# Who No Longer Has SIBO & HOW?



## freakzilla154l

I'm still battling my SIBO and welcome any advice in regards to eliminating this awful bacteria. My doc just told me to get a second opinion and left me out to dry that piece of trash! I've tried lots of things as stated in my previous post in the thread that was just closed. I've only had some success with HCL and a product called Humaworm that I tried 2 years ago. I'm gonna try again soon along with antibiotics in a few weeks. Probiotics make everything worse for me so there a 'no, no' in my case! The money I spent on them I would have rather gambled away!Thanks for listening... Most advice is good advice, so most is welcome!







FREAK


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## nw0528

I just had to reply to this thread because it's so depressing that there have not been any replies by people saying they no longer have SIBO. My 14 days on Xifaxan were like a dream...100% perfect - no yucky stuff - just one normal BM per day and I felt so normal. Two days off of it and my symptoms are back (somewhat milder, but they are back). I wish I were posting saying I was cured!!! But, Xifaxan Round 2 - Let the fun begin!Nicole


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## freakzilla154l

THanks nw0528.... Glad to hear you felt better. Did you stick to a diet or eat whatever you wanted? Also, what are your exact symptoms?


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## nw0528

I ate whatever I wanted while on Xifaxan. The idea was that as active as the bacteria were while on Xifaxan, the better to kill them...I had had IBS since 1985 (when I was 10, following parasitic infection with giardia). My symptoms were manageable (IBS-D) and for five years I had NO SYMPTOMS at all (still took a daily bulk forming laxative though to regulate BMs). Then, one year after a severe food poisoning episode that sent me to the ER, I developed symptoms very different from my regular IBS-D. I was having urgency after each and every thing I ate, and often would not make it to the bathroom in time! My stools were very oily/greasy (they ruled out celiac, as that was what we all thought I had). While on Xifaxan, I was 100% better. Nicole


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## freakzilla154l

The later half sounds like my case when things get bad. Right now, things have been ok, however I use anti-inflammatory suppository every night and take Lialda every day. I went from having ulcerative colitis to proctitis to IBS now... The docs know nothing in my eyes. My last GI told me he can't help me.... LOL...I did have the breath test and came back positive... Anyways, soon I'm gonna start a 2 week antibiotic treatment on myself. I did Xifaxin the first time and it didn't help at all and that was for 21 days at 1200mg a day.Now, I'm gonna do 500mg Cipro 2x/day and Neomycin 1000mg 3x/day for 14 days on a strict diet. I'm hoping now that my BM are 1-2 times a day and ok , that this will work.I still feel like cr*p. The only thing that got better were my BM... And it's only been for about 2 weeks.


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## JanEllen

I have been able to keep my SIBO in check by drinking Kefir (bought at certain grocery stores) and liquid yogurt from a local dairy. After two rounds of Xifaxan, without success, my doctor kind of threw up his hands. After that, I tried various probiotics, but the liquid dairy products seem to work the best for me. It took nearly a year of drinking Kefir and liquid yogurt, before I felt the SIBO was not an issue for me. I still try to drink it every day. I have found if I don't, the SIBO will sometimes want to return. Also, I do take Lotronex for IBS, but Lotronex does not work for SIBO.


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## Ernie_

Hi. I read that you have tried probiotics and that they made you worse. 95% per cent of the probiotic products make me worse too, but there are a few that make me a hell of a lot better.1. Avoid products containing fructologisaccharides (F.O.S). FOS feed good AND bad bacteria and should thus be avoided.2. Try avoiding products containing bifidobacter baceria. These make me worse too.3. Try a product with lactobacillus bacteria.Products filling these demands are:1. Nature's way Primadophilus Reuteri (contains lactobacillus acidophilus and lactobacillus rhamnosus).2. LYO-SAN Acidophilus & Yogurt Capsules (contains lactobacillus acidophilus)3. Biogaia Probiotic Chewable Tablets (contains lactobacillus reuteri)Try one or more of the above (start with a product that contains only 1 bacteria species).Good luck.


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## rockingirl

I just keep getting positive breath tests







I've taken one round of a more generic antibiotic (can't remember the name) and two rounds of Xifaxin. While I think I was a bit better on the Xifaxin, I've really had no change. Now my Dr. says I must be getting a false positive with the breath test


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## faze action

I think it is possible to get a false positive on a breath test... the results also do not show exactly what type of bacteria are involved in the SIBO, so eliminating it could be sort of hit or miss.I had a positive test back in April and went on rifaximin for 8 days, and it totally eradicated the SIBO. Within 48 hours I was "normal". Now, how long that will last I have no idea (I have begun to get a few symptoms back recently, but nothing like what I was experiencing previously). I also found that probiotics seemed to aggravate the situation and worsen my symptoms, and I still can't eat yogurt because I bloat and cramp like crazy. Not sure whether it's the pro-B or the dairy at fault though (I don't drink milk, and eat very little dairy anyway simply because I don't like it, so it's hard to tell).


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## MARK6331

I had giardia 15 years ago I was treated, ever since then I have had ibs-D four weeks ago I decided to eliminate wheat products from my diet (glutens) For the first time in 15 years I do not take any more diarrhea meds. This has been a real breakthrough for me. If you can just give up wheat products for just four days I think this will help you just like it’s help me.Markprobiotics also made me sick.****


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## IanRamsay

Probiotics often make things worse for a period of several days to several weeks before they start to slowly improve teh situation. this increase or worsening of symptoms is called the herx reaction and is caused by the often sudden and very large "die off" of bacteria in teh gut and along teh length of teh GI (depending on what probiotic you take). teh herx isnt a universal reaction but in my research it is obvious that it is suffered by at least 80% of people taking probioytic suppliments to some degree. the larger teh count of teh bacteria teh more severe that teh reaction is.Ian


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## Hester

Well, I had two rounds 10 days each of Tetracycline. During which time I ate like a pig and felt pretty good except for a lot of grumbling. I laid off the probotics and fiber and things went well. After antibiotics I ate lots of grapefruit seed extract, garlic and cayenne pepper. I have stayed sugar free and low carbs and so far the diarhhea has not returned. I still take some supplements but no probotics and things seem fine. (Fingers crossed.)


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## faze action

IanRamsay said:


> Probiotics often make things worse for a period of several days to several weeks before they start to slowly improve teh situation. this increase or worsening of symptoms is called the herx reaction and is caused by the often sudden and very large "die off" of bacteria in teh gut and along teh length of teh GI (depending on what probiotic you take). teh herx isnt a universal reaction but in my research it is obvious that it is suffered by at least 80% of people taking probioytic suppliments to some degree. the larger teh count of teh bacteria teh more severe that teh reaction is.Ian


That's interesting.. I had no idea that was common. Maybe I'll give pro-Bs another go. It would be very difficult getting through that "herx" period though.


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## IanRamsay

that is usually why people stop taking them. the severity of teh reaction can vary ALOT. some people just get a bit of gas and thats that. other people get something that resembles flu and lasts for 2 or 3 weeks, some people just get a worsening of the symptoms that they are currently experiencing, and some people dont suffer any reaction at all. there are no certain reasons why this is yet, but there are theorys. personally i think it is down to how efficient the individuals elimination systems are working, liver, lymphatic etc. i remember almost 4 years ago no i took 900 bil of bacteria twice a day for 7 days and that caused a very bad herx. but here is teh interesting bit. i took the same dosage of a different strain of bacteria 14 days later, and suffered no herx. then, 14 days later just to confirm my findings i took the same dosage of teh original bacteria for 7 days and experianced teh same herx again. we are still learning about the more uncommon strains of probiotic, and it is possible that some strains need less numbers to do their job, or that some strains will produce herx regardless of numbers. what i have found is that if you find the probiotic that your body needs, you will feel something, wether it is mild or severe. it woulod seem that some people need a broad spectrum of probiotics, where as others only need one or two. of course some people are not helped by them at all.cheersIan


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## Flowby Jonas

I have a question. HOw long must one go without an episode to know that they no longer have SIBO? is 3 weeks enough?


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## UrbanUrbane

Flowby Jonas said:


> I have a question. HOw long must one go without an episode to know that they no longer have SIBO? is 3 weeks enough?


That most likely depends on the individual, but personally I had two five-month intervals where I was 90 - 100% symptom-free right after Xifaxan, but always wind up back with all the same symtpoms.


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## SteveE

So is Dr. Pimental a quack? Is this whole SIBO thing bogus? Has he really cured anyone?I can't deny that the week I was on tetracycline was the best week (IBS wise) I've had in 16 years of suffering from IBS, but maybe it's just taking the edge off by temporarily reducing gas instead of permanently fixing anything. It's no wonder health care costs are spiraling out of control when we (those of us with IBS, fibro, cfs, etc.) keep coming back to supposedly reputable, published doctors and are still sick.


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## Hester

Steve = reachforthelasers, 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.


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## IanRamsay

i would be interested top see how long his recovery lasted, or if it is still going on after following pimantels flawed, in my opinion, treatment.Ian


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## Flowby Jonas

Well going on 4 weeks of no problems and this herb I took was 4 weeks ago and I am still doing ok. Biggest problem so far is I am still learning when I am hungry. I figure if I go year I will be considered cured? Its a rare herb but still widely available. I now think all of you think that acupuncturists are quacks and they have no real place in this. However 4 weeks of good tummy is nothing to sneeze at!!!If any of you read my post "It Just Keeps Comming Back" I ask those questions about longer time on higher doses of antibiotics.


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## idkwia

Flowby Jonas said:


> Well going on 4 weeks of no problems and this herb I took was 4 weeks ago and I am still doing ok. Biggest problem so far is I am still learning when I am hungry. I figure if I go year I will be considered cured? Its a rare herb but still widely available. I now think all of you think that acupuncturists are quacks and they have no real place in this. However 4 weeks of good tummy is nothing to sneeze at!!!If any of you read my post "It Just Keeps Comming Back" I ask those questions about longer time on higher doses of antibiotics.


So what is the name of this herb you describe?


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## idkwia

I saw the following in another thread and thought I would post it here as it does have a lot of relevance to this post I think: -_I just read a short journal article about a study done in Italy using the probiotic B. clausii to eradicate SIBO. It was a short article that baiscally summed up the study (the full details were not included), but essentially only one person out of forty reported any adverse effects (in this case, constipation) at all, and the efficacy reported by results stated that the "normalcy" rate for the breath test were virtually identical to those of antibiotics. In other words, the probiotic and the antibiotic both had the same effect in getting rid of the SIBO. The article was published in April of this year._If anyone tries this I hope they post back to let us know.


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## IanRamsay

trust in the bacteria.Ian


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## andiSIBO

Bacillus clausii as aTreatment of SmallIntestinal BacterialOvergrowthMaurizio Gabrielli , P hD1 , Ernesto CristianoLauritano , MD1 , Emidio cSarpe llini , MD 1 ,n Adrea Lupa scu , MD1 , Veronica Ojetti , MD 1 ,Giovanni Gasbarrini , MD1 , Nicol ò GentiloniSilveri , MD1 and Antonio G asbarrini , MD 1doi:10.1038/ajg.2009.91; published online7 April 2009To the Editor: Small intestinal bacterialovergrowth (SIBO) is a common clinicalcondition due to an increase in thelevel of microorganisms, in excess of 10 6colony-forming units / milliliter of intestinalaspirate, and / or of colonic-typebacteria within the small intestine (1) .Empirical courses of broad-spectrumantibiotics are the treatment of choicefor SIBO decontamination at present(1,2) . Probiotics may play an antibacterialrole on gut bacteria as a result ofmultiple mechanisms. Bacillus clausii is aprobiotic showing some unique properties:resistance to commonly used antibiotics;sporogenic activity to vegetativeforms in the intestinal tract; adherenceto intestinal wall; secretion of antimicrobialsubstances active against gram-positivebacteria; and immunomodulatoryactivities (3) . e aim of this study was to assessboth eT cacy and tolerability of B. clausiifor SIBO decontamination.Consecutive outpatients referred toour Gastroenterology Unit for chronicgastrointestinal symptoms (bloating,H atulence, abdominal discomfort / pain,and diarrhea) were evaluated. All of thepatients underwent a hydrogen glucosebreath test (GBT) under standard conditions. e test was considered as indicativeof the presence of SIBO when thepeak, that is the increase over the baselineof hydrogen levels, was > 12 partsper million (4) . Major organic gastrointestinaldisorders were ruled out, asreported in an earlier study (5) . Patientswith abnormal GBT were included in thestudy aG er written informed consent. e GBT was repeated 1 month aG erthe end of therapy in all the patients toassess SIBO decontamination.  e p rimaryoutcome was the SIBO decontaminationrate. Secondary outcomes werepatient compliance and incidence of sidee ects. Poor compliance was de! ned as> 20 % of vials returned. Side e ects werede! ned as the occurrence of “ adverseexperiences, ” that is, clinical ! ndingsor patients ’ complaints, which were notpresent in the 24 h before enrollment.Participants in the study underwenttreatment with B. clausii (each preparationcontaining 2 × 10 9 spores, Enterogermina,Sano! -Synthelabo OTC, Milan,Italy), one vial three times a day for1 month. A total of 40 patients (14 men,mean age 30 ± 15 years) were enrolled.The American Journal of GASTROENTEROLOGY VOLUME 104 | MAY 2009 www.amjgastro.com1328 Letters to the EditorNo dropout was observed during thetreatment.  e GBT normalization ratewas 47 % (19 / 40).  e overall compliancewas 95 % . Only one patient reportedside e ects during the treatment(constipation). is is the ! rst study, to the best of ourknowledge, that has tested the probioticB. clausii for SIBO decontamination.  eGBT normalization rate achieved withB. clausii is comparable to that observedwith many antibiotics. In fact, trialsassessing the decontamination rate of asingle course of a broad-spectrum antibioticshowed normalization of breathtests in 20 – 75 % of SIBO patients (1,2) .On the other hand, the treatment byB. clausii was extremely safe and well tolerated,as only one patient reported sidee ects without abandoning the study. ese preliminary results suggest thatB. clausii could represent a promising,easily handled and well-tolerated treatmentoption for SIBO decontamination.As SIBO is a common clinical conditionassociated with high recurrence rateaG er successful decontamination (1,5) ,the availability of a treatment alternativeto antibiotics could reduce both the riskof antibiotic resistance and the incidenceof side e ects.  ese data should be con-! rmed by future interventional trials inpatients a ected by SIBO comparingB. clausii with absorbable and nonabsorbablebroad-spectrum antibioticsand / or pl acebo.CONFLICT OF INTERESTGuarantor of the article : AntonioGasbarrini, MD.Speci c author contributions :Maurizio Gabrielli and ErnestoCristiano Lauritano had the originalidea for the study, designed and organizedthe protocol. Ernesto CristianoLauritano, Emidio Scarpellini, AndreaLupascu, and Veronica Ojetti includedand followed patients in the study.Maurizio Gabrielli and NicolòGentiloni Silveri performed the statisticalanalysis of the data. MaurizioGabrielli and Antonio Gasbarriniwrote the manuscript. GiovanniGasbarrini and Antonio Gasbarrinicritically reviewed the paper.Financial support :  is study was supportedby a restricted grant provided byFondazione Ricerca in Medicina, Italy.Potential competing interests : None.REFERENCES1 . Gasbarrini A , Lauritano EC , Gabrielli M et al.Small intestinal bacterial overgrowth: diagnosisand treatment . Dig Dis 2007 ; 25 : 237 – 40 .2 . Quigley EM , Quera R . Small intestinal bacterialovergrowth: roles of antibiotics, prebiotics, andpr obiotics . Gastroenterology 2006 ; 130 S(uppl 1) :S78 – 90 .3 . Urdaci MC , Bressollier P , Pinchuk I . Bacillusclausii probiotic strains: antimicrobial and immunomodulatoryactivities . J Clin Gastroenterol2004 ; 38 : S86 – 90 .4 . Kerlin P , Wong L . Breath hydrogen testing inbacterial overgrowth of the small intestine .Gastroenterology 1988 ; 95 : 982 – 8 .5 . a Luritano EC , Gabrielli M ,Scarpe llini E e t al.Small intestinal bacterial overgrowth recurrenceaG er antibiotic therapy . Am J Gastroenterol2008 ; 103 : 2031 – 5 .1 Internal Medicine Department, Gemelli Hospital,Catholic University of Sacred Heart , Rome , Italy .Correspondence: Antonio Gasbarrini, MD , CatholicUniversity of Sacred Heart, Largo Gemelli 8, Rome00168, Italy. E-mail: [email protected]


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## FONDUE

I read so much information on SIBO . While taking antibiotics, you have to stop all sugar, carbs,dairy, gluten long after your finshed with antibiotics you have to be on the sibo diet for maintence for a long time like six months up to, two years that is what I've read seems way to long! I guess if that is what it takes to end the excruciating suffering then I will do it because you have no life otherwise. I wish two weeks of antibiotics would do the trick, but the bacteria strong and just waiting for you to eat carbs ...sugar so it can have a feeding frenzy . I've gone over the statistics on only one antibiotics for SIBO, the one my doc wants me try in three weeks if the natural approach doesn't work . I think the one that had the highest success rate was Rifaximin (it cost $800 ) My insurance will pay a big chunk of it which is nice, I'm debating about trying it ...because I'm still on a remedy my ND suggested Now for the science part of your brain:







It looks like 14 days has a higher success rateRifaximin Dose Options:1) 1600 mg per day x 10 days- 70-85% success normalizing LBT, 82% success normalizing GBT (Scarpellini)2) 1200 mg per day x 14 days- 87-91% success normalizing GBT, 90-94% symptom improvement (Lombardo)3) 1200 mg per day x 10 days with 5 g per day Partially Hydrolyzed GuarGum -87% success normalizing GBT, 91% symptom improvement (Furnari)


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## Pete_SI

FONDUE said:


> I read so much information on SIBO . While taking antibiotics, you have to stop all sugar, carbs,dairy, gluten long after your finshed with antibiotics you have to be on the sibo diet for maintence for a long time like six months up to, two years that is what I've read seems way to long! I guess if that is what it takes to end the excruciating suffering then I will do it because you have no life otherwise. I wish two weeks of antibiotics would do the trick, but the bacteria strong and just waiting for you to eat carbs ...sugar so it can have a feeding frenzy . I've gone over the statistics on only one antibiotics for SIBO, the one my doc wants me try in three weeks if the natural approach doesn't work . I think the one that had the highest success rate was Rifaximin (it cost $800 ) My insurance will pay a big chunk of it which is nice, I'm debating about trying it ...because I'm still on a remedy my ND suggested Now for the science part of your brain:
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> It looks like 14 days has a higher success rateRifaximin Dose Options:1) 1600 mg per day x 10 days- 70-85% success normalizing LBT, 82% success normalizing GBT (Scarpellini)2) 1200 mg per day x 14 days- 87-91% success normalizing GBT, 90-94% symptom improvement (Lombardo)3) 1200 mg per day x 10 days with 5 g per day Partially Hydrolyzed GuarGum -87% success normalizing GBT, 91% symptom improvement (Furnari)


According to Dr Pimentel you have to eat sugar and carbs while your taking the antibiotics. It increase their activitys and encourages them to eat the antibiotics. After that is done you should follow a strict diet.


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## scouter99

Xifaxin only worked for me for 1 round. After round two the effect was minimal, round 3, nothing. I took Cipro after that and nothing. It's been about 15 months since I was diagnosed with SIBO and now after having an upper and lower GI I have been diagnosed with IBS by a different GI doc who basically turned her nose up at the SIBO diagnosis.I started the low FODMAP diet outlined in Patsy Catsos' book and just finished day 7 and feel the best I've felt in MONTHS! I know enough to get my hopes up... as I felt this way after the 1st round of Xifaxin and also after doing another diet from the book The Fungus Link by Doug Kaufmann.... but still- even having 2 good days makes me dance around like a fool!I hope to be able to report back in a few months that I've figured out how to kick SIBO and IBS in the tush!!! Denise


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## Pete_SI

scouter99 said:


> Xifaxin only worked for me for 1 round. After round two the effect was minimal, round 3, nothing. I took Cipro after that and nothing. It's been about 15 months since I was diagnosed with SIBO and now after having an upper and lower GI I have been diagnosed with IBS by a different GI doc who basically turned her nose up at the SIBO diagnosis.I started the low FODMAP diet outlined in Patsy Catsos' book and just finished day 7 and feel the best I've felt in MONTHS! I know enough to get my hopes up... as I felt this way after the 1st round of Xifaxin and also after doing another diet from the book The Fungus Link by Doug Kaufmann.... but still- even having 2 good days makes me dance around like a fool!I hope to be able to report back in a few months that I've figured out how to kick SIBO and IBS in the tush!!! Denise


How are you making out with your diet? I hope your still feeling good!


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