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Immunosuppressants causing SIBO

So am waiting for the final diagnosis, but following my first clinic visit to GI at King's in London the thought is I have SIBO due to the high dose of immunosuppressants I currently take due to my recent liver transplant.

I have done some research and the advice was to follow a low fodmap diet, and potentially take a biotic called Symprove for 12 weeks. I'm sure in the future my medication will drop but I'm not sure if this is along term solution when it's being agrevated by medication which I can't change.

Had anyone come across anything similar?

Has anyone tried Symprove?

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Hi there I was on methotrexate for eights years (chemo) I developed a gut condition called Dysbiosis. Please ask for a test for this, if you are you NEED TO GO OFF ALL CARBOHYDRATE. the bad bacteria live of carbs and destroy the good causing extreme blootig. Plesse take a strong ptobiotic

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GI at King's have run a barrage of tests, so just waiting on those, it appears that whatever name you call it by it relates to the same thing. I don't know how this will pan out as liver transplant unit are very clear that taking a live probiotic is a high risk food as my immunosuppressants effect how my GI system works, but GI want me to take probiotic, so there will have to be a discussion of which route is best, change meds, take probiotic or antibiotic.

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I would be inclined to do what your transplant team says as your liver is the most important, and putting a lot of live bacteria into your system may not be the best idea.

I am not a doctor, but id do have IBS and have a friend who has SIBO. SIBO is not a life threatening condition. There is also a lengthy test required to diagnose it & the treatment is antibiotics which may or may not work. I would definitely listen to your liver team.

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Once the GI unit have come to diagnosis my next port of call will be liver unit, I check all meds etc with them. Although SIBO isn't life threatening, I'm malabsorbing, anemic and losing weight, these aren't favoured by the transplant team so it needs dealing with. I am amazed as my tac level should be running high with diarrhoea, but it's currently okay.

Luckily both units are in same hospital and are reacting promptly to my issues.

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I see that it is very complicated. I am on the low FODMAP diet because of IBS. It is probably best to work with a dietician. If your doctors do recommend it, I have not found it very difficult to follow, other than a commitment to making some initial changes. I think it is OK nutritionally. One other thing, my dietician suggested I switch to sourdough bread. You might check on this.

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I find myself constantly checking what's high and low on the fodmap diet. Thank God for the Internet! I have a very good dietician who helped me alot with my liver issues which caused me problems with breaking down fats. I heard about the sourdough bread, I love my bread so it's great to have something avaliable. In the beginning I freaked out at the thought of the FODMAP diet, but settling in to it quite nicely.

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Actually, my dietician wants me to "test" the various fodmap groups so that I can expand my diet. I have, however, gotten so comfortable with the diet that I almost don't want to make any changes. Like you, I initially freaked out. Am glad you have good doctors & good dietician.

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