Dealing with SIBO: Any advice?

Walter Thomas18 said:The login was actually under the gastritis thread, and since H. pylori is such a common culprit for stomach issues, people often use breath tests to hunt it down.
Honestly, it doesn't even matter which specific bacteria is causing the trouble if you aren't using antibiotics to clear it out. That is, assuming you're dealing with a specific "bad" strain.
For what it's worth, I'm pretty sure I have SIBO myself. I take certain probiotics that help a little, but they don't solve everything. It's highly likely I have some "bad" bacteria sitting in my gut right now, and I probably won't be able to shake them without a round of antibiotics combined with a heavy dose of probiotics.

We really need to ramp up the research on SIBO; here in the States, we're only seeing tiny bits and pieces of the full picture. Even our doctors give conflicting advice—for instance, some will tell you that you shouldn't touch probiotics until those bacteria are completely gone. I've seen people spend months grinding through antibiotic cycles only to see zero improvement. With SIBO, everything is incredibly individual, which is why I always insist that you have to find your specific trigger. Otherwise, you could be popping antibiotics until the day you die and still get nowhere, all while dealing with the nasty side effects they bring. This whole thing is genuinely complex. My doctor actually told me that whoever figures out a definitive cure for SIBO is going to get incredibly rich. For now, you're basically just experimenting and praying to God that something finally clicks. You really have to spend a lot of time educating yourself through American support groups.

Walter Thomas18 said:The original post was actually under the gastritis thread, and since H. pylori is such a common culprit for stomach issues—and one of the easiest things to catch via a breath test—it made sense to put it there.
Honestly, it doesn't even matter which specific bacterium is causing the trouble; if it's a "bad" bug, you aren't getting anywhere without antibiotics.
For what it's worth, I’m pretty sure I’m dealing with SIBO myself. I’ve been taking certain probiotics that help a little, but not entirely. It's highly likely I have some other nasty bacteria lurking in my gut too, and at this rate, I probably won't clear that out without a round of antibiotics and a heavy dose of probiotics.

The post was originally under the IBS section before it got moved here. I put it there because so many people who think they're just dealing with IBS actually have SIBO, but they never get a real diagnosis because most doctors just aren't trained to look for it.

I went to Proimmun. It cost me about $220. The test delivered exactly what I expected—it gave me the confirmation I needed for what I already suspected. Along with the results, they provided a recommendation

Walter Thomas18 said:I went to Proimmun for testing—it cost me about $220. The results were exactly what I suspected, which basically just confirmed my own theories. Along with the results, they provided some specific recommendations

How long does the testing process actually take? And is there any special prep required beforehand?

SIBO is basically a test for when things from your large intestine migrate up into the small intestine, setting up shop and making themselves right at home. It creates this perfect little environment caused by slow gut motility, which leads to methane being released from food just sitting there too long—kind of like how alcohol cleans things out, if you catch my drift. The fallout? Brain fog, migraines, bloating, burping, shortness of breath, fatty liver, skin issues, hemorrhoids, polyps, blood pressure... the list goes on. The worst part is that mainstream American medicine doesn't actually treat the root cause; they just chase the symptoms. And man, it gets even uglier if your histamine levels spike.

The only way out is an absolute diet. No sugar, no bread, no soda. Quantity matters more than anything else. You need to eat nothing but pure nature—cook and bake only what’s strictly necessary.

A Paleo-style diet is your best bet. Just eat what people ate before electricity was a thing.

Stick to bitter salads; that’s the sweet spot.

Drink plenty of water and herbal teas.

In the morning, take a teaspoon of flaxseeds and grind five cloves in a coffee grinder, then mix it into a glass of water and drink it. Honestly, it works better if you soak them in water overnight and drink it first thing in the morning. It helps push those fungi back down to the large intestine and keeps you feeling full.

Keep moving. Swimming, hitting the gym, whatever.

Nothing else is going to touch this.

As for supplements—or what people call "therapy"—you really just want to speed up your gut motility using teas.

My advice? Don't try to kill off the fungi in your small intestine with heavy meds. If you do that, they start causing much nastier problems elsewhere.

Most importantly—and I mean this, pay attention—never drink anything at least 15 minutes before or after a meal. If you do, you're essentially nuking your stomach acid, which is the very first step in chemically processing your food.

After years of endless testing, I finally figured out what was happening through live blood analysis. You can actually see the presence of fungi and bacteria right there.

Maybe it was just psychological, but seeing those fungi swimming around in my own blood on the monitor changed things for me.

At the end of the day, we're looking at a massive issue. Very few people have the willpower to break the habits that define modern life.

Some healthcare systems actually recognize this as a legitimate condition: carbohydrate addiction. And the side effects are everything I mentioned earlier.

With this condition, the biggest hurdle is mental. It’s all about that psychological grip the carbs have on you.

Take care.

steeljackal7 said:How long does the testing take? Is there any special preparation required?

I received the vials and instructions. The testing is quick; the longest part is just blowing into the tubes for the breath test. That takes about an hour (you have to blow into one tube every 15 minutes).
Preparation involves being fasted (and you shouldn't have eaten anything the day before, if I recall correctly).

mistymoose5 said:SIBO is a test used when fungi from the large intestine migrate into the small intestine and create a comfortable environment there. This results in slow bowel motility, which causes methane to be released from food sitting too long in the small intestine—essentially cleaning out alcohol. The consequences include brain issues, migraines, bloating, burping, shortness of breath, fatty liver, skin conditions, hemorrhoids, polyps, and blood pressure. Worst of all, mainstream medicine doesn't treat the cause, only the symptoms. It gets even harder if histamine levels rise.

Treatment is only possible through a strict diet. No sugar, no bread, no soda. Portion control is vital. You should only eat what comes directly from nature; cook and bake only when absolutely necessary.

The Paleo diet is best. Eat what people ate before electricity was invented.

Eating bitter salads is best.

Drink plenty of water and herbal teas.

In the morning, take a medium teaspoon of flaxseeds and grind five cloves using a coffee grinder; drink it in a glass of water. Better yet, soak them in water overnight and drink it in the morning. This pushes the fungi back into the large intestine and promotes satiety.

Movement, swimming, fitness.

Nothing else helps.

Supplements, or what is called therapy, involve speeding up bowel motility with teas.

Recommendation: do not use medication to kill the fungi in the small intestine, because then they start causing more severe illnesses.

Most important: I repeat, most important: never drink anything for at least 15 minutes before or after meals. Doing so destroys your stomach acid, which is the first step in chemical food processing.

After years of various tests, I finally found answers through live blood analysis, where you can actually see the presence of fungi and bacteria.

Maybe it was just the effect on me, but seeing the fungi swimming in my own blood on the monitor changed things.

Ultimately, this is a massive problem because very few people can break the habits that define modern life.

In some medical circles, this is recognized as a concrete disease: carbohydrate addiction, and the consequences are everything I listed above.

With this illness, the biggest hurdle is psychological—specifically, the addiction to carbohydrates.

Best regards.

It isn't just about fungi. Bacteria also cause problems (the ones that don't belong in the intestines).

A SIBO test identifies whether specific bacteria are present... however... typically, a SIBO test is paired with a gut microbiome analysis which, beyond just detecting various bacteria, also reveals the presence of different types of fungi.

SIBO - Small Intestinal Bacterial Overgrowth

It’s confirmed via a breath test after drinking a lactulose solution.

The gas produced by the bacteria passes through the small intestine into the bloodstream and is eventually exhaled through the lungs.

A breath test can come back positive for:
Hydrogen
Methane
Hydrogen methane Hydrogen-sulfide (as far as I know, there isn't a test for this specific gas available here in the States)

or a combination of the above.

SIBO is actually the underlying cause for 70-80% of IBS cases.

It’s mostly caused by impaired motility—basically, the gut slows down significantly following food poisoning.

Antibodies like Anti-CdtB and Anti-Vinculin start appearing, which attack the intestinal nerves, though there isn't a test for that locally.

The lines of defense are:
- Antibiotics like XIFAXAN (around $500, insurance won't cover it)
- Herbal antibiotics
- Elemental diet—consuming liquid nutrition to starve the bacteria
- FODMAP diet—this only helps manage symptoms, doesn't fix the cause
- Speeding up digestion, e.g., Iberogast
- Keeping a 5-hour gap between meals; no snacking in between

Reddit is an excellent resource for info.

This guy explained exactly what most people with SIBO go through:
https://www.youtube.com/watch?v=53f1gsRUxvY

Google Dr. Mark Pimentel; he's been researching SIBO in the USA for years.

I'm dealing with this mess myself. Symptoms started in late 2020, but I didn't get a diagnosis until December 2021 after bouncing between doctors who kept telling me "nothing is wrong, you're imagining it." The real issue is that SIBO causes symptoms that aren't even related to digestion.

Took XIFAXAN in January 2022, but saw zero improvement. In a few days, I'm trying again following my doctor's advice—don't stick to restrictive diets while taking the antibiotics.

steeljackal7 said:Has anyone done SIBO testing in Chicago lately? Google keeps suggesting the Amruš Clinic. Does anyone have experience there? I'd love to know about pricing, if it actually helped, what the test is like, etc..

Hi there. I was at the Amruš Clinic recently for a GI consult and a SIBO test.

I've been dealing with gastritis and then IBS for years now. A few months back, my gut pain got really intense for almost two months, which is why I finally went in. After going through my history and some questions, the doctor at the clinic concluded it was post-infectious IBS. He ordered a bunch of stool and blood work. Everything came back clear, except for SIBO—specifically an IMO (intestinal methanogen overgrowth).

The test costs about $60 and takes two hours. You just drink a certain liquid and blow into a tube every 15 minutes. That’s pretty much it.

After reviewing everything, the doctor suggested taking Duloxetine 4 for 4-6 weeks before a follow-up. The idea is to manage the pain and influence serotonin, since 90% of it is produced in the gut. Honestly? I wasn't thrilled about starting that, especially since the pain had already subsided.

But when the pain flared up again recently, I went back to him. I asked how we could treat the actual cause instead of just masking the symptoms. He then recommended a combo of antibiotics (rifaximin + neomycin) along with the Duloxetine.

Has anyone else tried this specific combination? I haven't started yet. I'm thinking about getting a second opinion before I dive in.

Hey,

Since I started this thread, I’ve noticed some new comments popping up—so I figured I’d drop a quick update. Maybe my experience can help someone out here.

It’s been over three years since my symptoms first flared up. I won't claim I'm "cured" from SIBO, but honestly? I've learned how to live with it so well that I don't even notice it anymore.

In my case, it's the SIBO-D type—basically an overgrowth of hydrogen-producing bacteria. I did my breath testing at a local clinic like Planned Parenthood, though I know places like Proimmun offer much more extensive testing if you want to go that route. Once the test came back positive, I went to see Dr. Milorad Opačić at the Amruš Clinic, and I’d definitely recommend him. He’s super professional and actually knows his stuff when it comes to SIBO. The gold standard antibiotic for SIBO-D is XIFAXAN (rifaximin)—the doctor mentioned it too—but there's a catch: it's not covered by standard insurance, so you end up paying a fortune to get it through the clinic, and even then, there's no guarantee it'll work. We decided to try an alternative route instead: taking Clavocin (1g twice a day for 10 days) paired with a strict modified low FODMAP/SCD diet for a few weeks during and after the meds.

For me, Clavocin was a total home run. Zero side effects, and my symptoms cleared up pretty fast. Looking back, my SIBO likely triggered because of some inflamed gums—I ignored the dental issues for way too long, and my dentist back then didn't seem to care, so I ended up with periodontitis. Interestingly, while I was on the antibiotics for SIBO, my gum inflammation completely vanished. It made me realize there's actual truth to that old saying about healthy teeth being half of your overall health (well, in my case, healthy gums). I finally got the periodontitis treated, and ever since I've stayed on top of regular checkups and better oral hygiene, my gut health has stayed under control.

The silver lining to this whole SIBO mess is that I’ve started living way healthier than I ever did before. I've learned a ton about nutrition and how the body actually breaks down and absorbs food. Now, I eat incredibly clean and feel better than ever. I watch what I eat, stay away from heavy gluten and lactose, and make sure my meals aren't overloaded with carbs beyond what my body needs. Proteins and healthy fats have been great—never had any issues with those.

One massive factor during my treatment was something called the Migrating motor complex (MMC) and how it behaves when you have SIBO. If you're curious, look into the connection between SIBO and a sluggish MMC. The bottom line is: for digestion to work, you need periods where the gut can just chill, break everything down, and finish its business before you shove more food in. When treating SIBO, sticking to a meal schedule is huge—you need at least 3–4 hours between meals. It’s actually better to do 4–5 smaller, spaced-out meals rather than 3 massive ones, and you absolutely have to resist snacking between meals. Intermittent fasting works too, but only once you've reached the stage where malabsorption has stopped.

I also did some nutritional counseling with a specialist at a private practice in Chicago, and I'd highly recommend them. They really understand the SIBO situation and were super thorough and helpful.

If I could give one piece of advice to anyone dealing with SIBO right now, it’s this: start researching and reading on your own. Focus on medical journals or verified literature, preferably from American authors. Unfortunately, here in the States, people don't talk about this enough, and a lot of doctors are practically clueless about it. Over the last few years, I've burned through hundreds of scientific papers, articles, and books just to figure things out for myself. At the end of the day, it's my health on the line—who else is going to take better care of me than me?

I'd suggest starting with this book: https://www.amazon.com/SIBO-Made-Sim.../dp/0306846160

That’s all I got for now—hopefully this helps at least a few of you get on the right track.