# Did Xifaxan permanently ruin me?



## JeffR (Jan 20, 2017)

What exactly does the Xifaxan treatment do other than destroy all bacteria in the intestines? What is the best way to restore the good bacteria while minimizing the bad?

Asking because the Xifaxan has helped significantly reduce the extreme watery diarrhea but did not fully cure me, as I am having very loose stools every single morning. This is a daily occurrence, not an occasional occurrence.

Already tried Align, Activia, Colon Health. Nothing helped. My GI doc is also no help at all....telling me it's stress, and that I need to go take a yoga class....


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## rajiv_gupta (Jul 16, 2014)

I had taken Rifaximin for more than three years.

initially it helped me a lot but later on its efficacy dwindled and stopped taking it all together.

When consulted a GI Doc, he said the IBS D symptoms are due to slow motility of small intestines. he prescribed me a prokinetic drug to enhance the motility of small guts but the results are not very encouraging.


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## ibshell (Mar 21, 2017)

i just finished my 14 day Xifaxan treament it helped the diarrhea and some of my stomach bloat. but was having loose stools like you. i started mixing flex seeds with some of my food and they are helping with that. i try to eat 1 or 2 table spoons a day..


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## mellosphere (Sep 22, 2015)

I agree that the xifaxan leaves you with looser stools but it seems like over the next couple weeks they get a little harder. Wish i had a better answer but it seems pretty common.

I don't know if i'm going to take probiotics again...seems counterproductive if i'm trying to prevent overgrowth of bacteria. Probiotics just haven't ever seemed to make a positive difference for me. So just a thought that could be making it worse too.

Also i know i've read this before but why do people prescribe a prokinetic??? Seems like the last thing i would want with ibs-d.


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## JeffR (Jan 20, 2017)

My GI doc told me to take probiotics after the xifaxan treatment to restore the good bacteria since xifaxan destroyed all bacteria (good and bad). He recommended align first, then he told me to try colon health cause I told him align wasn't restoring my stool back to "pre-stomach virus" consistency.

What should I do now???? Should I just give up and live with this?????? Go see a different GI doctor??????????


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## mellosphere (Sep 22, 2015)

If you've taken xifaxan then you might never get back to that state and it certainly wont happen overnight. There are studies saying that probiotics dont really recolonize the colon so saying to put good bacteria back in isnt so cut and dry. If it were then ibs-d would probably be less of an issue overall.

Best suggestion? Read these boards and start trying stuff you want to try. Feel free to find another doc but there's no cure so might need to look at changing diet, trying to mask symptoms etc.

Good luck. I hate diarrhea but haven't found a cure yet


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## JeffR (Jan 20, 2017)

mellosphere said:


> If you've taken xifaxan then you might never get back to that state and it certainly wont happen overnight. There are studies saying that probiotics dont really recolonize the colon so saying to put good bacteria back in isnt so cut and dry. If it were then ibs-d would probably be less of an issue overall.
> 
> Best suggestion? Read these boards and start trying stuff you want to try. Feel free to find another doc but there's no cure so might need to look at changing diet, trying to mask symptoms etc.
> 
> Good luck. I hate diarrhea but haven't found a cure yet


SERIOUSLY?!?!

If this is true, I really wish the doctor did not give me xifaxan!!!! I was also told to NOT take any probiotics during my course of xifaxan treatment.

So....xifaxan DID permanent damage to me then!?!

This response just made me lose all hope of getting my life back!


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## mellosphere (Sep 22, 2015)

Obviously I cannot say for sure but xifaxan is a pretty intense antibiotic and your best bet will probably be to just wait it out without trying to overdo the probiotics and see if it gets better. If you had a normal gut prior to getting the stomach virus, then the "good" bacteria that probably still remain in your gut are the best option to recolonize your gut.

If you're like me and your gut was always wonky even as a kid, then the weird gut habits are probably here to stay.


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## JeffR (Jan 20, 2017)

My bowels were perfectly fine before the stomach virus in November (only had occasional diarrhea before November. Post-virus -- everyday diarrhea).

After the virus but before Xifaxan, I was worse than I am today since I had severe diarrhea which happened up to 10 times per day. I go only 1-2 times per day but my bowels are far from normal. I rarely get a well-formed stool (in fact, I only got 1-2 well-formed stools so far in 2017...which is very sad).


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## celestin (May 20, 2004)

So, where is your problem ?!
You have sayed, twice (!), that Xifaxan has helped you. Good!
Do not worry. Believe me : to destroy completely a gut flora you need to take very very strong antibiotics at a very high dose. Actually, it is nearly impossible!

!! After a viral digestive infection one can get a lactAse deficiency, transient but rarely for ever>>Be cautious with dairies....Eat a little bit of everything and slowly you will go back to normality.


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## PD85 (Aug 19, 2010)

Well, it seems to me that Xifaxan does not appear to be the cause of your problem, as you specifically claim that a virus was the cause of your problem. Also, as far as we know, Xifaxan has minimal effect in the large bowel. Finally, the research behind Xifaxan actually shows that it is an excellent antibiotic for IBS as it's selective towards good bacteria. Meaning it leaves them be. On the danger scale of all antibiotics it has to be one of the mildest ones.


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## AlisonfromSickofIBS (Dec 21, 2016)

Hi there,

The good news is that your body is designed to heal itself given the right support.

The problem with SIBO treatment is that it does not get rid of your IBS if the roots of it are elsewhere.

For example, if you are still eating a diet rich in industrially processed foods and sugars, the bad guys will be back.

If stress is one of your IBS triggers, then your IBS won't go away until you deal with it.

I have a lot of information on my SickofIBS blog which may help you. Stress was one of my triggers for sure.

I had chronic IBS for years and managed to beat it.

If yoga appeals to you, it may be great. If it doesn't, then do something else.

My advice is to try various different ways of bringing down your stress levels and see what is a good fit for you.

This could be a good start: https://sickofibs.com/well-being/a-powerful-ibs-stress-hack/

Alison


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## JeffR (Jan 20, 2017)

Celestin -- I have 2 noticeable issues. 1) Loose or watery stools in the morning. 2) White / cracked tongue (usually worse in the morning). And yes -- I can't seem to tolerate real milk anymore (but I seem to have no problem handling cheese)

PD85 -- My doc told me that Xifaxan does not know the difference between the bad and good bacteria and says everything gets completely wiped out and I have to take probiotics to get the good guys back (he never told me which one and for how long...I had to beg for a recommendation that's when he told me Align). If Xifaxan is "mild" I'd hate to be on a "heavy" antibiotic as that Xifaxan literally crippled me (I was weaker, felt as if I was wasting away, etc).

AlisonfromSickofIBS -- I went through a significant diet change during and after the Xifaxan treatment (completely eliminated soda and fast food from my diet, significant cut-down on sugars, no candy at all, switched to lactaid milk due to no longer being able to tolerate real milk.....and increased intake of fruits and vegetables). The diet change was due to my fatty liver.

This week I am trying the BRAT diet for a few days and it might be working (I actually didn't even go at all yesterday, my stomach was 100% pain free, no growling at all, even before/after meals).

It never really mattered what I ate the day before having loose stools (I could have a chicken salad or pasta dinner, same result next morning). I did cut down a lot on the pasta/pizza and have not had any fast food in the last 4 months.

My doc never told me if I have/had SIBO even though I did ask. He told me it's PI-IBS with diarrhea, keeps telling me it won't last forever (I'm losing confidence in that comment since it's been 4 months of this nonsense).

Thanks everyone for the responses.....it's more of a frustration than anything else. I had a few stomach viruses in the past but they only lasted a few days....the one I had in November was a really bad one that lasted a month with all these "aftershocks". Like pretty much every sufferer on this board, I want my life back.

EDIT -- I had a solid stool this morning!!! I hope this is the "beginning of the end" (I stopped probiotics and yogurt 2 days ago which is the last time I had my flare-up of loose/watery stool). Not keeping my hopes up unfortunately as it has fooled me before (thinking I'm all better, then BAM! Another loose one with stomach aches!). At this time my stomach is not even churning and I have zero rumbling in my intestines (just ate too).


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## celestin (May 20, 2004)

JeffR said:


> Celestin -- White / cracked tongue (usually worse in the morning).
> 
> >>> -- Xifaxan literally crippled me (I was weaker, felt as if I was wasting away, etc).


Your tongue: forget it

Xifaxan has helped you. You are/were weak because of the infection, not because of the treatment...


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## JeffR (Jan 20, 2017)

I think it's the probiotics causing my issues. I noticed my tongue issues when taking align, got better when I stopped, got worse when started taking align again (I now have 3-4 weeks supply that I'm not going to use)...

Any idea how long it takes for things to clear up once I stop taking probiotics?


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## PD85 (Aug 19, 2010)

JeffR said:


> PD85 -- My doc told me that Xifaxan does not know the difference between the bad and good bacteria and says everything gets completely wiped out and I have to take probiotics to get the good guys back (he never told me which one and for how long...I had to beg for a recommendation that's when he told me Align). If Xifaxan is "mild" I'd hate to be on a "heavy" antibiotic as that Xifaxan literally crippled me (I was weaker, felt as if I was wasting away, etc).


Your doctor is wrong on multiple levels. No antibiotic kills "everything". That's why there are literally thousands of different antibiotics. They are moderatly specific with what they target. Different infections and different bacteria are susceptible to different antibiotics. To kill the bacteria that cause stomach ulcers it takes 3 different antibiotics given at one time. If Xifaxan was such a destroyer of bacteria, don't you think they could just give the person person with a stomach ulcer Xifaxan? The reason Xifaxan isn't used in stomach ulcers is because H. Pylori is not susceptible to Xifaxan. These are the very basics of antibiotics.

If Xifaxan literally crippled you, then the bacteria in your small bowel were part of the reason you were feeling healthy. Now that they are gone, you feel worse. This seems like the most logical conclusion we can draw based on the information we know. There are many unknowns about antibiotics, just like every other drug. For instance the antibiotic class called flouroquinolones can cause cellular damage.

Here's a study where it shows Xifaxan actually INCREASES some specific bacteria strains and the microbial diversity in the large intestine, which is far away from "wiping out everything".

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4675645/

Given its limited efficacy in the large bowel, one can only speculate that its effect on colonic microbial diversity may be related to Xifaxan's ability to reduce bacterial overgrowth in the small bowel. Then the colon can correct itself without the pathogenic bacteria that were previously living "upstream" so to speak. This is my personal speculation and could be wrong.



JeffR said:


> I think it's the probiotics causing my issues. I noticed my tongue issues when taking align, got better when I stopped, got worse when started taking align again (I now have 3-4 weeks supply that I'm not going to use)...
> 
> Any idea how long it takes for things to clear up once I stop taking probiotics?


It depends on the strain. For Align I'd guess it dies out in about 3-10 days. Now if it was doing it's job, which would be creating a better host environment for good bacteria, and the good bacteria in you are thriving but also causing you issues, then the changes may be more long-term. I'd guess you'll be back to "pre-Align" symptoms in about a week.


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## JeffR (Jan 20, 2017)

So.....I probably never needed to take probiotics. Hmmm.......

Oh well...I felt great all weekend with better stools and only had one flare-up today. So, if stopping the probiotics and yogurt make me feel better I'll be very happy!


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