Maybe you have both. It is diagnosed by a breath test since it is bacteria and not inflammation. Shen wasn't able to give me a breath test. He went off what he did not see in my pouch and symptoms.

I think most often SIBO is diagnosed by a trial of antibiotics, such as xifaxan. And if improvement is seen, then its sibo.

I have been told my pouchitis is caused by SIBO, by my GI specialist. Reducing the SIBO dietarily has helped the pouchitis and certainly bolstered the theory.

The pattern of my inflammation ABOVE the pouch is what led them to suspect SIBO because it is not a Crohn's like pattern of inflammation. It's a pattern that is consistent with pooling of the feces above the pouch.

xifaxin actually did not help me much at all..so not sure thats the correlation for sibo which is my present diagnosis..i did not take a breathe test either with shen but i think he deduced it because pouch looked pretty good to him..i do not think your doctor allycat is crazy because all of this is not perfectly straight forward..for example without testing pouch for years i was diagnosed with pouchitis because antibiotics worked to relieve my symptoms..on further observation shen just thought it might be bacteria overgrowth because my severity of symptoms did not match my pouch exam and my antibiotics were becoming less effective and i got c-diff on top of that.thus my trying full out diet..in your case ally cat there may be some inflamation but there may be bacteria over growth..you`ve tried drugs i know but why not go for a shot at the diet full swing see what that does..if it is followed strictly and your most severe issues of flares is gone,than bacteria over growth might be the larger issue..if its something beyond that the fecal transplant may be the next best thing to check out..its what shen mentioned to me..i presently am not like the folks who have this operation and feel almost like normal bar consistency of b.m and going between 4 to 6 times but i am off antibiotics!!!and its getting better as i refine diet more..never been more optimistic than now..

xifaxin did not work for me and sibo is present diagnosis..et barrister may have explained it best..could be both but diet could be a step in reducing your worst issues..go for it..see what happens few of us who are going for it see real improvement..

CT, that is sort of what I have! Pooling at the dome or top of the pouch. Moderate inflammation. My GI said this is very common.

Fecal transplant was mentioned. Ugg! I started trying cutting out sugar and carbs, maybe I'm at 75 percent and added homemade kifer but...I'm losing weight which I can't afford to lose. I switched off xifaxan to pentasa for the time being. With all these holiday parties diet is hard.