# SIBO



## XxJustMexX (Dec 11, 2008)

I might be posting in the wrong section, since this isn't a antibiotic specific post, but this is the only place I saw anything about SIBO. I've posted here before, mostly out of being frustrated and annoyed. I was diagnosed with the breath test over a year ago. My doctor did very little to help me. I've helped myself mostly through this board. If I stick to a diet of rice products, meat, a few fruits and veggies, I feel ok. Anytime I fall off of the wagon, I feel sick. Bloating, gas, Diarrhea, pain. I was doing a little research this morning and a few more articles have been posted since the last time I checked. Now I'm flat out scared. I see that having this can lead to all sorts of other problems. I don't know what to do. I started taking Align and hope for some relief from that, but I'm unsure of what else to do. I'm going to start taking vitamins since I am missing out on so many foods and who knows whats actually getting absorbed. Can anyone make any recommendations? My doctor was very nice but didn't seem to know anything about SIBO. Can anyone recommend anyone in or near New York? I read that the SCD diet is very helpful for SIBO'ers. But I'm slighly confused. Is that forever or for the 1-6 month treatment period in which you also take peppermint and other herbs? Please help


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## Kathleen M. (Nov 16, 1999)

I think there are degrees of SIBO.Most of the IBSy SIBO I don't think is causing the more severe problems you see in people who have SIBO from other serious illnesses.Mostly because nutritional issues and inability to maintain weight are not seen in IBS, so the SIBO that looks exactly like IBS in all ways is also going to be on the lower impact side of things. Now a severely limited diet can be an issue, but you can run what you eat past any of the free online diet evaluation websites to see if there are any particular vitamins you are missing. A rice, meat and vegetable diet can be pretty complete depending on proportions and which things you eat. You don't need a wide range of starches to get vitamins. Now you may not be getting enough veggies and fruits, but you can check that out rather than assume it must be bad.And remember that for some people without SIBO they have to stick to that exact kind of diet to feel OK as starches other than rice feed bacteria in the colon. Doesn't matter where the gas is generated because it can cause problems if it is made in the colon, not only if a portion of it is made in the small intestine (and even with SIBO the colonic bacteria still makes way more gas as a lot of the left overs still get past the small intestine and most of the bacteria are living on our left overs.)Usually SCD is promoted as a for life thing, not just a couple of months. I don't think it will fix whatever allows the bacteria to get going in the small intestine in the first place, although that does sometimes seem to resolve itself over time in some people probably no matter what they did. I don't think they say you cannot take any other herbs or medications if you do SCD so I would continue the things that help you if you try it.


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## cherrypie09 (Jan 20, 2009)

What are the symptoms of SIBO and when and how do you know if you have it, how do you get tested.


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## Kathleen M. (Nov 16, 1999)

There really are no symptoms that prove you have SIBO rather than IBS. Even the GI doctors I go to say they can't tell who has SIBO based on symptoms even with ones they think may be a sign of SIBO and would get you tested.Distension and bloating and farting are all IBS symptoms so that doesn't do much to tell them apart. Only in severe cases does it cause more than IBS symptoms and those tend to be weight loss even with more than enough calories.http://www.medicinenet.com/small_intestina...wth/article.htm has some info.The common test for this is the hydrogen breath test, but they also sometimes take a sample from the small intestine and culture it to see how many and what types of bacteria are inappropriately in there.


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## faze action (Aug 6, 2009)

In my opinion (and I am not a doctor) there is no really decent method of testing for SIBO. Hydrogen breath tests can diagnose it, but I think that false positives are a real possibility. If you had a "positive" breath test result, then you really need to take a course of antibiotics. Did your doctor prescribe them for you? Rifaximin is the best one out there but, depending on your insurance, it can be somewhat expensive. If your symptoms clear up after the antibiotics, then you likely have a bacterial overgrowth. Probiotics are another way to go, but it can take much longer to get the results you;d see with antibiotics. I'm of the opinion that pro-Bs should be used following the ABs as a way of preventing (or delaying) recurrence of the bacteria. Unfortunately there are virtually no research studies (that I can find anyway) regarding SIBO recurrence and follow-up treatment.Also, have you had a Celiac test done? Since you feel better sticking to rice products it's possible you have a gluten sensitivity (unfortunately this won't always show up on the Celiac blood test either). If you opt to get this test done make sure that you are currently eating gluten in your diet, otherwise the results won't be accurate.At any rate, I think it's a good idea to take vitamins to make sure you're getting everything you need in your diet. SIBO can cause absorption problems I think, depending on the severity.


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## XxJustMexX (Dec 11, 2008)

faze action said:


> In my opinion (and I am not a doctor) there is no really decent method of testing for SIBO. Hydrogen breath tests can diagnose it, but I think that false positives are a real possibility. If you had a "positive" breath test result, then you really need to take a course of antibiotics. Did your doctor prescribe them for you? Rifaximin is the best one out there but, depending on your insurance, it can be somewhat expensive. If your symptoms clear up after the antibiotics, then you likely have a bacterial overgrowth. Probiotics are another way to go, but it can take much longer to get the results you;d see with antibiotics. I'm of the opinion that pro-Bs should be used following the ABs as a way of preventing (or delaying) recurrence of the bacteria. Unfortunately there are virtually no research studies (that I can find anyway) regarding SIBO recurrence and follow-up treatment.Also, have you had a Celiac test done? Since you feel better sticking to rice products it's possible you have a gluten sensitivity (unfortunately this won't always show up on the Celiac blood test either). If you opt to get this test done make sure that you are currently eating gluten in your diet, otherwise the results won't be accurate.At any rate, I think it's a good idea to take vitamins to make sure you're getting everything you need in your diet. SIBO can cause absorption problems I think, depending on the severity.


I was put on antibiotics for a couple of days, however I do not recall which is was. It helped a bit. But the antibiotics are a life long thing right? I was tested for celiac. Biopsy. It came back negative.


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## XxJustMexX (Dec 11, 2008)

Kathleen M. said:


> but they also sometimes take a sample from the small intestine and culture it to see how many and what types of bacteria are inappropriately in there.


And how would this help?


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## faze action (Aug 6, 2009)

XxJustMexX said:


> I was put on antibiotics for a couple of days, however I do not recall which is was. It helped a bit. But the antibiotics are a life long thing right? I was tested for celiac. Biopsy. It came back negative.


In order to eradicate SIBO (even temporarily) you would likely need to take a course of ABs for 10-14 days. That's what most doctors typically prescribe, depending on the AB. A couple of days will not do it. Antibiotics are not necessarily a lifelong thing. If the bacteria are wiped out and do not recur, then you should be set. If the overgrowth returns, then you are stuck in the same position that I'm in, which is trying to figure out why they are recurring.


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## Kathleen M. (Nov 16, 1999)

The SIBO sample from the small intestine isn't so much about helping as it is just to diagnose the condition. I assume diagnosing the conditions is somewhat helpful?The breath test was developed to be a less invasive way of testing. It also isn't about helping other than making a diagnosis.http://www.medicinenet.com/small_intestina...rowth/page6.htm has the standard doses and types of antibiotics used.


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## UrbanUrbane (Jul 31, 2006)

Just Me, a great doctor in NYC, please look up Dr. AA Starpoli (http://www.starpoli.com/)He specializes in acid reflux but he is very knowledgeable about SIBO. He is wonderful.


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## XxJustMexX (Dec 11, 2008)

My new health insurance kicks in February first, so I will attempt to get the AB's and give it another shot. My GI that diagnosed me with SIBO (hydrogen breath test) does not accept my new health insurance. I will see if my regular doctor will give me the AB's. UrbanUrbane - thank you for the Dr. recommendation. I will check to see if he takes my new insurance. A sampling of the intestines to check which bacteria are where diagnoses. But so does the breath test no? I am hesitant to get the sampling done if it doesn't shed any more light on how to fix/treat this problem, especially because I have a severe blood/needle phobia (I get severe anxiety and pass out at the sight of blood or whenever needles are involved). While on the AB's, should you continue to take the probiotics, or does the antibiotic just kill them? Also, should one eat normally (the normal food pyramid) or stick to diet of foods that typically are ok (for me they are rice products, meat, table sugar, and some veggies). How soon after the AB should the probiotics be taken? Should a normal diet be eaten? or the "safe" foods? I know not everyone is the same, but what is recommended. I can't ask a doctor, they never seem to know anything about this. What have you all done? Any input, recommendations, words of wisdom, would be greatly appreciated


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## XxJustMexX (Dec 11, 2008)

for those who take AB's on a regular basis, what happens when they get sick? Wouldn't the over use of AB's decrease the bodies ability to fight off infection and illness?


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## Kathleen M. (Nov 16, 1999)

Antibiotics do not weaken the immune system so it can no longer attack infections.It isn't that people's immune systems shut down, but that some bacteria will get resistant to antibiotics so are harder to treat with antibiotics.Antibiotic resistant bacteria are not more likely to cause disease nor are we unable to fight them off. The natural infection and fighting off process is the same (remember before antibiotics some people fought off any given infection and some did not, that isn't different, we survive them better because they antibiotics make it easier for us to clear the infection because now two things are trying to kill them rather than just one).


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## Hester (Jul 5, 2009)

Just my two cents on the sampling of the intestine to diagnos SIBO. The small intestine is 20 feet long. The instruments used in the upper GI can only reach into the very first portion of the small bowel. SIBO can overgrow in any area of the small bowel from upper to mid to lower. Most areas are unreachable. I have heard that a camera pill is in the works that can take samples which would be wonderful! But until then, the diagnosis is usually made on the basis of severe weight loss. This is my understanding and I am not a medical professional but have spent six months lying in bed reading clinical literature. IBS suffers usually do not have the profound weight loss or complain of the cloudy, achy, weak, fuzzy feeling that comes with SIBO. Both conditions have gas, can have pain and gut sounds. Some SIBO sufferers actually spike a fever now and then. I have noticed there seems to be more cramping and pain with IBS and more alternating between diarrhea and constipation. SIBO is all about diarrhea, gas, bloating and wasting away as the bacteria consume more and more of your food supply. I realize this is not much of an answer for you but the other poster is right, there are NOT any set test for SIBO. The breath test is OK but can have both false positives as well as negatives. Some people always test positive yet do not have SIBO. I personally think, if antibiotics work--it's SIBO. That being said, not all antibiotics work for everyone and some are way, way too strong and actually lead to overkill in the large intestine while not killing enough bacteria in the small bowel. Xifaxin is not absorbed into the blood stream while other products like Tetracycline and Cipro are absorbed systemically. A recent article in JAMA suggests that severe SIBO suffers have bad bacteria all through their body impacting many functions. But because it is the bacteria normally found inside the human body, your body does not respond as if you have an infection by irradicating the culprit microbe.







Good luck.


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