SIBO

Hi -

Wondering if anyone has been diagnosed with SIBO ((small intestinal bacteria overgrowth) post RNY? I was recently diagnosed with SIBO with constipation, and completed the first round of antibiotics. So far I have seen zero improvements in symptoms, so I am wondering what treatments and/or diet changes may have helped others.

thanks!

Hey stranger! Sorry about the SIBO, but it's good to see you.

I have no experience with it, but a fair number do. Hala probably knows the most about it. I'm sure she'll stop in.

Thank you! I need to get back here more often, life has been kind of crazy! But now that it's settled back down I hope to be here more often and really get back on track. Hope all is well!

I deal with that for a while. It sucks. I am maintaining mine with antibiotics, and diet and probiotics.

what antibiotics they gave you? for how long? what are your issues? etc.

I have had lots of abdominal bloating, constipation, and at times really bad gas. I did the breathe test to confirm. They tried to put me on rifaximin, but insurance said no. So I did 10 days of Augmentin. In two weeks he wants to try Cipro. He have no advice on vitamins/diet, which I find a little frustrating. I'm thinking I might find a new GI, and I have a wonkey digestive system between the RNY and no gallbladder...

Does it never really go away?

Does it never really go away? not for me so far. I have been dealing with my issue for a while now. Most of the time I am doing ok as long as I follow the diet.

Really low FODMAP diet. Google that. I need antibiotics treatment once every 4-6 months. I hate antibiotics so I wait a long time before I do that. The more you use them - the least effective they can be. both, Augmentin and Cipro are known for really bad side effects. Cipro - even neurological. not cool. Non reversible.

Your doc needs to fight with your insurance to approve the rifaximin. Mine did.

I also do not have a GB. so I get it.

You may need to be tested for allergies. With SIBO we can be prone to leaky gut (google that) and food allergies. we can talk about that more later.

Let me know what is your biggest concern?

Thats discouraging that it sticks around, I was hoping it was a one and done...

never really thought about good allergies. I did have a gluten sensitivity test done, which came back fine.

I will google the FODMAP and leaky gut, thank you for the suggestions.

My biggest concern is the bloating. Some days I look 6 months pregnant by the end of the day! I take Linzess for constipation, and it works alright. I would prefer not to take medicine for it indefinitely, but it's better than the alternative...

Thanks again for sharing your experience/thoughts!

I hear you. Linzenss do not work for me consistently. They work for 2-3 days, they they don't.

I take up to 3 cupfuls of Miralax equivalent (Costco or Sam's brand) every morning with coffee. Plus i take a lots of magnesium.

I try to follow a Low FODMAP diet. No grains, dairy or any high fiber veggies.

Plus IF - intermittent fasting- I try to push as many liquids as I can between 6 am and noon. I often do not start eating until noon. or 11 am. That works best for me.

When I do antibiotic treatment - I also take diflucan (Rx) to deal with candida.

after the treatment (2 weeks) I start a very heavy probiotics regime. VSL#3+ Florastor - 2 times a day for at least 2 weeks. That really helps. like really helps. My good time after antibiotics usually lasts 2-3 months. Then the SIBO is back in a full force. Like now. I start hurting when I eat almost anything. It sucks. Yesterday - late at night, I chose to have an apple and a beer. 15 min after I finished that I was in pain. probably apple was the cause. The pain and cramping lasted app 30 min.

I do try to avoid most food on high FODMAP diet list. Having a good daily BM is critical for me. I prefer a loose stool.if I don't have that every day - things are painful.

Thanks so much for all of the helpful information. My GI doctor has not mentioned any of this, except the antibiotics....maybe it's time for a new doc! Thank you again, I really appreciate taking the time and giving me some ideas of options to look at!

That your doc even if familiar with SIBO is a plus. My first gastro doc was a joke. But then I found my gastro - and kept him. He is good to great. But I need to do my own homework. And he is very open to suggestions and research. When I bring a subject to him and he is not familiar with it - he gets on it and next time he can give me his opinion.

He is not crazy about me taking as much miralax but as lot as this helps me - he is ok with it.

In case of really bad cramps I have Rx sublingual hyoscyamine sulfate. That works and works good. But it need 3 pills at least. I don't like the side effects of that, but I don't leave house without them. Seriously. They are in pills or sublingual form. The pills take forever. Sublingual- the cramps can be gone within 10-15 min. Get some Rx for them. Discovering them was a life saver for me.