SIBO Treatment for Weight Loss

Having gas and being bloated can certainly make you feel like you’ve gained abdominal fat, but does it mean you actually have? Recent evidence indicates yes.  The connection is a condition known as SIBO, or Small Intestinal Bacterial Overgrowth. SIBO can cause gas, bloating, abdominal pain, constipation, diarrhea, or both. Recent studies have been published correlating SIBO and being overweight or obese. And, most interestingly, after treating SIBO certain evidence has shown the ability to boost metabolism via lowering cholesterol and improving blood sugar levels.

What might this look like in the real world? In this video, I sit down with one of my patients who we recently treated for SIBO and who experienced fairly dramatic weight loss and improvement in her cholesterol levels in addition to vastly improved digestion. This is probably not the next weight-loss panacea, but I believe if handled the right way this may garner welcomed weight loss for those who have troubling digestive problems.

[Continue reading below]


Dr. Michael Ruscio: So hi, this is Dr. Ruscio. I’m here with Chris, and this is my first remote patient conversation. So thank you, Chris, for taking a moment. You had a really interesting case that ties in with something that has recently been published regarding SIBO.

We diagnosed you with both methane positive and hydrogen positive SIBO. And we had been treating you for that. And we had to do two rounds of treatment to fully eradicate it. And we still don’t know yet if we fully eradicated it because we’re just about to do some retesting. But based upon your symptoms which are really, really, really improved, I think we’re probably clear.

Treating SIBO

But there was one improvement, in particular, I wanted to kind of showcase for people that I think will be interesting. But before I jump into that, can you kind of share what changes you noticed as we’ve treated your SIBO?

Chris: Well, part of the problem was that I was on Prevacid for ten years.

DrMR: Sure.

Chris: That was a hard one to wean off. I think that might even be the cause of having the SIBO in the first place.

DrMR: Right.

Chris: So I went through a weaning off period of the Prevacid. And actually, I didn’t have too many problems with any acid reflux or any gas issues that came up from that. But you had put me on a treatment to kill off some of the SIBO or control the numbers of bacteria. And it seemed to help just control some of those gas symptoms.

DrMR: Yeah, so some of your typical gas, bloating. And I believe you were more so on the side of constipation. Is that—?

Chris: Yeah, my whole system seemed slow.

Weight Loss Results

DrMR: Right. Yeah, and then not to get too graphic. But a lot of people I’m sure are dealing with these same symptoms. So it’ll be interesting for people to hear. And there was one other symptom, in particular, you didn’t mention which is weight loss. And you had lost—was it 53 pounds at last?

Chris: Yeah, since we started, I guess the middle of April, I’ve lost 53 pounds.

DrMR: Yeah.

Chris: And part of that is from using the autoimmune paleo diet which helps too.

The autoimmune paleo diet is extremely helpful for weight loss. We see in the clinic, this initial weight loss from the diet. Click To Tweet

DrMR: Yeah. And so certainly I wouldn’t attribute all this to SIBO.

Chris: Right.

DrMR: The autoimmune paleo diet is extremely helpful for weight loss. We’ll see in the clinic, this initial weight loss from the diet. And then people kind of level out in terms of, okay, they’ve kind of exhausted how much weight loss they can get from a diet. And you seemed to start going through that deceleration of weight loss.

Chris: Right.

Improved Metabolism & Cholesterol

DrMR: But then we started treating SIBO. And you got another boost. And where that ties in with everything and what I wanted to discuss briefly is it has been published recently that people who have hydrogen and methane SIBO together actually correlates with increased weight gain. And treating the hydrogen and methane mixed-type SIBO has been shown to lower cholesterol levels and improve metabolism.

And so I think that was exactly what happened with you because 53 pounds—that’s a good amount of weight to lose. And that’s more than I typically will see with the paleo diet alone. And especially with your frame, you’re not a super large gal. So on your frame, that’s a lot of weight loss. And so, yeah, I thought that was interesting.

And that definitely correlates. As you achieved that additional weight loss, you also saw your digestive symptoms get a lot better too.

Chris: And my cholesterol levels are now in normal range whereas before they were above normal.

DrMR: Right. Right.

Chris: So they had brought those down too.

DrMR: Yeah, so you were a perfect case for this recent finding. So yeah, just wanted to kind of get a moment with you to share that with people. And that’s pretty much all I wanted to chime in. Is there anything else that you noticed that you think is worth mentioning?

Chris: Regarding SIBO?

DrMR: Yeah, or anything you’ve noticed over your treatment.

Chris: Well, I’ve noticed great changes. I’m able to sleep better, got my thyroid levels more in the optimal range.

DrMR: Right. Right.

Chris: Since I have Hashimoto’s, that has been a challenge. I think I’ve boosted up my metabolism to finally working again. I think it was completely stalled before.

What do you think? I would like to hear your thoughts or experience with this.

Discussion

I care about answering your questions and sharing my knowledge with you. Leave a comment or connect with me on social media asking any health question you may have and I just might incorporate it into our next listener questions podcast episode just for you!

104 thoughts on “SIBO Treatment for Weight Loss

  1. Hi Dr Ruscio,

    Do you feel lactulose or glucose is the best substrate for the breath test? i have had 3 negative breath tests with lactulose and am going to try glucose next but i feel my bloat stems from the lower part of my small intestine so not sure if all the glucose would be absorbed. do you think it may be usefull to consume both the glucose & lactulose sugars together? thanks for your time and happy new year

    Jason

    1. Hi Jason,
      They can both work, being mindful of the cutoff time for lactulose can help prevent a false positive. You may want to speak with your doctor about simply trying a SIBO treatment instead of spending more time/money on testing.
      Hope this helps!

      1. Thanks Dr Ruscio- im working with a few people now but still not getting answers. what are the best botanicals for treating SIBO in your opinion? also do you feel s.boulardii can be helpful? i find it helps with my bloat but also causes constipation.

        Happy New Year

        Jason

  2. Oh my God. I’m almost 100% certain that small bowel bacterial overgrowth is my problem. And I’m almost certain it is the methane variety. My stomach is always bloated, I’m constipated, and I’ve gained a lot of weight. And I’ve been exercising, cutting my calories, and drinking plenty of water. All measures that have resulted in weight loss before. I suggested this to my doctor, but he prescribed Amoxicillin. I know that is not the right antibiotic for. Can you tell me what is the best antibiotic to treat it? Thank you.

    1. Hi Frank,
      You will want to check in with your doctor on this, but Rifaximin and Neomycin are two to discuss potentially using together. This is if you have methane type SIBO.

  3. Hi Dr. Ruscio,

    I was finally diagnosed with SIBO after dealing with one health issue after another for years! The ND that I was seeing started me on 500 mg of Berberine 3x/day. After about a week I completely lost appetite, was constantly nauseated and then started vomiting. He took me off Berberine and started me on his own Essential Oil protocol – basically ingesting 9 drops of three different kinds of doTerra essential oils for 21 days and then 3 other kinds of oils for another 21 days. I’ve looked for studies to support this kind of treatment but did not find any. Because it did not feel right to me, I did not start ingesting these oils and while I am waiting to get in to another ND, I started myself on Biotics protocol. Currently I am taking 5 tabs of A.D.P (oregano), 2 caps of Dysbiocide and 2 caps of FC Cidal 3x/day.
    Dr. Ruscio, I’ve listened to you on multiple podcasts and would like to hear your opinion on treating SIBO with ingesting essential oils? Is that insane or is there any solid supportive evidence out there that you came accross?
    Thanks so much!

    1. Hi Rasa,
      I have not seen anything published using essential oils, but that does not mean they are ineffective. However, because we have other, well-studied treatment for SIBO I prefer to focus on those. Hope this helps! If you hit a roadblock feel free to contact my office for a Skype consult.

  4. Can u help live un scotland & doctors no nothin of sibo ave been reaky bad with acid & kept givin me ppi meds came of them but still got it cinstipated realy bloated even with water weight gain & there sayin its fibromyalgia its got me down as its all thats on my mind & stressin me out

      1. My niece has bad problems with fibromyalgia do you help with that or recommend anything she is only in her late thirties and used to be full of spunk and has children to keep up with what is your suggestions?

  5. Can u help live un scotland & doctors no nothin of sibo ave been reaky bad with acid & kept givin me ppi meds came of them but still got it cinstipated realy bloated even with water weight gain & there sayin its fibromyalgia its got me down as its all thats on my mind & stressin me out

      1. My niece has bad problems with fibromyalgia do you help with that or recommend anything she is only in her late thirties and used to be full of spunk and has children to keep up with what is your suggestions?

  6. I was just diagnosed Monday for SIBO. I have always been small until about 3 or 4 years ago. ALL of a sudden I ended up gaining 30 to 40 pounds. I felt like I was carrying a baby elephant!! Am just getting ready to start my meds tomorrow. My question is will the meds help in losing all of this unwanted weight gain? I also have been on Medium for years now due to having Barrett’s esophagus and it is my life saver. Have run out of them a couple of times and fell like I was dying. Will I have to give that up?

    1. Hi Debbie,
      Not everyone who treats SIBO loses weight, but many do and for some the loss is substantial. You may have improved reflux also, but you will need to seek guidance of a clinician to determine if you can come off and/or for monitoring.
      Good luck!

  7. Hello doctor Ruscio, I was just diagnosed with SIBO and really need to lose weight. I feel guilty because I gained back 65lbs 3 years ago after having very successful Bariatric bypass surgery. The weight gain happened in 6 months and I don’t over eat. I went from a size 4-6 to a 16. How can I get back to my dreams of success and beauty?

  8. Hi, Dr. Ruscio I’ve been suffering significant weight loss after treated for acid reflux and taken Pantopropraxole PPI for 4 months. Started constantly belching after the day of starting PPI. Now that I’m off of it. I have gas trap pain in my upper right rib cage every time I drink a high fructose drink or eating non organic foods with preservatives. The doctor told me it was due to low acid and was put on HCL Betaine. Helped a little but still have belching and upper right rib pain/trapped gas. Went to a ultrasound and was negative for gallbladder stones or infection. I’m thinking it’s IBS/SIBO related?

  9. Hi, Dr. Ruscio I’ve been suffering significant weight loss after treated for acid reflux and taken Pantopropraxole PPI for 4 months. Started constantly belching after the day of starting PPI. Now that I’m off of it. I have gas trap pain in my upper right rib cage every time I drink a high fructose drink or eating non organic foods with preservatives. The doctor told me it was due to low acid and was put on HCL Betaine. Helped a little but still have belching and upper right rib pain/trapped gas. Went to a ultrasound and was negative for gallbladder stones or infection. I’m thinking it’s IBS/SIBO related?

  10. Can you please tell me what method you used to treat the SIBO? I have gone through 3 rounds of antibiotics, paleo diet, low carb diets, thousands spent on acupuncture and supplements. I also have high cholesterol and am overweight. I am positive for both methane and hydrogen SIBO.

    Pretty desperate here.

  11. Can you please tell me what method you used to treat the SIBO? I have gone through 3 rounds of antibiotics, paleo diet, low carb diets, thousands spent on acupuncture and supplements. I also have high cholesterol and am overweight. I am positive for both methane and hydrogen SIBO.

    Pretty desperate here.

  12. Dr.Ruscio

    How do you treat SIBO in children and toddlers if they cannot do breath tests or we cannot judge their improvement completely? Also what botanicals or medicines would you prescribe for kids with SIBO.Do kids ever get SIBO ?? If so have you seen a lot of it among obese kids? Sorry for so many questions.Appreciate your website and the regimens,protocols.They are very effective per patient reviews,research and studies in the natural world…..

    1. I usually don’t test but treat empirically. Start with diet, then probiotics, then considering herbal antimicrobials. See my book for protocols, but use 1/2 to 1/4 dose for children or toddlers. Can’t say I’v seen an association to obesity, but we know it exists in adults.

  13. Dr.Ruscio

    How do you treat SIBO in children and toddlers if they cannot do breath tests or we cannot judge their improvement completely? Also what botanicals or medicines would you prescribe for kids with SIBO.Do kids ever get SIBO ?? If so have you seen a lot of it among obese kids? Sorry for so many questions.Appreciate your website and the regimens,protocols.They are very effective per patient reviews,research and studies in the natural world…..

    1. I usually don’t test but treat empirically. Start with diet, then probiotics, then considering herbal antimicrobials. See my book for protocols, but use 1/2 to 1/4 dose for children or toddlers. Can’t say I’v seen an association to obesity, but we know it exists in adults.

  14. I was just diagnosed with SIBO and have taken Keflex now I have Flagyl then he said 90 days of culturelle? I’m so bloated my stomach looks pregnant and it’s making my depression awful. Can anything help the bloating and how do I know if the medicine is working? Thank you so much

  15. I was just diagnosed with SIBO and have taken Keflex now I have Flagyl then he said 90 days of culturelle? I’m so bloated my stomach looks pregnant and it’s making my depression awful. Can anything help the bloating and how do I know if the medicine is working? Thank you so much

  16. I have been struggling with my gut for almost a year. Finally did the stool sampling and enterobacter cloacae came back positive but I’ve since found out that everyone has this in their GI track. Could SIBO be an issue too? I’ve heard that the test for SIBO is not a very good one. I can’t lose the 15 pounds that I’ve gained this year with the gut issues. I’ve tried intermittent fasting, and eat extremely clean. My blood work suggests subclinical Hashimotos, which I think is related to my gut. I feel downright hopeless. The drs just kind of blow it off but the bloating, weight gain and gas are dampering my quality of life. Thoughts?

    1. Hi Amy,
      SIBO could be present. Improving your gut health may lead to weight loss, it’s not a guarantee but I’v certainly seen it. I would focus on getting rid of your digestive symptoms first, and seeing what weight loss is produced as a by product. The best resource I know of to get you symptom free is Healthy Gut, Healthy You. I would purchase a copy and go through the self help plan.
      https://drruscio.com/getgutbook/

  17. I have been struggling with my gut for almost a year. Finally did the stool sampling and enterobacter cloacae came back positive but I’ve since found out that everyone has this in their GI track. Could SIBO be an issue too? I’ve heard that the test for SIBO is not a very good one. I can’t lose the 15 pounds that I’ve gained this year with the gut issues. I’ve tried intermittent fasting, and eat extremely clean. My blood work suggests subclinical Hashimotos, which I think is related to my gut. I feel downright hopeless. The drs just kind of blow it off but the bloating, weight gain and gas are dampering my quality of life. Thoughts?

    1. Hi Amy,
      SIBO could be present. Improving your gut health may lead to weight loss, it’s not a guarantee but I’v certainly seen it. I would focus on getting rid of your digestive symptoms first, and seeing what weight loss is produced as a by product. The best resource I know of to get you symptom free is Healthy Gut, Healthy You. I would purchase a copy and go through the self help plan.
      https://drruscio.com/getgutbook/

  18. Hello,

    I was diagnosed with SIBO last summer after years of gut issues. I have tried herbal antibiotics and then tried two rounds of rifamaxan a nd I still have symptoms such as gas, bloating, fatigue, weight gain etc. My first breath test was negative but my symptoms all pointed to SIBO. My second breath test showed methane dominant SIBO. I wanted to know what else there is to do? herbal antibiotics and rifaxaman have not eradicated my SIBO. I have been trying to treat this for nine months now.

    1. Hi Mckayla,
      I understand how frustrating this can be. SIBO might be an issue, but other forms of dysbiosis might be present also. Addressing dysbiosis, plus finding the right diet for your gut, are two very important starting points. Healthy Gut, Healthy You provides the most comprehensive plan to improve gut health I know of https://drruscio.com/getgutbook/ I would go through the self-help plan the book contains. Hope this helps!

  19. Hello,

    I was diagnosed with SIBO last summer after years of gut issues. I have tried herbal antibiotics and then tried two rounds of rifamaxan a nd I still have symptoms such as gas, bloating, fatigue, weight gain etc. My first breath test was negative but my symptoms all pointed to SIBO. My second breath test showed methane dominant SIBO. I wanted to know what else there is to do? herbal antibiotics and rifaxaman have not eradicated my SIBO. I have been trying to treat this for nine months now.

    1. Hi Mckayla,
      I understand how frustrating this can be. SIBO might be an issue, but other forms of dysbiosis might be present also. Addressing dysbiosis, plus finding the right diet for your gut, are two very important starting points. Healthy Gut, Healthy You provides the most comprehensive plan to improve gut health I know of https://drruscio.com/getgutbook/ I would go through the self-help plan the book contains. Hope this helps!

  20. I was diagnosed with SIBO when I had a colonoscopy in 2016? Can you detect SIBO that way? I was on Rifaximin for 2 weeks I believe and never got any relief from it. I have been gaining weight, feeling bloated, it is uncomfortable to sit and hurts to lay on my stomach,.I have been doctoring with this condition for over 10 yrs now and no one can fix this problem. How long are you on this medication Rifaximin? Should the breath test be done? I feel like I am getting closer to figuring this out and more hopeful to start feeling normal again after all these years.

    1. Hi Stacy,
      No, not via colonoscopy. I would go through the self help plan in Healthy Gut, Healthy You. It’s the best treatment approach for SIBO I can point you to.

  21. Hi, I was diagnosed with SIBO (hydrogen) I am on Rifaximin (Tagart) and currently eating normally (to keep the bad bacteria active) would you say this is correct? I am going to a dietitian to discuss the FODMAP diet and try that as soon as I have completed the antibiotics. Do you think this is the correct way to go about it? Also would you recommend eating 2 or 3 meals as opposed to snacking / 6 meals, kind of like IF as it could starve the bad bacteria? thanks, J

    1. I don’t think you need to eat FODMAP while treating SIBO, but you can. My book walks you through every step of SIBO treatment. There is no one answer, but the book will help you personalize the available options.

  22. Hi, I was diagnosed with SIBO (hydrogen) I am on Rifaximin (Tagart) and currently eating normally (to keep the bad bacteria active) would you say this is correct? I am going to a dietitian to discuss the FODMAP diet and try that as soon as I have completed the antibiotics. Do you think this is the correct way to go about it? Also would you recommend eating 2 or 3 meals as opposed to snacking / 6 meals, kind of like IF as it could starve the bad bacteria? thanks, J

    1. I don’t think you need to eat FODMAP while treating SIBO, but you can. My book walks you through every step of SIBO treatment. There is no one answer, but the book will help you personalize the available options.

  23. How would you treat SIBO that is and will be reoccurring since it is caused from a total colectomy? Also, which diet do you recommend for treating SIBO and maintaining constant treatment?

  24. How would you treat SIBO that is and will be reoccurring since it is caused from a total colectomy? Also, which diet do you recommend for treating SIBO and maintaining constant treatment?

  25. Anyone with SIBO needs to try Atrantil. Changed my life for the better. I use it everyday now as a maintenance dose. Wouldn’t want to live without it. Basically a miracle supplement.

  26. Anyone with SIBO needs to try Atrantil. Changed my life for the better. I use it everyday now as a maintenance dose. Wouldn’t want to live without it. Basically a miracle supplement.

  27. This is an old post but I’ll see if I get a response anyway. How is it possible I have gained 7 pounds of fat over the course of a year (3-4 in the past month) while averaging 1000 calories a day? I ate 600 calories of vegetables with olive oil yesterday and put on 2 pounds overnight. What on earth is my body actually using to pump blood and keep my brain functioning if all this is *fat*? Surely that can’t be true in everyone’s case. I am at my wit’s end. I’ve had anorexia and this is my worst nightmare.

    1. Hi Kristen,

      Under-eating can actually cause our bodies to hold on to weight because the body doesn’t know when the next meal is coming and essentially goes into starvation mode, holding on to as much as possible.

      I would suggest upping your calorie intake as well as working with a professional, as it sounds like you could use some support.

      Good luck!

    2. I understand exactly where you are. I gained 20lbs over a couple months. I went on a strict 1000 calorie diet and started exercising 5-8 miles hiking, 6 days a week. After 6 weeks I was still the same weight. I have always suffered from gerd and constipation. But this was a new unacceptable reality. I started Atrantil and burburing this week along with a low calorie low fodmap diet. Hopefully it helps. Good luck to you… and know you are not alone in this depressing condition/ailment.

      1. Hi Brooke,

        I hope the SIBO treatment helps. As I mentioned above, under-eating (1000 calories is not enough) will not be helpful for sustainable weight loss. You may want to rest, eat plenty, and focus on gut health. I’d recommend picking up a copy of Dr Ruscio’s book “Healthy Gut, Healthy You” as it has a great DIY protocol to help with stubborn gut issues. You can find it here: https://www.drruscio.com/getgutbook Good luck!

  28. This is an old post but I’ll see if I get a response anyway. How is it possible I have gained 7 pounds of fat over the course of a year (3-4 in the past month) while averaging 1000 calories a day? I ate 600 calories of vegetables with olive oil yesterday and put on 2 pounds overnight. What on earth is my body actually using to pump blood and keep my brain functioning if all this is *fat*? Surely that can’t be true in everyone’s case. I am at my wit’s end. I’ve had anorexia and this is my worst nightmare.

    1. Hi Kristen,

      Under-eating can actually cause our bodies to hold on to weight because the body doesn’t know when the next meal is coming and essentially goes into starvation mode, holding on to as much as possible.

      I would suggest upping your calorie intake as well as working with a professional, as it sounds like you could use some support.

      Good luck!

    2. I understand exactly where you are. I gained 20lbs over a couple months. I went on a strict 1000 calorie diet and started exercising 5-8 miles hiking, 6 days a week. After 6 weeks I was still the same weight. I have always suffered from gerd and constipation. But this was a new unacceptable reality. I started Atrantil and burburing this week along with a low calorie low fodmap diet. Hopefully it helps. Good luck to you… and know you are not alone in this depressing condition/ailment.

      1. Hi Brooke,

        I hope the SIBO treatment helps. As I mentioned above, under-eating (1000 calories is not enough) will not be helpful for sustainable weight loss. You may want to rest, eat plenty, and focus on gut health. I’d recommend picking up a copy of Dr Ruscio’s book “Healthy Gut, Healthy You” as it has a great DIY protocol to help with stubborn gut issues. You can find it here: https://www.drruscio.com/getgutbook Good luck!

  29. My 2 year old had chronic constipation from the time she started solid foods at 1 year of age. This year she kept having sores in her mouth once every month and a half. She took a stool test last month and we found at that she has Dysbiotic/ Overgrowth Bacteria. She tested high in Bacillus spp, high in Pseudomonas aeruginosa, high in Streptococcus spp. She also has Potential Autoimmune Triggers: High in Klebsiella spp, and high in Klebsiella pneumoniae. She also has Fungi/ Yeast: High in Candida spp. The doctor we were seeing told us to look into SIBO. However, we do not know if she has SIBO because she was underweight to take the SIBO breath test. The doctor put her on a LOW FODMAP diet which is not helping. She is currently taking a product called Biocidin to help with the bacteria overgrowth.

    We were told by our doctor to do our own research and search on the internet for a vegan SIBO diet. We did and found no SIBO diet that is plant-based. A lot of meat is what makes up the diet in efforts to starve bad bacteria. We found a lot of info that is very confusing because one website gives a list of foods to avoid and another website says you can eat those foods. The info on the internet suggests different phases of the diet in which to eat certain foods. Our naturopathic doctor didn’t inform us about different phases in which to eat certain foods/phases of healing. She doesn’t know how to help us.

    There are no doctors or dietitians here in Hawaii that are knowledgable in dysbiosis. We don’t know who to call for help, we need a plan, we need to speak with a nutritionist. Our daughter will be 3 in January 2019 and only weighs 19 lbs. We are stressed out about her weight, her health, not knowing what to feed my daughter, not knowing how to help her and not being able to find help. Does your book share how to help children on a plant- based diet? Please help us. Your website says you have openings for new patients in June or July next year. That’s a long wait.

  30. My 2 year old had chronic constipation from the time she started solid foods at 1 year of age. This year she kept having sores in her mouth once every month and a half. She took a stool test last month and we found at that she has Dysbiotic/ Overgrowth Bacteria. She tested high in Bacillus spp, high in Pseudomonas aeruginosa, high in Streptococcus spp. She also has Potential Autoimmune Triggers: High in Klebsiella spp, and high in Klebsiella pneumoniae. She also has Fungi/ Yeast: High in Candida spp. The doctor we were seeing told us to look into SIBO. However, we do not know if she has SIBO because she was underweight to take the SIBO breath test. The doctor put her on a LOW FODMAP diet which is not helping. She is currently taking a product called Biocidin to help with the bacteria overgrowth.

    We were told by our doctor to do our own research and search on the internet for a vegan SIBO diet. We did and found no SIBO diet that is plant-based. A lot of meat is what makes up the diet in efforts to starve bad bacteria. We found a lot of info that is very confusing because one website gives a list of foods to avoid and another website says you can eat those foods. The info on the internet suggests different phases of the diet in which to eat certain foods. Our naturopathic doctor didn’t inform us about different phases in which to eat certain foods/phases of healing. She doesn’t know how to help us.

    There are no doctors or dietitians here in Hawaii that are knowledgable in dysbiosis. We don’t know who to call for help, we need a plan, we need to speak with a nutritionist. Our daughter will be 3 in January 2019 and only weighs 19 lbs. We are stressed out about her weight, her health, not knowing what to feed my daughter, not knowing how to help her and not being able to find help. Does your book share how to help children on a plant- based diet? Please help us. Your website says you have openings for new patients in June or July next year. That’s a long wait.

  31. I am positive for both methane and hydrogen. One round of xifaxan did nothing and since I’ve gained 20 lbs in 5 months, all in my stomach and thighs. The most I’ve ever weighed in my life. We tried xifaxan and neomycin, but I had some pretty serious neurological side effects from the neomycin. Do you have an herbal antibiotic you suggest in place of the neomycin? I’m currently taking xifaxan and Atrantil. When I finish treatment I will start a SIBO specific diet and a herbal prokinetc. I’m hoping this helps as I’m miserable and the weight gain is making me very upset. All the information on the internet is overwhelming and doctors don’t seem to understand how to treat this in addition to antibiotics.

    1. Hi Bridget,

      I’m so sorry you’re dealing with this.

      I would definitely recommend picking up a copy of Dr Ruscio’s book, “Healthy Gut, Healthy You” as he lays out the exact herbal protocol he uses in his clinic to help patients overcome frustrating gut issues (including SIBO) in an easy-to-follow DIY format. You can find it here: https://www.drruscio.com/getgutbook

      You might also find some helpful info in this podcast: https://drruscio.com/sibo-treatment-protocol-episode-39/ but note that it’s personalized to that patient, and not as general as what’s going to be in his book.

      Hope this helps!

  32. I am positive for both methane and hydrogen. One round of xifaxan did nothing and since I’ve gained 20 lbs in 5 months, all in my stomach and thighs. The most I’ve ever weighed in my life. We tried xifaxan and neomycin, but I had some pretty serious neurological side effects from the neomycin. Do you have an herbal antibiotic you suggest in place of the neomycin? I’m currently taking xifaxan and Atrantil. When I finish treatment I will start a SIBO specific diet and a herbal prokinetc. I’m hoping this helps as I’m miserable and the weight gain is making me very upset. All the information on the internet is overwhelming and doctors don’t seem to understand how to treat this in addition to antibiotics.

    1. Hi Bridget,

      I’m so sorry you’re dealing with this.

      I would definitely recommend picking up a copy of Dr Ruscio’s book, “Healthy Gut, Healthy You” as he lays out the exact herbal protocol he uses in his clinic to help patients overcome frustrating gut issues (including SIBO) in an easy-to-follow DIY format. You can find it here: https://www.drruscio.com/getgutbook

      You might also find some helpful info in this podcast: https://drruscio.com/sibo-treatment-protocol-episode-39/ but note that it’s personalized to that patient, and not as general as what’s going to be in his book.

      Hope this helps!

  33. Hey. I am diagnosed with both types of sibo but i dont gain weight. I lost weight since i bekäme ill. Can this happen? I

    1. Absolutely. SIBO can prevent optimal digestion and absorption, causing weight loss in some people.

  34. Hello!
    My PCP has put me on Xifaxin for IBS. My recent blood work showed elevated triglycerides over 600. Do you think this will help to lower that? I also have an excessively bad belly bloat, diarrhea (already three times today) and weight gain. I’m 42 and I also have fibromyalgia. Otherwise in good health.

    Thank you for any advice you can offer and this was an incredible article!
    Kate

    1. Hi Kate,

      I can’t say for sure what will happen for you, but some people see a reduction in cholesterol levels after SIBO treatment.

      You may want to check out Dr Ruscio’s book “Healthy Gut, Healthy You” where he walks through a DIY protocol to fix stubborn gut issues (including all the symptoms you mentioned). You can find it here: https://www.drruscio.com/getgutbook

      Good luck!

    1. Hi Kate,

      Wine is high in histamine, which may worsen rhinitis in some people. Alcohol has been shown to irritate the gut, and may be a trigger for IBS flares in some people. If you’re working on trying to heal, it may help to cut it out for a while and then add it back in after your gut has had a chance to do some healing.

  35. Hello!
    My PCP has put me on Xifaxin for IBS. My recent blood work showed elevated triglycerides over 600. Do you think this will help to lower that? I also have an excessively bad belly bloat, diarrhea (already three times today) and weight gain. I’m 42 and I also have fibromyalgia. Otherwise in good health.

    Thank you for any advice you can offer and this was an incredible article!
    Kate

    1. Hi Kate,

      I can’t say for sure what will happen for you, but some people see a reduction in cholesterol levels after SIBO treatment.

      You may want to check out Dr Ruscio’s book “Healthy Gut, Healthy You” where he walks through a DIY protocol to fix stubborn gut issues (including all the symptoms you mentioned). You can find it here: https://www.drruscio.com/getgutbook

      Good luck!

    1. Hi Kate,

      Wine is high in histamine, which may worsen rhinitis in some people. Alcohol has been shown to irritate the gut, and may be a trigger for IBS flares in some people. If you’re working on trying to heal, it may help to cut it out for a while and then add it back in after your gut has had a chance to do some healing.

  36. Dr. Ruscio, are you familiar with spore based probiotics (that also produce endospores)? How would you treat a SIBO condition CAUSED by them? I have methane SIBO (according to breath test) that occurred right after taking these probiotics because I didn’t know they can be pathogenic in vulnerable people. They have not–and apparently cannot–be killed by Rifaximin + Neomycin because they are spores. Please let me know if there is anything I can do to fight this. I am desperate.

    1. Hi Debbie,

      I’m sorry to hear you’ve been struggling with this, I know how frustrating stubborn gut issues can be. I’m going to add this question to the list for Dr R to answer on an upcoming listener Q+A episode of the podcast – stay tuned. Also, if you’re interested in setting up a consult with Dr R to get personalized guidance, you can do so here. https://www.drruscio.com/gethelp Good luck!

  37. Dr. Ruscio, are you familiar with spore based probiotics (that also produce endospores)? How would you treat a SIBO condition CAUSED by them? I have methane SIBO (according to breath test) that occurred right after taking these probiotics because I didn’t know they can be pathogenic in vulnerable people. They have not–and apparently cannot–be killed by Rifaximin + Neomycin because they are spores. Please let me know if there is anything I can do to fight this. I am desperate.

    1. Hi Debbie,

      I’m sorry to hear you’ve been struggling with this, I know how frustrating stubborn gut issues can be. I’m going to add this question to the list for Dr R to answer on an upcoming listener Q+A episode of the podcast – stay tuned. Also, if you’re interested in setting up a consult with Dr R to get personalized guidance, you can do so here. https://www.drruscio.com/gethelp Good luck!

  38. Hi Dr Ruscio,

    Do you feel lactulose or glucose is the best substrate for the breath test? i have had 3 negative breath tests with lactulose and am going to try glucose next but i feel my bloat stems from the lower part of my small intestine so not sure if all the glucose would be absorbed. do you think it may be usefull to consume both the glucose & lactulose sugars together? thanks for your time and happy new year

    Jason

    1. Hi Jason,
      They can both work, being mindful of the cutoff time for lactulose can help prevent a false positive. You may want to speak with your doctor about simply trying a SIBO treatment instead of spending more time/money on testing.
      Hope this helps!

      1. Thanks Dr Ruscio- im working with a few people now but still not getting answers. what are the best botanicals for treating SIBO in your opinion? also do you feel s.boulardii can be helpful? i find it helps with my bloat but also causes constipation.

        Happy New Year

        Jason

  39. Oh my God. I’m almost 100% certain that small bowel bacterial overgrowth is my problem. And I’m almost certain it is the methane variety. My stomach is always bloated, I’m constipated, and I’ve gained a lot of weight. And I’ve been exercising, cutting my calories, and drinking plenty of water. All measures that have resulted in weight loss before. I suggested this to my doctor, but he prescribed Amoxicillin. I know that is not the right antibiotic for. Can you tell me what is the best antibiotic to treat it? Thank you.

    1. Hi Frank,
      You will want to check in with your doctor on this, but Rifaximin and Neomycin are two to discuss potentially using together. This is if you have methane type SIBO.

  40. I was diagnosed with SIBO when I had a colonoscopy in 2016? Can you detect SIBO that way? I was on Rifaximin for 2 weeks I believe and never got any relief from it. I have been gaining weight, feeling bloated, it is uncomfortable to sit and hurts to lay on my stomach,.I have been doctoring with this condition for over 10 yrs now and no one can fix this problem. How long are you on this medication Rifaximin? Should the breath test be done? I feel like I am getting closer to figuring this out and more hopeful to start feeling normal again after all these years.

  41. Hello doctor Ruscio, I was just diagnosed with SIBO and really need to lose weight. I feel guilty because I gained back 65lbs 3 years ago after having very successful Bariatric bypass surgery. The weight gain happened in 6 months and I don’t over eat. I went from a size 4-6 to a 16. How can I get back to my dreams of success and beauty?

  42. Hi Dr. Ruscio,

    I was finally diagnosed with SIBO after dealing with one health issue after another for years! The ND that I was seeing started me on 500 mg of Berberine 3x/day. After about a week I completely lost appetite, was constantly nauseated and then started vomiting. He took me off Berberine and started me on his own Essential Oil protocol – basically ingesting 9 drops of three different kinds of doTerra essential oils for 21 days and then 3 other kinds of oils for another 21 days. I’ve looked for studies to support this kind of treatment but did not find any. Because it did not feel right to me, I did not start ingesting these oils and while I am waiting to get in to another ND, I started myself on Biotics protocol. Currently I am taking 5 tabs of A.D.P (oregano), 2 caps of Dysbiocide and 2 caps of FC Cidal 3x/day.
    Dr. Ruscio, I’ve listened to you on multiple podcasts and would like to hear your opinion on treating SIBO with ingesting essential oils? Is that insane or is there any solid supportive evidence out there that you came accross?
    Thanks so much!

    1. Hi Rasa,
      I have not seen anything published using essential oils, but that does not mean they are ineffective. However, because we have other, well-studied treatment for SIBO I prefer to focus on those. Hope this helps! If you hit a roadblock feel free to contact my office for a Skype consult.

  43. I was just diagnosed Monday for SIBO. I have always been small until about 3 or 4 years ago. ALL of a sudden I ended up gaining 30 to 40 pounds. I felt like I was carrying a baby elephant!! Am just getting ready to start my meds tomorrow. My question is will the meds help in losing all of this unwanted weight gain? I also have been on Medium for years now due to having Barrett’s esophagus and it is my life saver. Have run out of them a couple of times and fell like I was dying. Will I have to give that up?

    1. Hi Debbie,
      Not everyone who treats SIBO loses weight, but many do and for some the loss is substantial. You may have improved reflux also, but you will need to seek guidance of a clinician to determine if you can come off and/or for monitoring.
      Good luck!

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