Symprove and SIBO: Does anyone know if... - Pernicious Anaemi...

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Symprove and SIBO

Pain12345 profile image

Does anyone know if Symprove helps with SIBO?

40 Replies

I had those awful Symptoms that relate to SIBO before i managed to get a diagnosis of Pernicious anaemia. I didn’t get a diagnosis for SIBO , because i was being treated as an hypochondriac by my doctor ( P.A.symptoms ! )!Anyhow i decided to treat those gut problems with Symprove , and hey presto -it worked! So i can only say try it . It can do you no harm anyhow ! The stomach pain was so awful , bloating and burping etc .etc. I took it for about 3 months . Haven’t needed to since . i have taken to self-injecting ,B12 , as 3 monthly was useless for me. Best wishes !

Pain12345 profile image
Pain12345 in reply to wedgewood

Thank you. I don’t have a SIBO diagnosis yet either. I ordered Symprove and the shipment is in transit (cleared Customs in New York today). I hope it works. My GI symptoms are queasy stomach, gas, and change in stool consistency consistent with malabsorption (floating/watery). I have had a colonoscopy and upper endoscopy in March and April, respectively. But, I was on a PPI in May.

wedgewood profile image
wedgewood in reply to Pain12345

The PPI will neutralise your stomach acid which upsets the stomach flora ( good bacteria) This leads to bad bacteria taking over , causing the awful gut problems

. Pernicious Anaemia also causes loss of stomach acid . The antibodies associated with P.A. destroy the parietal cells which produce the Intrinsic factor and stomach acid , both of which are needed for the breakdown and absorption of vitamin B12 .

jmc42 profile image
jmc42 in reply to Pain12345

An NHS dietitian has given me a month of Symprove to help with diarrhoea. It doesn't seem to have helped yet, though it has made me a lot more flatulent.

KCH/KCL has been doing trials with Symprove and IBS:

ncbi.nlm.nih.gov/pmc/articl...

The Parkinson's charity is funding research at KCH to see if it helps with constipation:

parkinsons.org.uk/research/...

12 weeks is the recommended dosage. I'm in the middle of deciding whether to continue it for another 8 weeks or not.

Ryzvtj profile image
Ryzvtj in reply to Pain12345

You have the exact problem as what i have, i had Exactly the same symptoms and causes. too much PPI.

Jeez, wonder if the course of symprove help you out? I heard that you usually gets 12 weeks of symprove courses (?) haha

also i had this abdominal discomfort/pain and loud bowel gurgling + tenesmus, as well as lots of change in stool consistency, mostly loose and mushy. Yikes. Sorry for the TMI.

Wonder if this related to your symptoms too?

Anyway how's your symptoms? does it improve your symptoms? wonder if it works, then i'll give a try.

Sorry if too much to asks.

I would recommend the fast tract diet by Dr Norman Robillard. I have been taking symprove and it hasn’t fixed my digestive issues although I think it is helping somewhat. You also need to work out the underlying issues which I think he says is carbohydrate malabsorption.

Thank you. Have you had success following his diet?

It sorted out my heartburn. My digestion is not very good in general and I probably need to stay on it long term to get better results. I confess I tend to adhere much better when I’m sick and slack off when feeling better.

Symprove was ok I did 11 weeks. At first I found it helped but it didn't last. On advice of my nutritionist I started Bimuno its a prebiotic it feeds good bacteria it is excellent and really helped and after a few weeks I added a probiotic (nutri advanced) taking both worked very well. Bimuno is on 3 for 2 offer at Boots, I highly recommend it.

If you have SIBO you will need an extended (14 days) course of metronidazole or doxycycline or amoxycillin, or, if you can get it, rifaximin.

Rifaximin is the best but not usually available through GPs. The other antibiotics should be rotated each time you have a flare.

It is vital that you have strong enough antibiotics for long enough to kill all the errant bacteria so that you don't cause antibiotic resistance and it is very difficult to get GPs to do this.

If you aren't lactose intolerant then the GI specialists recommend that you repopulate your gut biome after a course with "good" bacteria using probiotics from yoghurt style drinks.

Dr Robillard is against antibiotics for SIBO except in limited circumstances. He believes limiting carb intake is a better way of starving the bacteria.

That's possibly OK if you are specific about the type of carbohydrate that you are limiting and in certain circumstances, eg if the problem has been caused by a poor diet, but if there's a medical reason for the problem this is unlikely to be the answer and would then be an inappropriate suggestion.

A lot of the fibre in our diet comes from cellulose and hemicellulose which are carbohydrates and it is potentially harmful to cut fibre out of your diet.

In all cases a simple, nutritious, balanced diet is what should be aimed for and includes many foods - fruit, vegetables, nuts, cereals and other seeds - that contain a range of carbohydrates.

If the problem is due to something like pancreatitis then it could cause more problems by relatively increasing the percentage of protein and fat in your diet as a result of reducing the percentage of carbohydrate.

Everything has its place so it's good to be open minded and look at all options - including carbohydrate reduction - rather than just advocate one approach.

You need to get a diagnosis of SIBO before you treat it. This is a very specific condition and it is NOT the same as IBS type symptoms associated with gut dysbiosis. I would be VERY WARY of taking probiotics if you do have SIBO. As Denise has said the first stage is eradication. Rifixamin is available in the U.K. as I got it. I also had a proper SIBO diagnosis. You can repopulate the gut with good bacteria once eradication has happened. SIBO is an overgrowth of bacteria in a place they should not be; the small intestine. People assume it’s an overgrowth of bad bacteria only but this isn’t the case. Good bacteria in high numbers should also not be present in the small bowel. Taking more probiotics is likely to make your symptoms worse.

One last thing that struck me is the way you describe your bowel movements. Have you had a fecal elastase test to rule out pancreatic enzyme failure? If not I suggest you get this done. It is a simple test your gastroenterologist can arrange. In deed your GP should be able to do it. Low pancreatic enzymes have the impact you are describing and can be associated with PA and B12 deficiency. I had very similar symptoms to you. I did all the things I’m suggesting you don’t do. I did not improve. I went to a gastroenterologist and he confirmed SIBO gave me the correct treatment and then it was discovered I was malabsorbing still. He tested my fecal elastase. It was low. I was diagnosed with Exocrine Pancreatic Insufficiency and out in treatment. Others on here have the same. condition. Im not saying this to suggest that you have this condition. Im merely using my experience to suggest you may want to have it ruled out. I hope this helps.

Pain12345 profile image
Pain12345 in reply to

Thank you. I did see a gastroenterologist last week. He said we would do a stool work up but wanted me to change my diet for a couple of weeks first to see if diet was the issue. I will ask him tomorrow to do the fecal test sooner.

in reply to Pain12345

I had to insist on the fecal elastase test as I knew something wasn’t right. My intuition paid off. I do hope it isn’t your problem and that you can rule it out

Pain12345 profile image
Pain12345 in reply to

What was the treatment and are your symptoms better now?

in reply to Pain12345

It was a long process. I tried all the low carb diets etc and read all the on line research from so called experts. Nothing worked. This is for my SIBO treatment I mean. I got rifixamin which is a US prescribed antibiotic which is very specific in its work. It doesn’t kill everything everywhere like other antibiotics; it specifically targets bacteria in the small bowel. It came back so I worked with a qualified nutritionist using herbal antimicrobials and diet changes; I moved to a low FODMAP duet initially and to a Mediterranean diet thereafter. Took 9 months and touch wood I am good now. SIBO is bandied about a lot and you need a proper lab test for this. You can’t diagnose it from symptoms. I did this initially and I did not have it although contracted it later. It could be you just have gut dysbiosis caused by PA. This is because it causes a reduction in stomach acid which helps keep bad gut flora in check. If your pancreas doesn’t produce enzymes in addition to that then your bacteria end up having a party and you get terrible symptoms. The test will really help you sort out what you need to do. A bit of general advice: avoid sugar as much as you can. Your bacteria love it and you can end up with fungus overgrowth in your digestive tract. I had that too and it was horrible. I also avoid wheat as it seems to cause a horrible reaction although I’m not coeliac. Those two things alone have made a huge difference!

mlb87 profile image
mlb87 in reply to

Thank you, Martin.

mlb87 profile image
mlb87 in reply to

Martin- Thank you for all of your help! I am about halfway through the Rifaximin and Neomycin antibiotic treatment. My focus is shifting to repopulating the gut after the treatment ends in about a week. Do you have any suggestions (organic raw sauerkraut, specific prokinetics, specific probiotics, etc.)? I really appreciate your thoughts!

deniseinmilden profile image
deniseinmilden in reply to

Brilliant, as per usual, Martin.

Pain12345 this advice from Martin is straight forward, sound, scientific advice which is proven.

I was going to suggest a fecal elastase test and got sidetracked and forgot! Sorry!

If it shows a problem then you will be given an in-depth investigation into the health of your pancreas and gall bladder.

Although there are problems, you can can live without either organ so it's not the end of the world - you will need to take digestive enzymes (Creon is the gold standard but there are cheaper alternatives if your insurance won't cover Creon - I take it you live in the USA) with everything you eat. This helps loads!

Within reason, the sooner you get your diagnosis and treatment the better but, as I said, it is not life threatening, just a bit lifestyle limiting.

Thank you

deniseinmilden profile image
deniseinmilden in reply to

It sounds like you have managed to get your dx and treatment since we last caught up. How are you? Things any better? I really hope so!

I'm not doing too badly (short of a bit of ongoing hassle following an unscheduled lower abdominal cyst removal and unfriendly-hernia repair in March and my heart being a bit more temperamental than usual, but hey, they're the easy bits).

My guts are relatively good at the moment 🤞! I've just had a 6 month review and won't have to have any more investigation work for at least another 6 months - Woohoo! They are threatening me with a top-down camera and I'm not keen on the idea so I'm hoping for a miraculous recovery by then!

Never say I'm not optimistic! 😀🌞

in reply to deniseinmilden

Hello! Yes from a digestion point of view I just keep taking the Creon and SI EOD!! I had a few further tests and all good thank goodness. I’m watching my LFTs at the moment as they’re on an upward to the top so not sure what’s going on. Got some milk thistle so hopefully that works. My CRP shot up to 14 so not Sue about that either. I’ve got some liquid turmeric so will use that and text in a couple of months. I’m the must non scientific person I know but boy have I had to learn!! How are you doing? Well I hope!!

jmc42 profile image
jmc42 in reply to

When you say "I also had a proper SIBO diagnosis.", do you mean a breath test or other tests? The local NHS hospital where I live doesn't have this equipment; I believe that a lot of GE consultants appear to think that the tests are not accurate. The big London NHS hospitals (Guy's, UCH etc) use the breath tests which suggests they are effective tests.

in reply to jmc42

My gastroenterologist is an NHS gastroenterologist whom I saw privately. However he uses these in clinical practice at the Western General Hospital in Edinburgh on the NHS. These are breath tests. As I understand it still tests may be less accurate and are not used in the NHS.

jmc42 profile image
jmc42 in reply to

did you have both the hydrogen breath test which is described here on the UCH web site:

uclh.nhs.uk/patients-and-vi...

Is this the same as the lactose breath test or is there more than one test?

You can buy a home test kit for £160 though I've no idea how accurate it is:

healthpath.com/products/fin...

in reply to jmc42

Yes I had a glucose breath test. There is some debate about the accuracy of all tests. This is new science. Some test providers use lactulose as the testing substrate rather than glucose as it reaches further into the small intestine but again the science on this is new.

jmc42 profile image
jmc42 in reply to

Was the glucose breath test the only test you had when you got the diagnosis of SIBO? Bile Acid Malabsorption (BAM) is often cited as cause of gut problems and it is said to be caused by SIBO. In the UK BAM is tested by a SehCAT test. Did you have this test?

in reply to jmc42

No. My gastroenterologist did not believe that was the issue. He treated the SIBO and I am fine now. There are several believed causes of SIBO. EPI is one of them. I have that. Not sure if that was the cause, PA was the cause or the combo of both was the cause. I’m just glad it’s gone!

Pain12345 profile image
Pain12345 in reply to

Martin- I had the fecal elastase test which you mentioned the other day (waiting for the results). I also received the kit for the SIBO test. Will get that done tomorrow morning. I am having constant gurgling in my stomach.

in reply to Pain12345

Keep in touch and good luck. I wouldn’t worry about gurgling. That isn’t particularly associated with SIBO. I had that for years well before I had PA or SIBO.. My gastroenterologist put that down to dysbiosis and often they can’t find a cause. Good luck with the tests.

in reply to Pain12345

Excellent news.

Pain12345 profile image
Pain12345 in reply to

I just heard back from the GI and I tested positive for SIBO (methane). The GI says that it is treated with Rifaximin and Neomycin together (40% chance of eradicating SIBO with only Rifaximin and 60% with adding Neomycin). But, I have had two bouts with Clostridium Difficile Colitis (C Diff) since January and Neomycin is a broad spectrum anti-biotic known to trigger C Diff.

I don’t know what to do. Should I take the risk and use both anti-biotics together?

in reply to Pain12345

I really wouldn’t know how to advise you. The treatment proposal is the correct one but your reaction to the neomycin needs to be brought up with your gastroenterologist. These things are often a balance between risk (of C Difficile) and reward (clearing SIBO).

Pain12345 profile image
Pain12345 in reply to

I’m going to take the risk with both antibiotics. I read last night that SIBO is linked to liver disease. So, now I’m really nervous.

I would be careful about what you read on line. Even some medical research looks at things at the possible end of things rather than the probable end. I cleared my SIBO with treatment and a good diet and I’m sure if you watch what you eat you will get there

Pain12345 profile image
Pain12345 in reply to

My GI told me not to use a probiotic while being treated for SIBO. I was going to keep using the probiotic I have been taking because of the C Diff. But, now I don’t know what to do.

Don’t! Good bacteria will also be present in SIBO. SIBO is about bacteria in the wrong place, not simply bad bacteria in the wrong place. Eradicate first, repopulate second. Your GIvis right.

Pain12345 profile image
Pain12345 in reply to

Ok- thank you. Hopefully the C Diff will not come back.

Pain12345 profile image
Pain12345 in reply to

Thank you for all of your help!

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