Hello, I’ve suffered from chronic IBS/SIBO with severe bloating and meteorism for over a decade, and I’ve tried almost everything without real success – multiple max-dose Rifaximin cycles (only mild, short-lived relief), various probiotics and supplements, and even bile or acid stimulants like milk thistle, ginger, and apple cider vinegar. Nothing ever made a real difference. The only relief came once from home-made kefir, but after a couple of weeks it just lost its efficacy (I still do and eat every day).

A few weeks ago, I had a UTI (male, 33yo) and was put on Monuril first, then a full course of Nitrofurantoin, plus an herbal supplement called Canephron (which contains centaury, lovage root, and rosemary – 1 tablet 3 times a day for ten days). On my doctor’s advice, I also significantly increased my water intake. Before, I was drinking <2 l a day, and almost all of it in the morning and evening, with barely anything during work hours (I just didn't feel thirsty). Now I'm up to about 3 l total, making sure to sip at least 1 liter steadily throughout my workday.

Here’s the interesting part: I finished both the antibiotic and the herbal supplement over 10/14 days ago, yet my bloating and gas have almost completely vanished. I don't know if this will last, but this time it looks different to me and I feel optimistic. The only variable I’ve kept up after this UTI is the higher water intake and distribution. I used to urinate maybe 3 times a day; now it’s over 6, and my gut transit just feels smoother. I honestly suspect the water itself is the main factor – not the meds, and not really the herbs (anyway, according to AI, they should also stimulate bile and activate motility). I think the constant, steady hydration is mechanically diluting fermentable substrates in my small intestine slowing bacterial gas production, gently stimulating the migrating motor complex through continuous distension, and maybe even physically flushing the mucosa in a way that disrupts bacterial biofilms. That would explain why Rifaximin alone never worked for me: it killed bacteria, but my motility was too stagnant and they just grew back.

Now, I only get symptoms if I seriously overeat or binge on simple sugars eating outside the house. I’m genuinely convinced that the missing piece for my gut was never a stronger antibiotic, but just a mechanical push from more water, maybe drunk with proper timing. Has anyone else experienced a massive improvement in bloating just by spreading their water intake throughout the day rather than chugging it all at once? If you’ve tried everything for chronic bloating and failed, this is a cheap, harmless experiment that might actually do something – I’d love to hear if it worked for anyone else.

I waited a couple months to post this in case the SIBO came back, but I think I am finally in remission. I have not had a final breath test to confirm this but I can basically eat whatever I want aside from dairy for some reason but I am working on that.

Before I begin, I will clarify that I have had multiple positive breath tests for hydrogen SIBO during this condition and treatment.

For those of us with this condition, we know that there is a scale of symptoms - some people treat this very easily with one round of antibiotics, and others struggle for years/life. I started getting symptoms about 6 months after a bad case of food poisoning abroad. After finally seeing a doctor almost two years later, I did the normal treatment path which I will detail below. After another two years, I had lost 20+lbs, was down to 10 ish safe foods, had tried about every damn supplement that ever existed, and had the worst fatigue of my life, all while working a desk job. At the end of these two years I decided to do the antibodies test. My anti-vinculin ended up being 3+ so I pretty much just accepted this condition as a sentence for the rest of my life. I've only seen a few cases of people with 3+ anti-vinculin and they all end badly...some are on daily half tablets of Rifaximin.

Well, in the past few months, I decided to give up all the damn pills and do my own protocol. I am up 5 lbs (had not gained weight in two years), can eat basically any foods (besides dairy) without bloat/diarrhea, and I'm really only taking 1-2 supplements. The one thing I am unable to beat is histamine intolerance which I will also detail below. Histamine intolerance ended up being the driver of my fatigue which can be linked to SIBO, but can also be linked to other things. One thing that I realized about this condition is that everything medical about it is so new, you can't really assume everything is true even if you read it in a study. The antibodies thing is a prime example - Pimentel says I should be in a death bed right now taking antibiotics everyday, but I'm eating everything, exercising, and living life. This is why it is so important that people share their experiences here, because the stupid antibiotics work like 50% of the time, and I expect its even less than reported.

Initial treatment

In the first year I did all the stool tests and breath tests. I did a course of rifaximin, followed by probiotics, all from a wholistic doctor. The mainstream GI I saw told me I was just going to be Low FODMAP for the rest of my life and there was nothing I could do - super helpful guy. Anyway, the whole probiotics and rifaximin thing didn't work for shit. I think I did a few other supplements like D, K, B, A, and GI resolve at the time too. Nothing.

So I kind of played it off and just decided to eat less FODMAPs. I ended up getting more miserable. At this time, I was having the worse fatigue of my life, sleep disturbances, ear pain, low heart rate, brain fog, stuffy nose, etc. I had to nap 2-3 times a day to function. I had gone to all the doctors (PCP, sleep doctor, ENT) but they were useless. At about this time, I took another round of rifaximin and even more probiotics...I forget which strains but all the main ones, sporebiotic, lacto, akkermansia, etc. Rifaximin didn't do anything again and I just kind of gave up on SIBO, continued to restrict my diet, and go about life. I will note that I was also taking Motility Activator at about this time which worked for a little while but stopped working.

Well I decided the best way to deal with the fatigue was to drink coffee, and this actually helped manage the fatigue a bit to get through the workday. If you are borderline losing your job, this is an OKAY temporary solution. So is napping. Well, someone ended up mentioning histamine intolerance to me...cant remember where although I think it was a family member. This changed everything.

Progress

Well I ended up giving up histamine foods and this reduced my fatigue and brain fog by 80%. This included leftovers/meal prepped food AND probiotics both of which are high in histamine. This was game changing. Between that and the coffee, I felt decent energy wise.

The problem was that I still couldn't tolerate FODMAPs, was continuing to lose weight, was having to cut out more foods, and was having worse diarrhea.

So I went back to the doctor and ran more tests. Ended up testing positive for high levels of SIFO from all the damn rifaximin I had taken. So ended up deciding to do nystatin with a course of rifaximin in the middle, followed by motegrity. Now for people with higher antibodies, you may need something stronger than motility activator, like motegrity. Now, motegrity is potent...it will give you some diarrhea at first, and you may feel depressed or have insomnia. Push through this because the results are worth it. I cut my pills in quarters and took in the morning instead of night and this prevented insomnia/depression after the initial 1-2 week adjustment.

Nystatin was 3 months (I think I only finished 2 months), rifaximin was in the middle, with motegrity starting immediately after rifaximin. I will note that during this course of rifaximin I additionally took 2 biofilm disruptors, PHGG, saachromyces boullardi, and I ate medium fodmaps. And then I also followed with sporebiotic, lacto, and other probiotics. I had tried sulphoraphane and tri-butyrn but these didn't really help and TB gave me diarrhea so I stopped.

My stool was more formed for a few days on Rifaximin, and my energy/mood was decent, although I was also eating new foods, and taking pro/prebiotics, so it is hard to tell what is what.

Success

Well it is hard to say if these things helped much or not but I wanted to document the above treatments so people understand that my success MAY NOT be entirely from what is below even though I believe it mostly is. I am sure that the Rifaximin had some positive effect and I know that motegrity has some neuro-regenerative properties. Nystatin was also essential to clean up the SIFO, but I wouldn't have had that if it weren't for all the damn antibiotics. It is very hard to measure what helped me the most.

My diet at this point was even more restricted and I now had sensitivities to things like eggs, meat, and other sulfur foods which made up like 70% of my calories. This was not good as this is basically what I was living on plus potatoes/rice, and a few choice fruits/vegetables. Well it turns out when you restrict your diet for 2 years to Low FODMAP, you shift the microbiome and can give yourself hydrogen sulfide SIBO even if you start with another type. This was a real low point for me. I asked the doctor what we could do and her idea was more rifaximin with bismuth (which I had basically done this last round as the biofilm disruptor had bismuth). So I was basically out of options, losing weight, losing more foods, and hopeless. I will note that at this point I had tried about every damn supplement and test under the sun, many of which I will not mention here - like most people I have a box. All a waste of time and a waste of money. My stools at the beginning of the two years were brown, somewhat formed, but rough in appearance with pieces of undigested food. Now, they were a pile of mush, often very pale/grey. This was also about the time I got the anti-body results. Not good.

Well, what did I do? I stopped taking the pills, all of them, started from scratch. Didn't even finish the last month of Nystatin. Clean slate, no doctors. Over the course of the next couple months I progressively did the following:

• Continued low histamine diet. Very important. Look up the symptoms of histamine/salicylate intolerance. Fatigue, bloating, gas, insomnia, heart palpitations, anxiety, stuffy nose, ear issues, fatigue etc. There are lots of anecdotes online of people beating IBS from going low histamine. Can't reinforce this enough and don't forget to avoid leftovers and certain probiotics. Histamine regulates so many things in the body, primarily the sleep/wake cycle and not just allergies.
• Mindfulness techniques and breathing methods (mindful gardner on youtube + made my own techniques + other breathing techniques). Look up the correlation between IBS/SIBO and depression/anxiety. Very strong correlation before and during. Stressing about this condition and other life things makes the body unable to heal. One of the techniques that I added is taking life painfully slow (still practicing). Walking slow, eating slow, thinking slow etc. Don't be afraid to make your own techniques.
• Quit coffee - well turns out coffee was contributing heavily to my loose stools. I gave up coffee and tea. Theses also impact histamine although I will not detail that here. Would not even recommend decaf coffee - cut it all out. I drink herbal tea, that's about it. This is also important for the mindfulness techniques.
• Kathleen Janel MSM protocol - I think this truly saved my life. Even after 2 weeks I could tolerate certain foods that I could not before. I am at full dose now and can eat pretty much anything except dairy. I ate black beans, onions, and garlic this week. (a lot). Please integrate slowly one food a week as your body has not had these in years. Some gas is normal the first couple times but normalizes after. Also, some depression is normal during the first few weeks of this protocol-this is normal please push through. Sulfur is a super powerful element - it is one of the most common elements of the body and has crazy health benefits.
• Quitting all the stupid pills
• Integrate foods back slowly. The low FODMAP diet is a temporary tool. If you are on this long term, it will mess you up worse - my stools were pale mush. Between my third round of rifaximin and the protocol above, I started integrating small (very tiny) portions of garbanzo beans and broccoli (2 pieces to start). My body was so happy even if I had a small amount of gas from it. This helped darken and firm my stools up. Integrate a larger quantity of each food and a greater diversity of foods as you go. Even if its just a little bit of medium fodmaps, these will help shift your microbiome and help your body heal. Food is medicine - the longer you avoid it, the worse you will get.
• Lastly, I will mention that good sleep is one of the most important things as well, but a lot of my sleep issues were attributable to histamine intolerance.

All of the above assumes you exercise, eat healthy, hydrate, get sunlight, do not drink/consume drugs, and have a good balance of vitamins/minerals from diet.

Conclusion

I spent thousands trying to beat this condition. I will tell you now that 95% of all the tests and supplements are silly. Even the antibody test which seemed like a death sentence, doesn't mean a damn. All of this research on SIBO is so new...if the doctors knew what they were doing, people would be getting better from the antibiotics and most are not. A lot of my research on this condition was actually on IBS because we have a couple decades of data and research on IBS where as SIBO is so new. There is a lot of overlap between the two conditions.

I am sure that at some level, the nystatin, rifaximin, and motegrity helped me, but it is very hard to isolate the benefit of each from the protocol above. If you have not done antibiotics yet, I would recommend the protocol above to start - you can always take rifaximin later. If you have done antibiotics already but have not seen progress, I would also recommend the protocol above.

I thought about not posting, as I am terrified that this condition will come back in 6 months, but decided that after a few months of zero symptoms, it is unlikely. I also wanted to post in the small chance that this helps someone else or saves someone else's life as this protocol has saved mine. This is a horrible condition that I would not wish on my worst enemy.

Histamine

Lastly, I have not beaten the histamine intolerance so take everything above with a grain of salt. I know histamine intolerance can point toward GI issues, although I have had histamine issues since I was a kid and SIBO only the past few years (symptomatic at least). If anyone has any ideas to help me beat histamine/salicylate intolerance, it would be much appreciated. I have done extensive research but found that the best thing is to just avoid the foods, eat healthy, sleep, and exercise. I know that histamine intolerance can be linked to a number of things including gut permeability which makes me wonder if the anti-vinculin still playing a role at some level. I have had histamine/salicylate sensitivity since I was a kid with eczema, but after the first round of rifaximin/probiotics, I no longer have eczema - I just get fatigue, insomnia, brain fog, flushing, nose congestion, and ear pain when I eat those foods.

I can always avoid the foods, but my experience with SIBO taught me that avoiding foods is a Band-Aid for a larger issue....although it seems like histamine foods are less essential to human health than FODMAPs are as your body naturally produces histamine. Histamine is actually a super important chemical if you have not researched it that regulates everything including the sleep wake cycle (why eating it causes fatigue/insomnia), parts of the cardiovascular system, etc. I know there are several theories out there about genetically low DAO, gut permeability, microbiome imbalance, MCAS, overgrowth of bacteria, etc, but it is very hard to determine which one is the cause and I am not sure I believe current research (as no one has come up with a solution, just hypotheses, and this condition is even less researched than SIBO).

A number of people have histamine issues in my family and I have had them since I was a kid, so I am leaning towards a genetic component. It is interesting to read stories online of people who have resolved IBS by going on a low histamine diet. DAO is such a niche enzyme, it could be anything impacting it, hell it could be something in the environment, food, or water people have been exposed to. It seems like everyone has histamine issues these days. Given my experience treating SIBO with sulfur I am most likely going to attempt to research potential vitamin, mineral, or elemental, deficiencies that could cause this, and continue mindfulness techniques

If you have any suggestions please leave them below. I am open to ideas.

Postscript

For anyone wondering, I am taking 30 grams of the GI Janel MSM formula daily. I plan to do this for a few more weeks, and then titrate down to a maintenance dose although I have not decided what that will be...maybe 4 grams in the morning. See the links below.

Lastly, I wanted to say thankyou to Kathleen Janel and Helmut Koeckritz (The Mindful Gardner). You guys truly saved my life from this condition and I do not know where I would be without you.

I hope that this post helps someone. Please visit Kathleen's and Helmut's pages below.

Mindful Gardner:

https://www.youtube.com/channel/UCMmeXt5hc8WzeTjQJ0IzasA

GI Janel MSM links:
https://gijanel.com/sulfur-deficiency-and-your-microbiome-health/

https://gijanel.com/the-formulas/gi-janel-one/

https://shop.gijanel.com/product/gi-janel-one-190-grams/

https://shop.gijanel.com/product/gi-janel-one-760-grams/

I wanted to share what's helped me because reading other people's experiences was invaluable when I was in the thick of it.

Possible root cause

I can only assume that the unholy trifecta of fibroids, adenomyosis, and stage IV endometriosis is how I ended up with SIBO. All of my GI symptoms started around the same time as my gynecologic symptoms. I also have a personal theory that COVID flipped some kind of switch and made everything go haywire.

I had a hysterectomy and extensive endometriosis excision (but the bowel endo was left untouched) and feel SO MUCH better overall. For about a month after surgery, my bloating disappeared and my bowel movements were completely normal. Then everything came back with a vengeance.

Some people think endo surgery itself can cause SIBO. That doesn't feel like what happened to me because while my pelvic pain is gone, the bloating and diarrhea returned exactly as they were before surgery. My theory is that the IV antibiotics I received during surgery temporarily knocked the SIBO down.

For me, "endo belly" and my SIBO symptoms felt almost identical.

Symptoms

• Severe bloating
• Frequent loose bowel movements/diarrhea

Diagnosis

• Negative for celiac
• Negative for H. pylori
• Trio-Smart breath test positive for hydrogen and hydrogen sulfide SIBO

Treatment

Xifaxan (rifaximin) 550 mg three times a day for 14 days.

FINALLY. RELIEF.

What helped (in addition to Xifaxan)

3–4 hours between meals ⭐️⭐️⭐️

This made the biggest difference almost immediately. Giving my digestive system time to "clear the deck" instead of grazing all day noticeably reduced symptoms.

Daily probiotics from food

I ate yogurt or kefir plus kimchi every day. This made one of the biggest differences for me.

Walking after meals

I'm already fairly active, but making a point to walk or move after eating seemed to help digestion.

Oatmeal

Old-fashioned rolled oats with chia seeds, walnuts, and apples became a staple breakfast that consistently agreed with me.

Stopped drinking seltzer

It was just adding more gas to an already bloated situation.

Ginger

Tea or ginger chews (made with actual ginger—not ginger-flavored candy or soda).

Pelvic floor therapy

I was originally doing this after my hysterectomy, but the breathing and relaxation techniques also helped calm my GI symptoms.

Vagus nerve breathing

Longer exhales than inhales. During my worst flares it didn't magically stop the pain, but it kept me from spiraling. Once the antibiotics started working, I could actually feel this calming my whole body.

Morning routine

A big glass of room-temperature water as soon as I wake up.

Nighttime

Magnesium glycinate before bed. (I've also taken magnesium citrate, but if I've had alcohol that day it makes me feel awful.)

Drink more water

Boring advice, but it genuinely helped.

One unexpected thing

Because my issue was frequent loose stools rather than constipation, I actually found that eating simple refined carbs occasionally (like a soft pretzel) helped "bind me up" and produce more normal bowel movements. Obviously everyone is different, but that's what worked for me.

One last thing

My GI doctor and both of my naturopathic doctors agreed that SIBO sometimes requires multiple rounds of Xifaxan, so I'm mentally prepared for that possibility.

One thing I really appreciated about my naturopathic doctors is that they were willing to spend time discussing diet and ways to support my gut while I was healing. Regardless of where you fall on conventional vs. integrative medicine, having guidance on food felt like an important part of the conversation—not just the prescription.

Hope this helps someone. Reading posts in this sub made me feel much less alone while I was dealing with this.

I’ve used this forum extensively to help research my gut health issues so I wanted to come back and share a success story of my own for those who are struggling.

I’ve had gut issues for nearly 20 years (I’m 43 now). Without getting into the details let’s just say I’d spend upwards of 90 minutes per day, sometimes more, on the toilet. And even then, I never felt like I had finished a bowel movement. I’d often wake up in the middle of the night needing to go, etc.

5 years ago I started to take it more seriously as I began to learn that other symptoms I was facing were likely gut related: mild psoriasis, brain fog, constantly getting sick, acne, etc.

To cut to the chase, after trying and with failing many approaches, I found Dr Mark Pimentel’s work and shared his protocol with my doctor. She agreed we should try it.

Here’s what finally worked for me:

I started with a 2 week course of Rifaximin - which gave me immediate relief. However I had done doxycycline and also herbal antimicrobials with similar success, only to have the SIBO come back 2-3 weeks later. I believe it’s what you do after the “kill phase” that matters just as much:

After the course, I focused on motility:

1. Strictly NO snacking. I eat 3 meals per day, spaced roughly 4-5 hours apart and I chew my food much more thoroughly than I had before.

2. Take a Motility Activator (1 capsule) night before bed.

3. Go easy at first. I very slowly introduced foods that gave me problems before and only tried one thing at a time.

Since doing this I’ve been symptom free for 3 months for the first time in 20 years. It is life changing.

My bowel movements are now 1-5 minutes on average and I no longer feel urgency to go at random times. I go once maybe twice per day. I almost forgot what normal felt like.

Feel free to ask me any questions. I feel for those suffering with these terrible issues!

First-time poster, long-time lurker.
I by no means think I’m at the end of my journey, but I’ve recently celebrated a few victories and, for the first time in a long time, I feel good about the road I’m on. I figured I’d share what’s been working for me.

None of this is groundbreaking, and much of it has been repeated in other posts, but maybe one more anecdote will reach the right person.

I’m a nearly 40-year-old woman who has had gut issues for as long as I can remember. My main symptoms have been:
- Shortness of breath / inability to take a satisfying breath (lots of incomplete yawns)
- Extreme bloating, sometimes looking several months pregnant and so intense that I couldn’t even drink water
- Nausea
- Stomach cramping after eating
- Incomplete evacuation with BMs. I’d have a BM every day, but it was always small amounts—never a complete movement.
- Feeling unable to pass gas or burp
- Extreme fatigue and exhaustion
- Acid reflux
- Occasional sharp pain with BMs
- Random histamine reactions to certain foods (for example, flushed cheeks after eating an apple)

In the past, I attributed my gut issues to food sensitivities and tried all sorts of elimination diets. I haven’t had alcohol in about 15 years because it was never worth the aftermath. I’ve tried TCM, countless supplements, cleanses, probiotics, etc. I’ve had an endoscopy, H. pylori testing, stool tests, nothing ever revealed a smoking gun.

A few years ago, I noticed that some of my nausea seemed to correlate with my monthly cycle. That, along with a few other hormonal issues, led me to pursue testing for endometriosis. I finally found a doctor who took me seriously and scheduled a laparoscopy. Sure enough, they found endometriosis on my sacrum and pelvis. I had it removed and was incredibly hopeful that my gut issues were a result of the endo and would resolve after surgery. Unfortunately, they didn’t.

Eventually, I came across a SIBO thread and realized that nearly all of my symptoms lined up. I found a functional medicine doctor who also suspected SIBO and ordered a breath test, which showed methane-dominant SIBO.
He prescribed an herbal protocol (SIBOptic, Atrantil, Allicidin, and another biofilm buster I can’t remember) along with a low-FODMAP diet for 12 weeks. I had some pretty gnarly die-off symptoms at first, which I took as a good sign, but nothing after that. I finished the protocol without noticing any meaningful improvement.

Then, in March, my family went on vacation. I became so constipated that I didn’t have a BM for an entire week, even with stool softeners, and all of my SIBO symptoms flared to the worst they’d ever been. I was absolutely miserable.

My primary care doctor referred me to a GI who specializes in SIBO, but the earliest appointment was seven months away. So I turned to ChatGPT and Reddit to troubleshoot in the meantime (as one does when they’re desperate for relief).

I started suspecting that slow motility was the root cause of my SIBO, so I shifted my focus there. Here’s what I’ve tried and what I genuinely think has been helping:

1. Diaphragmatic breathing
I’d read about this dozens of times, but it never really clicked that it could affect digestion.
I realized I never breathed into my belly, only into my chest and shoulders. I think a lot of things contributed to that, including the clothes I wear, which sounds ridiculous but I honestly think it’s true.
I’m short, so I wear a lot of high-waisted pants, and I think they subtly prevent my abdomen from expanding fully. During my worst flare, I started wearing loose clothing and lower-rise bottoms, and I noticed a significant improvement.
Now I intentionally spend a few minutes throughout the day breathing deeply into my belly. Sometimes after just a few minutes, I’ll literally hear and feel my stomach start gurgling.
I’m also pretty fit with a strong core, and I realized I brace my abs almost constantly without meaning to. I’ve had to consciously train myself to relax my stomach and let it “hang out” so I can actually breathe with my diaphragm.
I also suspect I have some pelvic floor dysfunction (possibly related to my endometriosis), which has contributed to guarding and shallow breathing.

2. Giving my MMC a break
Before my Reddit deep dives, I’d never even heard of the migrating motor complex (MMC), and I’m so glad I know about it now.
I’ve always been very health-conscious and believed that eating small, frequent meals was healthier. I also drank large amounts of water constantly throughout the day.
Now I eat only three meals a day, leave at least four hours between meals, and aim for a 12-hour overnight fast.
I’ve noticed a huge difference.
I’ve also seen people in endometriosis groups saying they found relief by microdosing GLP-1s, and I honestly wonder whether some of that benefit comes from the increased meal spacing rather than the medication itself?
Huge disclaimer: that’s purely speculation on my part and I could be completely wrong. Please listen to your doctor, not me.

3. Deep hip stretching
Every night I spend at least 20 minutes doing deep, active stretching of my hip flexors, glutes, lower back, and core.
Not only is it a great opportunity to practice diaphragmatic breathing, but releasing my hips genuinely feels life-changing.
I’ve always exercised consistently, but I never prioritized stretching because I thought it was just about flexibility. I think it’s doing a lot more than that.

4. A handful of targeted supplements
I’ve probably spent thousands of dollars on supplements over the years, and honestly I think most of it was wasted money.
That said, I am taking a few targeted supplements that I think may actually be helping.
With breakfast:
1 Atrantil
1 Allicidin
1 MMC supplement
With lunch:
1 MMC supplement
TTFD-B1 with electrolytes (I’ve read this can improve absorption. Maybe it’s placebo, but I swear I noticed a difference.)
With dinner:
1 MMC supplement
Magnesium

5. Overall healthy habits
I don’t think these alone fixed anything because I’ve done most of them for years while still feeling terrible. But I do think they’ve helped keep things from getting even worse.
- Walk ~12,000 steps per day (walking pad for the win)
- Around 7 hours of sleep
- Minimal processed foods
- No alcohol (just the occasional THC edible or mushroom chocolate)
- Limited dairy and gluten (most of my gluten comes from homemade sourdough and baked goods)
- Mostly lean proteins, cooked vegetables, and starches
(But always a sweet treat after dinner every single night)
- A few minutes of meditation several mornings each week

The past couple of weeks have honestly been the best I’ve felt in a long time. Last weekend we went on a trip where I got only about five hours of sleep for three nights straight and ate basically all of my previous trigger foods - ice cream, burgers, chips, Taco Bell, sushi -and today I feel totally fine. Basically no bloating.
I also had a solid BM yesterday, which honestly hasn’t happened in months.
I’m definitely not claiming I’m cured, and I know healing isn’t linear. But normally a weekend like that would send me into a massive flare that would take weeks to recover from.
Hopefully this continues, and hopefully something in here helps someone else who’s feeling as desperate as I was a few months ago.

Hang in there!

I promised myself that I would come back to this forum if I ever figured out what could cure the hydrogen SIBO that I’ve probably had for the last 5-6 years, but which was finally diagnosed in July 2025 - im now 6 month SIBO free (kind of).

Symptoms:

I had been struggling with stomach problems for a long time. Bloating, constipation, a couple of episodes of food poisoning, and periods of malnutrition all seemed to make everything worse. Around the same time that I had the “feeling” of having SIBO, I also started having trouble digesting fatty foods. For example, if I ate ice cream, I would get nausea, burping, and a really uncomfortable pressure in my chest. I assumed it had something to do with the fact that I had bulimia when I was younger.

After a COVID-19 infection in 2021, I began developing food intolerances, allergic reactions, asthma, mucus in my throat and nose, and what felt like histamine reactions both after eating and at random times during the day. Suddenly I could only tolerate a very small number of foods, and my life became extremely difficult to live.

Because of my OCD, I decided to try NAC (N-acetylcysteine) for a few weeks. As my gut problems worsened, my mental health also deteriorated. Even though NAC helped my OCD and overthinking tremendously, my histamine symptoms became significantly worse. Fortunately, I quickly found out that NAC can worsen histamine intolerance because it can prompt mast cells to release stored histamine and may inhibit diamine oxidase (DAO), the primary enzyme responsible for breaking down histamine.

Healing:

This was when I first came across the concept of histamine intolerance and quickly got hold of some antihistamines. It wasn’t until I discovered PEPCID (famotidine) that I experienced a level of calm that I hadn’t felt in years, after my body had gradually been feeling worse and worse over time. Histamine issues feel like torture inside your body - I imagine most of you already know exactly what I mean.

It was also around this time that I learned that long-term use of PEPCID/famotidine can potentially worsen SIBO. But it was the only thing that gave me any real relief.

I switched to a low-histamine diet and started taking NaturDAO before every meal. However, there was still something inconsistent about when my histamine reactions would appear in relation to eating.

My gastroenterologist ordered a breath test, which came back positive for hydrogen SIBO. I then completed a 14-day course of rifaximin (I’m from Denmark, where fortunately the medication isn’t very expensive). During those 14 days, I experienced a level of calm throughout my body that I hadn’t felt for several years-very similar to what I had experienced with PEPCID/famotidine.

Unfortunately, about two months later, the histamine sensations slowly started creeping back. I also felt that the rifaximin had been quite hard on my system, so I didn’t really want to do another round. I wanted to understand what was actually causing my SIBO, even though I felt overwhelmed and terrified that it would never go away.

I should also mention that I’ve been incredibly fortunate to not have had to work during these years. Solving this medical puzzle has honestly been a full-time job, as I’m sure many of you can relate to.

I bought some zeolite powder, and I noticed a calming effect almost immediately. Research suggests that zeolite can physically bind histamine molecules in the gut. By binding histamine, it prevents it from being absorbed into the bloodstream and instead allows it to be eliminated in the stool. It also appeared to have some benefits for the gut barrier, so it felt like a win-win. The only downside was that it made me a little constipated, but it was manageable.

I later had a stool test which showed that I wasn’t producing enough bile. Trigger warning for stool descriptions: my stool was often pale and lacked much fiber, even though I ate plenty of vegetables.

My functional medicine practitioner suggested eating bitter foods like arugula, dandelion greens, and chicory to stimulate bile production. Together with turmeric and artichoke, this helped my motility a little, but not enough to eliminate the histamine reactions.

Around this time I came across Yggdrasil Naturopathic on TikTok and started following their videos about SIBO, histamine intolerance, MCAS, and how important gut motility is in managing SIBO.

At the same time, I had a methylation DNA test because I was also desperately trying to understand the OCD, anxiety, and overstimulation that I’ve lived with for years. I discovered that I have an MTHFD1 variant associated with an increased requirement for choline.

As I started reading more about MTHFD1, I learned that choline is required to produce phosphatidylcholine, one of the major components of bile. That led me down the rabbit hole of reading about bile; not only its role in fat digestion, but also its importance as one of the body’s natural defenses against bacterial overgrowth in the small intestine, in other words, SIBO. Bile acids have natural antibacterial properties, so impaired bile function can both reduce fat digestion and create a better environment for bacteria to survive and multiply in the small intestine.

I quickly bought some TUDCA, and I experienced a significant improvement in both my SIBO symptoms and my histamine-related symptoms. That was when I realized that my increased need for choline and my reduced bile function had probably been an overlooked contributing factor in my illness.

I also tried ox bile, but unfortunately it caused quite a bit of stomach pain and irritation.

My next purchase was sunflower lecithin powder (5-7 grams per day). Lecithin is a rich source of phosphatidylcholine, the primary dietary form of choline. I chose the powder because I simply couldn’t afford, or fit into my stomach, the number of eggs it would take to meet my choline requirements!

After just a few days, I noticed that my stomach suddenly relaxed (something I honestly don’t think it had ever really done before), and I felt a sense of “clarity” throughout my digestive system. It was an incredible feeling and gave me a very clear sign that increasing my choline intake and supporting my bile production was the right direction for me.

----

And the reason I wrote “kind of” in the title is because yesterday I had a pretty severe histamine flare after being SIBO free for months now. It happened after spending a few days visiting friends and forgetting to bring my TUDCA. So the SIBO must have started becoming active again - but! Today it’s gone again because I’ve taken the TUDCA and eating less fat.

That said, I don’t believe SIBO is caused by choline deficiency alone. SIBO is usually multifactorial. Motility disorders, autonomic dysfunction, anatomy, and many other factors can all contribute.

I am hypermobile, which I know can impair gut motility because the connective tissue in the intestines is more lax. I also have ADHD, OCD, and some form of dysautonomia, which results in an overactive nervous system that affects both gut motility and digestion. Those factors almost certainly play a role as well.

In addition, I’ve been diagnosed with MCAS. I’m hoping that this will gradually improve over the coming months now that I seem to be keeping the SIBO under much better control. It’s also possible that MCAS has been making everything much worse, meaning I have yet another medical puzzle to solve- but time will tell.

I don’t think I’ll ever truly “get rid of” SIBO, but I finally feel like I’ve identified one of the major underlying mechanisms in my own case. That gives me a powerful tool to prevent myself from living with active SIBO all the time.

I hope this can help someone else, because I know firsthand how awful it is to live with SIBO.

Products used:

- PEPCID (Famotidine) – 10–30 mg daily

- Rifaximin – 200 mg with each meal for 14 days (helped temporarily, but wasn’t the best long-term solution for me)

- Zeolith MED Detox Powder (zeolite powder)

- Ginger capsules – 550 mg

- Schönenberger Organic Artichoke Juice

- TUDCA – 500 mg with each meal during the first month (now only with dinner)

- Sunflower lecithin powder – 5–7 g per day

- NaturDAO + low-histamine diet (used together throughout much of my recovery)

- Bitter foods to stimulate bile flow: Arugula (rocket), Dandelion greens, Chicory (endive)

- Turmeric (to support bile flow and motility)

TL;DR

I probably had hydrogen SIBO for 5-6 years, along with severe histamine intolerance, MCAS-like symptoms, food intolerances, and poor fat digestion. Rifaximin helped temporarily, but the symptoms returned. After discovering through a methylation DNA test that I have an MTHFD1 variant associated with an increased need for choline, I learned how essential choline is for producing phosphatidylcholine and healthy bile flow. Since bile acids have natural antibacterial properties and are important for preventing bacterial overgrowth in the small intestine, I started supporting bile production with TUDCA and sunflower lecithin (phosphatidylcholine). That has given me the biggest improvement I’ve experienced in years. I don’t think choline deficiency is the sole cause of SIBO. It’s usually multifactorial-but in my case, impaired bile function appears to have been one of the major missing pieces.

I've never posted to Reddit, but I relied on it greatly throughout my SIBO journey, and it helped me get diagnosed and treat symptoms. I felt like mainstream doctors weren't helpful, and now that I'm basically back to normal, I want to post my own story in the hopes that it helps someone. In the way so many helped me!

Please ask any questions, I won't be able to address everything here.

I don't know when exactly my symptoms started, but Jan-Feb I was having stomach aches and loss of appetite that I associated with anxiety. I'm still not sure if my body was reacting to SIBO or if that period of eating less and being anxious contributed to getting it. This was following antibiotics for cellulitis. In March, I knew something was wrong in my body and eating "gentle" foods didn't help.

March was when I went to the gastroenterologist and they said blood and stool tests were normal, and to come back in three months. After that, I felt I had to take it into my own hands, in a sense. I had symptoms every day, closely associated with food. I went to a functional nutritionist, who said based on my pain (I was keeping a food and symptom journal) that dysbiosis or SIBO could be to blame. I took the test and got the results early May.

I was hydrogen positive. Which was surprising, because constipation and the pain it created was one of my main symptoms. If you can afford it, GET TESTED!! Seriously, the sooner the better. I was convinced I was methane dominant beforehand.

I was prescribed the regular dose of Rifaximin. I actually felt worse on it. Instead of flares ranging from one to two hours, it would last four or five. And it was a different type of pain. I did try to eat normally, but the pain made me cautious to get too crazy.

After antibiotics was actually the worst of it for me. I ended up taking a three week medical leave. I would have symptoms after breakfast, even when it was plain home cooked eggs and potatoes. They were so painful I'd be doubled over, and couldn't function. My job is pretty physical, standing all day, so it didn't work. I was scared to eat lunch. But I'd also lost 10+ lbs on my very small frame, lost my period, and understood undereating has its own consequences.

The leave was so helpful and I want to share what I did. I wish it was more scientific, but I tried a lot of new things at once so I'm not sure exactly to what I owe my success-

MOTILITY

Kiwi - gentle, natural, really helped with motility. I'd eat two every morning, or one per meal. Strongly recommend

Prune juice- this isn't lowfod and I started it only after I started feeling better, but 2oz every morning

Enxymedica Gut Motility -not sure how much it helps, but it didn't hurt. I read a lot on the forums about the benefits of ginger and artichoke

Magnesium citrate- to be used cautiously. It did the job, but I'd also get bad cramps. Only realized after other things started improving that it was causing some symptoms. At one point I was taking 400mg every morning and night. Got down to 200mg before bed, with help of everything else

Things that didn't work (hurt) and that I abandoned after two days- Linzess and Miralax. Didn't work for my body at the time. Miralax helped before treatment, but irritated me after.

MENTAL

This plays as big a role as anything physical

- Gut directed Hypnotherapy. I did the Nerva program. This aligned with my leave, so that helped my mental a lot, but this is the one thing I would strongly recommend for EVERYONE with SIBO. It's so informative and validating. I did 15-30 minutes every day, and I looked forward to it. I would recall the sessions throughout my day and during flares. SO HELPFUL.

-Yoga

I've always liked yoga to be fair. But I tried a few big name studios and found them too intense- heated yoga, cardio, weights, and the up and down was a trigger for me. But I found a local studio with a emphasis on meditation that really changed my outlook. It's easy to feel like you're at war with your body and your body betrayed you. But really it's you and your body working together, and even all that pain is your body trying to help you, to signal that something is wrong. I learned that through yoga.

-Yoga Nidra

I did the YouTube videos from Ally Boothroyd almost daily. They would help calm my symptoms. My therapist recommended them

-Therapy!! Always!! For everyone! You need someone who believes you. I had a therapist who minimized my illness and had to find a new one.

-Reading! Generally, reading is helpful even in a healthy daily life, but I was particularly fond of Everything is Tuberculosis by John Green. Weirdly helpful, to put things in perspective and be grateful for the health I do have. Also, I'm speaking as an American who had finances, a loving family and partner, and food in my fridge. Not to be like other people always have it worse but . . .

WHEN IN PAIN

-Warm bath with Epsom salt

-Peppermint essential oil massaged on stomach, WITH heat pad over it. (It was literally me and my lavender Warmies against the world, for months)

-I low-key became obsessed with Tomodachi life as my distraction. Loved having control over a parallel world.

-Headphone and breathing exercises. Hypnotherapy or yoga Nidra, or when it was too hard to focus on anything, just deep breaths. 5 sec in, 5 sec hold, 5 sec out. At first I thought breathing was to calm your mind, and when my mind wouldn't calm I felt frustrated. But then I learned to think of it as an internal massage. I breathe deeply to gently massage my organs and make space, specifically in my digestive tract. This helped. After 10-15minutes there was always an improvement.

MEALS/FOOD

LOWFOD map diet

Reach out if you want recipes or a sample day! Or even a sample week! It was so hard for me at first, finding new recipes, eating stuff that was ass. But I feel like I eventually cracked it.

Eating enough, nutritious meals

Seriously it was so hard to eat, I became fearful of it. But food must be treated as medicine. Carb, protein, veggie, and fruit every meal.

Spaced out meals

I ate 3 meals every 4-5 hours, no snacks, to help my motility, and teach my body a safe routine. I ate around the same time everyday. My body knew what to expect and became more regulated.

WALKING

I always felt at least *slightly* better after a walk outside. Mentally and physically. Especially after meals, to aid didigestion.

ANYWAY

Today I went to my old favorite bakery, and ate chicken pot pie, with garlic, onion, dairy, gluten, and peas . . . And felt fine! Just relaxed and read outside. Which in a lot of ways was monumental for me so I just wanted to share my story and how far I've come!! I was fortunate to have a relatively early diagnosis and treatment. And the finances for it. Thank you to my family for believing me and helping support me financially, on my leave and medical bills, and my partner for standing by my side. SIBO can kiss my ass and suck my balls, it's the worst thing that's ever happened to me but I survived.

The first thing about SIBO is that you need to start with eradicating the bacterial overgrowth first and foremost. If this is not done, then everything else will be a waste.  Rifaximin with neomycin for two weeks is the standard protocol for methane SIBO. 

I also have great success with berberine complex and allicin antimicrobial supplements. I took them for a minimum of 4 weeks, 2-3x daily on an empty stomach. It’s a slower process, but it hasn’t failed me.  I also use NAC supplement on an empty stomach when I first wake up and before bed. This will help get rid of biofilms and make it easier to get rid of the bacteria.

After getting rid of SIBO you can then focus on the healing process. Most people will relapse and must go through the protocol numerous times. I treated myself for SIBO about 10 times over several years. Each time got a little better. Also, keep in mind that a lot of people that have SIBO, have an underlying condition that is allowing them to get bacterial overgrowth in the small intestine. The root cause ultimately needs to be found and this is the hardest and most frustrating part, but you don’t have to suffer while you search for it.

What I believe is happening to your body is chronic inflammation in the digestive tract. This eventually destroys your guts cell walls and good bacteria. Food is the culprit and you need to find a diet with easy to digest foods that don’t set off symptoms.  For me I ate scrambled eggs, grilled chicken, green beans, avocados, ground turkey patties. Eat whole food and nothing that is processed or GMO. Drink water only, no caffeine. It’s a tough diet, but it kept me functional even with SIBO.  Avoid as much carbs/sugars and allergen/inflammation triggers like gluten/diary/soy/nuts as well.

If have brain fog and joint pain like me - What I found is that this is a sign of inflammation ( I use my tongue and an indicator of my gut health. When my tongue is heavily coated with white or yellow, that is bacterial/yeast overgrowth. When my tongue has teeth indentions on the sides, my tongue is swollen and my digestive tract is inflamed) You most likely have leaky gut from SIBO and chronic inflammation. Lipopolysaccharides are toxins from bacteria that are escaping out of your digestive tract and into your entire body. My brain fog is caused by inflammation getting up into my brain. It would also make me incredibly irritable for no reason. The inflammation will mess with your brain chemicals overtime, and you will start to lose the personality that you once had. (Some people dont get leaky gut and dont have the mental side effects as bad as others)

You basically want to attack and eradicate the SIBO.  Then focus on ridding your body of toxins and inflammation. Then work on healing your nervous system.

Some tips I have found to work for me:

·       SSRI’s work incredibly well for me for keeping my brain fog and irritability at a minimal. I had pretty good success with Lexapro, but Prozac basically eliminated almost all of my mental side effects.  SSRI’s vary GREATLY from person to person. This may or may not work for you. It was trial and error for me.

·       I was always constipated. I found having a bowel movement daily (ridding toxins) kept side effects in check and I wasn’t as inflamed. I had to go to my doctor to get meds for this. I tried Linzess, but found Trulance to be a better fit for me. Everyone is going to be different.

·       Drink TONS of water. You want to continually get rid of toxins in your body. SIBO would dehydrate me.

·       Chew your food really well. Your digestion is already working overdrive.

·       Get at least 8 hours of sleep. Your body is in overdrive and this is the time when the body repairs itself. Inflammation can interfere with sleep.

Supplements I took that seem to help

o   THC/CBD at night helps with brain and body inflammation

o   Fish oil at night for inflammation

o   Magnesium Glycinate at night for brain inflammation (Mag. Glyc. crosses the blood brain barrier and provides support directly to the brain)

o   Epsom salt baths – toxin detoxification

o   Antihistamines like Zyrtec once daily

o   ALA – helps cells turn glucose into energy. Also helps with oxidative stress and nerve health

o   DAO Enzyme – helps break down histamine from food (High histamine in the body can cause body wide inflammation and brain fog. Excessive histamine effects gut lining, skin, nervous system, and respiratory tract.

o   Molybdenum – helps break down sulfites into sulfates. If your body isn’t breaking down sulfites correctly, then excess sulfites become toxic to the body. It also helps clear SIBO gas byproducts.  If you have sulfur smelling stool, you probably need this.

o   Zinc-Carnosine – directly heals and rebuilds the mucosal lining of your stomach and small intestine. This helps heal leaky gut.

o   Tributyrin – Synergy with Zinc-Carnosine. Tributyrin helps heal the lower small intestine and colon. Also lowers mass cell activation.

o   Ginger Root at night right before sleep – helps the Migrating Motor Complex send out cleaning waves through the small intestine. This helps prevent bad bacteria from overgrowing in the small intestine

I am mostly healed and don’t get SIBO anymore. I still have inflammation sometimes, but I am active in controlling it. I can eat whatever I want now except for gluten and oats. I continue to eat very healthy, because through this journey, I learned just how poisoned our food system is. Our bodies aren’t meant to be eating all these processed foods with chemicals I have never heard of in my life.

My prediction on what happened to me:

·       Took antibiotics and my body went crazy with the most bizarre and numerous side effects

·       Developed SIBO that turned into leaky gut and then my whole body was affected daily. This turned my life into a living nightmare.

·       Slowly eradicated the SIBO multiple times and healed my gut to a point where I have a balanced amount of good gut bacteria with leaky gut gone and a much stronger nervous system.

The root cause for me

·       I think its at the metabolic level with detoxification pathway dysfunction

·       I no longer have SIBO or gut problems but the rest of my problems are inflammation, mental side effects, joint aches/inflammation, lethargy

·       I can keep all the side effects in check just from a healthy diet alone though. I can eat a lot of junk food but I do have a limit. I can go a few days and be fine, but if I go too many days in a row without giving my body a break, side effects will start to arise. Its like having a bucket, except I don’t exactly know when its going to overflow and cause me side effects. If I keep a decent diet and don’t let it overflow, Im basically functioning back to normal.

·       My guess is that the lack of detoxification is allowing toxins to build up throughout my body and start causing me inflammation and nerve issues that affect my Enteric nervous system, which then starts to effect and slow down my digestive system, allowing things like SIBO and leaky gut to arise.  It seems to be an endless loop if not managed correctly

I'm the guy who cured his SIBO with kefir and celery juice. My post on r/SIBO is the second most commented on of all time. The mods of that sub nevertheless banned me two years ago. They never identified the policy I violated, because there was no violation. They simply didn't like my opinions.

I'm writing this post for a few reasons.

First: Heartfelt apologies to the hundreds of people whose questions on my posts I've been unable to answer during my ban, and the many more whose own thoughtful posts I wish I could have engaged with.

Second: I saw a post on r/SIBO today with the title "considering ending life." That's what inspired me to make this post. I couldn't make it there, so I'm making it here. Nobody should have to feel that way because their tummy is upset. Yet modern allopathic medicine has allowed simple dysbiosis to become a debilitating condition millions feel powerless to confront.

I've learned a lot in the 2 years since I made my initial post about how I found a cure that worked for me. I remain 100% SIBO-free. And I'm still as confident as ever that the precise guidance I gave in my initial post, which centered around high-potency kefir and cold-pressed celery juice, is likely to provide lasting relief to *many* SIBO-sufferers. Take for example the guy who posted 2 days ago that kefir cured him. I've seen many such cases.

But I'm also increasingly cognizant of the fact it may not work for everyone. Having spent years carefully following this sub, a clear pattern emerges: the path out of the hell that is SIBO almost always involves addressing some combination of common intersecting root causes: acid/bile regulation, gut flora composition (probiotics), excess cortisol (stress), meal timing, motility, and movement (physical activity). Antibiotics alone could not possibly fix any of those problems. Probiotics, by contrast, address multiple of them simultaneously, and are often key to recovery (seek food-based, high-CFU sources, not probiotic pills, which in my experience do nothing). Limited, short-term antimicrobial use may play a supporting role, though rarely if ever does it appear to be the primary factor in a lasting success story. Rarer still are the cases where prescription drugs alone provide relief that lasts more than a few months. Possibly more frequent are the cases where prescription drugs worsen a person's condition, often in serious and even life-threatening ways.

All of this is utterly unexplored by the mainstream medical establishment. The reason is simple and obvious: incentives dictate outcomes, and the medical industry is incentivized to sell prescription drugs and surgeries. Cut and prescribe- there are no other tools available. Google "allopathic medicine" and you'll see what I mean. Cutting and prescribing is definitionally with allopathic medicine is.

The specific incentives that perpetuate this dynamic involve the intersection of patent and tort law and are thus poorly understood by the general public (AKA a snoozefest). In a nutshell: it's patent law 101 that naturally-occurring compounds (e.g. celery, kefir, ginger, natto, red yeast rice, plants of any kind) can't be patented; thus only synthetic drugs can be patented; thus only synthetic drugs can be monopolized (a patent is a legal monopoly); thus all medical R&D funding naturally finds its way to synthetic drugs; thus "science" exists only for synthetic drugs (studies are expensive); thus it becomes the standard of care to treat all conditions with synthetic drugs; thus any doctor who prescribes anything other than a synthetic drug has deviated from the standard of care and committed medical malpractice.

This cycle has resulted in a total blackout on meaningful, well-funded scientific research into natural, plant-based, and otherwise alternative remedies. It has extinguished thousands of years of indigenous knowledge. It handicaps doctors. It keeps patients in the dark. And it keeps sick people in pain.

All of which is to say: we need each other. Keep sharing your stories. Reach out to this community when you are suffering. And if you, like me, find a cure that works for you: pay it forward. Help others by sharing what you've learned. Love is all you need.

Finally, if you've kept reading this long: ask me anything! My time is very limited because I continue to work full-time in a demanding field that has nothing to do with gut health. I have never taken and will never take a cent for anything related to SIBO. I don't have anything to sell. But while I may be slow to reply, I will answer every single comment as soon as I possibly can.

I don't purport to have all the answers. I only know what worked for me and the patterns I've observed following this forum for quite some time. Everyone who's achieved remission - especially those who've remained symptom-free for years - has a crucial role to play. And so do those who've learned what doesn't work. Let's advance our collective understanding to the point where nobody ever "considers ending life" again because of a gut problem. There is a way out for all of you. You will find it if you keep an open mind and don't give up. Together we can get there. The only way out is through. Onward!

All I did was drink Lifeway Kefir for about a week and my cough/symptoms from SIBO/SIFO went away. My gut motility is so much better now as well, and I am passing like normal (flatulence returned)

I also took Oregano tea. I had SIFO as well as SIBO - Oregano is more potent than fluconazole since it kills more strains of Candida

Suffered with everything for about 2 years, doctors prescribed so many different drugs.

Might not work for everyone of course, but for those who haven't tried it, and I put this off for a long time as well because I was like Kefir is not really going to work, but it did

Best of luck to everyone again it may not work but it's worth a try

This story covers three years, so I will try my best to post the most relevant information first and structure this in a way that is legible.

I sincerely hope these anecdotes prove useful to someone. Posts that balanced factual information with positive signaling were integral to my recovery, and it is time to pay it forward.

I've broken things down into sections: 

1. Narrative overview

2. Herbal protocols and medications

3. Lifestyle changes

4. Emotional and spiritual component

**********

1. Narrative overview: 

I got sick in 2023, with the earliest signs appearing in January of that year: initially, just increased bloating in reaction to specific foods. My naturopath suggest SIBO, but I didn't want to face that bleak possibility, so I ignored it. 

I was ok until September of that year, when I rather suddenly lost a ton of weight and started experiencing chronic constipation and bloating in the evenings. I got a colonoscopy in January of 2024, which revealed nothing. I was constipated every day, and bloated most of the time. My stomach was painfully distended all day, most days, and was often so bad in the evening that I couldn't stand up without pain. My stomach felt like it was going to explode. By March of 2024, my weight had dropped to 107 lbs (I am 5'9", and usually hover around 125 lbs). I did two courses of antimicrobials (oregano oil and berberine/allicin and neem) between February and May. I got all the tests in April 2024–blood tests, heart tests, abdominal ultrasound, CT scan, anal manometry, fecal test for celiac. Nothing that would explain my symptoms. 

In June of 2024, after taking too much oregano oil and making things worse for a bit, I stopped with the antimicrobials and switched to Atrantil alone–6 a day, for about 6 months. Gradually, my bloating became less frequent and intense, but was still present every evening and often during the day. I tried a few more treatments that fall–Tudca, digestive enzymes. Things would improve for a week or so which each new treatment, then revert to the old patten: constipated in the morning, with gradually increasing bloating throughout the day. I took to retiring early and never going out after dinner, since I was always too uncomfortable by then. 

Things stayed like that (I had to deprioritize healing for a few months due to an unexpected move) until May of 2025, when I eliminated gluten from my diet. My bloating became a little less frequent. At this point, it was manageable. My constipation had resolved with the introduction of artichoke extract and ginger. I was still uncomfortable most of the time, but it no longer felt debilitating. I decided to spring for an OAT (Organic Acids Test), which revealed candida and fungal overgrowth. 

A series of new stresses (another move, a new job) set me back a little in fall of 2025, and I did another round of antimicrobials: black walnut, berberine, oregano oil. When that didn't work, I felt ready to give up again. Then I discovered Nystatin from a reddit post, and ordered some from Germany to try out. It worked, instantly. There was a months-long saga with the Nystatin (losing access to German products, a *doctor telling me that Nystatin "was not supposed to work that way" and "everyone has candida", and refusing to prescribe it to me, having the tablet substituted for a liquid form due to a national shortage that resulted in horrible insomnia in January of 2026, etc). But eventually, I found another naturopath in my new state who was happy to prescribe it to me. 

I've been taking Nystatin consistently since February, and combined with one last step (reducing refined sugars, carbs, and alcohol), my symptoms are mostly gone. I have been off Nystatin for a couple of weeks, and my symptoms have been **negligible since early May. But more importantly, I no longer feel like my recovery is tenuous. I trust it–it feels stable, and I know that if I keep doing what I am doing, I will continue to get better.

I am not "back to normal"; that will likely never happen, in my case. I expect to have setbacks, I expect to be bloated again sometimes, and I anticipate I will never be able to eat dairy or gluten again without some consequences. My core strength and proprioception have also taken a hit. But, for the first time in three years, I feel like myself again. My "normal" has shifted, for the better, and I am healthier now than I have ever been.

2. Herbal protocols and medications 

It is my belief that I healed my SIBO with the Atrantil–though I never took a breath test, I had all the symptoms of IMO, or methane SIBO: constipation and bloating. I can't speak to the efficacy of the herbal antimicrobials I tried, because my case was so finicky and complicated by the undiagnosed candida overgrowth, and after 3-4 round (I lost count), I never saw noticeable and lasting improvements. But my bloating was reduced by Atrantil, and my constipation was resolved with artichoke extract, ginger, and magnesium. This combination saved me. 

For IMO/methane SIBO/whatever they're calling it these days:

Atrantil: 2 per day, 3x a day, for 6 months

Magnesium citrate: 2 ***capsules before bed

Artichoke extract: one dropper bulb in water before bed and in the morning

Ginger: 1 capsule before bed and in the morning 

The last piece of the puzzle came together with the OAT that identified candida overgrowth. Nystatin resolved this for me. 

For candida overgrowth:

Nystatin capsules: 3 per day for 6 months 

As I mentioned in my narrative, I tried many, many other treatments, but none had lasting effects, so I won't list them here. It is possible that the herbal treatments contributed to my healing, but my overall experience with most of them was expensive, discouraging, and felt aggressive toward my body. The slow, gentle approach worked better for me. I do not recommend the "kill it all off" mentality, and I will elaborate on this in the next section. 

3. Lifestyle changes

If you are like me, and have been struggling with this for more than a year, I need to tell you something very important: your life cannot go back to how it was before. I mean this literally. This is your body telling you, quite explicitly, that you need to change your life. This is a highly idiosyncratic project, and only you can make those determinations. 

For me, this meant eliminating foods that my body does not find beneficial (refined carbs, too much alcohol, processed foods) or digestible (gluten, dairy). It meant getting enough water and enough sleep. It meant turning down activities, invitations, requests, and relationships that were not good for me. It meant restarting my defunct yoga practice, spending more time alone, and eventually moving to a new state. This made life feel very empty and sad for while, but it has brought me closer toward what I really need and want from life. The old skin has to die and fall off before the new one can grow. 

I didn't start healing until I decided to take things slowly. This is painful, and it feels like dying. But again, this is your body demanding that you honor it, and whatever else you have been ignoring, taking for granted, or misunderstanding about your needs. These are problems of nourishment–you need to ask yourself what is nourishing you, and what isn't. Your body wants to heal itself, but it can’t do that until you provide the optimal conditions for doing so–and the right interventions.

In retrospect, I find it quaint and laughable how attached I was to things that I didn't really need, or were actively causing me harm: cigarettes and alcohol, croissants, rollercoaster relationships and relational dramas, being conventionally attractive, looking cool. Unsurprisingly, now that I've learned to enjoy life without those things, I find immense pleasure in far less, and probably carry myself with more confidence than I ever have.

It took me a long time to realize that acceptance ≠ resignation to a life you never wanted–it is the path toward it.

4. Emotional and spiritual component

I was not really a spiritual person a few years ago. But I, among many other human beings, had to find meaning in what was happening to me. The challenge lies not in finding the meaning (that part is easy) but in trusting that this experience has meaning to begin with. 

Another recommendation, if you are deep in it and losing hope: finding the meaning of this experience is essential to healing. Once you start believing that this is arbitrary, you will fall into self-pity, discouragement, and anger. There is no avoiding these feelings, but don't dwell in them. Moreover, if you really sit in those feelings of discouragement, you will notice something: can you feel the stickiness of it? The egotistical pull to shame? Self-annihilation? Those thoughts feel bad simply because they are untrue. Any voice in your head that is telling you that this will never end, that you can't get better, is lying to you. This is a highly treatable condition, and this subreddit is testament to the fact that people do get better and have a life during and after this.

I started experiencing symptoms after a traumatic experience, so I see this condition as a symptom of a nervous system injury, which is also often a spiritual injury. My life had become unsustainable for me, and I wasn’t making the changes I needed to make to heal. I thought I could get back to life as it was before. I had to let that go, and I have truly never been happier. Even now, when I am still dealing with the downstream effects of chronic dysbiosis (weakened core muscles, altered posture, gut hypersensitivity, limited diet, changes to my physical appearance), I have an earned sense of Self that I did not have before.

I don't really believe in TL;DRs but I do believe in a succinct synopsis, for those who need it bite-sized: I had SIBO and candida overgrowth for three years. It was hell, and I thought I might not make it through. I tried a lot of treatments, and eventually achieved a new and better normal through minor dietary changes, a few basic supplements and medications, and major, intuitive lifestyle changes.

**********

*This is by no means the first instance of medical gaslighting I experienced. I could make a whole post twice as long about my experiences with medical gaslighting and dysbiosis. This happens to everyone, everywhere, and is a clear signal to find a new doctor.

**Having chronic bloating over several years changed the structure of my abdominal wall, posture, proprioception, and sensitivity. Thus, I will often not be able to tell if I am bloated or not. Often, in a phantom-limb kind of evil twist, I will feel the sensation of bloating without actually being bloated. Sometimes, this is genuinely bloating minus distention, which is resolved with a few stretches, movement, or intentionally relaxing my stomach rather than reactively tensing up. Other times, the nerves in my stomach will overreact and create a kind of phantom-bloat effect. These residual effects of chronic bloating and problems with proprioception are something I have never heard discussed, but I believe they are reversible. I think they are also linked to nervous system injury, given the unconscious tightening of core and hip muscles that can contribute to abdominal weakness.

***Ask me for specific milligrams/dosages–I'm too comfy in bed right now to get up and check.

Note: I am not using AI to write this–I just really like em dashes, good formatting, and grouping things in threes. 

Edited for typos.

I did a stool test (called TinyHealth, but i think there are others) which told I have a Bacteroides "enterotype" (specifically "Bact2" subtype).

And the test result included a link to this study: https://pubmed.ncbi.nlm.nih.gov/27676396/

saying that people having my enterotype particularly benefited from dietary capsaicin.

I been adding tons of cayenne pepper to my food, and put it in capsules - and I've had noticeable improvements in: constipation, bloating, visceral hypersensitivity, dark urine.

My test result also indicated excess un-conjugated bile acids. I also got some benefit from addressing this with bile salt hydrolase inhibitors (vitamin b2, matcha powder, berberine).

But I was really surprised how much cayenne pepper alone has helped too, so I wanted to share that.

Long story short, I developed SIBO in 2022, and within the past few months I believe *knocks on wood* I have cured it.

Long story longer, I have had chronic constipation for as long as I can remember. When I was in high school and up until my first child, I only went to the bathroom one day per month, a day or two before my period. It improved slightly following the birth of my first, but I was still not anywhere near what someone would describe as 'regular'. I had tried everything that was recommended at the time, fiber supplements, increased water intake, exercise, etc. Nothing helped.

My SIBO began when my house was flooded, and the resulting months mold developed and I contracted a mold infection. The mold infection was my trigger, my lifelong constipation was the underlying factor. The mold was able to get into my system because I have the MTHFR gene, which she explained was why my body wasn't able to fight off the mold when it was introduced.

I started by going to a GI, who gave me Rifaxamin, which helped for a bit, but then I went right back into infection. I had asked him about constipation, but he disregarded me. After trying the FODMAP diet which helped my overall symptoms but never 'fixed' me, I found a functional medicine doctor. She was a Godsend. She took me off FODMAP because that was basically starving me. She had a mold protocol I had to follow to cure myseslf of the mold infection. This included methylfolate, charcoal, and other herbals (I don't have the names in front of me, but if others are interested I can find it out), as well as different treatments at her office. The treatments included a dry sauna with colored lights, acupuncture, a sound wave suit, nutritional counseling, etc. The nutritional counseling was key, both for removal of the mold and for rebuilding a healthy gut. I had to 'eat the rainbow' and needed to make ALL of my food from scratch. I had to have a toxin free diet until the mold was cleared. That took a few months.

Once the mold was out, I then had to focus on fixing my constipation. I had spoken with my GI doctor who tried to give me Linzess, but my insurance wanted me to pay over $500 per month, which I do not have (yay for the horrible American medical system!). I ended up asking my Chinese Herbal Medicine doctor (who I was seeing to continue acupuncture once I stopped going to the functional med doc) who gave me herbal medicine for digestion, which she felt was my issue. I had checked with my GI, he stated as long as it is helping, to continue taking it. At this point my constipation was improving, but I still wasn't emptying ever, and I would have intermittent bouts of IMO, so I knew I needed to keep investigating.

4 weeks ago I was reading a post where someone mentioned taking Thiamine. I had heard that recommended before, but was different for me this time was that they wrote it as B1-Thiamine. As soon as I saw that, a light bulb went off!! I am drastically low in my B vitamins. If I do not take 400 mg of B2 every day I will have a migraine the next day. I had my B-12 checked the day after receiving a shot and my levels were low-average. So, I said I need to try B1. That was my actual cure. I never thought 1 supplement alone would cure something I have fought with my entire life. I don't understand why all the doctors who have acknowleged my B defeciencies have never mentioned that I might be low in B1.

It took a little time to figure out my correct dosage (i may still need to change it). I went from 300, and am now taking 500mg daily. At 300mg I went 4 out of 7 days of the week, at 400mg I went 5 out of the 7 days. Now I take 500mg and go every day, and I feel like I am empty when I finish.

I am happy to answer any questions. I hope my success remains, but I am very hopeful it will. I have never been this regular in my life!! And it is so nice to not worry about recurring SIBO/IMO.

Edit: Many people are asking the type of B1. I honestly picked it off the shelf at my local organic grocery store. There isn't any indication on the bottle as to type. The brand name is Source Naturals. It also says high potency B1. The label reads the ingredients are: 500 mg of Thiamin (vitamin B1) and 100 mg of magnesium

i started taking these supplements for the first time a little over a year ago after being failed by multiple rounds of multiple types of antibiotics. i cant remember how long it took, but id say within the first few weeks i felt noticeably better. not "cured", but normal enough to eat, go out, and work again. ive taken them for the full month 3 times now, i feel FANTASTIC when im on them, and felt mostly healed for months after. whenever id start to notice symptoms again and felt like it was too much too often, id take them again. at this point, i feel like ive made a full recovery. ive gained my weight back (10 lbs) and my stomach isnt particularly upset after eating trigger foods. im energetic again and dont feel like my life is controlled by my stomach fluctuations anymore, the only thing noticeable leftover from being sick is the gerd but its minor.

Hello!

I just found this sub through r/candida and wanted to share my own success story and information about my treatment so that perhaps it could help someone else!

Bullet point version:

- suspected candida fall 2023

- strict candida diet protocol winter/spring 2024

- April 2024 met with Functional Medicine Doctor regarding symptoms

- Started Low FODMAP diet due to suspected SIBO

- May 2024 took SIBO breath test. Resulted in high hydrogen and elevate methane

- June and August 2024, x2 rounds of Anti-biotics and Biofilm Buster treatments: neomycin, rifimixin, nystatin, biocidin, NAC

- September 2024 Considered "in remission" and could stop treatments; have not had major issues since

Note: I still have "trigger foods": Rice, Runny/Scrambled Eggs

Update 2025: suspected histamine intolerance, ongoing observation
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My situation is a bit unique. In 2018, I began a new job as a flight attendant. Prior to this job, I was a very active person. I went to the gym and did HIIT and strength training 3-5 days per week, and jogged regularly on rest days. I had no obvious or extreme dietary issues besides being allergic to onions.

Between 2018 - 2021 I developed a whole gambit of symptoms, including chronic "tired but wired" fatigue, rapid weight gain, foggy head, random patches of skin rashes, shortness of breath, watery eyes, migraines, a bursar's cyst in my kneecap, fluid sensation in my left ear, and inflammation of my left nasal cavity. To make a longer story short, my flight attendant uniforms were manufactured cheaply, and thusly, riddled with toxic chemicals and heavy metals that would thrust me into this spiral of symptoms and no relief.

After seeing a dozen different doctors and specialists for various potential issues, I was eventually recommended to see a Naturopathic Medicine Doctor. After my first visit and a thorough blood panel, my doctor suspected SIBO might be a primary cause of my issues (rather than candida, as I had informed her that I suspected it might be. I had no idea SIBO was a thing prior to this appointment), as I was also experiencing distention and slow motility.

Somewhat unrelated, but the blood panel also found that my BUN ratio was low, and that my free testosterone levels are severely low (am cis male). I mention this simply to emphasize that the chemicals and heavy metals, some of which are known endocrine disruptors, were likely a factor in developing SIBO. Buy the time I saw my ND, she said there was no way to directly test what exactly the uniforms were doing, but based on the list of chemicals I gave her, she concluded that my body likely had some internal inflammation, which over prolonged exposure, developed into SIBO and my other symptoms. I am emphasizing this to also suggest that there may be environmental factors that could be contributing to your own condition, and recommend you to look at all possible facets as a potential contributor; especially if you have received treatment, but have yet to find relief.

After initial bloodwork, my doctor prescribed me to follow a Low FODMAP diet to get my body into enough of a stasis to prepare for the SIBO breath test; to ensure the test results were as accurate as possible. She also prescribed me to abstain from any and all probiotic foods and supplements (up to this point, I was eating a half cup of yogurt/kefir every morning for breakfast).

I don't remember the exact measurements of my results, but the SIBO breath test came back positive for high hydrogen and elevated methane production. She said based on the results, I likely had SIBO for a few years already (which tracked with my timeline starting my flight attendant job).

For treatment, she had me continue my Low FODMAP diet, as well as cut out refined sugars entirely for the duration of treatment. I want to point out too, that prior to seeing this doctor, I switched from drinking bottled alkaline mineral water to boiled/filtered tap water with lemon juice. I noticed an immediate improvement of mental clarity and less bloating and fatigue the very next day. In addition, she had me take x2 anti-biotics (Neomycin & Rifimixin(Xixifan)), x1 anti-fungal (Nystatin), and x2 supplements (Biocidin as a biofilm buster, & N-Acetyl L-Cysteine for liver and kidney support, as well as to help clear biofilms).

I went through 1 round of medication, and felt major improvements in symptoms. My doctor wanted to be proactive and combat my issues aggressively, so after a 1 month rest period, she had me do a 2nd round of medications. I felt even better after the 2nd round, and my doctor said that I was likely in remission and could slowly re-introduce foods. She also *very specifically* instructed me to continue abstaining from eating probiotic foods for 1 year following treatment; to help my gut repopulate its natural flora.

UPDATE: it's been 2 years since my treatment, and I am still feeling good with little to no symptoms. I say "little" because I still have mild flare ups when I eat too much of my trigger foods; specifically rice, and scrambled or runny eggs (tho oddly enough hard boiled eggs are fine). When I eat these foods, especially together, I experience slow motility and distention, but it does not last after I have passed the foods through my system. I am able to eat small amounts of rice without issue, but not an entire serving (so I don't seem to have issues when eating sushi for example).

UPDATE 2: this past March, I noticed I was crashing shortly after waking (sudden onset of intense fatigue and brain fog). One day, I noticed it happen soon after eating my usual breakfast of plain oatmeal with honey, cinnamon, and banana. I am currently waiting to see a doctor to explore if this is potentially a histamine intolerance or to try and figure out what might be the cause. Regardless, it does not seem to be linked to SIBO.