Hello. I recently discovered this site and for the first time, I see that I am not alone. I was deeply moved, and I sympathize with everyone going through tough times. I hope the year 2024 brings health to all of us. Relying on your experiences, I would like to ask a few things. I have hydrogen and a high level of methane gas. Additionally, I was diagnosed with intestinal permeability in 2015. I have tried various diets and supplements. A year ago, I had a colonoscopy, and I believe my SIBO was triggered afterward because I did not improve. I'm not sure if this idea makes much sense, but the fear that the colonoscopy disrupted my flora due to the enema has affected my mindset, and I'm not sure if I've gotten worse. Here are my questions:
1- Can a colonoscopy cause SIBO?
2-My rifaximin course is completed, but I stopped metronidazole due to discomfort. Was it necessary to continue, and can I benefit from continuing with herbal antibiotics?
3-I heard that Atrantil pills are therapeutic for methane gas. Can anyone with experience share insights on this?
4- I take digestive enzymes and Betain HCL, but I haven't had tests done for them. Is it problematic to use them this way, or should I get tests done first?
5-Do you know of an antidepressant that doesn't affect the gut or a soothing natural supplement? 6-Are there any recent developments regarding SIBO, especially related to methane?
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neylanozgule
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I don't know for sure of course, but maybe the colonoscopy prep stripped your colon of natural bacteria? Prep is pretty brutal and completely cleans out the gut, which is rather an unnatural thing. The gut is not naturally meant to be compleetly washed out.
Did your doctor say you have SIBO definitely?
Have you tried a probiotic since the colonoscopy, and if so, was there any -even small -improvement? Or did it make things worse?
If you haven't, maybe you could try Alflorex or Symprove. I have heard good things about both. But they might not help if you definitely have SIBO.
There are I think, antidepressants which are not SSRIs, but I don't know enough to tell you which ones. Can you ask your doctor about that? You would need a doctor to prescribe them anyway.
Luisa22 thank you for your response. Yes, I had a SIBO test, and I have very high levels of methane and hydrogen gas. I think getting a colonoscopy was probably a mistake because I got worse. I had previously taken Alflorex. I've taken so many probiotics that I can't remember which ones were good. Right now, I think I'll only use herbal antibiotics and follow a diet. Afterward, depending on my condition, I'll start trying probiotics again. You're right; I need a prescription for antidepressants, but I wanted to ask if there might be a natural supplement that could have a similar effect.
Hi neylanozgule , Unfortunately, the breath tests for SIBO are inaccurate, so you may or may not have it. I had false positives for both methane and hydrogen and went down the route that you are going down now. Rifaximin did nothing for me. Did it help you in any way? If not, that might be an indicator. I worked with nuritional therapists on this and sorely regretted it. They advised me to continue with natural antimicrobials, but I just ended up destroying my microbiome. I now have chronic IBS-C (much of stool is made up of bacteria) and need to consume vast quantities of fibre to have regular BMs.
Another indicator might be whether probiotics over time (allowing for an adjustment period) make your symptoms far far worse (normal trial period is 3 months). If they don't significantly adversely impact you, perhaps you don't have SIBO.
It is only possible to have SIBO if you have one of its root causes. If highly suspected, focus should initially be on treating the cause of SIBO, then tackling the overgrowth of bacteria, otherwise it will keep coming back. The causes are listed below - might be worth working through the list with your GP or gastro (not a nutritional therapist - they are not medically trained). Note that the first four causes of SIBO in the list below should be identifiable through a small bowel MRI scan:
Stasis: dysmotility – problems with muscle contraction in the gastrointestinal tract
Surgery (loops, vagotomy, bariatric)
Short Bowel Syndrome
Stuck open ileocecal valve (which sits between the small and large intestine) allowing bacteria from the large intestine to flow back into the small intestine
Achlorhydria – no stomach acid – unlikely if you can experience acid reflux. Additionally a faecal elastase test would show if you aren’t breaking down proteins correctly (which require stomach acid for digestion)
Hypochlohydria – low stomach acid – see above – the only real test is a PH test directly into your stomach, but many practices do not carry this out and home testing is inaccurate
PPIs – proton pump inhibitors for GERD/acid reflux – this is particularly related to long term use
Malnutrition – excess bacteria in the small intestine can compete for nutrients that your body needs
Collagen vascular disease – immune system inflammation e.g. arthritis
Immune deficiency
Advancing Age
Chronic Pancreatitis – this causes constant abdominal pain/fatty stools
Chronic antibiotic use
IgA Deficiency – identified from GP blood tests
Coeliac Disease – identified from GP blood tests
Crohn’s Disease – identified through GP tests and colonoscopy if GP tests indicate referral is needed
NASH – non alcoholic fatty liver disease –identified from GP blood tests
Cirrhosis
Fibromyalgia – widespread pain
Rosacea
Regarding natural antidepressants, there is St John's Wort, but you'll need to investigate this further since it has many drug interactions:
Thank you for this long and detailed response Rifaximin helped, but I had to stop metronidazole immediately. Thyme works well for me, and I feel better when I don't eat carbohydrates and starch. Unfortunately, I am 100% SIBO. I will try probiotics again. I started everything from scratch. I have been dealing with this for 9 years. For example, I have these questions:
1-How can I tell if my motility is functioning properly?
Additionally, is it dangerous to use these supplements without getting a stomach acid test, digestion enzyme test, as you mentioned, done? Because maybe my stomach acid and digestion enzymes are working properly. Unfortunately, these are all expensive tests. The doctor gave me betaine HCL. He said if it burns your stomach, it means you have stomach acid. I am taking three right now, and there is no burning. This means my stomach acid is probably low. Everything is very confusing. I am very tired of these questions and uncertainties.
1-How can I tell if my motility is functioning properly?
It is unclear what your overall symptoms are. Normal bowel movement frequency is considered to be between 3 times a day to 3 times a week. Types 3 and 4 on the Bristol stool chart are considered normal: medicalnewstoday.com/articl...
When I spoke to my gastroenterologist about enzymes, he said that true enzyme insufficiency is rare. Whenever I have taken enzymes, they cause me pain even in small amounts.
I was given betaine HCL. I had no burning in my stomach, but it did cause me intestinal pain within a couple of days. I don't believe that I have low stomach acid. This test is probably more 'theoretical'.
Yes, the problem with IBS is there isn't enough conclusive research, sufferers end up doing their own research, which is very frustrating. You are not alone.
It's a case of trying different things, only try one new thing at a time and keep a diary to find out what works for you.
I will never be 100% but much better now I stopped the antibiotics. Also on a gluten free diet as I am celiac. Dietician suggested lactose free with has helped and printed off the dos and don't of fodmap diet which I loosely follow.
hi Neylanozgule, Gosh a lot of conflicting replies. Think we are all so different when it comes to dealing with these digestive problems. I was diagnosed with SIBO in 2022, I felt extremely ill. I cannot go near probiotics or prebiotics(I had taken probiotics for many years) I went on a very strict diet for 6 weeks once diagnosed lost a lot of weight which was a bit worrying but it worked. I went down the herbal route on advice from a Naturopath which has worked. I was SIBO hydrogen. I still take Betain HCL and digestive enzymes (suggested by my Naturopath ) which I believe help me tremendously. But you have to find what suits you. I also have IBS (for 24 years) so managing that as well. Diet for me is what can ‘do me in’ . I have to avoid brassica veg, legumes, can eat only greenish bananas no other fruit and sadly alcohol doesn’t go down well. I hope you find some answers.
hello Sallybt. I'm glad to hear that you are feeling well. Did you do any tests before starting betaine HCL, or did the doctor recommend starting them right away to learn about your digestive enzymes? Can you share which brands you use? I'm having difficulty with gas-producing foods like legumes and broccoli. Currently, I can only eat kiwi. I don't have bananas either. I've lost a lot of weight, and my mental state is not good. I hope I don't become a cholesterol patient due to meat and eggs:((... Sometimes, I wonder if everything is purely psychological. I would love to be one of those who heal through the power of thought, but I haven't succeeded yet. Thank you for sharing.
Hi Neylanozgule, the only test I had was the SIBO breath test which seems to be the only test available. I did have classic symptoms. I think one of the symptoms is low stomach acid which I’m positive I have. As long as you get a good brand Betaine HCL with pepsin, cost about £23 for 100 tabs and follow the instructions you will be OK I get them online (don’t think I can suggest brand unfortunately) The digestive enzymes, £23 for 100 I get from health shop same brand. I do know what you mean about mental health, it really is a struggle and you do feel alone. The ‘die off’ period was horrendous. Thank goodness for facilities like these where we can share and know we are not alone.
"I am talking to people who have experienced SIBO for the first time. In my own country, there is no platform dedicated to this issue. Seeing that I am not alone gives me strength. I hope we all get better."
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Rifaximin helped, but I had to stop metronidazole immediately. Thyme works well for me, and I feel better when I don't eat carbohydrates and starch. Unfortunately, I am 100% SIBO. I will try probiotics again. I started everything from scratch. I have been dealing with this for 9 years. For example, I have these questions:
SIBO/IMO investigations
IBS or SIBO
Methane Overgrowth
IBS or SIBO
SIBO Diagnosis
