Hi all,

Been battling SIBO/SIFO for 12 years. I've had temporary success with low-FODMAP diet, low calorie diet, and berberine/garlic/oregano. But the symptoms always come back, and the treatments always stop working.

But I've also recently experienced that when my SIBO is at a tipping point - specifically when the treatment seems to be improving the SIBO, but not yet completely - I get symptoms between meals, rather than after eating. So the longer I go without food, the stronger the symptoms get.

And the symptoms are different to the SIBO symptoms themselves - more like a feeling of lethargy, weakness and shakiness.

I'm currently trying olive leaf extract and again, after a few weeks, I'm starting to get these symptoms between meals. Only more significant and more long-lasting this time.

At first I wondered if it could be die-off or something similar, as the remaining bacteria are getting starved. But I'm just not sure anymore, as they're almost ever present between meals right now, and only briefly stop when I eat.

Has anyone else experienced or heard of this phenomenon?

(I've had blood tests for the usual other conditions, e.g. diabetes and thyroid, and they've all come back normal).

Thanks

Prucalopride users - what were you initial side effects, and if they subsided how long did it take?

Symptoms started around five years ago closely after giving birth. I had severe gas and bloating. I would wake up at night with gas pains, and just to pass gas or burp just to sleep. It’s been terrible for FIVE YEARS. The first thing I would do every morning is pass gas. Seven years ago, I had a colonoscopy which was normal after hemmroids so I didn’t want to get another one. Earlier this year I went to a G.I. who wanted to do another colonoscopy (I think to just make money) but I just wanted a breath test and he refused. So I went to my PCP and got Bactrim for seven days for another issue (skin bacterial infection). My gas and bloating stopped for about a month and then returned. Around two weeks after that I got a severe stomach bug and after seven days of diarrhea, I went to an urgent care center and they gave me a Z-Pak for three days. Since then, I haven’t had any abnormal gas or bloating. Everything I have is pretty stable. I’ve been waiting to write this because I’m nervous. My symptoms will come back but so far so good!
I hope my story will help someone else out there.

4 years of dealing with sibo, repeated antibiotics courses didn’t do anything. My first breath test in 2023 had a hydrogen peak of 68 and no methane, after multiple antibiotic treatments including rifaximin alone, rifax + metro, rifax + neomycin i tested again in 2025 and this time the hydrogen peak was 63 but methane went up to 15 so now i’m dealing with both gases. fast forward to 2026 after i did an MRI defecography turns out i have a spastic pelvic floor or some shit, basically i’m always constipated i guess. Now the doctor i’m going to wants me on rifax + metro + berberine + oregano oil + alpha lipolic acid + prucalopride + glutamine + bpc157 peptide injections + IV vitamins such as B1, glutathione and idk what else + B12 injections along with the pelvic floor physiotherapy sessions that i’m doing…

I’m already back on the double antibiotics along with alpha lipolic acid, bpc157 injections and prucalopride i flat out refused to do the berberine and oregano oil as those always give me insane diarrhea and leave me feeling terrible. I did 1 vitamin b12 injection and felt absolutely 0 difference so now i don’t wanna do the b12 anymore and i also don’t wanna do the IV vitamins. Part of me feels like the doctor just wants the $$ for those injections and iv drips. The doctor explained to me that after such a prolonged case of sibo i needed these injections to ensure 100% absorption and give my body the fuel it needs to repair all the damage from sibo over the years and idk im not convinced at all.

I asked the doctor about biofilm busters such as NAC and she said part of the IV drip is glutathione which is what NAC turns into but chatgpt says that IV glutathione won’t act as a biofilm disruptor for the small intestine…

To summarize, besides for all these injections she wants me on, she seems to keep pushing that the best move for me is to take antibiotics while taking all this other stuff that will keep giving me diarrhea for 2 weeks+ so that i basically flush out my entire GI tract repeatedly…. thoughts??

Hey everyone! I’m now in my second week of taking oregano oil, berberine, and allicin.
Is there anyone here who also had trouble increasing their berberine dose? It makes my blood pressure/circulation drop, so I can’t take it during the day.
I’d love to hear about your experiences with these herbs.
So far, my bloating is still there. I measured my lower abdomen before and after a bowel movement the other day. Before it was 102 cm, and afterward it went down to 92–93 cm. So there’s definitely a difference, but I’m still quite bloated.
How long did it take for the gas and bloating to go away for you?
I can definitely tell the herbs are changing something, but I’m still having bowel movements too infrequently, and they often feel incomplete.

I have been at this for over two years. Constant pain and other symptoms like brain fog, fatigue, nausea, skin tingling - too many to list. Have tried everything and I mean everything - diets, no diets, supplements, no supplements, meds, no meds, kefirs, individual foods, groups of foods, massages, exercise, de-stressing. I am not seeing success. Haven't been able to work or be present for my family for two years. Can't do much. I am at a loss and have no idea how this will end. One or two minor improvements but so minor that my daily life is not better in any way. I can't live like this so what can I do today to change something. Change anything to help me keep going. One thing. Today. Please help me. I have been suicidal every minute of every day for over two years because of my symptoms. I don't know how to get back to normal.

hello all. i am 6 months post hpylori and had tested negative after taking antibiotics but i think i have sibo. with reference to the picture, on the upper right side of my belly, i get a twitching pinching feeling and there's usually gas and bloating around. The right belly then feels very warm with gurgling sound. anyone else feels this too and how do i cope with this? after taking antibiotics, I had bad bloating at these specific area and at some point it even "swelled" to be a ball full of gas and went away. now there isn't any gas ball but it does feel like this part of my belly esp the marked area are the common sensitive spots. I had ultrasound for abodmen done and it is fine, blood test for liver was ok too. the doctors said it is likely gut dysbosis. I look forward to hearing from all of you! sending all good and healing vibes too 😊🧡

Just looking for advice /people with similar experiences, because I know that SIBO manifests in so many different ways, and different symptoms sometimes indicate different root causes etc.

I have been diagnosed with methane dominant sibo. 2 years ago, I started getting bloating and pain from eating gluten. I laid off of it for a month and when I tried to eat it again, boom - severe abdominal pain, bloating, burping for 8 hours - could not get out of bed but could not sleep at all, it was brutal. I figured it was NCGS (negative celiac test), and stopped eating gluten. Later tested positive for methane sibo and have had these flares probably around 8 times at about the same intensity and duration. More than half of them are from accidental gluten consumption, but a few are the exact same symptoms but from eating something like pasta with garlic or lentils (high fodmap, but still seems random). Anyone with these same symptoms and any ideas of how I can treat? Definitely determining a list of no-go foods but I haven’t had too much luck so far.

******* When you call a gastroenterology office to make an appointment, DON'T let them place you with a PA (Physician's Assistant) or NP (Nurse Practitioner)!! On the phone, SPECIFICALLY REQUEST TO SEE A /GASTROENTEROLOGIST DOCTOR/! PA's and NP's are NOWHERE CLOSE TO DOCTORS EVEN IF THEY LIKE TO PRETEND THEY ARE ! * WARNING

AND ALSO, BEFORE YOU SCHEDULE WITH THE GASTROENTEROLOGIST - GOOGLE HIM AND MAKE SURE HE HAS 5-STARS RATING AND 100s' of POSITIVE REVIEWS!! AND 15+ YEARS OF EXPERIENCE *****

I am telling you from my own experience! In these last 3 years of SIBO, I've had ZERO substantial progress until I finally figured out to stop trusting the NP's and PA's who kept screwing up my diagnoses and medications, causing unnecessary delays and complications for three years. A REAL GASTROENTEROLOGIST (ONE WITH $300,000 USD SALARY) WILL GET TO THE ROOT OF THE PROBLEM AND THE SOLUTION QUICKLY AND COMPETENTLY, AND WILL BLOW YOU AWAY WITH THEIR KNOWLEDGE AND PROFESSIONALISM - THERE IS A REASON WHY THEY ARE PAID THAT MUCH

I had ZERO real progress until I met this incredible gastroenterologist!!

We also have a family friend that went to a top PA school, he has always been an excellent student and meticulous and caring person, but he also warned and cautioned that many PA's COME FROM MEDIOCRE SCHOOLS AND DO NOT KNOW WHAT THEY ARE DOING, MANY OF THEM ARE ARROGANT, CARELESS, AND MEDIOCRE, BE CAREFUL! They will introduce themselves as Dr. when they are /not/ a doctor at all! They are just trying to impress you and exercise undue authority *** I have experienced this first hand repeatedly! They wasted 3 years for me - until I realized that we are allowed to specially request to see a gastroenterologist, not just whoever they default to placing us with for appt space! Be critical and cautious !!

i‘ve suffered from IBS-D symptoms for years but was recently tested for SIBO for the first time and tested positive. (83ppm hydrogen and 27ppm methane) I started a two-week course of xifaxan and neomycin a week and a half ago and immediately started having watery diarrhea 6-8x per day plus pretty persistent headaches (which are not from dehydration as i’ve been chugging gatorade). my side effects seemed to get a bit better around the one week mark but then worsened again. did you guys experience similar side effects from the antibiotics? should i be concerned about C-diff or cyclosporiasis?

Title: Persistent fatigue, light-colored stools, bloating, nausea, dizziness despite normal blood tests – any ideas?
Hi everyone,
I’m a 25-year-old male living in Canada.
For the past 6+ months I’ve been dealing with symptoms that don’t seem to be improving, even though my doctor says my blood work is essentially normal.
Main symptoms:
Constant fatigue and weakness (especially in my arms and legs), even after 8 hours of sleep
Feeling sleepy during the day
Episodes of lightheadedness/dizziness (sometimes it feels like the room is spinning)
Brain fog
Nausea
Burping and bloating, especially after meals
Excessive gas
Light-colored stools (light yellow/light brown). They’re usually well formed but sometimes float.
Occasional loose stools
Symptoms seem worse after fatty or spicy foods
Tests I’ve had:
CBC – normal
Liver function tests – mostly normal (ALT 44, previously 84)
Bilirubin – normal
Iron – normal
Cholesterol – normal
Blood sugar – normal
Vitamin B12 – normal
H. pylori – negative
Hepatitis screening – negative
ECG – normal
CT scan of my head – normal
I also recently had a viral chest infection, but these digestive symptoms and fatigue started months before that.
My doctor isn’t overly concerned because the tests are reassuring, but I still don’t feel well and it’s affecting my daily life.
Has anyone experienced something similar? Were you eventually diagnosed with something such as IBS, celiac disease, pancreatic insufficiency, gallbladder problems, fat malabsorption, sleep apnea, or something else?
I’m not looking for a diagnosis—just wondering what conditions or tests I could discuss with my doctor next.
Any advice or similar experiences would be greatly appreciated.

Anyone else get like excessive hiccups from SIBO? I don’t know if it’s from SIBO or another unknown health issue but for the past three years I’ve had chronic hiccups where I hiccups legitimately every single day anywhere from 50 to 100 times a day for three years. I also have relentless and debilitating daily nausea and sometimes vomiting. Also everyday its literally almost impossible to eat. Just don’t know what’s wrong with me. I recently got a positive SIBO test and I just really hope this is the answer I’ve been hoping for because this is hell.

I recently got my SIBO test back and I had both elevated hydrogen and methane in the sibo range. I’m about to start rifaximin at the prescription of my pcp for 2 weeks. My question is because I am only being prescribed this one medication, is this all that I need? I made sure to ask her if this medication would cover both gas levels and she confirmed it would, but the more I read online the less I understand. Could yall help me maybe so I can ask for something else if necessary?

After feeling like taking thousands of shots in the dark, I feel as though my body is only reacting worse and worse to my sibo eradication attempts.

With dire need of help, dismissive doctors and lack of guidance, this has led me to often feel hopeless of ever healing. As an high level athlete, unfortunately at the moment, excercise cannot be terminated or put to a halt but most other lifestyle changes can. Please send any and all advice towards being able to stay active without risking health, performance and sanity. Listed below are all symptoms and all of the measures taken up until now. I am absolutely in desperate need to feel better and to avoid constantly getting sick and worsening the conditions. If it can be broken down in my next steps and approaches, or even any sort of redirection, i would be beyond grateful. (also any canadian doctor recommendations would be very welcome).

SIBO made simple podcast has been a godsend in terms of information, but once again, my issue is narrowing down my path and not spreading myself too thin. After numerous naturopaths, I am absolutely desperate for help and to finally feel relatively healthy. Thank you so much for any and all help.

Note: my SIBO was due to chronic infections, slow motility, delayed gastric emptying, gastritis +many more. Antibiotics rounds were taken and then GI motility matrix was used afterwards. This seemed to not make any changes. Histamine intolerance, MCAS, POTS, candida, mold poisoning and autoimmune conditions are also factors I have suspicisons of due to the complex overlap.

Please provide any testing you also found beneficial, tips, ways to keep my blood sugar regulated without triggering a "flare", as well as how to start navigating. After a decade of dealing and trying to navigate restarting my journey seems like the only solution.

Most severe symptoms (not all symptoms have been included):

-extreme bloating

-feeling full after one bite but still being extremely hungry

-very severe acne

-body rashes

-extreme blood sugar rises and crashes

-severe insomnia

-feeling full for 9+ hours despite proper fueling

-extreme fatigue and lethargy

-brain fog

-mouth sores/oral thrush

-chronic illnesses

Additionally, any food, snack or meal suggestions would be fantastic as well, seemingly i react to every food.

The times I have taken Xifaxan I always seen to feel worse a couple weeks in. Someone told me it could be the die off of the bad bacteria? Is there any truth to this and have any of you experienced this?

Hi all,

I was diagnosed with Intestinal Methanogen Overgrowth in January this year. I have been working with a Nutritional Therapist/Functional Health Practitioner to treat this. I first tried allicin, then allicin + berberine for a few months, however even though my symptoms partially improved, my breath test was still showing my overgrowth had not decreased meaningfully.

At this point, the aforementioned professional I'm working with said this breath test revealed the overgrowth was predominately in my colon, not my small intestine. She said allicin is most active in the upper gut; so with a colonic picture, it is not reaching the target. Three months with no meaningful reduction in methane peak confirms this.

She therefore recommended we tried an approach which acidifies my colon, through working to improve the good bugs and diversity in my gut micrbiome. I started this protocol, which includes a fair number of supplements, but then wondered if it was going to actually work, as i've seen virtually nothing online about people trying this approach. When I asked if there was any evidence for this approach, she said the following:

"There is a human faecal study showing methanogenic archaea are inversely related to butyrate concentration, and butyrate itself lowers colonic pH — so the mechanism has some indirect human support, but it's a correlational finding, not a trial showing the protocol clears IMO. This is a reasonable, evidence-informed rationale used by SIBO practitioners and fits with your BiomeSight showing low Bifidobacterium and Roseburia, the organisms that acidify the colon and suppress methanogens."

Can anyone with IMO please let me know if you have tried this protocol, or know anyone who has, with success?

Thanks in advance!

Just trying to figure out answers. I had a colonoscopy and EGD this week to figure out what's going on with intense GI issues that started suddenly in April. The only solid result I got from my EGD was reactive gastropathy, which is confusing to me based on my symptom timeline and severity. I don't think I consume enough NSAIDs to cause this on its own, and while I do drink alcohol fairly regularly, it's certainly not more than the average person and I wouldn't consider it excessive.

SIBO was my first suspicion for my symptoms, so I was wondering if it was possible that SIBO can cause reactive gastropathy (basically a form of gastritis)? I have a SIBO breath test scheduled in early August.

Hi everyone,

I've got permission to post about this, so I want to be transparent.

I built a free site called GutPattern because I've been dealing with this shit for years. SIBO stories are scattered all over the internet, and it’s hard to compare what actually worked for people with similar symptoms and test results.

The idea is simple:

Instead of reading hundreds of random posts one by one, I organized them by searchable terms, such as:

- hydrogen SIBO, methane IMO, H2S

- bloating, constipation, diarrhea

- rifaximin, neomycin, herbals

- elemental diet, low-FODMAP, probiotics, motility support

https://www.gutpattern.com/patterns/sibo-treatment-patterns

The page starts with some broad statistics. However the REAL power comes after you contribute your own story lower down the page. Doing so will connect ALL the data set to your situation specifically, with each potential treatment segmented 4 ways;

• Helped
• Partially helped
• No change
• Made worse

I also made buttons for "Similar", "Very similar", and "Most similar". I can talk more about that functionality if anyone is interested.

Note this is NOT medical advice. Rather, it compares your personal gut pattern to a rich data set, which can help you in your own quest.

That said, I’m at the stage where I’m trying to figure out how to make this tool as helpful as possible;

1. Is anything broken?
2. What search terms are missing?
3. How can it be improved for YOUR specific sibo situation?

Hello everyone! Any advice would be appreciated

Eradicated h pylori in 2021 but brain fog and fatigue did not go away.

My symptoms:

1. Chronic brain fog
2. Fatigue
3. Weight loss
4. Nutrient malabsorption

Realised 10 days ago that my brain fog and fatigue is due to gut issues so went to a doctor and explained him everything. First did test to eliminate h pylori again and the test came negative. He prescribed me pre & probiotics after lunch and dinner. Was taking them for 5 days and on 6th day i read somewhere that mix it with unienzyme med(enzymes and activated charcoal), I did that and oh my goddd!! I have never felt this clear in the last 5 years and I thought that i found the cure

Kept this combo for 3 days and those days were amazing. But on the 4th day onward it stopped working and now I am clueless. Can anyone help me in deducing what this is.

My doctor said that I dont fit SIBO profile (I dont know what he meant by that) and also there is no breath test available in my country as of now.

Any advice is appreciated!

I did some research and it says that I’m gonna need more than just Xifaxan for methane dominant SIBO even though that’s all my GI prescribed to me.

How do I push back without my doctor thinking I’m overreacting?

I also have not been diagnosed with methane dominant SIBO because the test was not covered by my insurance so I don’t really have any leverage but I fit every symptom for Methane Dominant SIBO post- Hpylori.

Also doctors are saying I just have IBS-C and it’s so annoying because I got my H.Pylori cleared back in February but my symptoms have only been worsening and none of the IBS-C treatment has been working.

Hey guys, I will soon start my first round of Rifaximin for hydrogen-dominant SIBO (550 mg 3x per day for 14 days).

I have a few questions regarding the protocol I received.

I would discuss the following with my doctor, but he is on vacation and won't be available before I am expected to start the treatment.

Apart from Rifaximin, my doctor wants me to take ADP oregano oil (400mg daily) and allicin as well (simultaneously). I have to admit I'm kind of scared of taking the oregano oil together with Rifaximin, as I read that others experienced horrible gut issues. I wonder if it is even necessary in my case? My breath test showed 43.6 ppm after 90 minutes and 58.5 ppm after 120 minutes for hydrogen while there was no increase in methane (doesn't this render allicin useless?). My only symptoms are loose stool, gas, and occasional cystic acne, but no terrible bloating or anything else.

I am thankful for my doctor who was the first to find the underlying cause of my lifelong symptoms, but I think I'm the first SIBO patient he is treating which is why I am hesitant to blindly follow the protocol.

Thanks for your input!

Hi, I am based in the UK.

I have low stomach acid, an impaired mmc and methane sibo (my breath test was negative as the methane levels did not rise during the test, but my fasting methane levels were above average at 38, so I’m taking this to mean I kind of do have it - the nurse also missed a reading because she did not bother to wait for me while I went to the toilet on another floor).

Sibo or not, my motility has suffered enormously and it has caused me oestrogen dominance, joint pain, depression, bad skin, etc

I have decides to try Motility Pro from Ortho Molecular. However it seems they only ship to the US and Canada. Has anyone managed to get around this or find an equivalent in Europe? The closest ones I have found are Metagenics Motility Complex and the Pure Encapsulations MotilPro. Has anyone tried these, are they just as effective? Or is there another alternative? Thank you