# About to take xifaxan again



## JeffR (Jan 20, 2017)

I first took xifaxan 6 months ago for my pi-ibs....any harm taking it again so soon? I'm having occasional diarrhea about 2-3 times a week (both sat and sun, no bm today so far). The same GI doc prescribed it again based on what i told him...


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## Rboe (Mar 26, 2017)

You need to check with the doctor about whether or not it is a good idea.

If xifaxin helped you, it may be that you have SIBO. Have you been tested for it? If you do, then look into the SIBO specific diet to help you after your round of antibiotics. http://sibodietrecipes.com/the-sibo-diet/


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## JeffR (Jan 20, 2017)

Well....my doc is the one who told me to take another round and gave me a prescription. It did help some last time but my bowels are not perfect so I hope whatever it is that I ended up with will be gone with trhis round. I also feel a whole lot better right now than I did when all this started (except for the loose bowels and diarrhea).

He also told me to take align probiotics for 1 month after I finish the 14 day course of xifaxan.

I also finally confirmed my fatty liver is not connected to these bowel issues (it had me extremely worried for a long time since my doc expressed major concern about my liver initially when he saw the blood work withbelevated enzymes, which since came back down to normal levels). However it's almost a blessing in disguise as I probably would've never known and just continue my old diet, as I feel much happier on my new diet and lost 15 pounds!


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## JeffR (Jan 20, 2017)

I have a question about "patients may be retreated up to 2 times if the symptoms come back".

Does this mean "3 strikes you're out"? Asking because I am on my 2nd treatment of Xifaxan (1st treatment was Dec 2016), and am worried that I only have one more chance for relief after this one.


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## JeffR (Jan 20, 2017)

I've never been tested for SIBO but so far, no diarrhea since i started the xifaxan Monday evening (last time I had diarrhea was Sunday). Today I had some constipation (something I thought I'd never see again). During my first xifaxan treatment in December I still had diarrhea but it was less intense, so I hope this round kills all the bad stuff left on my body).

Colonoscopy was done January, nothing was found except for a small polyp (if I had chrons would that show in the colonoscopy?)


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## dekkalife (Aug 21, 2015)

I don't think you are limited to only 2 courses per se. Moreso, if you have not benefited after 2 courses, it's probably not the right treatment for you.


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## JeffR (Jan 20, 2017)

4 days since my last flare-up, and I am not feeling bloated at all during this round of xifaxan (i felt so bloated during my first round in December and so weak that I had to stop it early, not to mention I was still getting diarrhea).

I wonder if I was just too sick back in December and the xifaxan was not effective enough, or maybe it was cause I was still on my very poor diet (with my new diet I'm feeling quite good except for diarrhea, I seem to be getting much better results this time around, hope I can keep this momentum going and beat this IBS once and for all!)

Starting to wonder if I did end up with SIBO since probiotics did not help much either, although my doc told me to take probiotics after I finish the 14-day treatment.


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## JeffR (Jan 20, 2017)

Day 5 -- still no diarrhea, not even any gurgling! I think the xifaxan is working well this time!!!

I hope my symptoms don't return after my 14 day treatment is over........any advice on permanently killing the bad bacteria would be awesome!


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## Akn1965 (Jan 13, 2017)

I have taken Xifaxan 400mg three times daily.During medication I think my ibs-d was going to cure.But after completion of two weeks course another 15 days it lasted then returned.
Thanks.


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## JeffR (Jan 20, 2017)

Back in December I was on 550mg twice a day, for 10 days (I had to end early because I was feeling extremely weak and the doc thought it was because of xifaxan).

Since last Monday I've been on 550mg 3 times a day (morning, afternoon, night). I'm not feeling weak at all this time and I think it's working so far.....but I need to figure out what else to do to stop the bad guys from coming back (my doc told me to take probiotics after I finish the 14 day xifaxan treatment).

Problem is -- I don't know if I will ever fully recover from whatever I got in November (certainly trying my hardest to). But if xifaxan is helping, I doubt a psychologist will be able to help with my IBS-D.

What about a naturopath?


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## Liz26 (May 31, 2017)

If you take the antibiotic and you feel fine while doing it, most probably is because you have SIBO. The problem is that you need to replenish again your system with good bacteria because antibiotics wipe out good and bad bacteria. Another thing is that when you kill bad bacteria, when they die, they leave toxins in your body so you also need to fllushh those toxins out of your system. I think many doctors forget that and theyjust simply treat the symptoms and move on. Remember all of this if you plan on taking yet another round of antibiotics and try to design a plan that best works for you with your doctor GI/Nutricionist/Naturopath. Remember that you and only you know what feels normal and what does not.


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## Liz26 (May 31, 2017)

Also forgot to mention that when your body is getting rid of bacteria, parasites or whatever thing that is making us feel uncomfortable, it actually make us feel like we are sick all over again but it actually isn't. That is what is called a "curative crisis". And it is different in every person.


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## dekkalife (Aug 21, 2015)

Curative Crisis? Is that the same as a Herxheimer Reaction?


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## JeffR (Jan 20, 2017)

Liz26 said:


> If you take the antibiotic and you feel fine while doing it, most probably is because you have SIBO. The problem is that you need to replenish again your system with good bacteria because antibiotics wipe out good and bad bacteria. Another thing is that when you kill bad bacteria, when they die, they leave toxins in your body so you also need to fllushh those toxins out of your system. I think many doctors forget that and theyjust simply treat the symptoms and move on. Remember all of this if you plan on taking yet another round of antibiotics and try to design a plan that best works for you with your doctor GI/Nutricionist/Naturopath. Remember that you and only you know what feels normal and what does not.


So are you saying that I'm supposed to feel sick while on Xifaxan vs not taking Xifaxan?

And yes, my doc told me to take probiotics after finishing the Xifaxan treatment. He recommended Align or Phillips Colon Health (which one is better)?


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## JeffR (Jan 20, 2017)

Had mushier stools this morning, although I had 2 slices of pizza last night (was that a "no-no"?) I had absolutely no stomach pain or gurgling after eating pizza.

Or do I just need to be patient with the Xifaxan (1 1/2 weeks into the treatment period).


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## Akn1965 (Jan 13, 2017)

Yes,mushy stool is due to pizza. After completion of rifaxmin you should take Phillips colon health probiotics.

Thanks.


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## JeffR (Jan 20, 2017)

This morning I had even mushier stools that was liquid enough to make my toilet water cloudy. I had a chicken caesar salad for lunch yesterday and I think I noticed some lettuce in my stool. Still on Xifaxan 3 times a day until Monday, and my tongue is still not looking normal.

No gas, no bloating, no pain, etc.

AUUGHHH!H!H!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

WHAT SHOULD I DO NOW!~?!!??!?!?!?!?!?!?!?!??!?!?!?!?!??!?!

I also tried some ice cream (something I haven't had in over a year) last night for dessert as I read somewhere it may be a good idea to get the bad bacteria active as it will give the xifaxan a better chance of killing the bad bacteria (and they strive on sugars I hear).

Any advise is greatly appreciated.......thanks!!!!!!!!!


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## mellosphere (Sep 22, 2015)

I've said it before...while on antibiotics, expect your stools to get worse. Personally I don't take that as a bad sign...it happens. The improvement I saw after antibiotics came about 2-3 weeks after the course of antibiotics was over. You just have to wait it out.

Also lettuce and ice cream would set me off even on the very best of days so...maybe try sticking to an easier digestible diet.


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## JeffR (Jan 20, 2017)

Thanks for reminding me mellosphere, sorry im sure you did mention that before. I panicked because my first 2 days back on xifaxan I was constipated and my stool was rock solid. It got a little softer last week and this morning it was mushy.

I do have to say the last major diarrhea attack/flare-up was June 4th, haven't had one since so maybe I need to keep that in mind, hoping that I will finally get better (it's been a long 6 months).

Been also trying to eat as healthy as possible which is why salads became more frequent in my diet. Maybe I just can't have a salad every day (or even every other).


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## PD85 (Aug 19, 2010)

You could look into diet based treatments. Clearly you're just eating random stuff, like pizza, which could easily be eliminated and solve your issues.

Just a thought.


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## Liz26 (May 31, 2017)

dekkalife said:


> Curative Crisis? Is that the same as a Herxheimer Reaction?


Sorry for the late response, but yes it is. I did not knew that "curative crisis" was known as Herxheimer reaction. Actually I did a little research on that and was really amazed by the variety of symptoms that getting better could set off, specially inflammation.

Aside of that, well, even though I use prescribed medication, i feel like im more of an integrative practicioner (I actually dont know how to describe it well) since my grandma always thaught me how to cure myself with teas, plants, and all of that, but Im very curious if anyone here has ever tried to get their blood cleaned since a very repetitive symptom in all of us is inflammation/pain or a cleanse of the kidneys and/or liver. Just curious.


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## JeffR (Jan 20, 2017)

Tried several different diets, makes absolutely no difference. Just had diarrhea a few minutes ago (I am on xifaxan until tomorrow afternoon).

...sniff....sniff.....


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## dekkalife (Aug 21, 2015)

Personally, I wouldn't recommend eating foods like lettuce and ice cream whilst taking xifaxan. Xifaxan is already, in some ways, an irritant to your bowels, so adding fibre and sugar to the mix will probably just increase inflammation more than anything else. Don't be too discouraged. If I ate ice cream, I would be feeling it for an entire week.


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## adamjeff (Oct 22, 2010)

Hello, I think all of the advice that has been provided so far has been spot on. You definitely need to be on a probiotic after your full Xifaxan treatment. That antibiotic kills good and bad bacteria alike and you need to replenish. In reality, you should take probiotics for the rest of your life, just rotate brands every 6 months or so in order for your body to get different probiotic strains. Kris Kresser has some really interesting podcasts that discuss SIBO that I recommend you listen to. Also, not sure if you have done this yet but you really should get tested for food allergies, intolerances, and sensitivities...and yes there is a difference between all three of those categories. What I mean is, let's say that you have a sensitivity to something like potatoes. For most of us on this board, potatoes seems like a pretty "safe" food. But if you are sensitive to potatoes and you eat some, it creates inflammation in your gut. That inflammation might not manifest itself immediately (like urgently needing to run to the bathroom) Then, let's also say that you have a sensitivity to garlic, which is used in almost every recipe. Now you consume garlic and that creates more inflammation in your gut on top of the inflammation that already exists from the potatoes. Now you are really starting to build up the inflammation and you eat something you think is pretty benign but by this point your gut is massively inflamed. You see where I am going with this? Your issues could be more than just the SIBO and the only way to find out is by getting tested. I got tested through my functional medicine doctor and found out that I have 41 food sensitivities, which is a lot. The good news is that many times the sensitivities can be reduced through healing the gut and eliminating that inflaming food from your diet for a little bit.


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## JeffR (Jan 20, 2017)

Thanks adamjeff.

My GI doc said I tested negative for celiac disease. How do I get him to test for other possibilities?

Gonna start Phillips Colon Health later today (he recommended this or Align). Align made my tongue do weird stuff, not sure if it really helped last time. Plus the Colon Health has 3 strains and 1.5 billion CFU's (Align has one strain and 1 billion CFU's).


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