l am now feeling so out of my depth. Having been screened and cleared for obvious causes I have seen an NHS Consultant who says I am positive for SIBO. I have tried to work with low fodmap diet previously but without much success. My test with lactose was “equivocal” but a following one with glucose was positive - and I do agree from observing how I react to food that this is how the symptoms affect me. However I never get diarrhoea - indeed I’m prone to constipation and therefor have a half sachet cosmocol one day and one tab docusate the next, third day nil to keep me moving. SIBO is typically with diarrhoea.
I am being prescribed with 2 weeks of rifamicin and I have read scary reports of it - and I don’t react well to any drugs really. I very much want to be well again but is it honestly a good idea to start on these antibiotics? Any comments gratefully received. (I am 77 woman and care for my husband who has prostate cancer and had a TIA- he’s fairly well at present but needs a lot of my support.)
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Skyline4
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Having spent a long time looking after my late mother who had dementia, contributed in me being diagnosed with IBS due to stress and anxiety. I know looking after a partner is no walking in the park! Therefore I suspect your condition is due to the stress and anxiety you are experiencing 24/7 caring for your husband.
In the seven years since being diagnosed with IBS, I have avoided going on any kind of medication, even though I have come close to the wire on several occasions! However, I am due to take some antibiotics soon due to a problem with my teeth. I know that antibiotics can wipe out both good and bad bacteria in my stomach, which is some what alarming. However I have taken the approach, that if I continue to eat healthy by eating plenty of fruit and veg, drink kefir (yoghurt), eat plenty of nuts etc., that my stomach's good bacteria will return. This may be somewhat a naive approach with not actually having taken the antibiotics yet and unsure how my body will react but I know I will get over it, one day at a time.
I also believe in spending time for myself and indulge in things that I love to do, like going for walks in nature, exercise and having a range of active hobbies that I do everyday.
With not knowing you complete circumstances, I am uncertain as to how much time you have for yourself each day, however, I am sure you will have a little bit of time to yourself each day. Are you able to 'treat' yourself, with your favourite drink or perhaps do a crossword, or even go for a little walk around the block/spend a few minutes sitting in the garden and listen to the birds? All of these things are proven to reduce stress and anxiety.
You are not alone in your situation! We are hear for you whenever you want!
thank you so much for replying, MountainHare. I agree very much about caring for ourselves and I reckon I do… there was a period in 2022 when this was hard but I do think that currently I am managing that quite well. We enjoy our garden and I see friends and have time to do some art work. Last year I started Tai Chi which I’m sure is a big plus. My IBS - type problems have been evolving for more than 10 years , so I suspect it is more complicated…..( but stress certainly is a factor and in my experience the effects can continue way after the stressor has gone. )
Coincidentally I also had to take antibiotics for dental reasons about 6 months ago and I did find some relief from my digestive problems then. I am taking probiotics at present
It is hard for me to eat the foods I would prefer for a healthy diet - most fruits are a real problem, though I enjoy (half) bananas. Instead of tea/coffee, I have diluted oat milk (‘without sugars’) chicken, fish, rice, white potatoes, root veg. I do enjoy gf biscuits for something sweet. I also have zero fat yogurt. Sorry if this is too much info! but it’s all part of the picture.
It is a big help to know I am not struggling alone and to hear how other people are managing with similar symptoms - and to compare treatments.
SIBO doesn't always present with diarrhea. There is "methane" SIBO which is likely to present with constipation.
As far as I have heard, antibiotic treatment for SIBO can bring some relief while on the treatment. If you're lucky it will get rid of it. But often SIBO can return, so I am not saying it's a cure. But it might be worth giving it a shot?
hello I have just completed my second round of Rifixamin (apologies if spelt wrong) a gut anti biotic … it helped greatly and I believe is more of a herbal biotic .. I will now start a course of 3 pre pro biotics ..
I was dubious initially but with clean food options and fresh air and less stress I feel I have turned a slight corner
hi Skyline, I too was diagnosed with SIBO two years ago. I consulted a Naturopath as I wanted to use herbal medicine. I went on a very strict SIBO diet for 6 weeks. Everything I ate I made myself with no additives whatsoever it was tough but absolutely worth it. I went on herbal antibiotics, HCL supplements, digestive enzymes etc. I had hydrogen SIBO very constipated. I’m pleased to say I have hopefully recovered from SIBO. Apart from IBS flare ups now I have good readings (Foodmarble Aire digestive breath tester) my hydrogen levels normal. SIBO can give you low stomach acid it certainly did me and I take HCL supplements everyday. Also pre and probiotics make me ill I took probiotics for years. I hope you find an answer we are all so different. There is a lot of helpful info on line.
I would say it's more useful for SIBO than IBS. I find my IBS more unpredictable than SIBO. The device gives you readings for hydrogen and methane in your breath which is helpful with reaction to certain foods for SIBO symptoms.
Sibo can present with diarhea, constipation or both. Hydrogen is usually thought responsible for D, methane for C. There are two schools of thought on treatment - antibiotics ( rifaximin) is good for D but for methane it’s usually Rifaxamin plus another ( sorry I can’t remember which). The FP’s will offer a variety of anti microbials - these are botanicals and not antibiotics. Berberine, oregano, allicin usually in combinations. Both these treatments can cause inflammation in the gut- resulting in gastritis. Sibo is not recognised by many NHS health professionals. I had two positive Sibo tests, plus 3 months of treatment, but my gastro completely dismissed them, without seeing me or doing any testing, just based on the GP usuall round of basic tests, he declared I had severe IBS and to ‘eat yogurt’ 🙄. All the literature says you need to get to the root cause of Sibo ( of which there are many, but good luck with getting any tests) otherwise it will return. Sorry it’s not a very positive reply, but I’d take the antibiotics which are the most effective treatment , and follow up with probiotics - a good Lacto bifido blend. Dr Ruscio has some good info on this- he’s a US physician but is on all social media. You would also need to address the motility issues which your gastro should be able to help with.
This is great advice...I had methane dominant SIBO and took 2 antibiotics together...neomycin and rifaxamin...I have constipation... Also followed a low Fodmap diet for a few months... But, sadly I think it has returned...
I came across this paper as i had overgrowth of bilophila bacteria - it says berberine can cause stomach cancer. bmcmicrobiol.biomedcentral.... So its interesting that you say these treatments can cause gastritis - maybe thats why? How do you know about the gastritis?
ps I ended up getting rid of that bilophila bacteria (hydrogen sulphide producing) either by eating less cheese (as i have dairy allergy now) but it seemed to make a turning point after i took Dr Gut (UK chemists sell..) which is mineral clay and simethicone. I had right sided lower stomach pain and it went away within 5 minutes of taking that. And after taking it for a couple of weekend only, I didnt notice the smell of sulphur again. Miracle! I still have the dairy allergy though but trying to cure it with Rhamnosus LGG and might start taking Vivomixx again as my microbiome test results were a helll of a lot better on that probiotic... just it makes me bloated Do you have info about hydrogen sulphide bacteria SIBO by any chance?
Unfortunately SIBO tests are inaccurate and you can get false positives. Also as I understand it Rifaximin works on hydrogen SIBO (which tends to cause diarrhoea) and Neomycin works on methane (which tends to cause constipation). It is a tough one. I believe Rifaximin is limited to action in the small intestine, so its effect should be localised.
One thing to bear in mind is that it is only possible to have SIBO if you have one of its root causes. Focus should initially be on treating the cause of SIBO, then tackling the overgrowth of bacteria, otherwise it will keep coming back. 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
It might be worth working through this list with your GP/gastro before moving forward.
Much appreciated. Not sure my NHS gastro will oblige but she has referred me for the dismotility test, so that’s a start! Fingers crossed. It is such a help to have a better understanding of this.
My understanding is that a positive Methane result usually indicates constipation dominant SIBO while a positive Hydrogen result indicates loose stools. I was diagnosed back in August 2021 and given Rifaximin along with Metronidazole. I had no issues with Rifaxmin since it stays in the digestive tract and does not enter the blood stream. I had a terrible reaction to the Metronidazole (nausea so severe I could barely eat and lost 20lbs). That being said I have swung from struggling with constipation to having to be close to a bathroom most days. I have also not been able to regain all the weight I lost which now leaves me borderline underweight. Not sure if it was the antibiotic or just the stress of trying to "cure" the SIBO. I would think the stress of being a caretaker could possibly be contributing. I started using sleep meditations to help with stress and it helps but I still have to work to keep my stress levels low. Wishing you luck.
SIBO breath tests are quite unreliable. You could ask if he is sure its not a false positive as you dont get diorrhea? Methane bacteria is more common with constipation.. But dont think they have a breath test for that one.
I’ve had multiple rounds of Rifaximin that I’m now on a low dose of antibiotics every day just to keep the SIBO at bay. I have slow motility due to bowel blockages so that’s my root cause and I’m unable to improve that. Try the Rifaximin it may help it may not we are all different. Lay off the sweet stuff, lactose and stay low FODMAP good luck. By the way I never felt any side effects with the Rifaximin apart from it damaging my wallet !!
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Do you have info about hydrogen sulphide bacteria SIBO by any chance? 
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