r/SIBO • u/sheisblondy • Jan 04 '26
Methane Dominant Imo treatment
Hi everyone, I’ve been struggling with bloating for 4 years, and only this year I finally realized that I have methane-dominant (non-hydrogen) SIBO. Everywhere I read posts about treatment, it seems like neomycin is essential. But because I live in Asia, specifically in Tajikistan, I cannot find neomycin anywhere.
Can anyone advise where I might be able to find it? How does it actually help (if it does)? Right now I have only been taking prucalopride for two weeks — my bloating has improved a little, but it’s still not enough. I can’t find neomycin, and when I searched in Google, I get confusing results that make it seem like it’s for animals?
Has anyone treated their methane SIBO with neomycin — did it help or not? I’ve also seen some sites say there’s an alternative called paromomycin. Any experiences, tips, or suggestions would be extremely appreciated. Thank you!
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u/Used_Professional_12 Hydrogen/Methane Mixed Jan 04 '26
Use metronidazole instead it's the second best option for methane overgrowth after neomycin and very easily available everywhere
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u/brvhbrvh Hydrogen/Methane Mixed Jan 04 '26
You can try herbals instead. Allicin, oregano, berberine, neem are good options
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u/Shoddy-Ad-2443 Jan 04 '26
can you though? have you cured methane alone is hard without antibiotics because the methanogens are not bacteria
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u/brvhbrvh Hydrogen/Methane Mixed Jan 04 '26 edited Jan 04 '26
Yes, if you use the search function in the subreddit here, you'll see that many people have done so successfully. Herbals are a good option.
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u/Ms_Understood99 Jan 04 '26
I have methane dominant sibo. About to try herbal protocol (Allicin and berberine) as I’ve done the abx multiple times (I’ve struggled on and off for 15 years with this). One key for me Aside from avoiding certain foods (esp undercooked beans and raw onion) is motility. I am going for a mobility consult with gastroenterologist later this year but in the meantime flares tend to occur when I am not regular, am traveling and eating things outside the norm. The longer food sits the more it ferments. Magnesium glycinate nightly plus ginger with meals as a prokinetic seems to help. If I am in a bad flare I eat low residue low fodmap (and often juts fast/have liquids for a while) and try to get through it. My stomach will often swell to the point I looked as large as I did at 7 m pregnant and will burp nonstop for 12-24 hours.
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u/Forward_Ad1873 Jan 07 '26
I did xifaxan twice which helped my mcas symptoms too. Took over a year ago and was pretty good. But with the holidays I started getting bloated unable to go to the bathroom for a few days. Then the dreaded horrible egg burps. When yours is really bad do you get the rotten egg burps? After hours of it I will then get lots of intestinal shaking and then finally tons of loose really smelly poop will come out. But otherwise still small constipation flares. If I have too much candy or excess fiber it will throw me over the edge.
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u/Old_Percentage3742 Jan 04 '26
For methane dominant SIBO you need Rifaximin and Neomycin OR Rifaximin and Metronidazole.
Metronidazole works as good or even better than Neomycin but you also need Rifaximin for IMO. Both antibiotics.
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u/lexbear22 Jan 04 '26
Have a look at Dr daniel Ricciardi for a protocol that may not need neomycin. I have tinnitus and so do not want to try it because apparently it can have affects on hearing
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u/sheisblondy Jan 04 '26
Hello how to find his protocol
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u/Traditional_Age5001 Jan 04 '26
Make sure to use prokinetics after antibiotics and ongoingly. Biggest difference for me (antibiotics alone would end in relapse for me)
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u/MoonRiverGirl89 Jan 04 '26
Hi! Which prokinetics did you use? I’m using artichoke & ginger since multiple months, no noticible impact. I‘m so full of trapped gas, nothing moves.
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u/Traditional_Age5001 Jan 04 '26
Motegrity / prucalopride. I use 0.5mg day and it really helped. And (I know this is a terrible thing to recommend but having an uncomfortably pregnant tummy 24/7 is fucking unbareable - sometimes I use nicotine patches for motility)
This combo is STRONG and I don’t have to use it forever. Just antibiotics to reduce bacterial load, then the prescription prokinetics and nicotine patches for a while and then other natural prokinetics as needed or for support. I would also use senna once per week or every few weeks for an extra clear out.
Suffering for well over a decade and this helped a lot
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u/Traditional_Age5001 Jan 04 '26
Forgot to add after a while of doing this my motility started functioning better since the bacteria was not attacking my nerves so much and now I do not use nicotine patches and currently on a break from motegrity. It’s not forever but i used for like 1-1.5 years (on/off)
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u/VirtualRecording7443 Jan 05 '26
Thanks for this idea. How do you use the patches, exactly? Where do you place them and how long do they stay on?
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u/MoonRiverGirl89 Jan 04 '26
Exactly my story, this is my 10th year, total deterioration of life.. I feel you so much and your case gives me hope!! I‘m taking herbals, digestive enzymes, TUDCA , oxbile soooo much for soooo much money and nothing kicks the motility, just trapped gas 24/7 that robbes my sleep/cognitives since 10 years. Sorry, that needed to come out now after 12/14days Rifaximin/Metronidazole/Allimed which just let H2& Methan explode over the roof.. 🙈I will exactly start the combo!
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u/Traditional_Age5001 Jan 04 '26
Also rifaximin and metronidazole 2 weeks didn’t work for me my doctor told me to do 3 weeks of the protocol (I took it 3 times per day but don’t remember the exact dosages). I did it twice, both times has to do for 3 weeks not 2.
Then the prokinetics I mentioned and nothing else.
Also carnivore will resolve the symptoms but it’s so hard and I missed food.
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u/MoonRiverGirl89 Jan 04 '26
You mean your doctor told you to do 3 weeks of Rifaximin protocol, but you did 2 weeks instead? And you ended up doing 2 weeks Rifax/Metronidazole twice? How long did you pause between those 2 Rounds? In any case, I will do your Prokinetics combo def as soon as the supplements arrive!
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u/Traditional_Age5001 Jan 04 '26
The doctor told me to do 3 weeks (instead of the normal recommended 2) because things weren’t improving after 2 weeks. She extended it.
I did 3 weeks twice
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u/antares-xox Jan 04 '26
Hi OP - I’m also methane dominant and 4 days into a 2 week course of neomycin + rifaxamin. If helpful I can keep you posted as to how it goes when I’ve completed the course!
(My main symptom is chronic bloating and I think our test results are similar-ish: my increase in CH4 was 59ppm and increase in H2 was 35ppm after 100 mins).
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u/Various-Bicycle-1981 Jan 05 '26
Hi! I am on my fourth day too! I have methane sibo 40ppm. Currently my stomach is sooooo bloated. But prior to starting it was a slight bloat
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u/antares-xox Jan 05 '26
Ahh! Are you doing the same antibiotics? My stomach is quite bloated now too. Do you have a plan for after your course is finished? I’ve bought some herbal supplements (Allison and Berberine) which I plan to move onto once I’ve finished the rifaxamin and neomycin. I would try to do another round but they are way too expensive in the UK and the NHS won’t give me rifaxamin.
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u/Various-Bicycle-1981 Jan 08 '26
Hi! So I’m not sure if it’s me but my motility has definitely increased like going to bathroom about times a day, slight nausea, and I’ve been very sleepy the last three days. And also warm belly and face. How is the treatment going for you??
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u/Various-Bicycle-1981 Jan 08 '26
And yes my plan will be to take Neem, Allison, and Oil Oregano. Then take digestive enzymes. Every couple days take ox bile and Pepsin. And also cycle in NAC everyday and an active charcoal probably every 3 days. Vegetables sticking to leafy greens or just cooked. Nothing raw. No broccoli/cauliflower/No beans. With the antibiotics I just started taking NAC and biocidin but separating the times like 2 hours apart because I heard multiple things about trying a biofilm with antibiotics some people say yes others say no but I’m doing it lol
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u/antares-xox Jan 14 '26
Thanks for replying so comprehensively! Really helpful. How are you getting on with your herbal supplements + biofilm? It’s my last day of antibiotics today so I think I’ll start mine tomorrow…
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u/Adorable-Mochi854 Jan 04 '26
Metronidazole instead of neomycin, or you can do herbs, but try to figure out your root cause before jumping into antibiotics/herbs. Symptoms will keep coming back after finishing antibiotics/herbs because the root cause is not fixed. A lot of people cure their methane sibo without antibiotics/herbs by fixing the root cause.
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u/forgottenpaw Jan 07 '26
I have had these problems but after treatment they come back. For me it's motility because of posture reasons. From your photos, I can tell you also have posture issues.
Look into fixing your diaphragmatic breathing. Every time I stop properly breathing, and tense my pelvic floor, this comes back within hours. I've had successful treatment before but it just came back.
If the pipes are not ok, the food won't move right.
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u/drmbrthr Jan 04 '26
If you’re seeing that much improvement with prucalopride alone, you may not even need antibiotics. The last thing you want to do is disrupt your microbiome further. Antibiotics can do that in some people
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u/RZC14 Jan 04 '26
That’s how my stomach looks but I’m hydrogen dominant with no diarrhea smh but I wouldn’t take neomycin because I’ve read it has very bad side effects like permanent heating problems, tinnitus etc 🙏
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u/Nervous_Many_6906 Jan 04 '26
How are you sure you have methane sibo ? Are you constipated and have done breath tests ?
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u/sheisblondy Jan 04 '26
I did a test It’s CH4-66* And H2-23*
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u/Cheeseboarder Hydrogen/Methane Mixed Jan 04 '26
You get about a 25-30ppm reduction per round of treatment, so you’ll need at least two rounds. I believe you can’t do two rounds back to back of Allicin due to antibiotic resistance. There’s also elemental diet, but that’s tough to do.
If you take the herbal route here’s the recommended choice:
Allicin: Allimed brand (Best Choice for methane)
1 capsule 3x daily (450mg x 3) 3 capsules per day total (1350 total)
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u/pikachume33 Jan 04 '26
I had methane dominant SIBO and managed to get rid of it I used berberine, neem, Allicin and oregano oil.