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Does anyone have any experience, suggestions on how to deal with small intestine bacterial overgrowth? As many of you know, I no longer have a jpouch. I'm suffering from massive bloating, abdominal pain, no appetite, belching better than any beer drinking male I've ever met, massive amounts of gas in the ileo bag, and significant weight loss - now officially in the "seek medical attention" section on the BMI charts!

My GI doc had me do a round of xifaxan which helped after two weeks, but then all the symptoms promptly returned within two days of stopping the antibiotic. Just had an ileoscope which showed nothing else wrong, so we definitely think my problems are SIBO. Dr. Shen said it could be caused by adhesions preventing things from moving through as they should as I have had so many surgeries. But I don't understand why it would crop up now.

I put myself back on the xifaxan, but was told I shouldn't be on it indefinitely. Plus it makes me fatigued. I've cut out all sugar and reduced carbs.

What else can be done?
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I was diagnosed with SIBO last year... did you do a breath test to confirm?

Xifaxan was the only treatment offered to me. We never really explored it further because my GI's theory was that the SIBO was aggravating my UC, but Xifaxan didn't improve the rest of my symptoms so we kind of stopped exploring that avenue. From what I've read online Xifaxan might not be the antibiotic of choice for SIBO anymore.

Unfortunately my understanding is that diet based interventions for SIBO don't need to be no sugar/low carb but actually VERY low carb -- like strictly limiting vegetables, no starch, no fruits, mostly meat diet.

Also, far be it for me to claim to know more than Dr Shen about anything ever, but I would think that if this were adhesions or conformation related it would show up on an MRI? Maybe?
no breath test. Just think it was a process of elimination diagnosis. And also confirmed by the fact that xifaxan has made a huge difference.

I have only read about xifaxan for sibo. So Liz, please share what else you found. My luck, its probably one of the other 7 or so antibiotics I'm allergic to that they might recommend.

As for the adhesions, I don't think they show up on a MRI. But regardless, even if they did, nothing can be done about it, unless you just operate again and cause more adhesions! It is highly likely that adhesions could be causing trouble. I've had five massive abdominal surgeries and I know that in the last one the surgeon had to do a massive lysis of adhesions before he could get to anything. But I don't understand why this sibo thing is cropping up now, as my last huge surgery was over a year ago.

As for diet- I am I supposed to live on meat alone? I don't understand. I have always found better health with a very high protein diet and I eat a lot of meat. I just can't imagine - cutting out vegetables though.

so the question is.. what can be done if I'm not supposed to take antibiotics indefinitely. I can't get either of my GI docs to focus on this problem as they are caught up in trying to get my butt wound to heal, and hoping their lab rat experiments with me will result in a publication.

Someone here on this board must have some real sibo expertise. Searching the internet,I find a lot about it but nothing related to colon-less people.
Sugar is the culprit to it. Shen diagnosed mine at Cleveland CLinic.

There are a lot of recipes and cookbooks out there for small bowel bacteria overgrowth. Mainly just sugar, but sugar is in everything. The minute I went gluten free and sugar free I was off antibiotics. It can take a year for it to really work it self out. For me after a week it is a drastic difference. Processed foods also are very bad for it.

Pinterest if you follow it has great recipes for small bowel bacteria overgrowth. Paleo is a diet to follow that are along the same lines. Paleo is nothing processed, no dairy, sugar or grains. Mainly a lot of healthy fats like coconut oil or grapeseed, almond flour to bake, veggies, certain meats.

I personally don't eat fruit since I also have a chronic yeast/candida overgrowth and that is just like sugar.

I have a food blog if you want I can PM you the URL and have a few books I have bought on Amazon to make paleo bread or desserts that taste pretty damn good.

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