I followed all the prep instructions for the breath test (restricted diet the day before and fasted before the exam), but my results came out kind of strange. My baseline hydrogen (H2) level was already high at 33 ppm, and it didn’t rise much over the next 90 minutes.The doctor said it was negative for SIBO, but the results were unusual. He told me I could either try metronidazole or rifaximin + 60 days of probiotics (Lactobacillus helveticus R0052 and Bifidobacterium longum R0175). I’ve had SIBO-like symptoms for over two years now, and it’s honestly been ruining my life.I went with 14 days of metronidazole + low-FODMAP diet. I didn’t feel much better right after, but I started improving around 15 days into the probiotics. “Improving” just meant being able to poop at least once a day. I still had issues like passing small amounts of stool several times in the morning, feeling like I wasn’t fully empty, and abdominal pain.Now I’m on day 50 of the probiotics, and I’m starting to feel worse again. Today I only managed to go to the bathroom after lunch (normally it happens after waking up), with small stool volume. On days like this, the belly discomfort is much worse, it feels like my gut is slowing down and becoming more constipated. If this goes on for 2 days, I usually stop going altogether unless I take laxatives.During the probiotic phase, I also tried ginger and artichoke extract, they helped speed up digestion a bit, but didn’t solve the problem.cont.
>>76704144cont. Overall, my digestion is terrible: it’s slow, I burp a lot, have frequent constipation, abdominal pain (like my intestines are full of gas and overly sensitive all the time), and yellow stool. I’ve tried every kind of diet, done tons of blood work, stool tests, 2 endoscopies, and 1 colonoscopy. The only findings were mild lactose intolerance and slight gastritis in the end of the stomach (treated with omeprazole). The first few doctors only looked for stomach or colon issues and didn’t find anything else.I live in a pretty remote area in Brazil and had to see five different doctors before one even mentioned SIBO. The tests weren’t very conclusive, and I still haven’t improved with treatment. I have a follow-up appointment in a week, but honestly, I’m exhausted — the pain and discomfort are wearing me down, and I feel like I can’t keep fighting this anymore.When I was feeling a bit better, my stools weren’t yellow and I wasn’t constipated, but I still had belly pain and had to go to the bathroom 2–4 times every morning, always with that “not empty” feeling.This all started in November 2023, after I tried bulking up. Earlier that year, I also did magic mushrooms twice, and the year before that I had two cases of food poisoning and a lot of stress and trauma. That’s all I can think of as possible triggers. I had gastritis back in 2013 (treated with lansoprazole), but since then I’ve eaten clean and exercised regularly. In 2018, I had one episode where my digestion basically “stopped” for a week after overeating, it only improved after using laxatives. I never used them again until this chronic constipation started two years ago.
Hey it must be your lucky day, I am a sibo "expert".First, have you mentioned your yellow stool to each and every doctor you've talked to? This is the most peculiar part of your symptoms.All diagnostic tests for diseases have false positives and false negatives - given this, the hydrogen breath test for SIBO is notably bad for false negatives, especially if you have constipation + SIBO. Did you feel 'better' at all while taking metronidazole, or do you think this was due to the probiotic? It's weird that you were prescribed a probiotic, they would not likely due that in the States. > the year before that I had two cases of food poisoningMark Pimental, famous SIBO researcher at Cedars-Sinai, has hypothesized that for most people with gut surgery, food poisoning is likely the cause of SIBO. Basically you damaged the nerves in certain sections of your gut enough that they don't push food anymore. If I were in your position:1) I would ask for rifaximin 500mg twice a day for 28 days (don't take the probiotic if they give you one).2) spend hours on r*ddit /r/SIBO, especially look for success stories from people with your type of SIBO that cured it3) really hone in on your diet. Unfortunately you're not going to have an instant success like "I stopped bread for three days and I never had a problem again", it's going to be more like, "if I obstain from starches and especially guar/xanthum/whatever gum for 10+ days my symptoms become manageable but if I stray from my routine they come roaring back."I'll check back if you have any questions brazilanon
>>76704144holy shit a fellow SIBO bro, I'm sorry man it's sufferingRifaximin was like night and day for me but my symptoms returned after about a year. I've done multiple courses, and same story, better for a while but then back to symptoms (though mine are IBS-D symptoms). But don't despair, my SIBO is "recurrent SIBO" so you might not be as screwed as I am.
>>76704144Idk wtf sibo is but I had your symptoms and stopping weed, swapping to exomeprazole and starting MK677 at 25mg/ day literally fixed my gastroparesis altogether
>>76704144I fixed my SIBO by mashing eggshells into powder and eating it. One eggshell a day for a month. No evidence, no studies, just this anecdote. Do with it what you will.
>>76704144>>76704632>>76706108Also, don't forget after your rifaximin to take 0.5mg prucalopride before going to bed every day - this is critical because the SIBO will return due to your migrating motor complex nerves being damaged. If you don't do this, food will just rot in your small intestine again and SIBO will reoccur. Also, you must space out meals with at least 5 hours in between after rifaximin.
>>76706698>Also, you must space out meals with at least 5 hours in between after rifaximin.Indefinitely?
>>76706700Good question, that depends (both the meal spacing and prucalopride). Ideally, your body would adjust after a few months and you'd be able to go back to normal. But the problem is that the nerves in your small intestine are damaged, which caused the SIBO in the first place. So for some people, doing this protocol for a few months might fix it, but for others it might not.I forgot to mention this in my other post but you should also be doing the low fermentation diet after your rifaximin course.This is all information I've gathered from SIBO communities online as well as Dr. Pimental's research (he's the forefront doctor researching this stuff). I'm about to start this protocol myself in a few weeks once I get everything sorted out with my insurance.
>>76706783I'm looking into the low fermentation diet now, interesting how distinct it is compared to low FODMAP; for example, LF allows for onions and garlic while low FODMAP doesn't
