How to manage SIBO symptoms?

I was diagnosed at the Mayo Clinic this past November with SIBO, small bowel damage, and Exocrine Pancreatic Insufficiency. After 25 years of suffering I am finally feeling well. The Mayo put me through a round of 3 different antibiotics to kill the bacteria. I was told to begin taking Align Probiotic daily. Probiotics are very important in keeping the bad bacteria from taking over. I include probiotic rich foods in my diet daily in addition to the Align, such as Kefir, yogurt, Kombucha, supplemented juice blends. I no longer really need anti-nausea medicine, but I used to take Promethazine, which I found to work better than Zofran. I also found that a simple Gas-X chewable would often help with belching and bloating. SIBO creates an excessive amount of gas. I hope this helps, and that your wife feels better soon!

@lizbee78 I had read that patients with SIBO were not supposed to take probiotics, prebiotics or foods with high fiber, as it feeds the bad bacteria. I had stopped taking Align (which I had been doing for many years), but now I am wondering if I did the right thing.

Hi everyone, Im new here, Ive been suffering with gi issues for years now, been thru a lot of testing and procedures but finally just recently had sibo breath test results were positive. A year ago I had 2 rounds of xfaxian, a month apart from each other, it barely made a difference in my symptoms. My 3rd doctor wants to also do a fructose and a sucrose breath test before she treats me with flagyl for the sibo, to determine if I have a fructose or sucrose intolerance. I have so many questions, I hope maybe someone has had a similar experience and can share theirs. Im concerned the positive sibo result may cause the fructose breath test to be a false positive? Any thoughts?
Im not sure if there is any value for the sucrose breath test for me considering I have eliminated sucrose from my diet 3 years ago. Any thoughts? I understand she wants to determine what is causing the sibo, as do I, since sibo is only a symptom. Is there always a concrete reason for sibo or isn't it a constellation or different variables at any given time. I follow the low fodmap diet with occasional deviations. Im loosing weight, I feel fatigue and sick a lot, I have headaches and 2 of the medications i take orally are not absorbing properly which is having a bigger effect on my life. I feel very frustrated and impatient for treatment and results, there are months before the other tests are done and I feel every day that passes more and more damage may be done to my small intestine. Im worried that it may be irrational to think its permanent but no one seems to know how to treat malabsorbtion...does anyone have any thoughts suggestions? Or experience? Thank you for your help in advance. I really appreciate any insight anyone has.

@eileene7 In your post you say that you have SIBO however Flagyl is usually used for IMO (methane sibo) along with Xifaxan. Have they clarified that for you when you spoke with your doctor?

@azj Thank you for asking, yes, its hydrogen dominant sibo.

@eileene7 my protocol included using the trio smart breath test which identified that I had methane dominant and the prescription protocol that was prescribed for me was the combination of xifaxin and Flagyl. This follows the protocol advised by Dr Mark Pimentel at Cedar Sinai who has done the preponderance of research regarding SIBO. I found reading his research helpful and the doctors that have worked with me also referred to his work. This journey has included much self education. A good team will be able to find the cause hopefully for you which will make this journey easier. I wish you the very best.

One of the theories that Dr. Pimentel has is that SIBO is caused by having food poisoning at some time before all the GI problems started. That could be true for me. I did have food poisoning while on a trip to Europe.

@azj Thank you so much. Would you mind sharing what was your cause? Im trying to compare notes in the hopes of speeding up my recovery. I will look into Dr Mark Pimentel. Thank you!!