SIBO, Irritable Bowel, Tips, Tricks, Helpful Hints?

on 9/10/19 9:06 am
RNY on 02/04/15

Hello all!

I had my Roux-en-Y surgery in February of 2015. I was 300 pounds and how holding steady for the last two years anywhere between 165 and 170. This morning I was 167. My lowest weight was three years after surgery and that was 153.

In January of this year I began to have diarrhea daily, to the point where I was going upwards of 10 times a day. My family doctor prescribed me Viberzi and I had some success with it up until about June. I am now on Zaxine for a 14 day course. My doctor thinks I have SIBO - small intestinal bacterial overgrowth so we are trying the Zaxine. I am 4 days into the Zaxine and I realize I will have to give it more time but things are no better.

I am wondering if anyone has had the same problem as me and if so, what did you do and did you get better? Any tips/tricks?

I have tried:

Metamucil capsules, Align probiotics, unsweetened Kefir, Greek and Skyr Yogurt with probiotics, kimchi and apple cider vinegar all with really no lasting results.

Any advice or suggestions you could offer would be greatly appreciated.

It isn't easy being green - Kermit the Frog


(deactivated member)
on 9/10/19 11:39 am

Ooh brought up a REALLY pertinent subject . There's a demonstrated connection between beneficial gut bacteria and lower body weight ... and Serious Digestive problems are the disturbing and often persistent problems on the low end .

What would I do ? Well first I'd clean up my diet which I'm sure is HARD considering fiber makes an IBF sufferer essentially handicapped ... chained to a toilet .

Honestly it sounds like you tried everything ... there are some refrigerated probiotics in the Vitamin Shoppe and GNC that helped me get over antibiotic caused lack of gut bacteria in the past ... but if these don't work ( and they're not cheap )

i MIGHT consider a fecal implant .... yep I kno... but health trumps everything right ? Please keep us posted ((())) hugs

on 9/10/19 11:54 am

Over 20 years ago, I was diagnosed with IBS-D and have tried to control it the best I could with diet and Imodium. Feb. 2018, I had the RNY surgery. I am no longer taking Imodium. At the end of 2018, was diagnosed with Sibo. After RNY surgery issues, issues starting happening in Oct. I was immediately put on temporary antibiotics and the issues went away. Issues came back in December. In December, I took the SIBO breath test and I was positive for SIBO. I was immediately put on temporary antibiotics again and the issues went away. So far, they have not came back! My understanding, when one antibiotic fails, the doctor may add another antibiotic or change to a different antibiotic. However, the doses of antibiotics, the duration of treatment, and the need for maintenance therapy to prevent recurrence of SIBO have not been adequately studied. Most physicians use standard doses of antibiotics for one to two weeks. I try to keep things "moving" in my system and drink extra fluids/water. I feel your frustration.

on 9/11/19 10:52 am

Forgot to state, back in the days/years before surgery I was using daily Konsyl Fiber supplement as well.I have removed Konsyl & the mutli Imodium pills from my daily intake since RNY surgery! Yea! I do use on occasion keep things moving daily! Guessing I might have had SIBO all these years and not IBS-D, but one will never know. Either way...we FEEL you, it sucks, its tough, but dont give up. Hopefully things will straighten out and you will have good days and some not so good days.

on 9/11/19 5:26 am
Revision on 07/05/16

I was diagnosed with IBS-C 25 years ago, which I managed with Metamucil until RNY in 2011. I switched to Miralax and did well. I had my distal revision in 2016 and I was taking more calcium and protein, I needed to add Metamucil 2x day (switched to Konsyl, it has more fiber per tsp) for acid stools along with the 2x day Miralax. Over time, I developed rectal fissures and I increased the M&K plus added a script med for IBS-C. It only helped briefly, so I became desperate due to the painful bleeding fissures, and added some simple carbs (bad ideal) to help loosen things up and that worked for a while. Meanwhile, I started seeing a functional medicine doctor for possible hashimotos (my endrocrine doctor of 7 years said my thyroid was ok). She dx me with leaky gut, hashimotos, SIBO and now probable adrenal fatigue/insufficiency. I only thought one had diarrhea with SIBO, but I was wrong. I was put on 2 courses of antbiotics (xifaxan and neomycin) because my constipation was so severe and I probably had SIBO for some time. I knew the antibiotics were working because I began to have diarrhea within a day. I had stop all my vit supplements because I knew of the diarrhea side affect and didn't want it all be flushed down the toilet, but I did restart the calcium, which did help bulk the stool along with Konsyl. I also continued my daily probiotic and added a generic Florastar which has s.boulardii, that was recommened to add during SIBO treatment. I also learned that I was feeding my SIBO with the simple carbs. It's been 6 months since the antibiotics and things are so much better. Now to get my adrenals taken care of, so I can feel back to my ole self.

FYI: It takes a lot of Metamucil capsules (16) to equal a dose of SF Metamucil. It takes 2 tsp SF Metamucil to equal a tsp of Konsyl. At my worst before treatment, I was taking 6 tsp Konsyl twice a day (NOT RECOMMENDED BY MAKERS OF KONSYL). During treatment, I took 6 tsp Konsyl a day. It was changed to once a day because I added in thyroid meds that needed to be separated from other meds especially calcium by 4 hours and I had run out of hours in a day! Now I take 3-4 tsp of Konsyl daily. Konsyl has no additives, I add it to my True Lemon w/ raspberry drink. Like Metamucil, Konsyl needs to be taken 2 hrs away from medications or it will block absorption.

HW322 SW296 GW150 LW196 

RNY 8-29-11

Revision to Distal bypass 7-5-16

SW262 GW165 

John 3:16



on 9/11/19 5:51 am

I have been dealing with the same problem for the past 6 months+. I am 6 years post op and lost 125 pounds (lost more and gain back some). I have used Metamucil it made me worse. I used Align it made me a bit better but now I am using the probiotic in the fridge at your local pharmacy. It is a bit pricey ($68 CAN) but so far so good. I hope this help.

H.A.L.A B.
on 9/11/19 11:34 am

Yea... tough one.. I have been dealing with that for the last few years. Mine is different than your, mine cause constipation, that often is really really difficult to manage.

SIBO: Small intestine bacterial overgrowth: the small intestine should not harbor bacteria. And if any - not a lot of them. Good, bad, anything in between.. they are not suppose to colonize the small intestines.

When that fails- and bacteria are in the small intestine - and we eat food high in FODMAPs - that can feed the bacteria and create gas. Some bacteria generate gas that can be irritating, causing rapid spasms of the intestine and runs. Other type of bacteria can generate gas that make the muscles in the intestine "almost paralyze" , preventing the food form going anywhere. In both situations, the gas is not suppose to be in small intestines in such qty, and the gas sometimes gets trapped, causing small intestine expansions and severe pain. The cramps can also cause a severe pain.

There are meds (Rx) that help with the cramps. A good gastro can prescribe that. I often need to take 3-4 when dealing with severe cramps due to gas.

I know having runs can be horrible. That may deplete you of electrolytes. And that can be really dangerous. And painful, not even mentioned embarrassing. Sometimes when my guts "let go" and I ended up with runs, I have to stay home close to the bathroom. Last Sunday we planned to see a movie at 12:45. As we were driving there, I told my guy to turn around and that we can see the movie at 3:45. Thankfully, my guy is amazing, and he knows my gut is my boss, and when things start there is not much I can do.

Google, and read what even you can about SIBO, specially any research studies, and the connection with IBS, leaky gut that can lead to rosacea, fibromyalgia, food allergies, increased joint's inflammation (arthritis), skin issues, etc etc... Even depression and mental fog. Not forgetting hormonal imbalances...

Often the SIBO comes together with Candida overgrowth. Speically when SIBO is treated with antibiotics. Antibiotics kill the bacteria - the good the bad and in between, but don't work on fungi - yeast. One we kill a lot of bacteria that often control internal yeast, that can turn into a candida. Candida - a colonies of Yeast, that can be close to impossible to eradicate completely.

To manage SIBO and Candida - a person may need to go on a diet that limit high FODMAP foods. (google what it is and for low FODMAP list).

One think I would suggest is for you to consider allergy testing. Then try to do an elimination diet. Find foods, combination of foods that you can tolerate. And when your system gets out of control - you may have foods that would allow you to get better.

For me - that food is (all organic) Chicken cooked in IP, with carrots, celery and leek. Cooked under pressure for at least 30-40 min. I often make 5-6 quarts, and either can that in glass jars or portion and freeze. I know I need to have at lest 3 days wort of that (3-4 meals a day) so when my gut gets severely irritated, I can have something to eat, when I have to eat.

I take antibiotics for 2 weeks, at least 2 times a year, often - 3 times to control my SIBO. and during the 2 weeks of the treatment - I also take Rx for yeast infection (to kill Candida). Only after I finish the treatment - I would start introducing good bacteria - I us VSL#3 and Florastor. Both. Because Florastor has the friendly yeast we need to digest foods. For people who don't take meds to kill Candida, Florastor may not be necessary.

I try to follow low to very low FODMAP diet. Also elimination foods that I am allergic to (dairy, soy, etc)

Because my SIBO cause gastroparesis - very slow transition of food through my digestive system, my system works best when I follow IF (intermittent fasting) with a keto-paleo type diet. During teh time I don't eat - I try to drink as many non caloric liquids to help flush my system and prevent SIBO growth in my small intestine.

The IF and drinking liquids helps to push the food with bacteria down my digestive track.

Right now I know I need to go on a 2 weeks antibiotics. Probable very soon. I see my gastro next week and I'll get a script for a 2 weeks o f a Xifaxan® (rifaximin 550 mg) and Diflucan. Why ? becasue I deal with gut pain and cramps EVERY day. Even when i eat my safe foods.

I also plan to go on a elemental diet (very strict, nasty and expensive, but I hope it could help to keep my SIBO under control much better)

Beside the antibiotics - I also take natural supplements to help the meds to deal with SIBO and Candida. I plan to take Berberrine (2x500mg, x 3 per day). and some colloidal silver. Plus a few other natural remedies to help to disrupt biofilm of SIBO and candida. (read on biofilm of that - "bacteria Biofilms are densely packed communities of microbial cells that grow on living or inert surfaces and surround themselves with secreted polymers ".. )

Hala. RNY 5/14/2008; Happy At Goal =HAG

"I can eat or do anything I want to - as long as I am willing to deal with the consequences"

"Failure is not falling down, It is not getting up once you fell... So pick yourself up, dust yourself off, and start all over again...."

on 9/13/19 5:47 am

You are a WEALTH of information, thank you! FYI - yes, me too. when I was diagnosed with .SIBO and was having issues and put on the antibiotics...then came the yeast infection. Happens/happened to me as well. Another RX to the rescue for that.

I laughed at your comment - "he knows my gut is my boss, and when things start there is not much I can do".... the reason I laughed...this happens in our house too! Glad there are others other there with the same helps to make it thru the day!

H.A.L.A B.
on 9/12/19 1:07 pm

This is very interesting read about biofilm - bacteria biofilm...

This site in an advertisment for some products but it describes in details why just taking an antibiotics for 2 -3 weeks works initially but eventually some symptoms may return.

..."Biofilm is a toxic, slimy film that these bugs secrete. They use it to live within and build colonies inside our bodies. And science now thinks it's the big reason why so many long-term health conditions persist and why antibiotics aren't as effective as they once were.

And it's because these biofilms are nearly impossible to penetrate.

It's also been documented that bacteria protected within biofilms are up to 1,000 times more resistant to antibiotics than if they were free-floating. [4] Bacterial Biofilms in Nature, J. William Costerton, 1987

Only now are researchers beginning to get a handle on just how these biofilms operate.

It wasn't very long ago scientists believed these bugs were free-floating throughout our body. Now, they've discovered that about 95% of the bacteria and other harmful bugs, (yeast, fungus and parasites), are not free-floating, but are instead thriving in the body, protected within these biofilm communities. ..."

Hala. RNY 5/14/2008; Happy At Goal =HAG

"I can eat or do anything I want to - as long as I am willing to deal with the consequences"

"Failure is not falling down, It is not getting up once you fell... So pick yourself up, dust yourself off, and start all over again...."

(deactivated member)
on 9/12/19 4:30 pm

Interesting article Hala ty ! To me the most striking fact is the huge link between SIBO and fibromyalgia.

As one of those who totally doesn't understand this condition cuz I never suffered it - just a few questions ... doesn't say drinking fresh pressed green juices help ? ( they're filled with natural healthy enzymes )

how about sipping say 0 fat Siggis liquid yogurt ? I know I'm being pretty naive but these are what I turn to and crave after antibiotics . I just keep adding skim milk to the bottle and drinking it slowly ... it seems to help put things right .

I'm assuming fresh vegetables can be tricky because of the fiber ... but you can always food processor purée or even strain out the fiber if you're super sensitive , no ? I also love your idea of homemade chicken soup - it really DOES help cure all ills as our loving Mommas said :)