SIBO/IMO breath test results

I have also tested positive for IMO in the past. The two antibiotic regimen seems like a lot. I sat down and determined when the best times to take the pills based on my schedule and spacing of the pill doses, and I set reminders in my phone to keep me on the schedule. Also to note I keep those in my phone after I am done with the pills to be used for future treatments. My IMO has recurred so it's handy to have that schedule already figured out. Good luck with your treatment!

I learned on a Gemelli Biotech webinar that with IMO you may see lower levels of hydrogen on a breath test because Methane consumes Hydrogen.

My baseline CH4 was 53 and it rose to 79, but only after 90 minutes - that was how my test was conducted. No treatment yet, as my gastroenterologist wants to wait until I have an Endoscopy with US and colonoscopy. She also wants to blame the methane on constipation, but I have frequent loose stools, never constipation. Were you advised about any kind of diet?

@lucyvt Hi lucyvt, your GI doctor's priorities do make sense to me - I'd already had endoscopy and colonoscopy, both now showing a problem. You don't want to start slamming that antibiotic cocktail unless it's really necessary.

I think my GI doc talked about a consultation with their Integrative Medicine nutritionist when he first ordered the test. So I'll follow up with that. I've also been educating myself by watching presentations by Mark Pimentel, the big SIBO guy at Cedars-Sinai who talks a lot about diet and nutrition with SIBO/IMO. I'm aware of the low FODMAP and low fermentation approaches.

@sm80 Thanks for your response. I will also be setting up my phone like you did.

I've also read that hydrogen may be suppressed when the methane level is really high. I'm guessing that's why the approach is both Rifaximin and Neomycin.

How rough was the course of antibiotics for you? I'm told by another person that even after the antibiotics are finished, the methanogens are still dying off and make for a rough month or two. Oh joy.

@jacqincalifornia Methane is created by Archaea which is a different organism than bacteria and my understanding is this is why they use 2 antibiotics for treatment of IMO. Research has shown that Methane slows the movement of the gut down which contributes to constipation.

I didn't find the antibiotics to be rough at all, but I was pretty miserable before taking them so there's that. The hardest part for me was just the feeling like you're constantly popping pills. If you haven't gotten the RXs yet, just a word of warning from experience Rifaximin is ridiculously expensive, make sure insurance will cover it or check into things like GoodRx coupons and confirm the cost before you go to pick it up.

@lucyvt Was your breath test a 2 or 3 gas test? If you only had a 2 gas test maybe look into the Trio Smart test by Gemelli Biotech. There is something called ISO which is hydrogen sulfide overgrowth I believe. This may explain your test results and loose stool combination. They are making progress in figuring out treatments for that. Check out the MAST program at Cedars Sinai -Dr. Mark Pimentel has been involved with research there trying to find treatments for SIBO, IMO and ISO.

@sm80 Thank you again. You are correct about the reason for the antibiotic cocktail for IMO instead of just Rifaximin. I have Tricare (TFL) and get my prescriptions from Express Scripts. It's more expensive than my usual copay amount but not actually ridiculously expensive, about $50 if I read the website correctly. Tricare, not Medicare is my pharmacy provider and though they often cover the same meds, that's not always the case. Thankfully in this case.

Another possible wrinkle I'll consult with my doctors about is the potential for Neomycin to cause inner ear problems which, if they do occur, are not necessary temporary. I already have some mild hearing loss and tinnitus so I will ask my doctor about alternatives to take with Rifaximin, like metronidazole. I appreciate this discussion.

accidentally sent a reply to the wrong poster. deleted it.

@sm80 IT was a 2 gas test. I will ask about the Trio Smart test. thanks for the info.

have heard from an eastern/western doctor that you can take Neem instead of neomycin. could be easier on you system.