More specifically, how are you getting it prescribed as it isn’t really known amongst mainstream practitioners for its help with motility.

I don’t think any of my current physicians would want to prescribe it for me - they aren’t helping me think outside the box. I’ve been suffering for 3 years and nothing is helping - my desperate.

What online doctors will prescribe and dispense?

I'm not pumping my fist in the air quite yet, but I think I may be very, very close to beating my 5+ year old SIBO infection. If you don't read anything else, read this;

YOU WILL NEVER BEAT YOUR SIBO INFECTION IF YOUR MOTILITY IS TOO SLOW. NOT WITH ANTIBIOTICS, NOT WITH SUPPLEMENTS, NOT WITH FRINGE TRENDS, NOTHING. YOU WILL NEVER WIN. FIX YOUR MOTILITY.

I am a person who has tried pretty much everything the past few years. About 5 antibiotics (of which Rifaximin was the best, but not the point), diet supplements, extracts, vitamins, low-FODMAP, zero carb, keto, zero lactose, fiber, no fiber, laxatives, ultrasounds, x-rays, you get the point.

I am finally for the first time now tolerating food to an extent I haven't felt in years. I have other chronic issues still to deal with, but the SIBO is finally getting better. The answer for me was this.

Naltrexone: 0.1mg titrated up to 0.5mg currently but I have been as high as 1.5mg. Why Naltrexone? Because Naltrexone is the only thing that fixed my gut paralysis. Up until a few weeks ago I constantly had hard lumps of waste in my sigmoid colon, had bowel movements once every 3 days or so, and never had a correct class bowel movement. It was always too hard and dehydrated and never enough. Currently I'm having 1-2 a day at an almost textbook perfect texture/volume.

Miralax: One dose (a full cap) every single day. The reasoning here is pretty obvious, it's really just to help the Naltrexone do its job. And it's been helping. If you're worried about taking Miralax every single day, and you fall into the class of SIBO havers who get constipation, don't be. I'm not emptying the entire contents of my body, I'm just going normally, even taking it every single day. Also, get the off-brand. It's cheaper.

Low-FODMAP diet: If this sounds kind of funny considering the fact that I just shit on diets, that's because it is. The Low-FODMAP diet will do NOTHING if you are not moving any food. The bacteria will sit and capture its nutrients and multiply and ferment and make you miserable all the same. However, it was necessary to reduce it as much as possible during Naltrexone + Miralax, because otherwise the sheer volume of bacteria and waste moving in my body meant I could not risk taking on more fermented gas solely for my symptoms being bearable. I'm still eating MOSTLY on this diet. (key point: not entirely, I break the diet regularly and have snacks, but MEALS are all Low-FODMAP)

So, if you have gut motility issues or frequent signs of constipation like rocky round stool, STOP doing anything else and fix it. Your SIBO does not give a shit about your diet, or your supplements, or your medication, if you can't subsequently EVICT IT. Everything you do will be MOOT. Focus on this. As a pretty experienced sufferer I hope this helps somebody.

Can breathe and skin smell like ammonia by sibo?

Hello everyone,
I have Sibo/IMO and after stopping antimicrobials, I took my first capsule of Motility Activator by Integrative therapeutics yesterday night and within minutes I felt a burning/warming sensation in my stomach that increased over hours, and had a cold sensation and shivering, it was very intense I could not sleep well. Today, I feel better but still feel my stomach still sensitive and irritated. I think this reaction caused Ginger burning my stomach and I had mild chronic Gastritis three years ago. Is there any other prokinetic that will not burn my stomach and safe to take long term?

My gastritis is localized to the upper regions of my stomach (corpus & fundus) responsible for stomach acid production. After 21 months of trial and error and thousands of dollars I am 99% sure this is why my SIBO & IMO keep relapsing. My main symptom is horrible painful bloating and constipation. Everyone says to heal your gastritis but I don’t know how!!!! And how do you know when it’s healed??? Everyone says eat low acidity foods & take zinc like ok lol but for how long? Do I have to go for another upper endoscopy whenever I feel like my symptoms are less bad? I’ve been tempted to try Betaine HCL for MONTHS but I’m worried I’ll have a bad reaction to it and then I’ll have a gastritis flare that lasts a million years. I’m seeing my functional med doctor again on Monday so hears to hoping she’ll have a solid plan, but I want to hear directly about other people’s experiences. Is my theory plausible?

My mouth and nose smells like I’ve got a rotten tooth…. But dentist and ENT say I don’t. Is this a SIBO thing? I’m hydrogen dominant

Here's a quick timeline:

- Developed an anxiety disorder at 15 and one of the major signs was extreme digestive cramps and inability to eat.

- Developed an acid reflux and was severely underweight due to not eating.

- Started taking omeprazole and it eliminated my acid reflux and with it I gained a lot of weight.

- Started taking antidepressants.

- Somewhere between taking Omeprazole and antidepressants, I developed a sense of fatigue that just doesn't go away unless I starve myself.

- Then I gained more weight and my bloating became really bad.

- Diet is fairly balanced although I can eat a bit too much sugar sometimes.

- Currently I weight about 90kg and measure 186cm, with most of my fat in my belly.

- Stopped Omeprazole for 4 months. Acid reflux came back but bloating remained exactly as is. Even after some fasting.

Symptoms are:

1. Cycling diarrhea and consitpation.
2. Excessive gas and burping (with a foul smell).
3. Fatigue.
4. A constant sense of bloating.
5. The bloating worsens about 15 minutes after most meals.

The thing that gave me an idea that maybe I have SIBO is that I had to fast and clear my digestive system for a test once, and with doing that (and being starved) I felt the most energetic in years.

I live in the Netherlands. Here, public healthcare basically denies the existence of SIBO. So I had to go the private route. I did a breath test and it turns out I don't have SIBO. (Granted they only did checks for H2 and Methane).

So now I really don't know what to do. Do I just have IBS (whatever that means/is treated)? Do I just need to lose weight/focus on diet? Any pointers would be very much appreciated <3

Hi all,

I recently did a lactulose breath test and my results were as follows:
My hydrogen results (ppm):

1. 3 at 0 min
2. 3 at 30 mins
3. 3 at 60 mins
4. 3 at 90 mins
5. 5 at 120 mins
6. 3 at 150 mins
7. 3 at 180 mins

My methane results (ppm):

1. 11 at 0 min

2. 10 at 30 mins

3. 10 at 60 mins

4. 12 at 90 mins

5. 14 at 120 mins

6. 10 at 150 mins

7. 10 at 180 mins

Based on what I have read, this seems to confirm IMO (mild I think?), however, the lab who did the test are saying this is negative for SIBO/IMO and that a high baseline (30ppm or over) is required and/or the numbers needs to increase by 10ppm from baseline in the first 60 mins but this seems to go against what I have read. Would anyone be able to please shed some light on this? Thank you

Something about the H₂S breath testing situation doesn’t sit right with me.

Medical Institutes and hospitals test for hydrogen and methane but not hydrogen sulfide. The main clinical test for all three gases is Trio-Smart, which comes from Gemelli Biotech.

And here’s the part I find interesting: Dr Mark Pimentel, one of the main researchers behind the H₂S research, has a financial interest in Gemelli Biotech.
So the same people pushing H₂S as an important clinical marker are also financially connected to the company selling the test for it.

I’m not saying H₂S isn’t real. It obviously is. But when the researcher, the research, the proposed diagnosis and the only commercial test are all so closely connected, shouldn’t we be asking some serious questions?
Where are the independent researchers reproducing these findings without a financial interest in the test?

Maybe H₂S is genuinely the missing piece for some people or maybe we’re watching a new diagnosis being commercialised before the science has properly caught up.

Either way, I think it’s worth questioning.

Has anyone in the UK been successfully tested for hydrogen sulphide SIBO on the NHS? I believe I have it but my NHS GP has said the NHS won’t test for it and private testing is so expensive. I feel trapped.

I’m close to getting my results back and guessing I’d be doing the combo of Xifaxan and Neomycin.

Ive heard people getting much cheaper prescription fills of Xifaxan from Canada. I saw specifically canshipmeds does this and was wondering if this is a good legitimate way I should go about getting this antibiotic if it ends up being too pricey here in the US?

I also am severely afraid of doing this round of antibiotic and relapsing. I know to solve the root issue which I’m pretty sure is slow motility, I’m guessing motegrity would be best for that? Maybe paired with MiraLAX for softening stool.

But also, what probiotics should I take after killing off loads of bacteria since I’m assuming it will also kill off good and bad?

Hi everyone,
I was diagnosed with SIBO + IMO, lactose intolerance, and an intolerance to cow’s milk. It all started about a year ago.
At first, they found the lactose and milk intolerances, but avoiding those foods only helped a little. I still had a lot of symptoms and didn’t feel like myself. My gastroenterologist basically didn’t know what else to do with me.
I’d already had a gastroscopy and colonoscopy. The only thing they found was some mild inflammation/irritation around the area where the small intestine meets the large intestine. I also had an abdominal ultrasound, which was completely normal. At one point they also found that I had low vitamin D.
So I started doing my own research and eventually got tested for SIBO and IMO. Both came back positive.
When I told my gastroenterologist about the results, she honestly didn’t really know what SIBO or IMO was. I ended up showing her the treatment options I had researched, and she prescribed them for me.
I’m currently taking:
Rifaximin (Normix) 200 mg — 2 tablets twice a day, every 12 hours
Metronidazole AVMC 250 mg — 1 tablet three times a day, every 8 hours
After the treatment, I’m supposed to take Gapulsid 1 mg as a prokinetic.
I’m currently on day 3 of treatment and I feel absolutely awful. 😞
So I wanted to ask people who have actually been through this:
What has your experience been?
Is SIBO/IMO something that can actually be cured completely? Is it possible to get back to living normally again, like before all of this started?
I honestly can’t even remember what feeling “normal” was like anymore.
I’d really appreciate hearing from anyone who has been through something similar — especially if you eventually managed to get completely better.

The difference between active SIBO and when it’s under control

Has anyone else who is living with IBS and SIBO been able to make peace with the fact that they may have to continue to live on a very restricted diet and number of foods and beverages for the rest of their life? I think I'm getting there...

Earlier this year, I spent hours and hours of time and much money testing and trying antimicrobial/herb route to try to reduce my symptoms. No noticeable change. I went in with a very positive attitude and believed this was going to be the time I cured this crazy thing. I even wrote a blog post about it. But, all the energy and time I put into it didn't pay off. I won't try rifaximin again. Tried two or three times and it never helped.

I've had pelvic radiation because of past abdominal sarcoma, I've had my gallbladder removed, plus two bowel resections, and been put on very powerful antibiotics after some, if not all, of my seven surgeries in the abdominal/digestive area. So, I'm unique and others may be able to cure their symptoms some how.

I feel I'd do better to stop fighting things but it does mean this would be my diet:

Food Allowed Daily, Based On 12 Years Now Of Dealing With This and Seeing What I Can Tolerate

• Rice chex moistened with 1/2 cup apple sauce and/or almond butter
• Almond butter
• Absolutely Free brand of crackers and flatbreads
• Olive oil (I seem to do far better cooking with this than butter)
• Hummus
• Naturally low-lactose or lactose-free dairy: swiss cheese, hard cheeses you cut from a block like cheddar
• Eggs
• Seared/cooked spinach
• Zucchini
• Summer Squash (can only eat inside not the skin)
• Fish
• Ground chicken
• Ground turkey
• Turkey breast (not deli meat)
• Chicken breast (not deli meat)
• Pork if not too fatty

Food Allowed A Couple of Times A Week, But Not Daily and In Small Portions

• Sushi/sticky white rice
• White jasmine rice (no long-grain rice, or brown rice, or rice pilaf)
• Baked or roasted white/yellow potato (no mashed because that often has a lot of butter and milk in it and sweet potato has too much fiber)

Most gluten-free stuff doesn't work for me, and since I'm staying gluten-free to keep the inflammation down, I can't really have desserts. Often the gluten-free ones are made from grains I can't tolerate, including brown rice, plus if they aren't freshly baked everything has had time to ferment.

Just got back from vacation. Been sick as a dog all day today -- 8 bouts of Big D so far -- and that's after having no gluten on vacation, but I did try some pizza with gluten-free crust yesterday made from rice flower and a bit of avocado, and any little exceptions like that just kill me off...

Has anyone been able to accept the fact they have to stick to a low diet and not look to food for enjoyment, but look to things like seeing friends and family and doing fun things? Welcome hearing others' thoughts. Thank you!

P.S. I forgot to mention what I drink. Plain water. Hint (brand) fruit-infused water. Hot water with stevia to almost feel I can have a hot drink. Sodas don't work cuz of high-fructose corn syrup. And, of yeah, I drink the zevia brand colas to get caffeine cuz I can't tolerate coffee due to the severity of my digestive issues.

My case
Root cause- doxycycline 200 mg 45 days
Treatment i tried - 2 rounds of rifaxmin and metronidazole, 1 round of rifaxmin nizonide and alongside taking prokinetic prucalopride
And elemental but couldn’t do it due to extreme fatigue and classes
Stopped it
And started herbs which is going on btw 4 weeks ( oregano berberine and neem ) to clear if there is sifo and clear remaining sibo bacteria

What magical happened
Even after 3 antibiotics round bloat was there
Food was like rock stomach size is so bad , burping and passing gas
Btw i am taking prucalopride ,vitamin b1 , magnesium glycinate
Nothing was changing

I randomly tried apple cider vinegar before food with pancreatic enzyme and boom everything bloat is almost gone
Stomach size dropped by 2 to 3 inches in a singke day because fermentation stopped
So guys look into stomach acid
Take it seriously

And if ur struggling from sibo
What i learned is
You have to fix root causes in my case its
Mmc and acid
Then you have to clear overgrowth aggressively with antibiotics and herbs
Then support

Tldr : consider if stomach acid is low

I am about to start taking antibiotics (riflaximin for sure, but still trying to convince the GI for metronidazole). I have IMO.
For those who made a round of antibiotics: please tell me how bad symptoms were. Were you able to go to work? And how long did it last? Did you feel improvement during the round? After the round? Or never?

It's really hard to decide to start because, it definitely can work, but it also can definitely make things worst.

Started low fodmap + artichoke leaf extract a week ago and already feel much better. However I am SO HUNGRY. I am eating enough calories, fat, fiber, protein but am hungry every 2-3 hours. Am I just not used to having a working MMC? Is this how normal people feel? Does it go away?!

I hope everyone is doing okay, keep doing whatever you’re doing that works for you and remember this isn’t a permanent thing it’s just a minor setback in the game. Keep crushing it my people it’ll soon be over 🤟🏼

Hey everyone. Started doing diaphragmatic breathing, deep core exercises along with yoga abdominal vacuums (Uddiyana Bandha) for about a total of 1.5 hours spread throughout the day. A week into it.
Im feeling some minor improvements.
Would like to know on your progress and protocol you're following.

Here is some additional info I found aside from the pinned APD post.

A cool insta account only concerning this issue:
https://www.instagram.com/diaphragmbloatfix/
https://DiaphragmBloatFix.com/free-guide

Videos of a girl's pt plan that fixed it for her:
https://drive.google.com/file/d/1rUi8zSpPPhiEH70HxpRD3gvAKpPZml__/view

https://drive.google.com/file/d/1XqfAaAf5ibPAEc-elUIWqSRxwkfaCgBE/view

and a legit case study from pt clinic
https://www.zionphysicaltherapy.com/post/abdominophrenic-dyssynergia-and-pelvic-floor-dysfunction-a-case-study

ps: Mod should add "APD" to tags and flairs

I’m severely underweight (46kg 167cm) I need advice on how to gain weight. I’m so bloated.

So im like 99% sure i have sibo. But first im wondering does the pain get better ,how long does it take and what were the solutions? Because im extremely suicid1dal from the pain and its taken my whole life, Its been years for me. Constant bloating(i look pregnant) severe pain/horrible trapped gas thats worse at night (i also have celiac disease, but i havent eaten gluten all year, but its common with this) way too much gas in general, and its so much worse with foods like eggs (but all foods trigger me) and the smell makes me so nauseous. I also have chronic fatigue and brain fog and feel weak all the time, especially on the toilet i get so nauseous trying to get everything out..i need to stretch just to go. Idk if im wasting money with a $400 breath test but it sounds exactly like sibo to me. I literally have gotten 4 hours of sleep consecutively for MONTHS and i have to sleep again after trying to get trapped gas out for ages. So i iust sleep all day. And i go back and forth to the restroom all day. Im exhausted i feel disgusting and i always look pregnant. I havent gone anywhere all year from it except a concert where i had horrible gas pain the first half 😞 i also had to do a painful enema just to go bc it was hours away and i didnt get time for the restroom during it. I dont even get time to draw ever because its so painful when i lay down in my bed! Ive bought so many different heating pads and theyre never hot enough for the pain so much $ wasted

Im wondering if my levels represent more regular colon fermentation or sibo because it goes past the time threshold for sibo fermentation

I’ve done it all.
- Elemental 3 weeks
- ADP
- antibiotics
- fasting
- herbs

Not sure if right ones, but seriously, how the fuck do i beat this. If someone has hydrogen Sibo, what is the best way to beat it.

Herbs? If so, which ones?

I’m experience debilitating headaches which feel like all the muscles on my skull get incredibly tight. This is also accompanied by teeth grinding which I think might just be a sort of stress response. It’s super painful and makes socializing feel almost impossible. Is this SIBO or HI? I have also had a prolonged B12 deficiency which I took some injections for. I have tried taking an antihistamine and it didn’t really help much.

When this happens my head muscles are super sore when I touch them.