My SIBO Treatment With Rifaximin + Neomycin 

I’m on day two of xifaxan. I’ve struggled for four months of diarrhea, nausea, vomiting, boating, and GERD.. It’s helping lots -

@@ambuler0025 Hi Amber, I'm so glad to hear that. Let's hope it continues to help you feel better! Thanks for watching!

@@ambuler0025 Hello, I am on day three of Xifaxan as well but my diarrhea, bloating and gas got worse (especially bloating and gas). Have you experienced a gradual improvement on your symptoms for each day you took the meds?

Hello :) what was the antibiotic dosage you took during the treatment? Thank you ❤️

Hey! I took 1200 mg rifaximin for 14 days but make sure to use a prokinetic such as artichoke+ginger supplement (1 capsule 2-3 times a day) when you start the treatment. Even though I had diarrhea dominant symptoms, I got severely constipated when I started rifaximin. That prevented the medicine moving fast enough in my small intestines, that's why you need a herbal prokinetic.

I'm glad the info was helpful, that prokinetic is SO helpful post-treatment to help prevent a SIBO relapse.

Thanks, Angie, I think it will. And thanks so much for watching!

You're welcome, thank you for watching! Is there anything in particular I can help you with?

Do you know what triggered the initial 3 day crazy phase?

Hi Kim, do you have only hydrogen SIBO? Or both hydrogen and methane? If you have both, the researched protocol is to pair it with a second antibiotic. If you only have hydrogen, then rifaximin alone is the recommendation. I hope that helps. Thanks for watching!

Hi JL, I can't give direct advice, but this video may answer some of your questions...ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-GBDkP0qYZl4.html @ 8:37, I discuss probiotics during SIBO treatment, and this video, which gives an overview of SIBO treatment in general, and may answer your questions. Sorry you're feeling so icky....reach out if you're ready to work with a practitioner (me!) who is really attentive and makes sure you have all the information and support you need to travel this road with confidence. You can book a time with me at www.ibsandsibosystem.com/call-org .

Hi PF! I'm glad you're finding them helpful! I bought through Marks Marine Pharmacy in Vancouver Canada, but had a prescription from my US ND. Dosage as prescribed was 550 mg rifaximin 3x per day, and 550 mg neomycin 2x per day. I know firsthand how confusing all of this stuff can be! So if you're struggling with unpredictable gut symptoms and are in need of a solid plan to feel better, I'm currently enrolling students in my brand new 8 week online program to help...if you'd like to see if you qualify for a seat in the program, you can schedule a time to meet with me here: confluencenutritionappointments.as.me/?appointmentType=22887800 THanks so much for watching and take care!

Hi, rifaxamin is the generic (brand name Xifaxin). I was able to order a 21 day supply from canshipmeds.com (with a prescription from my ND) for about $125 cash. They had brand name rifaxamin for about $500. A prescription was definitely required. To my knowledge, there is not a way to access it without a prescription, unless you are in certain countries with different pharmacy requirements.

Hi Chelou, well, the short answer would be to avoid eating the things you're intolerant to! It sounds like those foods are triggering a histamine reaction inside your sinuses, near to your eyes. You can also work to support your body's histamine tolerance with a few particular supplements. Here's a video I did to discuss more about histamine intolerance: ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-GFRUxLJD1SU.html

It's natural to be nervous, but let's hope it makes a huge difference with your brain fog! Thanks for watching :)

@@ConfluenceNutrition thank you so much!

@@GabrielleStuart You're welcome :)

Hey Kiki, I've been on it now for 5 days or so. IT seems to be helping, but the effect is nowhere near as strong as what happened while I was on the antibiotics. I have been taking a half tablet, so maybe I need to increase the dose. Then again, that particular mechanism may not be what's slowing down my gut...I'll keep you posted!

@@ConfluenceNutrition yes please do! It's so individual what works v doesn't but my GI didn't recommend a prokinetic follow up when I asked. Not sure why!

@@ConfluenceNutrition did u take partially hydrolysed guar gum i read it helps with gut motility which is a problem mostly the methane positive sibo patients face or if you know about it

@@shaimaya1117 I did take it during my second treatment protocol, During my third round, it made me more bloated, and I was flaring, so I stopped. Thanks for watching!

@@ConfluenceNutrition I c thanks for ur reply

Hi HH, specific guidelines for SIBO protocols are available at siboinfo.com. I believe the double antibiotics are not recommended for hydrogen SIBO, just the rifaximin. I ordered mine from Mark's Marine Pharmacy in British Columbia, Canada. HOpe this helps!

Hi Julian, yes, I followed up with testing and future treatment, here are the follow up videos: SIBO Treatment Round 2: ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-ZocMJ9eZjgI.html SIBO Test Results post treatment: ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-8vu3IFdLsh8.html SIBO Treatment Round 3: ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-8c3VKZZ-9AA.html Final SIBO Test Results: ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-FkJLJFEkZqo.html Final Update, 1 year later: ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-0TEK0zbXQDk.html I didn't test for C diff because I don't have diarrhea. THat's usually a pretty clear symptom. Hope all that helps!

WHen clients experience this, I'll often suggest they temporarily back off of the doses for a day or two, OR to add in a "binder" supplement, like GI Detox. It's used in between or before all meals of the day. Usually, this clears up soon. I hope so for you!

Hi Jessica, a great question I know many people have questions about. I did not change anything as I have for a very long time been on my body's best diet. I'm totally clear about my trigger foods and avoid them. My triggers are some FODMAP foods, some histamine foods, and some oxalate foods. If I hadn't already changed my diet, I would suggest a paleo diet if you haven't done any diet work yet, a low FODMAP template if bloating and gas is your primary concern, or a low histamine diet if diarrhea and allergic symptoms are more prevalent. See my latest video for a more thorough discussion of this topic: ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-01SpA3G9qu0.html

If anything.. Stay away from a high fat high protein diet.. And good luck with a Gastro Dr.. I've seen 2 and besides getting a Endoscopy they are absolutely useless Doctors.. I've found that a high fiber diet helps.. The whole FODMAP, Histamine diet is BS.. That's just a band-aid.. Trust me I've been through all of that.. I'm still on the journey but compared to a year ago I'm getting there..It takes time it's not a quick fix.. Patience is key..

@@toneman8478 Hi T, it sounds like your trust was damaged by your practitioners, and I'm sorry to hear it. And I'm glad that you're clear about which diet practices help your case of SIBO, though this doesn't mean your truth is true for everyone. But your comment illustrates perfectly how what's right for each of us is individualized. We need to understand HOW to use these tools properly to get the most out of them, but that doesn't mean everyone needs the same solutoin. I've seen many people improve on the FODMAP and low histamine diet, but you're right, they're not right for everyone, some people don't. I hope you find your best path to wellness, and the right supportive guide who is willing to work with what's true for YOU :) Thanks so much for watching.

@@toneman8478 Why not high fat high protein diet? That was by next move, if this is not the right I want to find out before I start this new diet plan.

If SIBO is hydrogen only, then typically, rifaxamin alone is the next step, and this is what I did.

Hey there, thanks for your question. If you knew me in my normal life, you would know that I am generally very anti-prescription medication. I haven't taken antibiotics in more than 20 years. Due to the duration of my symptoms and the lack of success using herbals, antibiotics were one of the things I hadn't tried yet, partly because I was worried, and partly because the rifaximin is difficult to access without insurance. But i decided that to not use an available treatment out of fear or dogma was kind of silly. We often get scared out of trying a pharma solution, but what if it actually helps? The rifaximin in particular only affects the small intestine, and the neomycin has been long used. I haven't regretted it, so far, it has helped me feel better. What will be the long term effect? I'm not sure. I'm on round 2 right now and will be making another video on it soon. My advice to you is to weigh the risks against the possible rewards. What do you have to gain by trying something new? And what do you risk? Only you can answer those questions, but I wish you well in your process.

It's true that neomycin may have this side effect. However sometimes I see people forego the big picture benefits of a medication due to a short term possible side effect. The course of neomycin is short. A life without SIBO symptoms is long and enjoyable. There's no one right answer for all, but I encourage my clients to consider the negatives against the possible positives and make a decision for themselves about whether or not to proceed. Thanks for your comment.

@@ConfluenceNutrition Oh no I'm definitely not trying to turn anyone off of Neomycin! It's a great drug with unique properties and is really the only thing that deals with Archaea (Methanogen producers) while not being innately systemic. Though the side effects can be a potential concern for most SIBO sufferers due to potentially increased absorption from inflammation in the gut or from ulcers/other damaged tissue. I was just trying to point out why you may have had worse joint pains while on the drug. But if this was part of the issue it would be a fairly easy fix by incorporating a bit more of the necessary electrolytes into the diet (easy to do since the drugs let you eat pretty freely for two weeks) to counteract any muscle tightness/pains. Another option is an electrolyte drink taken middle of the day (as the Neomycin tends to be early morning and late evening,) for maximum absorption.

@@thomasc1270 Interesting tips, thanks for sharing! Oddly, joint pain was one of my symptoms before treatment as well, but it did get worse during this one particular course. I think that for me, the joint pain was coming from candida, and once I used antifungals post antibiotics, it was better. But electrolytes could definitely be a mediator. Thanks~

@@ConfluenceNutrition which antifungal did you use post SIBO treatment?

@@brothercaleb Hi there, I first used fluconazole, which according to my ND focuses it's action more on the GI tract. Later, I used nystatin, which is supposed to work more on the whole body, but didn't tolerate it very well, so used minimal dosing for a while then stopped.

All antibiotics carry some risk of opportunistic infections like C. diff, but your question is really most appropriate for your doctor to answer. On another note, oily or light colored stool can indicate that your bile flow from your gall bladder isn't ideal, so you may need some support digesting fats and getting that bile flowing (think daily lemon water, or castor oil packs). Thanks so much for watching!

Hi FX, my suggestion here would be to find a GI that understands SIBO, or try to find a naturopath to work with who can prescribe. An ND is who helped me with this project. Thanks for watching!

It's helpful to retest to understand what you're really dealing with before doing more treatment, but yes, multiple rounds of treatmnet are sometimes necessary to treat SIBO fully. I worked with my local naturopath, who prescribed FOUR separate courses of rifaximin before my SIBO was under control. But if you do have methane as well, you're supposed to have a second antibiotic, either neomycin or metronidazole. I didn't have insurance when I used the neomycin, and with a GoodRx.com coupon it wasn't that much for cash pay, so if insurance declines, you can try to find it for cash at an affordable price. I believe my Rx was around $20-$30 US. Thanks for watching and good luck! And Atrantil may help, as well!

actually : getting away from radiation would Improve all conditions! Like ulcerative colitis...crohns...lymphoma...inflammation in organs as thyroid gland, gynecological organs, etc . Check out the corona effect regarding this - I recommend videos w Sacha stone and Robert o young

Thanks for your comment...some people do seem to be sensitive to EMFs, while others are not...I hope you keep feeling better!

Everyone's treatment path is different, so not necessarily. My ND did recommend I do the bi-phasic SIBO diet, which is basically a low fodmap-low histamine template in between, but it's basically how I already eat, so not much different!

The most common side effects from probiotics are bloating, abdominal pain, or a change in stool, so diarrhea or constipation. Some people may also experience nausea, itching, or headaches, so in other words, histamine symptoms. Prokinetics should be started right after your antibiotic treatment ends and continued for at least a few months.

Hi Bri, I hope and pray for you that it does help, keep me posted, please!

My ND called the prescription to a pharmacy in Canada (Mark's Marine Pharmacy, canshipmeds.com) and they are able to order from India.

I had tried to use probiotics many times prior to SIBO treatment, but was only tolerating the Sacc B. During and after, I haven't been able to tolerate them, so I don't use them at all! Occasionally, I will eat fermented foods or drink fermented beverages, like kyvita kefir water, but too much bloats me. But what worked for me may not be right for you. The most important thing to keep in mind is to listen to what your body is saying about the things you're testing out, like probiotics. Generally, probiotics will often flare SIBO patients and shouldn't be used during treatment, and only after if your gut doesn't react badly to them.

Yes, metronidazole is the alternative that is usually recommended by SIBO practitioners.

Hi Jia, I think I had about a month between my courses of rifaximin, mostly because I had to wait two weeks to test after treatment, and then wait for my rx to ship from India. IT might have been 5-6 weeks. Thanks for watching!

I'm sorry you've had that experience...it's not uncommon...thanks for watching!

Hi Mary, what basic symptoms are you experiencing? Bloating? Constipation? Diarrhea? Allergic symptoms?

@@ConfluenceNutrition thank you so much for replying to my comment I did sibo breath test and it was positive.. I want to know what kind of diet I should be on?? Thank you so much🙏🏻💕

@@maryabraham9182 Hi Mary, thanks for clarifying. For folks with SIBO, I usually suggest they start with the low FODMAP diet, and if they see minimal improvement there, to move into a low histamine diet. I have videos on both on my channel. Let me know if I can clarify anything!

Hi Angela, it's definitely possible. I recently read a referenced article that suggested GERD is caused by "intra-abdominal pressure" and not high acid, and that one of the causes of the pressure is bacterial overgrowth. I personally experienced a significant reduction of reflux after SIBO treatment. My best to you!

@@ConfluenceNutrition my naturopath is saying just for me to try rifaximin as the neomycin is harsh. I wonder why she says this? I’m struggling to get the rifamixin, I don’t know where to get it.

@@angelataylor2049 Hi Angela, neomycin is more of a general spectrum antibiotic, so may have some effect on the microbiome. However, best outcomes in treatment for methane SIBO include both in the literature. Rifaximin can be difficult to acquire with insurance, but you can order from Marks Marine Pharmacy in Canada, if your ND or doctor is willing to call it in. Take care!

2 year post-treatment, my gut symptoms are still vastly improved. With a wider diet palette now, sometimes I overdo it on the carbs and can get bloated, but that's on me! I did have to treat 3 times to completely eradicate SIBO, there are two other videos in the series about my treatment, so check those out if you want to hear more about the follow up after my first round of treatment.

Protease is simply a digestive enzyme to help digest and absorb proteins, and can be a helpful addition to any program, as long as you tolerate it well. :)

Confluence Nutrition Thanks Amanda🙏🏽 Is it generally hard to tolerate?

@@lindareif584 In general no, your body produces it! But some people do have some irritation or stomach burning side effects.

Mexico u can get neomycin over the counter. Its a medicine u take to stop diarrhea

I didn't use probiotics because most of them flare me. It was also not my NDs advice to use them either. I don't recommend changing too many things at once either, so if it was me, I would just do the rifaximin and wait to try probiotics until later. Take a deep breath, you've got this! I hope that helps, and thanks so much for watching. And if you're in need of ongoing support and help, reach out about booking a free discovery call to learn more about my Calm Digestion Method program and how it can help you go from food anxiety, endless questions, and second guessing to a confident plan for calm digestion.

Hi Juan Pablo, I used 500 mg rifaximin 3x per day, and 500 mg neomycin 2x per day. I'm actually almost through my second round of treatment, and I'm working on a new video to document my process, so stay tuned!

@@ConfluenceNutrition thanx for your answer. Let me ask one more. I have SIBO and I'm histamine Intolerant (as I understand you are too), I also suffer from constipation. I'm finding very hard to find foods that fill the Low fodmap diet + low histamine diet filter + dont worsen constipation. What are you eating? Do you have like an Everyday Base Diet? (maybe mentioning 6 foods...?) thanks again!

@@juanpablovelasco1474 this is a very real problem! But it can be done! One thing to know is that even with a FODMAP and/or histamine intolerance is that you likely aren't totally sensitive to ALL the foods on those lists. Doing the elimination AND the reintroduction properly helps you know which foods you really react to, and which you may be able to tolerate sometimes. So though my personal diet is relatively low FODMAP and low histamine, I know which foods are my worst triggers. For example, broccoli constipates me, but cabbage and cauliflower are fine, even though they're high FODMAP foods. My diet centers around white rice, potatoes, and winter squash for starches/carbs, chicken, buffalo, and limited fish for protein, and zucchini, red bell pepper, carrots, lettuce, kale, cabbage, cauliflower, bok choi, tomatoes, cucumber, and avocado for veggies, plus light onion and garlic.

@@ConfluenceNutrition thank you.

@@juanpablovelasco1474 i had same problem. I just eat some raw ginger and honey at night half an hour before bed. It cures my constipation and gut mobility. This may help.

Indeed, meditation is so so important.

Hi Anthony, it's called Mark's Marine Pharmacy, and their website is canshipmeds.com. You still need your doctor to provide them with the prescription, but if they are willing to do that, the rest is easy, and affordable.

I took mine with meals, as I'm prone to nausea from medications and supplements. Best of luck to you, let's hope it's a game changer!

@@ConfluenceNutrition Hi Amanda, I finished my 14 day Rifaximin course and found benefits with Brain Fog and BMs, not so much with bloating. However after the 14 days my tongue appears very white after waking up. Are these yeast/fungal symptoms from antibiotics, is it normal? Thank you.

@@xploit811 Hi there, I'm glad to hear you got some relief from brainfog and your BMs...it is quite common after antibiotics to have some fallout with your yeasts. Sometimes, Saccharomyces boulardii probiotics can help, or antifungals are sometimes necessary. I used Rx antifungals after my treatment, and it really helped, but that's not necessary for everyone. IT's also a good idea to retest post treatment, so you know specifically what happened with your SIBO. Sometimes it can take several rounds of treatment/ It's also possible your bloating has another underlying cause besides SIBO. Thanks so much for watching!

@@xploit811 how are you doing now?

Hi Amanda, what is the best way to contact you?

Everyone is different, but Dr. Pimentel, the main SIBO expert, recommends against any probiotics, especially for persistent, recurrent SIBO. He very often finds this reflares his patients. I am one example of this, I cannot tolerate probiotics, even the most high quality types. This may be one reason why your treatments are not providing long term relief. However, I was also asking about prokinetics, drugs or supplements that support good motility in your gut to prevent SIBO recurrence, have you used those? There are so many layers to this problem that need to be dealt with properly and in the right order, and doing things differently than recommended can compromise your success.

Hi Gerardini, it's common during treatment to experience effects like these. After all, your gut microbiome is changing, and this may temporarily cause new symptoms. Don't give up! You might want to check out this video to make sure you follow up correctly after your treatmnet: ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-YmHVrMyjA50.html

Hi Raooul, I didn't order from Mexico because you still need an RX, and my ND normally uses the Canadian pharmacy. My ND is Dr. Miriam Peachy, she is one of the doctors at Northcoast Naturopathic Medicine in McKinleyville, CA. If you're not in CA, you likely can't work with them. For specific SIBO antibiotics protocol information, I recommend visiting Dr. Alison Siebecker's page www.siboinfo.com/antibiotics.html Hope that helps!

Hi Hassan, for me it cost about $100 including shipping for the rifaximin, and another $60 for the neomycin. I don't have health insurance, so paid out of pocket.

Where can I get this without prescription? Where do you live

@@latebloomerearthchild I live in Pakistan.

Today is my last day taking them. I took Rifaxamin 15 minutes after food and the neomycin about 20 minutes after Rifaxamin. I experienced nausea daily with neomycin but it became better during the second week.

How are you now?

@@chewbacca90210second week of neomycin? They dont advise to take neomycin for more than 5 days. I believe taking either antibiotics for sibo should be limited to 1wk and let your own flora take care of itself

You would use both if you have both hydrogen and methane SIBO, or only methane SIBO. I hope your doctor got it right too. Regarding endometriosis, unfortunately, there isn't a simple way to visualize/diagnose it. Laparoscopic exploratory surgery is the only way, unless you have large endometriomas on your ovaries, or changes in the walls of your uterus. These two changes are visible on ultrasound if the tech is skilled. However, there is a blood test, often used as a marker of ovarian cancer, which is also often high in endo patients, and that is CA-125. You can request your doctor to order.

Hi Srab, yes, metronidazole is an accepted alternative, but I believe the dosing is also around 500 mg twice a day. You can see the standard SIBO treatment protocols at Allison Siebecker's website siboinfo.com.

Hi Nickole, I just made a video about this question a few weeks ago, here's the link for a detailed answer: ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-XmvjfYjlJyw.html Your NP is generally correct, but if FODMAPs aren't the reason for your food intolerances, then Low FODMAP won't help. Me personally, I had created a custom diet with many experiments prior to my SIBO treatment. I did need to avoid some FODMAP foods, as well as some other things that made my symptoms worse. I encourage my clients to work to discover the CAUSE of their food intolerances, rather than apply an "out of the box" diet. I strongly advocate eating whatever diet minimizes your symptoms DURING SIBO treatment, and not feed the bacteria. Check out the video to hear more about why I suggest that.

Yes, it did...my bloating was not my primary bothersome symptom, but once I started the medication, my bloating reduced, and I suddenly realized how persistent and in the background that bloating had been. So yes, the treatment helped relieve my bloating.

Hi Srab, you can try it and see how you feel. The litmus test is always this: do you feel better when using it, or worse? If you feel better, continue, if you notice a negative side effect stop, and retry later.

Hi there, my Rx was sent by my ND to a Canadian pharmacy (canshipmeds.com) and the pharmacy ordered from India. So yes, I needed a prescription. Thanks for watching!

It's normal to have some negative symptoms while treating. With your doctor's approval, you can temporarily decrease the dosage/frequency until you feel better, or you can use what's called "binders", like the GI Detox product (activated charcoal and bentonite clay) to help with the die off by products of treatment. ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-Hl56_WFyWcM.html Discuss with your treating doctor...If the constipation keeps happening, a simple enema can help relieve things too. ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-fXFS4xjJVuk.html

Hi Jayna, my naturopathic doctor called the prescription in to Marks Marine Pharmacy in British Columbia, and they can either send you canadian produced rifaximin or Indian produced rifaximin. The price difference is several hundred dollars, so I opted for India! Then they mail them to you from India. It takes about 4-5 weeks to arrive from India to the US. Thanks for watching!

Hi Adnan, it's possible that gas pressure from SIBO is influencing the back pain. OR could also just be inflammation somewhere. Food sensitivities? Stomach autoimmunity? No matter what you think is going on, approach from the perspective of: what makes a difference for my symptoms to try and understand the cause. So if your rifaximin treatment you're trying right now improves things, you can presume that SIBO gas is making it worse. If rifaximin doesn't improve it, then you know the cause is something different, and you need to look somewhere else. I hope that helps.

Hi Jihane, neomycin is a prescription medication, so unless your friend is a doctor, they won't be able to send you neomycin.

Hi there! If you're at all concerned with the side effects you're experiencing, I strongly urge you to contact your prescribing practitioner to discuss with them! It is possible to have a rebound C diff infection, and it's also possible to have other complications. I can't comment specifically on your situation since I don't know anything about your case. In general, bloating and other symptoms can get worse before they get better, but I often feel like if things are getting worse and worse, the body is giving a signal it's not right. So talk with your doctor/ND/prescriber, and have them help you decide what to do. Thanks for watching.

@@ConfluenceNutrition thank you so much! I am on day 5 and for the last 3 days my diarrhea disappeared, so I assume the bloating is a side effect for me. I am using an app called Reddit and there is a community for the individuals with SIBO, they suggested partially hydrolyzed guar gum + enterogermina supplements. I will buy them and use them. I am considering using anti fungal medicines when my treatment is done as well. Unfortunately I live in Turkey and even most of the doctors here don't know about SIBO treatments, that's why I am buying all these medicines and supplements myself, including the rifaximin. I recommend creating a Reddit account and joining both IBS and SIBO communities, if you promote your channel there you can reach to more people for sure :)

@@gryma1313 Thank you for the reddit suggestion, I have to look into that, but it sounds like a reasonable one! Partially hydrolyzed guar gum is a FODMAP friendly fiber which was shown in a SIBO clinical study to increase the chances of treatment success, so that's a good idea. But with anything, start low and slow, and work up to a full dose. I don't know what eneterogermina is. Good luck!

Hey, that kind of sounds similar to me, i also have to do a lot of research and decisions on my own bc i live in Serbia and it's hard to find a good doctor. I coudn't even afford the sibo test sice it's so expensive here so i decided to try rifaximine anyway. My main symptoms are bloating, excessive burping (which i'm guessing caused acid reflux) and gas. I'm on day four of rifaximine and i'm having a lot of bloating and yellow- ish loose stool. (it was normal before but when i changed my diet to more high fat it became like that so now i'm worried i have low bile) I'm at a complete loss at what to eat and what tests to do. I have no idea if i have alergies or intolerances to certain foods. I'm also scared of C. Difficile....i don't even know where i'm going with all this. i'm pretty certain i have gastritis too. It's so confusing and overwhelming. Do you have any advice?

@@thequeenofcydonia I am on day 7 and taking both enterogermina (probiotics) and partially hydrolyzed guar gum with rifaximine. As far as I heard, c. difficile is something very rare and the diarrhea becomes non-stop for most of the cases, but I assume they are talking about watery diarrhea where you lose so much water and also weight so fast, if this is the case for you then you might wanna get that checked. So far my plan is to stop using probiotics, just go on with PHGG + rifaximin for 7 more days and complete the treatment. After that I will take fluconazole for 21 days for 1 pill per day because I am suspicious of fungal issues on my small intestines. If you wanna talk on the Discord app let me know.

Hi Jia, I only used Saccharomyces boulardii probiotics during treatmnet, because for me, those were the only kind I tolerated. Some people don;t tolerate any. I still don't tolerate probiotics, so I don't currently use them. And I repeated rifaximin after repeat testing I was still positive. It took four courses total to clear. Each round was separated by a month or two of time in between for testing and reevaluation.

@@ConfluenceNutrition Thank you for sharing your story! My doctor told my Rifaximin will not disrupt my good bacteria and will only target the SIBO but I have bee reading and hearing that it wipes out everything. My concern is it will help the SIBO but will leave me with no good bacteria and prone to getting another overgrowth. I have decided I am not comfortable to rounds of an antibiotic as I believe thats how I get here in the first place so after this round, I plan to use herbals if SIBO is still present. I am currently taking an SBO but was considering getting Dr. Amy Myers 100 billion as many say you need both to rebuild a healthy gut. Thoughts?

@@heartsoulholisticservices Hi there, I hear from a lot of people with this same concern, and if you feel more comfortable with alternative options, you can use them. It's important to know, however, that they usually take longer, and I typically see worse side effects in clients who use the herbs vs the antibiotics. Regarding probiotics, everyone is different, but Dr. Pimentel typically advises against them because he sees so many of his patients react badly to them, and THIS often makes overgrowth worse. You'll have to evaluate for yourself whether you're someone who feels better or worse with probiotics. I myself don't tolerate them. Ultimately, it's important to have a strong strategy to approach this problem, and to know how to manage the various options if you run into a dead end. Is this something you're needing help with currently?

@@ConfluenceNutrition Thanks for your reply! I have bever reacted poorly to probiotics. I feel nothing or I feel better. I will definitely do the antibiotic like my doctor suggested wit a biofilm disruptor and hope I can kill SIBO with one big knowck out! Thanks so much.

Hi J, I have gained a little weight since treating wtih rifaximin. I don't know that oregano oil directly influences weight gain or loss, but changing the gut microbiome can definitely affect your metabolism. Your sensitivity to fermented foods suggests you don't tolerate histamine, so this is the direction I would go with food. Dealing with oxalates with probiotics is not my preferred path...it's more about dealing with the often associated yeast overgrowth and reducing oxalates temporarily. This is a multi step process that can take some time. I'll be running my 8 week program to help with this process again in the fall. Let me know if you'd like to learn more about that. Thanks for watching!

​@@ConfluenceNutrition Thank you for responding! I really don't want to gain any more weight, since I have put on a lot of weight since developing SIBO (prior to that I was quite slim but now my weight seems to go easily and readily). However, when we are suffering burping and bloating and food intolerances and the associated misery, you are more willing to try anything--even antibiotics that might have that side effect! Every time I have yogurt I get a recurrence, which is frustrating because it's supposed to be good for your gut health and metabolism. Thanks again, I will certainly consider your program :)

@@j6453 Yes, there are those fermented foods again (yogurt). Even the healthiest of foods can cause symptoms. In your case, histamine sounds like it's a trigger. We need to listen closely to what our body is telling us and work there.

Hi Martin, my teenager has this problem, but we haven't tested for SIBO, so i don't know if they are SIBO positive. This can definitely be a sign of some kind of underlying infection or dysbiosis. Thanks for watching, and thanks for your question!

Sorry you experienced that...were you able to continue?

@ConfluenceNutrition Thank you! I did it! I finished the antibiotics. And now I'm trying to do the low fodmap sibo specific diet! I gotta say, it's crazy how everyone has different ideas about what's ok and not ok to eat. Very confusing 😕 And It's super hard for me not to eat veggies or rice. It's my favorite food, it's also the bacterias favorite food.

@@82AHoss Good job! Do you feel any better after finishing?

Hi Rita, I'm curious which elemental diet product you were using? Berberine and oregano are enough for some people but not all to eliminate SIBO, you'll have to see what your retest looks like afterwards to evaluate. Thanks for watching!

@@ConfluenceNutrition It is called elementAll biological diet. I am in Canada.

@@ritae3364 Hi Rita, I'm not familiar with that one, but I don't doubt it tasted terrible. There's a great one I recommend in the US, but it's not able to ship to Canada. The Integrative Therapeutics Physician's Elemental isn't gross, though maybe not terribly exciting. I don't know if you can get that in Canada. If you can. I might suggest trying again...good luck!

There can be different reasons for sinking stool...for me, my floating stool was a sign of poor fat digestion and excess gas, for you the sinking may be a positive, but it does sound like the consistency is still not right. If you're ready for some support with this, I'd love to meet with you to see if my coaching program would be a good fit to help, you can book that call here: confluencenutrition.com/contact.

HI Claudia, it's quite common to have side effects from antimicrobial protocols. There are a couple of htings you can do. Check out this video I made for more details: Dysbiosis Treatment Tips: ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-Hl56_WFyWcM.html I hope that helps, and thanks for watching!

Hi Brooke, sorry for the delayed reply...often times the treatment RELIEVES many of those symptoms. I resisted the antibiotics for years due to fear, but they were the thing that changed my digestion for the better, and almost immediately too. DId you ever start the treatment?

I took it just after my meals. I believe it can be taken before or after, whatever works best for you.

Thank you for your answer :) Im just on third day on it, fighting with my SIBO. After how many days of your treatment your bloating went away? if i can ask please :)@@ConfluenceNutrition

@@piotrharasim6060 If I remember correctly, it slowly abated during the treatment. Good luck!

All antibiotics are not created equal, and the decision to use them is very personal. Rifaximin has been designed to primarily affect ONLY the small intestine, so is less likely to cause some of the bad side effects we expect from other antibiotics. Neomycin is different and I was lucky. To be clear, I DID experience some unpleasant side effects, but the overall benefits FAR outweighed the downsides. I had had SIBO for probably well over 10 years, and I made massive progress for the first time with the antibiotics. I had much worse side effects from the herbs which is how I found the bravery to try the antibiotics. We all have to find our personal best path to walk. You can do this!

@@ConfluenceNutrition What about diet during this treatment did you do. I’m about to do my first treatment of both antibiotics.

I suggest waiting 2 weeks to retest, then you'll wait for another week or so to get results, and then need to get another prescription. For me, it ended up being 6-8 weeks.

@@ConfluenceNutrition Thank you very much ❤

@@doctorvpc YOu're very welcome

Neomycin/rifaxamin is the exact combo recommended for high methane. The high methane is likely disguising high hydrogen because the methane bugs consume the hydrogen.

@@ConfluenceNutrition thanks so much for the reply!

@@456012 You're welcome.

Prebiotics are often a trigger for people with SIBO, so they are generally not recommended until after treatment, and only if tolerated. With regard to probiotics, there are 2 schools of thought on this for SIBO. In one, probiotics are helpful to assist in getting rid of SIBO, as shown in a meta-analysis study (compilatoin of several research studies), while the other school suggests that probiotics often make SIBO worse and relapse again, especially for those with chronic cases. Also, rifaximin is only active in the small intestine, and doesn't seem to disrupt the microbiome in the large intestine like other antibiotics. In short, there's no one right answer for everyone, which is why I recommend using theory to identify possible options, but using your body as the measure and guide of what to do. For me personally, I haven't been able to tolerate probiotics for some time, nor prebiotics. I rely on food-based fiber for my prebiotics, and occassionally eat probiotics foods and beverages, and am working back towards tolerance. That was a long answer, but I hope that helps answer your questions!

@@ConfluenceNutrition Hi Amanda - great video and info. I am a Sibo - c (or now aka IMO) sufferer for the last 5 to 6 years. With regard to the antibiotics- I get your take on Rifaximin - very targeted and only acts in the SI. But what about Neomycin- that may wipe out everything in the large intestine- so to support that should one take some probiotics? Btw I started my rifaximin/ neomycin 14 day protocol today…..

@@akashk650 Hi Akash, presumably, the neomycin may have an effect on the large intestine. I really don't know much about it specifically. Probiotics can be helpful for some people with SIBO, while for others they make everything worse. For those who choose to try using probiotics during SIBO treatment, I usually suggest tryiing them with care, and stopping if they seem to be making things worse. In some cases, it's best to wait until you finish treatment, and are on a prokinetic agent. I hope that helps.

How are you now? Do you recommend it?

Hi Irma, the meds did work for me, though it did take 4 rounds of treatment and addressing my root cause (endometriosis and scar tissue), but I've been SIBO free for almost 9 months now. I personally don't believe in following a diet that long unless it is truly helping you. Did your symptoms improve with the diet changes she recommended?

@@ConfluenceNutrition hello I just started my meds. I didn’t have a good relationship s thr Hollistic doc. I am looking for another one. I have seen some improvement not because of diet she had out e on a mucosa lining for about a linty while I was seeing her. So I had Covid in November of 21 and my symptoms just got so worse. I am starting to feel a tiny better. From the mucosa lining powder I use in water. It will take time. For now I am doing a mess route from my GI. Yes I don’t believe I diet either. They are few ways to treat SIBo. So did u retest after ur meds to see if you not have it anymore. I have also GERD and IBS she told me it all causedby SIBO for at least 60% of IBS. I also had diarrhea for like 11 months ans it stopped she gave me Hollistic drops which helped I took them for a month. Thanks

@@irmakalember9403 Yes, I did retest after each round of treatment, and used those results to help guide my next steps. I'm not a doctor, but I host a coaching program to support people in resolving their IBS and SIBO symptoms. Would it be helpful if you were able to create a personalized plan to address your symptoms with the support of an expert coach?

Hi Juan Pablo, I don't really know how to answer this question, other than I'm not sure that neomyin is quite as targeted as the rifaximin. This is really a question for a doctor. Antibiotics do impact your microbiome, but you can generally protect yourself during and after treatment with probiotics. And I know there are differing opinons about probiotics during SIBO treatment, but there is high level clinical research that suggests people taking probiotics succeed better at SIBO treatment.

@@ConfluenceNutrition thank you, again, Amanda.

@@ConfluenceNutrition do you know any good suggestions of what probiotic medication brands to use with xifaxan? I’m starting my treatment of xifaxan tomorrow cause I been tested for sibo and my gastro doctor said the bacteria level was pretty high. The instructions say take the xifaxan morning, midday and night. So how many times should I take probiotics

@@Mandalore.The.Hero7 Hi Obito, my apologies for not replying sooner. You're probably mostly through your SIBO protocol, but generally, I suggest using probitoics 1-2 times per day...I hope you're well in the new year!

Yes, I wish you all the best!

Hi Jaz Jaz, it doesn't really matter. It's up to you and how it feels. It's probably best to take on an empty stomach, but I can never tolerate that. Thanks for watching!

Hi Sainath, yes, I would take them together at breakfast and dinner, and at lunchtime, only the rifaximin. Thanks for the question, and thanks for asking!

Thank you, Can you please tell me which brand of Neomycin tablet are you using? (I mean manufactured by?) Did u get it from India? Iam from India and Iam finding it difficult to get Neomycin oral tablets, I got Rifaximin very easily

@@sainath8947 the manufacturer is Teva Pharm. I was able to buy easily at my pharmacy in the US, but it does require a prescription in the US...it's an antibiotic. I think it's a generic form. I hope that helps!

@@sainath8947 aap india se ho mei bhi india se hu aapne treatment kiya aapko fraq laga medicine se plzzz help me

@@Aish_plays mein india se hun par USA mein rahatha hun. Aapka problem kya hai? Mera bloating aur smell hai. Rifaximin jyada help nahi hua magar phir se karna chahatha

Hi Dave, i see Dr. Miriam Peachy, she is here in northern CA. Due to California laws, you can only see her if you live in California. Her site is ncnatmed.com If you're elsewhere in the US, I recommend Dr. Ruscio and his team in Austin TX, they do telemedicine, and their website is ruscioinstitute.com.

IT was much less expensive, like around $100, but I was able to get it via a Canadian pharmacy, where my ND had sent my Rx. To my knowledge, you can't just order it directly without an Rx.

@@ConfluenceNutrition I'm looking at paying $2400 for a 2 week course.. Tks for posting this reply a day before I found your vid

@@StoryThyme100 I hope you can find a way to get a cheaper prescription!

@@StoryThyme100 glad I could help!

Have you confirmed that your SIBO is all the way gone? I generally recommend confirming this before doing food reintroductions. You might want to check out this video: ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-29qsUdBLKlk.html and this one: ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-QZTJCj3sVV4.html

@@ConfluenceNutrition thank you ma'am☺️

@@Daswiftie You're welcome :)

Hi there, I used Mark's Marine Pharmacy in Canada, your doctor should be able to call the Rx in there. Their website is canshipmeds.com

I ordered my rifaximin from Mark's Marine Pharmacy, I believe their website is canshipmeds.com, but you must have the prescription from your MD or ND sent there in order to be able to order. I got my neomycin from my local Costco pharmacy, again, called in by my ND.

Hi DMX, yes, there is a correlation in the data between SIBO and thyroid. In other words, some studies have shown that when you improve/treat SIBO, thyroid numbers improve.

My methane numbers were very high, and in her clinical experience, she'd seen 3 week courses work better than 2 week courses. Even with that, I still had to do 3 treatments to eradicate SIBO.

Hi Tavinte, a lot of people are concerned about this, and there may be some truth in it, but the larger data and research about SIBO treatment shows that it generally succeeds in treating SIBO and leaves people better off. There are always some that don't respond as well, but with conscientious management, I think the SIBO treatment is usually a net gain of function and quality of life for patients. Thanks for watching!

What I don't understand is Methane SIBO is NOT a bacteria it's a archea. It plainly says all over internet, and from other natural paths that methane SIBO can not be treated with antibiotics because it's not a bacteria. There's a different course of treatment for methane SIBO!! TAakingnantibiotics for it will mess you upo more!!

and if your symptoms were stable after treatment course? or anything else was....

@@gautam.2317 Hi, yes, I had persistent constipation for years with SIBO, and a mild and slowly increasing bloating. The constipation was improved after treatment, but the bloating returned after a few weeks off the treatment both times. I have to solve for the reasons for this to get better, and I'm working on it!

I have major problem of fat malabsorption that's why it's hard for me to maintain my weight...im too skiny right now cause of sibo

@@gautam.2317 yes, sibo can create inflammation in the small intestine area, which can compromise your ability to digest certain nutrients. Treatment can help relieve this inflammation, and restore your gut function. There can also be a number of other things that need support. I am running a program, starting June 29th to support people with these challenges...would you like to hear more about it?

Thanks for watching! The antibiotic can definitely change your poop qualities. Probiotics or the right kinds of fiber may help re-regulate things for you. Does that help?

@@ConfluenceNutrition thanks ..very2 helps for me

@@syahironazhar4301 how are you now

@@syahironazhar4301 how are you now

Hi Jill, apologies for my delay in replying. I hope you managed to get through this. It's common for people to have die off symptoms, or temporary worsening of symptoms during treatment. I usually advise my clients to temporarily ease off on treatment for a day or two, and then continue.

It's not typically recommended for SIBO. Usually rifaximin, plus either neomycin OR metronidazole for methane SIBO. Thanks for watching!

Hi Violeta, I hope your treatment helps you feel better! I usually suggest people stick with whatever diet they are already eating that minimizes symptoms, and that they wait to reintroduce foods to test for tolerance until after they're feeling better. I don't support feeding bacteria and then needing the antibiotics to work harder. Best of luck on your journey!

@@ConfluenceNutrition Yes, it makes sense. I really appreciate your quick response. Thank you!

@@violetcountry You're welcome! Your question inspired me to make a video about this question because a lot of people ask it!

Hi Michele, it's really different for each person what helps, but this treatment protocol has been the only thing that has really significantly helped over these many years i've had SIBO. There may be reasons it doesn't help, and in that case, alternative options need to be considered. FOr some, the herbal protocols are better. I'm sorry you're really bloated all the time :( Would you like to learn more about my new online program to help people with bloating go from food anxiety, endless questions, and second guessing to a confident plan for calm digestion? You can schedule a time to learn more here: confluencenutritionappointments.as.me/discovery-call Thanks so much for watching!

@@ConfluenceNutrition thank you! i signed up, i really appreciate your advice

@@ChrisFarleyisGod Yay! I'll look forward to meeting you soon!

I wasn't given specific instructions on this, but I took with meals, just because that is simple and easy to remember. Thanks for your question!