SIBO Pt 3 - Antibiotics, Herbal Antibiotics, Elemental Diet

Question 1

What are symptoms of die-off?

Answer 1

• Fatigue (can’t get off the couch/out of bed)
• Flu-like sx (or cold/URI sx): Body aches, h/a, swollen nodes, congestion; ‘feel like getting sick/coming down w/something’
• Worsening of current GI sx (ugh!): Diarrhea, constipation, bloating, nausea, pain…
• Worsening of any other existing sx (Rosacea flare)
• New GI sx (cons or diarr when used to have other)

Question 2

What is the most suitable pharmaceutical antibiotic(s) discussed for a patient suffering from SIBO-Diarrhea type, with elevated hydrogen only on SIBO breath testing?

Answer 2

Rifaximin

550mg tid x 14-21 d

Question 3

What is the most suitable pharmaceutical antibiotic(s) discussed for a patient suffering from SIBO-Constipation type, with elevated methane only on SIBO breath testing?

Answer 3

Rifaximin + Neomycin OR

Rifaximin + Metronidazole

Question 4

What is the most suitable pharmaceutical antibiotic(s) discussed for a patient suffering from SIBO-Constipation type, with either hydrogen only or both hydrogen and methane elevations on SIBO breath testing?

Answer 4

Rifaximin + Neomycin OR

Rifaximin + Metronidazole

Question 5

What are the herbal antibiotic options for a patient suffering from SIBO-Diarrhea type, with elevated hydrogen only on SIBO breath testing?

Answer 5

Berberine, Oregano, Neem (choose 2)

Berberine + Neem OR
Berberine + Oregano
Neem + Oregano occas

Question 6

What are the herbal antibiotic options for a patient suffering from SIBO-Constipation type, with methane elevation on SIBO breath testing?

Answer 6

Berberine/Oregano/Neem (choose 1) + Allicin

Question 7

Why do an in-house LBT at 2 weeks of Elemental Diet?

Answer 7

To determine if you should do a 3rd week of the elemental diet.

Question 8

Of the 3 treatment options (Abx, HAbx, Elemental Diet) which one can lower gas levels the most in one treatment course?

Answer 8

Elemental Diet

Question 9

Of the 3 treatment options (Abx, HAbx, Elemental Diet) which one(s) tend to be best for sensitive (highly reactive) patients?

Answer 9

Abx