Saturday, 17 May 2014

Treating SIBO

AKA Bugs be gone!

I won’t go too much into what SIBO (small intestinal bacteria overgrowth) is in this post as I’ve covered it a few times before, main one being HEREI’ve also shared THIS LINK from the guys at SCD Lifestyle which has a great video and audio to explain it further. If you want the brief overview, Aglaee Jacob has a great blog post HERE.

Choosing which way to go

As I alluded to in my last post on SIBO, I’d had a visit with my GP where we discussed possible medication options for treatment of SIBO. I’d tried once before with a basic broad spectrum antibiotic but my symptoms remained: constipation, bloating, constant reactions to food, acne, brain fog, fatigue and nausea. 

I was initially put off due to the cost (one of the two drugs is not covered by the government medical system), as well as the fact I’d spent a decent amount of money on unsuccessful drugs for blastocystis last year - so I was hesitant. But when I started working with my health coach, Angie Alt, she advised me that due to the nature of my symptoms and the duration of my stomach issues, that the meds were the best way to go. Herbal antibiotics are also an option but they take longer, aren’t anymore cost effective, aren’t always more gentle and they effectiveness is slightly less. Also, with constipation predominant SIBO, it can be more stubborn to treat.

I still believe a large part of the reason my endeavours in eradicating blastocystis were ineffective largely because of the bacterial overgrowth in my gut holding up the works! So I was ready to tackle it head on.

Meds and Diet

With Angie’s help I got my prescription for Rifaximin (the usual first line medication for SIBO) and Metronidazole to make the whole process more effective. Neomyocin is also used but Angie and I decided on a Rifaximin + Metronidazole combo and my GP was happy with that option too.

If you’ve read any of my posts on diet you know that I’m a fan of JERFINGI’ve tinkered in the PALEO AUTOIMMUNE PROTOCOL and I’m a big fan of Aglaee Jacobs GUT HEALING PROTOCOL and had a pretty good idea of WHAT FOODS WORK FOR MEAlong with this I’d also recently reduced FODMAPS in my diet to help relieve pain and bloating. 

I had a few cheats during my treatment as I’ve read that it’s beneficial to have some fermentation in the gut when you’re trying to treat SIBO. So I had a few extra serves of sweet potato, some dark chocolate and a few fruit/nut bars (things I usually avoid) during my 2 weeks or treatment. I found on these days the side affects were actually lessened… Maybe because the meds had something to work on? I don’t really know. 

After treatment I realised that starches don’t really agree with me and due to fatigue I thought it would be a good idea to drop coffee and chocolate for awhile… So I’ve found myself doing a low FODMAPS, no dairy, no nuts, low fruit version of the specific carbohydrate diet. The book I’ve found most helpful for this is the eBook by the SCD Lifestyle guys OVER HEREElaine Gottschall’s book Breaking the Vicious Cycle is the original book on the subject and still full of great info. I like this approach as you start with an intro diet and then very, very slowly add foods in one at a time to create your own customised diet. Aglaee Jacob has a similar approach in her book, Digestive Health with Real Food.


The first week of taking the meds I had more energy than I had in ages, I was delighted! But as the drugs built up in my system I started to feel pretty unwell, nothing I was unfamiliar with but intense and I was unable to shift it - so I just rode it out and my health coach assured me I’d feel ok again once I’d completed my course of meds. 

It took a few days for the brain fog and heaviness to clear, and it’s still early days, but I’m feeling better. I’m not in as much pain, I have more energy, I have less nausea, bathroom visits are more predictable and I don’t rely on strong laxatives, enemas or colonics to relive symptoms anymore. My diet is still restricted and I’m taking a few things for gut healing including: multivitamins specific to my MTHFR mutation, l-gluatmine, probiotics (prescript assist), digestive enzymes and magnesium. I’m also taking a low dose antibiotic, erythromycin, nightly to prevent reinfection.

I think this is the main step many people miss, strict diet, gut healing and ensuring bowel function to prevent a relapse - which is usually and unfortunately quite common!

Angie’s help was pivotal during this whole process. I’d done way too much research and had almost paralysed myself with too many options. She was there to guide me through my bad days (she had been down this road twice already) and was there for encouragement on my good days. The journey can be tough, and lonely! And with so many doctors and professionals out of the loop on gut issues it’s really important to find someone you trust and can relate to, to ensure your success. 

Below are some of Angie’s blog posts on SIBO, personal experience and an overview of a recent SIBO symposium. All good stuff so dive in!

From here I’ll continue with my gut healing protocol and strict diet for 3 months, slowly doing some food reintroductions as my gut begins to heal and I can tolerate more things. I’m still struggling with some skin issues but I’m hoping as I build up the good bacteria in my tummy and continue to fight inflammation they’ll soon be a thing of the past too. I’m still struggling with some adrenal fatigue which shows up in shakes, nausea and spaciness when I don’t make sleep a priority. So still a ways to go but I feel a lot more in control of my symptoms and now feel like I’m playing an active role in the process - not just being a passive passenger on a ride my body was taking me on.

So there you go, my adventures in SIBO!
K xx


  1. This a great post! I'm about to embark on the antibiotic route after suffering for 5 months. Did you take Prescript Assist, and any other supplements while taking the antibiotics? Or did you add them in after? Thanks for your awesome article.

    1. Hey Lisa, because Prescript Assist is so expensive I decided to wait till after treatment to take it as to not risk killing the good bugs in the product. Also cos I was taking meds 3 x a day I didn't have a window of 4 hours to take probiotics away from meds... Which is ideal. The only things I took during the meds were l-Glutamine, 6 tsps a day which is the healing dose and my MTHFR supplements. When I treated Blasto with meds (unsuccessfully) I tried other supplements during but didn't notice a difference. I took Biokult during one round and SB Floractiv during another. Whether you do or not is a completely personal choice and I've read things on both sides of the fence in regards to taking probiotics during antibiotic treatment.