurrence.

I also took Florastor, upon recommendation of my doctor, which is the only evidenced-based probiotic shown to help prevent C. Diff and survive the environment in the gut when you're also taking an antibiotic. The first time I took Xifaxan without it and I immediately noticed the difference when I took Florastor. It's also pricey, but worth it to me for the peace of mind.

It is expensive if your insurance won't cover it--thankfully my insurance was willing to cover it, twice.

I haven't had a recurrence, but I took steps to improve my motility as much as I could--did pelvic PT to learn about abdominal massage, I take Iberogast which can act as a prokinetic, make sure to move around after I eat, practice diaphragmatic breathing, to try to prevent a recurrence.

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I've been battling SIBO for 4 years. First 2 times with Xifaxan alone, but the DR.s I had didn't know much about SIBO. So 3rd time Xifaxan + Neomycin 14 day program killed the SIBO. The hardest part for me is the special certain foods you have to eat. Natural cures. Please read about these Wild Oregano Oil, Berberine, Neem, Triphala, Also Sibo will deplete certain Vitamins. VIT. ADK, Iron, Magnesium, D3. It's a year or so long if you do everything right. Good luck, it drains your energy too.

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Sorry, no success story from me. I tested positive, "off the chart" with SIBO and I think I've been suffering from birth with it. But the Xifaxan (which cost me $1,900) didn't work for me at all. (The Florastor didn't work either.) As I heard someone here on this site say, the Xifaxan doesn't get at the cause of the SIBO so it comes right back as soon as you stop the Xifaxan. And last I heard, they still don't know what causes the SIBO, so no wonder there doesn't seem to be a cure for it.

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@h8bigbiz

Sorry, no success story from me. I tested positive, "off the chart" with SIBO and I think I've been suffering from birth with it. But the Xifaxan (which cost me $1,900) didn't work for me at all. (The Florastor didn't work either.) As I heard someone here on this site say, the Xifaxan doesn't get at the cause of the SIBO so it comes right back as soon as you stop the Xifaxan. And last I heard, they still don't know what causes the SIBO, so no wonder there doesn't seem to be a cure for it.

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I'm sorry it didn't help you. The first time I took Xifaxan, it improved my symptoms slightly, but I didn't have complete resolution.

It turned out I had methane-dominant SIBO and for methane-dominant SIBO, they've found that Xifaxan + Neomycin (another antibiotic) is more effective. Did your breath test indicate what type of SIBO you had?

It's so frustrating.

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Yes, the test showed both methane and hydrogen. My doctor called in both Xifaxan and Neomycin. He also said I could look up SIBO diet on Dr. Google. Thank you to emo too. Good to know I may need to take the Neomycin with food. Keeping my fingers crossed.

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@emo

I'm sorry it didn't help you. The first time I took Xifaxan, it improved my symptoms slightly, but I didn't have complete resolution.

It turned out I had methane-dominant SIBO and for methane-dominant SIBO, they've found that Xifaxan + Neomycin (another antibiotic) is more effective. Did your breath test indicate what type of SIBO you had?

It's so frustrating.

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I don't know if the breath test indicated what type of SIBO I've got or not. I'm not going to bother to try seeing our local Gastroenterologist practice again (or even call them) to find out: it takes about 8 months to get an appointment and about 15 calls leaving messages to get a call back, seriously. I hear that there's a really good (better than ours anyway) Gastroenterologist practice in a town about 30 min. from here but they're only taking patients that live in that town.

This town isn't super small but you'd think we were with how sparse our local medical professionals are.

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@p95

Yes, the test showed both methane and hydrogen. My doctor called in both Xifaxan and Neomycin. He also said I could look up SIBO diet on Dr. Google. Thank you to emo too. Good to know I may need to take the Neomycin with food. Keeping my fingers crossed.

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Everyone’s different, but neomycin definitely did a number on my stomach whereas the first time I took the Xifaxan I don’t recall many side effects. I used Florastor with it.

I have a GI dietician and she said there’s not a ton of research on diets but I could see what made me feel better. The one thing she did say was not to change my diet while on the antibiotics because you want the “bugs” to be active so you can kill them off? Not sure if that’s true, but it kind of made sense at the time.

I found Dr. Pimentel’s protocol for preventing relapse here (he’s done a lot of research on SIBO): https://www.siboinfo.com/prevention-of-relapse.html

Fingers x’d for you that the treatment works!

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Xifaxan is a treatment for symptoms of SIBO. Every time I went off it, my symptoms returned. It’s not enough to take any pharmaceuticals or natural supplements without also changing your diet. My doctor has a dietitian that helped with kinds of foods to eliminate for a period of time to be reintroduced later one at a time until my gut healed.
There’s also a great book - SUPER GUT - you can order on Amazon that’s really helpful on foods that are gut healing, includes easy recipes. It’s worth checking out.

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@h8bigbiz

Sorry, no success story from me. I tested positive, "off the chart" with SIBO and I think I've been suffering from birth with it. But the Xifaxan (which cost me $1,900) didn't work for me at all. (The Florastor didn't work either.) As I heard someone here on this site say, the Xifaxan doesn't get at the cause of the SIBO so it comes right back as soon as you stop the Xifaxan. And last I heard, they still don't know what causes the SIBO, so no wonder there doesn't seem to be a cure for it.

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h8bigbiz. We're so different and treatment is as well. I took Xifaxan for ??IBS (my diagnosis) and it worked great. A year of so later my symptoms ramped up so I was prescribed Xifaxan again but it did not work as it did before. Later on I had another colonoscopy and my GI doc did multiple biopsies throughout my colon which revealed microscopic colitis. I was ordered Budesonide for 3 months. Results was amazing. All was great and then a year later the diarrhea plagued me again--5-6 trips to the bathroom every day. I just finished the 3 months last week. The good results came within a couple of days and continues now. If I had to go through the treatment every year or two, it is well worth it. Good luck.

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@fdixon63

h8bigbiz. We're so different and treatment is as well. I took Xifaxan for ??IBS (my diagnosis) and it worked great. A year of so later my symptoms ramped up so I was prescribed Xifaxan again but it did not work as it did before. Later on I had another colonoscopy and my GI doc did multiple biopsies throughout my colon which revealed microscopic colitis. I was ordered Budesonide for 3 months. Results was amazing. All was great and then a year later the diarrhea plagued me again--5-6 trips to the bathroom every day. I just finished the 3 months last week. The good results came within a couple of days and continues now. If I had to go through the treatment every year or two, it is well worth it. Good luck.

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I'm glad it worked for you. Although I've never been tested for microscopic colitis, I doubt I have it since I have IBS-C (chronic constipation since the day I was born).

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