Small intestinal bacterial overgrowth (SIBO)

Posted by maryannegau @maryannegau, Oct 25, 2018

I’ve been battle SIBO for months now and have tried Rifaxin, Flagyl and antiviral meds. Also have tried Zithromax and am taking Atrantil (an herbal remedy). I can’t eat sugar or carbs or my stomach hurts quite alot. Any suggestions?

@maryannegau – SIBO is something I always have to struggle with too. Xifaxan used to work ok, but only for a while. Also very costly. The key for me is to avoid constipation. I use Pepto Bismol to control the bacteria, often every 4 – 6 hours. Activated charcoal capsules and probiotics too.
There doesn’t seem to be any miracle cure.

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Thanks for your reply. I haven't heard about activated charcoal capsules – where do you get those? It seems to be very hard to get rid of.

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@maryannegau

Thanks for your reply. I haven't heard about activated charcoal capsules – where do you get those? It seems to be very hard to get rid of.

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I decided to join this discussion as it appears that I am now in what I call the SIBO limbo or no man’s land. From reading these posts it seems like my struggle has just begun. My symptoms began in mid July and it is believed that two consecutive rounds of antibiotics to treat two different conditions triggered it. I cracked a crown in late May and ended up with an extraction and implant. I took an antibiotic then but can’t remember what it was. Then I went for my annual physical in late June and was prescribed Clindimycin for a UTI. Symptoms of diarrhea, gas and bloating started about a week after I finished the Clindimycin. Long story short, my internist thought I had contracted CDiff from the Clindimycin and put me on Flagyl for ten days and performed a stool test which came back negative. The Flagyl helped for a week but then the symptoms restarted. My internist basically dismissed me at that point and told me to find a GI doctor, which took a few weeks and lots of phone calls. The GI doctor performed some routine blood work which was normal, and sent me for a CT scan of my belly, which fortunately also came back normal. He diagnosed me with SIBO and dysbiosis based on my symptoms (no breath test) and put me on another round of Flagyl. The cost of the Xifaxan would have been nearly $1500.00 for two weeks. So I took the Flagyl again since I tolerated it the first time. It helped for about two weeks and I then gradually slid back to the loose stools and lots of gas. He also put me on a low FODMAP diet, which helps a little but does not eliminate symptoms either. I have lost 15 pounds in three months due to diarrhea and being afraid to eat anything. I had a routine colonoscopy last year which was normal and I think that is why the gastro doctor is not in a rush to do another one (plus the normal CT scan). So here I am. I am not on medication right now, not eating much, afraid to eat anything. I am not even sure I have the correct diagnosis, but too many carbs make me gassier and when I am gassier I also tend to have looser stools. I go to work but rarely socialize with friends because it all revolves around food. Thankfully I am married and my husband has been very supportive. I cry a lot and have dark moments when I think I have cancer or will never be well again. I am afraid of what the gastro doctor will say when I see him next or that he will tell me there is nothing else he can do for me like my internist who basically abandoned me. How long have other group members been coping with this and what has helped? I am now researching a diet called the specific carbohydrate diet. Anyway, feeling desperate and looking for solutions like all of you. Thank you for “listening.” I hope I can also be of support to others here.

Liked by thull

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I cried a lot in the hospital after the 3rd surgery could not get to the obstruction. The surgeon said the adhesions were so bad it looked like glue had been poured over my intestines. I went home after 17 days in the hospital and on TPN and clear liquids. After about 2 weeks, things started clearing. I had been doing gentle abdominal massage and I really believe it helped. I am still on a low residue diet, but have colonoscopy scheduled 11/16 to look at where they reattached my colon together. The next step will be to look at small bowel and then introduce some fiber back into my diet. I know exactly what you mean about being afraid to eat. It is not a fun thing to go through! I hope your doctor is able to help you and really listens to you. I have been dealing with IBS for many years so when I started having issues last December, I just thought it was that acting up. Ended up with emergency surgery in Jan with my sigmoid colon removed and a temporary colostomy. Had that for 6 months. Had the reversal surgery, then the adhesions caused obstruction in small bowel. I hope I never have to have another abdominal surgery because I am scared to death of more adhesions.

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@thull

I cried a lot in the hospital after the 3rd surgery could not get to the obstruction. The surgeon said the adhesions were so bad it looked like glue had been poured over my intestines. I went home after 17 days in the hospital and on TPN and clear liquids. After about 2 weeks, things started clearing. I had been doing gentle abdominal massage and I really believe it helped. I am still on a low residue diet, but have colonoscopy scheduled 11/16 to look at where they reattached my colon together. The next step will be to look at small bowel and then introduce some fiber back into my diet. I know exactly what you mean about being afraid to eat. It is not a fun thing to go through! I hope your doctor is able to help you and really listens to you. I have been dealing with IBS for many years so when I started having issues last December, I just thought it was that acting up. Ended up with emergency surgery in Jan with my sigmoid colon removed and a temporary colostomy. Had that for 6 months. Had the reversal surgery, then the adhesions caused obstruction in small bowel. I hope I never have to have another abdominal surgery because I am scared to death of more adhesions.

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So sorry you have been through all this. Mine does not even come close to your pain and suffering. Any idea of what caused your adhesions in the first place?

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@guthealth

So sorry you have been through all this. Mine does not even come close to your pain and suffering. Any idea of what caused your adhesions in the first place?

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Just the surgery itself. When they did the reattachment 7/31, the surgeon said he cut through quite a lot of adhesions that had formed after the January surgery. I guess I am just one of those people who are prone to them. If I have to have anything else done, I hope to have laparoscopic surgery as there is a lower incidence. It is a catch 22, you may have to have a procedure to deal with adhesions, which in turn can produce more adhesions!

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@maryannegau

Thanks for your reply. I haven't heard about activated charcoal capsules – where do you get those? It seems to be very hard to get rid of.

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I find activated charcoal capsules at Walmart in ther vitamin section. I take 2-4, it takes the edge off. Also rotating with PeptoBismol.

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@astaingegerdm

I find activated charcoal capsules at Walmart in ther vitamin section. I take 2-4, it takes the edge off. Also rotating with PeptoBismol.

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I wanted to share with the group something new I am trying which has helped me tremendously in three days. It is called the specific carbohydrate diet and comes from Elaine Gottschild. It is an old theory which has gained a great deal of traction again in recent years. Lots of free information on the internet that is readily accessible and free . Diet made a lot of sense to me and it seems to be working. I have had solid BMs in three months. Hope others here check it out for bloating and diarrhea. Diet is both simple and complicated. Worth checking into.

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I am new to this forum. After two months of suffering from diarrhea, loose stools, gas and bloating and trying my best to reverse the symptoms through natural means, I was finally able to get in to see a GI doctor who diagnosed me with SIBO through symptoms alone (no breath test). He prescribed a two week course of Flagyl and Align probiotic plus a low FODMAP diet. All this is news to me and I am now scrambling to find answers. I think my problem originated from two rounds of antibiotics I took earlier this year when I underwent a tooth implant and subsequently when I took a round of Clindimycin for a UTI. Rifaximin was prescribed before the Flagyl, but I could not tolerate it (gave me horrible diarrhea ). I have read so much about SIBO during the past five days and feel so confused. Any insight is appreciated. Another question I had for the group is whether anyone has used the probiotic S Boulardi for this condition and has it helped? I am looking for information, support and answers. Thank you for “listening.”

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@drpepper

Started taking Nexium, zantac, antacids, etc when belching started. When SIBO diagnosed, should you continue these products or eliminate as they should cut down on digestive acid which helps eliminate bacteria?

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I used to take Zantac religiously before being diagnosed with SIBO. All these drugs are listed as contributing factors to SIBO because they suppress the acid necessary to get rid of bad bacteria in your gut and maintain the bacterial balance. I stopped the use of PPI’s ten years ago after reading about their side effects. I have not taken Zantac in four months and have not needed it since changes in diet (elimination of many carbs) have essentially eliminated my heartburn. When you stop taking a PPI, however, you are likely to experience horrible acid rebound that may last weeks. Not an easy thing to go through. I would consult with your doctor if you want to stop taking or reduce the number or doses of several of these acid suppressing drugs. It can be done but I would not do it all at once. Also it is not advisable to get off these medications if you have dysplasia, Barrett’s esophagus or other precancerous conditions. The short answer to your question is yes but best done under medical advice and supervision.

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@guthealth

I used to take Zantac religiously before being diagnosed with SIBO. All these drugs are listed as contributing factors to SIBO because they suppress the acid necessary to get rid of bad bacteria in your gut and maintain the bacterial balance. I stopped the use of PPI’s ten years ago after reading about their side effects. I have not taken Zantac in four months and have not needed it since changes in diet (elimination of many carbs) have essentially eliminated my heartburn. When you stop taking a PPI, however, you are likely to experience horrible acid rebound that may last weeks. Not an easy thing to go through. I would consult with your doctor if you want to stop taking or reduce the number or doses of several of these acid suppressing drugs. It can be done but I would not do it all at once. Also it is not advisable to get off these medications if you have dysplasia, Barrett’s esophagus or other precancerous conditions. The short answer to your question is yes but best done under medical advice and supervision.

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Solid info. Thanks!

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@drpepper

Started taking Nexium, zantac, antacids, etc when belching started. When SIBO diagnosed, should you continue these products or eliminate as they should cut down on digestive acid which helps eliminate bacteria?

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Hi
I just had my appointment with the gastro specialist. He explained to me that the nerves give off mixed messages to the abdomen. He told me to google monash university and search the low FODMAP diet. He said this is what he’s has recommended for patients with issues like ours.
Hope this works for you. Changing what you eat will certainly help.
Robin.

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@guthealth

I used to take Zantac religiously before being diagnosed with SIBO. All these drugs are listed as contributing factors to SIBO because they suppress the acid necessary to get rid of bad bacteria in your gut and maintain the bacterial balance. I stopped the use of PPI’s ten years ago after reading about their side effects. I have not taken Zantac in four months and have not needed it since changes in diet (elimination of many carbs) have essentially eliminated my heartburn. When you stop taking a PPI, however, you are likely to experience horrible acid rebound that may last weeks. Not an easy thing to go through. I would consult with your doctor if you want to stop taking or reduce the number or doses of several of these acid suppressing drugs. It can be done but I would not do it all at once. Also it is not advisable to get off these medications if you have dysplasia, Barrett’s esophagus or other precancerous conditions. The short answer to your question is yes but best done under medical advice and supervision.

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Try the low Fodmap diet. Research this and study the monash university

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@robinl

Hi
I just had my appointment with the gastro specialist. He explained to me that the nerves give off mixed messages to the abdomen. He told me to google monash university and search the low FODMAP diet. He said this is what he’s has recommended for patients with issues like ours.
Hope this works for you. Changing what you eat will certainly help.
Robin.

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Will do..Thank you.

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@drpepper

Update: picked up script for Rifaxam ($700 for 30 pills 200mg). Decided to read a bit more before starting the antibiotic. On Atrantil website read that one should not take probiotics while trying to treat SIBO. My ileocecal valve was removed during a sm bowel resection in '99. Started having belching in 2015. Reflecting on my past medical history it was about that time I started probiotics that I started having belching problems. I started (dr recommend) more serious probiotics and belching got worse. Doctor after doctor and suggestion after suggestion e.g. – remove gall bladder, stop cpap use, repair hiatal hernia, and on and on… The site (Atrantil) said taking probiotics was like adding fire to fire. So I delayed the antibiotic treatment and stopped all probiotics. Within 2 days my insane belching was diminished by over 50 % and at this point close to 75 %. I have the Rifaxam on standby but right now I am feeling better than I have in years!..

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So maybe your problem was more reflux than SIBO? I had a massive bowel obstruction and had an emergency right hemicolectomy 2 1/2 years ago which includes removal of 18" of my colon cecum, illeocecal valve, appendix . I developed chronic SIBO and have not been able to get off Xifaxan for any length of time so I am on it daily. I also take Align daily. My dr told me to take a trial off Align and my intestines were a wreck after 4 days. Went back on it and within a few days was fine. Go figure! I think a lot is trial and error.

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