Three Effective Ways to Treat SIBO

SIBO is a common infection in which an overgrowth of bacteria occurs in the small intestine leading to IBS symptoms of gas, bloating, and altered bowel function. There are three effective ways to treat SIBO, and the treatment option you choose also influences the duration of treatment.

If you need help managing your SIBO, click here

Three Effective Ways to Treat SIBO - image2

Three Effective Ways to Treat SIBO

This week we discussed the treatment of SIBO with Rafaximin and how the duration of treatment might be dependent on the levels on your breath test. Higher levels may require longer treatment. Here are three effective treatment options and their durations.

Antibiotics

An effective and well-studied SIBO treatment is with pharmaceutical antibiotics. The primary antibiotic used in treating SIBO is Rafaxamin, as discussed in Monday’s video. The typical treatment duration is 14 days. However, research is now showing that a longer treatment duration may be more effective in some cases. Rafaximin is primarily used for hydrogen-positive SIBO with diarrhea as a main symptom. In the case of methane-positive SIBO in which constipation is present, Rafaximin is usually combined with another antibiotic such as Neomycin or Metronizadole for 10 to 14 days.

Herbal Antimicrobials

The use of herbal antimicrobials is another option for treating SIBO. The use of single antimicrobials and the use of broad spectrum antimicrobials have both been used successfully. Some common herbs used in SIBO treatment include oil of oregano, allicin, berbine herbs, and neem. The treatment duration with herbal antimicrobials is typically longer than with antibiotics. Usually a protocol will last four to eight weeks.

Elemental Diet

Another option for treatment is a liquid elemental diet. This is typically the last-resort option because it’s difficult to do and the taste is not pleasant. A liquid elemental diet consists of a predigested formula that you drink for 14 days to starve the bacteria while still nourishing your body. No food is allowed during this two-week period. Only the elemental formula is to be consumed.

If you need help managing your SIBO, click here

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!

18 thoughts on “Three Effective Ways to Treat SIBO

  1. Hi Dr Ruscio. What company do you use for stool tests? And , are there any reliable home breath tests on the market? cheers

  2. I had a breath test done by a lab thru Dr Siebeckers site another by an OAT both showed positive results. Both are expensive and insurance does not cover them. I had the OAT done for other reasons as it covers much more than SIBO.

  3. I had a breath test done by a lab thru Dr Siebeckers site another by an OAT both showed positive results. Both are expensive and insurance does not cover them. I had the OAT done for other reasons as it covers much more than SIBO.

  4. Dear Dr. Ruscio

    I’m not sure if you read these comments anymore but I wanted to see if you can help me. I have tested negative for SIBO multiple times, the Cyrex leaky gut tells me i dont have leaky gut, i have unusually low sIGA in my stool, blood iodine a little low, T3 a little low, i tend towards constipation and require daily magnesium (the beginning part of my BMs are always hard). All my other tests are normal- they checked me for everything. If i take even a minuscule amount of any type of fiber I will bloat, if i eat pears or fruits with fructose i will bloat. I am gluten free, dairy free, soy free, egg free, nuts in moderation, grains in moderation, and nightshade free. I also have histamine issues. Im still not getting better and this is going on for years. I take probiotics and digestive enzymes as well. Do you have any idea what might be wrong with me? any other tests I should take? My life has been destroyed because of this. I blew threw all of my savings seeing doctors, getting tests and buying supplements (most of which I cant even tolerate). My parents are worried for my life and tell me i always look too thin and sickly. If you have any recommendations I would be eternally grateful

    All the best,

    Brandon

    1. Hi Brandon,
      I’m sorry to hear of your struggles. Sometimes the testing doesn’t show us anything, likely because we can’t test everything that can cause GI problems. So we will revert to a more empiric treatment approach. There is nothing I can offer you now, other than being seen at the clinic, but my book will walk the reader through a personalized, step-by-step guide to healing their gut. If you can wait until Jan-ish of 2017 then this might be your best bet.
      Hope this helps!

  5. Dear Dr. Ruscio

    I’m not sure if you read these comments anymore but I wanted to see if you can help me. I have tested negative for SIBO multiple times, the Cyrex leaky gut tells me i dont have leaky gut, i have unusually low sIGA in my stool, blood iodine a little low, T3 a little low, i tend towards constipation and require daily magnesium (the beginning part of my BMs are always hard). All my other tests are normal- they checked me for everything. If i take even a minuscule amount of any type of fiber I will bloat, if i eat pears or fruits with fructose i will bloat. I am gluten free, dairy free, soy free, egg free, nuts in moderation, grains in moderation, and nightshade free. I also have histamine issues. Im still not getting better and this is going on for years. I take probiotics and digestive enzymes as well. Do you have any idea what might be wrong with me? any other tests I should take? My life has been destroyed because of this. I blew threw all of my savings seeing doctors, getting tests and buying supplements (most of which I cant even tolerate). My parents are worried for my life and tell me i always look too thin and sickly. If you have any recommendations I would be eternally grateful

    All the best,

    Brandon

    1. Hi Brandon,
      I’m sorry to hear of your struggles. Sometimes the testing doesn’t show us anything, likely because we can’t test everything that can cause GI problems. So we will revert to a more empiric treatment approach. There is nothing I can offer you now, other than being seen at the clinic, but my book will walk the reader through a personalized, step-by-step guide to healing their gut. If you can wait until Jan-ish of 2017 then this might be your best bet.
      Hope this helps!

  6. Hi I have high positive SIBO and very low stomach acid. Have you experienced patients having problems with ADP oil of oregano? I feel worse – extremely bloated and reflux after taking 3 each meal. Is there anything less aggressive I can start with?? Thanks.

  7. Hi I have high positive SIBO and very low stomach acid. Have you experienced patients having problems with ADP oil of oregano? I feel worse – extremely bloated and reflux after taking 3 each meal. Is there anything less aggressive I can start with?? Thanks.

  8. What brand or oregano oil is safe to consume? I have heard about potential issues on the market with knock offs from my GI.

  9. What brand or oregano oil is safe to consume? I have heard about potential issues on the market with knock offs from my GI.

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