Dealing with SIBO: Any advice?

How much do people actually know about this issue around here?

It took me over two years—and thousands of dollars wasted on endless tests, scans, and other total nonsense—to finally find out I have SIBO. During that time, I bounced between several different gastroenterologists, and every single one of them came up empty. Their big "conclusions"? Stress, IBS, a bad diet, lack of exercise... which was honestly laughable because I’m a healthy guy—I rarely get sick, I eat clean, I hit the gym regularly, and my stress levels are zero. I just couldn't accept those excuses.

I only landed on the diagnosis after months of obsessively digging through research and trying every diet under the sun, which eventually led me to get a breath test done at a Bonifarm clinic. Honestly, my experience dealing with the US healthcare system regarding this has been an absolute train wreck. I’m currently in the middle of treatment—just finished a round of antibiotics and I'm sticking to the FODMAP diet now. Fingers crossed this actually works.

If anyone else here has dealt with this nightmare, I'd really appreciate it if you could share your experience or any advice you might have.

Hey,

here’s a bit of solidarity for you 🙂

I’ve been dealing with digestive issues for ages—honestly, it sounds like the exact same story as yours, just stretched out over a few extra years. It was the usual suspects: gastritis, IBS, the whole works. Digestion was a mess, and my stools were always pale and loose. I’d say I saw quite a few gastroenterologists, but none of them really seemed to grasp what was actually going on. Eventually, I did some digging online, figured out what might be happening, and paid for a private test that showed high hydrogen levels.

I went through two rounds of antibiotics, about a year apart. After the meds, I stuck to a low FODMAP diet for a month. To be honest, I wouldn't go so far as to say I'm "healthy" yet, though it does feel like things have improved slightly. The biggest headache with treating this is just trying to pinpoint the actual cause. A lot of the research points toward low stomach acid, which is something most doctors here almost never consider—if you show up with symptoms, they immediately throw an PPI at you. It’s a massive bummer that we don't have easy access to a Heidelberg test that could actually tell if you're dealing with too much or too little acid. Since the treatment for those two scenarios is polar opposite, it leaves you kind of stuck...

Robin Scott9 said:Hey,

here's some solidarity 🙂

Been dealing with gut issues forever—honestly sounds just like my story, only mine dragged on a few years longer. Gastritis, IBS, the whole standard routine. Digestion is trash, stools are loose and pale. I’d say even after seeing a handful of gastroenterologists, none of them really seemed to get what was actually going on. Ended up digging through the internet myself, found out what it was, and did a private test that showed high hydrogen levels.

Did two rounds of antibiotics about a year apart. Followed up with a month on a low FODMAP diet. Unfortunately, I wouldn't say I'm "healthy" yet, though I feel slightly better. The biggest headache with treatment is just trying to pin down the actual cause. Most articles point to low stomach acid being the culprit—something our doctors here almost never even consider (if you have symptoms, they immediately shove an PPI down your throat). It's a huge bummer that we don't have easy access to the Heidelberg test here, which literally tells you if your acid is too high or too low. Since the fix for high vs. low acidity is polar opposite, it leaves you stuck...

Yeah, unfortunately—I figured it was something like that. My test was hydrogen-dominant too, though my methane levels were also high enough to trigger a positive result. As far as symptoms go, the worst parts for me are the bloating and chronic fatigue.

Which antibiotics were you on, and which doctor did you see after that positive test?
I went to the clinic in Mayo Clinic territory—they recommended it over at Bonifarm because I was honestly lost. Got prescribed Augmentin (875mg + 125mg) twice a day for 10 days. My doctor pitched it as a cheaper alternative to Rifaximin, which I’d read is the standard go-to. Right now, I'm not having major issues, just occasional mild abdominal pains. Planning to re-test after a few weeks of FODMAP to see where I stand.

And I totally agree on the stomach acid thing—I deal with reflux every now and then. I talked to my doctor about it ages ago, and he just mindlessly prescribed an PPI. I refused to take it; I'd rather try to manage it through diet changes. But hey, I haven't reached a definitive conclusion either, other than knowing something is definitely wrong.

How do you even measure your stomach acid levels?
I spotted some undigested carrot bits in my stool, which apparently points to low hydrochloric acid according to some symptoms...
At the same time, I'm stuck on a control diet because of reflux... honestly, I'm at a loss here...

For context, my glucose-based SIBO test came back negative, but I haven't done the lactulose one yet....

It’s honestly a tragedy how little mainstream medicine actually cares about the gut microbiome; the way they handle testing and treatment is practically nonexistent.

I can point you toward some decent books on the subject, but my biggest piece of advice is to be extremely careful with antibiotics. If you aren't cautious, you risk wiping out your good bacteria, which creates massive problems down the road.

If you're up for it, shoot me a DM with your SIBO results. I spend a lot of my time looking into this stuff and I'm always hunting for more data; if there's any additional interpretation included with the report, that would be incredibly helpful.

I’d also suggest getting a stool analysis done to see exactly which beneficial bacteria are missing from your microbiome.

There’s plenty more I could say, but most of it falls under alternative health, and I don't want to get flagged here. We can move the conversation to private messages if you want.

Best,

Glad someone finally decided to kick off a discussion about SIBO over here. Honestly, just like feralfalcon37, I’ve dragged myself through an endless parade of doctors—plenty of gastroenterologists included—and it’s honestly pathetic that none of them, even the ones acting like "world-class" specialists, have even heard of SIBO. Out of everything I've tried, Atrantil was the biggest lifesaver, even though the die-off symptoms hit me pretty hard at first. MegaSporebiotics is also solid. I’m basically living on digestive enzymes at this point. I'd steer clear of antibiotics if I were you... for now. There's a really great Sibo-soS group on Facebook with some killer advice too.

Would you be so kind as to elaborate on the specific nature of your die-off symptoms, and furthermore, which particular digestive enzymes have you found to be effective in your regimen?

Rachel Bishop93 said:Can you share what kind of die-off symptoms you're getting and which digestive enzymes you swear by?

For me, it was a total mess—diarrhea, bloating, stomach cramps, chills, waking up in the middle of the night... basically just high histamine levels. That's my experience, anyway. Here's the rundown on what usually happens:

Common symptoms include fatigue, headaches, flu-like vibes, joint pain, dry mouth, bloating, constipation or diarrhea, sinus issues, rashes, skin redness, and those intense cravings for sugar and carbs—plus increased appetite and irritability. Basically, the toxins have to get flushed out through the liver, which is why your whole body reacts during detox.

Not everyone hits every single symptom—some people don't feel anything at all. They can pop up constantly or just every once in a while, usually lasting about 1-3 weeks. Since everyone’s biology is its own unique system, the reaction is totally individual. Seeing "die-off" symptoms really only means one thing—you're successfully taking down the yeast.

Hey everyone, my gastroenterologist is sending me in for SIBO testing because I’ve been dealing with these endless, constipated stools... I've already gone through the whole gauntlet—colonoscopy, endoscopy, calprotectin, AST levels, basically every blood test under the sun—and everything comes back perfectly normal. Does anyone know if you can actually get a SIBO test covered by Medicare?

Megan Johnson2 said:Hey, my GI doc is sending me for SIBO testing because of this constant constipation—I've already done everything else, colonoscopy, endoscopy, calprotectin, stool tests, dozens of blood panels, and everything came back fine. Does anyone know if you can get a SIBO test covered by Medicare?

Nah, but it’s not exactly pricey $100 at Bonifarm.

Kefir helps me with the constipation... or that Flobian probiotic thing.

Might be worth getting a microbiome stool test at Proiumun too...

Walter Chase2 said:No, it’s actually not that pricey $100 at Bonifarm.

For me, kefir helps with soft stools, or maybe that Flobian probiotic...

It wouldn't be a bad idea to get a full microbiome stool analysis done through Proium...

Thanks so much for the reply. I just finished a stool test looking for bacteria and parasites because my doctors have absolutely no clue what's going on with me anymore, so now they're sending me off for SIBO testing. I think I'll give the kefir a shot. Right now, I'm trying yogurt and carob (I read somewhere that combo works well). Honestly, the soft stools aren't even my biggest issue right now. It's just strange because this wasn't happening before...

So, I finally got my breath test results back at the end of August, and yep—it’s a positive diagnosis for SIBO. My doctor has me on a regimen of two different antibiotics paired with a strict FODMAP diet. To be honest, I’m really struggling to pull the trigger on starting those antibiotics. It feels completely futile to just blast my system with meds if I don't actually understand what triggered this mess in the first place. I've been being super disciplined with the diet, but I'm honestly not feeling any better. Should I be looking into digestive enzymes, or is that just adding more noise? And more importantly, how does one actually dig deep enough to find the root cause of all this? Right now, I'm dealing with constant constipation, bloating, gas... and a whole laundry list of other issues. I'd love to hear from anyone who's been through this—please share your experiences!

I don't follow. If you already have your treatment plan figured out, why bother seeing a doctor at all?

A physician prescribes a regimen for a reason—yet here you are, ignoring the instructions and expecting things to magically improve. And as if posting on a forum is going to change that.

Do you also believe the Earth is a flat disc?

You need to get rid of H. pylori without relying on antibiotics.

Sent from my Galaxy S21 Ultra using

Walter Chase2 said:The symptoms include a coma-like state, diarrhea, bloating, abdominal pain, chills, and waking up at night due to high histamine levels—that was my experience. Here is what it says:

Some symptoms include: fatigue, headaches, flu-like symptoms, joint pain, dry mouth, bloating, constipation or diarrhea, sinus infections, rashes, skin redness, cravings for sweets and carbs, increased appetite, irritability, etc. Toxins must be flushed out via the liver, which explains why the entire body reacts during detoxification.

Not everyone experiences every symptom; some might not feel anything at all. They can be constant or intermittent, typically lasting 1-3 weeks. Since every body functions as its own unique system, reactions will be individual. Experiencing "die-off" symptoms means only one thing: you are successfully fighting the yeast.

I have all those symptoms (for me, it’s diarrhea rather than constipation). I’ve done various tests and nothing helped (mostly Controloc or Emanera). Now my gastroenterologist is sending me for a SIBO test and a stool analysis for bacteria.
Look, at least one gastroenterologist actually knows about this. It's a shame you can't just get this covered by Medicare; it isn't cheap. But fine. If a real problem is found and I fix it, it won't be a waste of money.

Walter Thomas18 said:You aren't going to get rid of H. pylori without using antibiotics.

That isn't even the issue we're dealing with here!

WarKO said:.

Thanks! Honestly, I’ve spent so much time scouring the internet that I feel like I’ve lived through all this research myself, but here in the States, it feels like so few people—including most doctors—have even heard of SIBO. The US is easily twenty years ahead of us on this, and having access to the right guidance is everything, which is tough because I don't have many options locally. I actually reached out to a functional medicine clinic yesterday, so we'll see how that goes. 🤞
Most doctors around here just default to an IBS diagnosis, even though so many patients actually have SIBO without ever realizing it. That’s why I was so curious to hear about people's experiences within our own medical landscape. There are some fantastic SIBO support groups on Facebook, but those are mostly Americans too. Plus, half the supplements everyone talks about are basically impossible to get your hands on over here.

fadedorca84 said:I got a positive breath test result at the end of August. The plan is two antibiotics combined with a low FODMAP diet. Honestly, I'm struggling to commit to the antibiotics because it feels pointless if I don't understand what actually caused this in the first place. I’ve been sticking to the diet, but I’m not seeing any real improvement. Should I try digestive enzymes? How do you even figure out the root cause? On top of everything else, I'm dealing with constipation, bloating, gas... and then some. Please share your experiences!

I went through a round of antibiotics for H. pylori once, and it absolutely wrecked my gut microbiome. I wouldn't do it again if I had a choice; I felt much better before that treatment than after. You could give digestive enzymes a shot.
Try electrolytes too—sometimes your gut just needs more hydration.
Find some high-quality probiotics to see if they make a difference, and keep digging.
One thing that worked for me was taking Normabel with food. If I take it on an empty stomach, it has a calming effect on my head, but it doesn't touch the actual issue. When I take it with meals, it settles those stress signals from my gut. It helps prevent that mental spiral because we have the enteric nervous system—our "second brain." With IBS, the root cause might very well be sitting right there in that neural connection.

Try these methods and keep searching until you find what works. Personally, I wouldn't touch antibiotics unless there was absolutely no other way.

Olivia Jackson64 said:I don't get it. If you already have a roadmap for your own treatment, why are you even bothering to see a doctor?

The doctor hands you a prescription, you decide to ignore it entirely, and then you sit there wondering why you aren't feeling any better. And on top of that, you actually think scrolling through posts on an online forum is going to fix your health issues.

What’s next? Are you going to tell me the Earth is flat, too?

Why on earth would you even address me with such primitive, low-blow outbursts?

fadedorca84 said:It isn't even about that specific bacterium!

The login was under the gastritis thread, and H. pylori is the most common cause of stomach issues—plus, a breath test is one way people detect it.
Honestly, identifying the exact bacterium doesn't matter if you aren't using antibiotics. That is, assuming a specific "bad" bacterium is actually the culprit.
For what it's worth, I likely have SIBO too. I take certain probiotics that help somewhat, but not entirely. It’s highly probable I have some "bad" bacteria in my gut as well, which I probably won't fix without antibiotics and a heavy dose of probiotics.