# Why does SIBO come back after using antibiotics?



## Freud (Mar 22, 2012)

I've read about SIBO a lot. Almost everyone say they get much, much better using antibiotics but that their symptoms come back when they stop taking it. Why are SIBO coming back? If they feel good at first I mean. And how can it be back so soon - someone said he or her got worse only three days after they stopped the antibiotics treatment.I know no one knows for sure. But, what are your theories?


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## Lucygoosey (Jun 3, 2012)

My theory is that the bacteria resistant to the antibiotic you are taking are the ones that grow back. Presumably, no antiobiotic can cover all of the hundreds of different types of bacteria in the intestine. And if the underlying problem is still there (eg. poor motility), then the bacteria will grow back.


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## Kathleen M. (Nov 16, 1999)

The small intestine is supposed to keep itself clear of excess bacteria when it functions normally.Taking antibiotics doesn't fix the problem that allowed the bacteria to overgrow in the first place.So whatever mechanism allowed them to accumulate the first time is still there and they accumulate again.Traditional SIBO (rather than the newer IBS/SIBO) usually formed in people where it is pretty obvious why they have the problem (result of a surgery, or from a serious health condition) and they have always had to take antibiotics several times a year to clear things out.We don't really know what is wrong in the IBS/SIBO people but if there wasn't something off to begin with the small intestine would have kept itself relatively bacteria free like it does in the vast majority of humans.


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## DEUCE CLICK (Jun 20, 2012)

It has to do with the migrating motor complex.(MMC) In a healthy individual the MMC functions normally, but in those with SIBO, for some reason does not, and therefore allows bacteria to proliferate in the Small Intestine. Doctors have tried to develop a drug or protein to fix the MMC, but with no avail. I have a theory that the MMC could be stimulated via Acupuncture. I am going to see an acupuncturist soon and I will see what happens.


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## faze action (Aug 6, 2009)

DEUCE CLICK said:


> It has to do with the migrating motor complex.(MMC) In a healthy individual the MMC functions normally, but in those with SIBO, for some reason does not, and therefore allows bacteria to proliferate in the Small Intestine. Doctors have tried to develop a drug or protein to fix the MMC, but with no avail. I have a theory that the MMC could be stimulated via Acupuncture. I am going to see an acupuncturist soon and I will see what happens.


...and to add onto this: multiple things can affect the MMC such as past GI surgery, various autoimmune diseases (Celiac, diabetes, etc). If the root of the problem is, for example, diabetes, then treating the diabetes will, in turn, treat the issue with the MMC, which will prevent the SIBO from returning.Of course, having said that, mine appears to be idiopathic. Prokinetic herbs seem to be hleping me a little, as is a gluten-free diet.In fact the gluten-free diet seems to be helping a lot of issues I was having(like iron deficiency).


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## Freud (Mar 22, 2012)

Thank you for all your answers! Could it also be possible that biofilms (the formation of a biofilm involves the attachment and accumulation of bacterial cells within a slimy substance on a solid surface) is part of the problem?You kill some bacteria but the rest is "hiding" in the biofilm and cannot be reached by the antibiotics. If you could destroy the biofilm, maybe you also could fix the problem?


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## refuse to live this way (Apr 25, 2012)

Freud: I do think you have a good theory there, and I would love to be the one who figures out what "BomB" we need to kill off the bio film. I have a son going to the University of Illinois and is in the physics engineering program, maybe I can have him see what he can do about it and I'll let everyone know. But, I'm not getting my hopes up. The worst part of this is if you do start feeling better you never know when you will be hit again and making plans if very difficult. I have 2 daughters getting married in the next year and my son will be graduating from college. I really don't want to have to miss any of it because of this darn illness. Probiotics have seemed to have helped me the most, namely Florastor, so I will continue on this and see what else, if anything, I can find that might help. I'll let you know if I do. In the meantime, best of luck to you, wishing you the best.


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## Freud (Mar 22, 2012)

_Refuse to live this way_, I found a post by a user named Hester who seems to have the same theory "A member here was cured after like four rounds of very strong and multiple antibiotics. I think SIBO is very hard to kill becuase you are dealing with 20 feet of living tissue and mucus. Sometimes (just my thoughts) *the bacteria is probably inside the mucus and the wall of the small bowel lining making it very hard to kill*. 80% of the body's defense is in the gut. Hence, the lining/mucus/defense once infested with some microbe, probably has a hard time getting it out of there. If mucus is the defense and the microbe hides in it, the bacteria may very well be protected."I really think there's something to it. I'd be happy if you could ask your son. All information is valuable!Wish you the best too, and I really hope you, and I, and everyone dealing with this condition could recover and live happily ever after







_The question is - How do we destroy biofilms?_


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## IBS is BS (Jul 2, 2012)

If biofilms are involved then it makes it so much harder to draw accurate conclusions from self-experiments.I myself tried Rifaximin several times at higher and higher dosages... to no avail. It may be possible I don't have SIBO at all and it's something else which gives me these terrible cramping pains.I agree with the above posters about the underlying cause remaining thus recurrence happens... but there are some theories that it is the presence of the bacteria themselves that exacerbates the lack of gut motility. It would make sense that they evolved to do this.I also think that the antibiotics will kill too many good bacteria in the large intestine which means that they won't be there in great enough numbers to prevent recolonisation of the small intestine by bad bacteria when SIBO recurs. I think SIBO rises upwards from the large intestine. Not downwards from the stomach.Note that I also think whether a bacterial strain is classes as good or bad is hugely dependent on WHERE it is in the body. Most are good while in the large intestine, but would be negative elsewhere.


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## IBS is BS (Jul 2, 2012)

Freud said:


> _The question is - How do we destroy biofilms?_


Have you looked into NEEM?I've heard it's a chemical compound which can destroy biofilms.


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## olaureno (Jun 2, 2013)

http://paleodietlifestyle.com/you-and-your-gut-flora/


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## Dianaearnshaw (Feb 22, 2013)

The book to give you the insight is Gut and Psychology Syndrome by Dr. Natasha Campbell-McBride. Or look at the website:
http://gaps.me/preview/?page_id=344

This takes you to a page that might be helpful.


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## hadenuff29 (Sep 18, 2007)

Freud said:


> Refuse to live this way, I found a post by a user named Hester who seems to have the same theory "A member here was cured after like four rounds of very strong and multiple antibiotics. I think SIBO is very hard to kill becuase you are dealing with 20 feet of living tissue and mucus. Sometimes (just my thoughts) *the bacteria is probably inside the mucus and the wall of the small bowel lining making it very hard to kill*. 80% of the body's defense is in the gut. Hence, the lining/mucus/defense once infested with some microbe, probably has a hard time getting it out of there. If mucus is the defense and the microbe hides in it, the bacteria may very well be protected."I really think there's something to it. I'd be happy if you could ask your son. All information is valuable!Wish you the best too, and I really hope you, and I, and everyone dealing with this condition could recover and live happily ever after
> 
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Freud said:


> Refuse to live this way, I found a post by a user named Hester who seems to have the same theory "A member here was cured after like four rounds of very strong and multiple antibiotics. I think SIBO is very hard to kill becuase you are dealing with 20 feet of living tissue and mucus. Sometimes (just my thoughts) *the bacteria is probably inside the mucus and the wall of the small bowel lining making it very hard to kill*. 80% of the body's defense is in the gut. Hence, the lining/mucus/defense once infested with some microbe, probably has a hard time getting it out of there. If mucus is the defense and the microbe hides in it, the bacteria may very well be protected."I really think there's something to it. I'd be happy if you could ask your son. All information is valuable!Wish you the best too, and I really hope you, and I, and everyone dealing with this condition could recover and live happily ever after
> 
> 
> 
> ...


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## tummyrumbles (Aug 14, 2005)

The below study draws a lot of conclusions. One, that IBS is mostly SIBO related and two, that a dysfunction of the migrating motor complex is responsible.

http://www.hydrogenbreathtesting.com/downloads/IBSSIBO-handout-2-28-Jan-2014.pdf

"SIBO is not an independent diagnosis, because something causes it (most

commonly IBS)"

"The main source of food for bacteria in the small intestine is carbohydrate, which worsens and perpetuates SIBO."

Doctors have their pet theories and studies can reflect this. I don't believe that it's been proven that IBS is SIBO. I'm hoping it is, but testing is far from conclusive. This study also mentions a false negative based on constipation.

Carbohydrates certainly worsen and aggravate SIBO and IBS. We've all experienced this. A round of antibiotics might momentarily kill of a certain number of bacteria but most people probably continue with their same diet, so the bacteria eventually repopulate.

The migrating motor complex is believed to sweep bacteria from the small intestine to the colon. It relies on fasting as eating interrupts this cycle. The cycles are believed to be shorter at night. An early dinner and bedtime is beneficial for digestion generally.

A clue to all this might be how we all got here in the first place. I was a heavy drinker, prone to snacking late at night. But then again not everyone who does this gets SIBO or IBS. If you eat the same foods as your family but you're the one with all the gas this would seem to suggest a bacterial overgrowth of some sort. It's possible that IBS can escalate from simple gas issues - then IBS-leaky gas to IBS-D / SIBO and eventually to inflammatory bowel disease if not managed through diet.

This particular link claims that potatoes, pasta, rice, bread and cereals are acceptable. These are the worse possible foods for me because of their constipating / gas inducing effect. You have to keep an open mind on everything because there's a lot of bad information out there. Try to fill up on low FODMAP vegetables as much as possible and keep the constipating foods to a minimum. If your symptoms improve then you'll know this is the way to go.


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## Blair (Dec 15, 1998)

I had that test done too, it was positive. I asked the lab tech if he ever tested himself he said yes and he was positive but it didn't affect him like it did " us sick people" and the h2 gas went away when he quit drinking milk.

Cedars Sinai dr Pimental he told me to quit eating sugar free gum which I did and consequently developed much tooth decay. back on Sugar less gum but i have since found I don't have IBS

I doubt this helps anyone but its part of my story.


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