Prokinetics after SIBO treatment?

[Pain12345]

Has anyone used a prokinetic after taking Rifaximin for SIBO and was it helpful in preventing the SIBO recurrence?

[deniseinmilden]

I hadn't heard of the name "prokinetic" but am hugely grateful for your post as it could be useful to me too - I have been told I'm in the 2% of slowest guts!

That said I've used Metoclopramide to good effect in animals to get their guts working again so am aware of their availability and efficacy.

Depending on the cause of the SIBO I would think prokinetics could be very useful - possibly in conjunction with probiotics too.

I've had metronidazole for SIBO and it worked so well I needed far less B12 for a while. Rifaximin is the best antibiotic but not available through my GP although I have been told I can have it if needed, in an alternating treatment cycle with Doxycycline too. Amoxycillin works well for some people but hasn't for me.

I first discovered that my guts - operation and especially absorption - could be improved with antibiotics when I had a course of Nitrofurantoin but that is not one they usually use. It makes me feel dreadful so I'm not volunteering for it unless I'm getting desperate! 😁

They suggested probiotics after SIBO but withdrew this recommendation for me because the best probiotics are milk based and I'm lactose intolerant.

My GI team said SIBO is a known reason for needing extreme amounts of B12.

My requirement for B12 dropped significantly after I had the SIBO therapy and I was needing only about 2/3 the injections I normally need for several weeks.

My guts are gradually getting worse and I'm back to needing every day B12 again now. At the moment I'm managing but will need another course of antibiotics before too long. I think it's important to not let things get too bad before asking for help (like I usually do! 🙄) because I get a horrible reaction from the bacteria dying off if there is an extreme burden.

I'm sorry I haven't been able to be any help to you but I'll ask your question on my Chronic Pancreatitis group and get back to you if I get anything useful from them.

I'd love to hear your ideas.

[Bonjourtristesse]

I have seen fresh ginger (can be made into tea), magnesium citrate and Iberogast (a herbal tincture for digestion) suggested as prokinetics. Mag cit can be taken in the morning eating, I have been taking half a teaspoon before breakfast.

[Pain12345 in reply to Bonjourtristesse]

One of the top SIBO doctors here in the U.S. uses low dose Erythromycin (50 mg) for the prokinetic. He starts it as soon as the antibiotic course ends. At that dosage, he says it does not have antibiotic properties. I am going to try to talk to my GI today about it. I am currently on Rifaximin and Neomycin for the methane SIBO (about a week to go). If I can’t get the Erythromycin prescribed, I might have to use 1,000 mg of ginger root when the antibiotic course ends.

I don’t know what to do about repopulating the gut, though. Would probiotics work- Symprove, organic raw sauerkraut, etc.?

[mickeymouse42 in reply to Pain12345]

In the U.S. how is SIBO diagnosed - via breath tests?

[Pain12345 in reply to mickeymouse42]

Yes, they gave me the lactulose breath test.

[Bonjourtristesse in reply to Pain12345]

This is beyond my scope unfortunately.