SIBO: The Pros & Cons of 3 Treatment Options

The Small intestinal Bacterial Overgrowth (SIBO) is a condition that is common where there is an overgrowth of bacteria is observed inside the small intestine, leading to IBS symptoms like gas and bloating, diarrhea, or constipation.

There are three ways to manage SIBO and I’ll discuss the pros and pros of each method based on my own experience.

Antibiotics

The main antibiotic used to treat SIBO can be Xifaxan (Rifaximin). Xifaxan is typically used to treat hydrogen-positive SIBO with loose stool or diarrhea as the main sign.

In the event of methane-positive SIBO where constipation or slow passage time occurs, Xifaxan is usually combined with an additional antibiotic, for example, Neomycin or Metronidazole.

The standard course of antibiotics to treat SIBO lasts for two weeks.

PROS:

Xifaxan is generally well tolerated and not absorption systemically. Its antibiotic effects are mostly restricted to the intestines and cause lesser side effects from antibiotics.
Xifaxan is anti-inflammatory and acts on the mucosa of the intestinal
The duration of treatment is shorter when compared with herbal antimicrobials like the length of the treatment in the diet elemental
70-85% success rate normalizing the breath test using lactulose.

CONS:

Xifaxan is usually not insured and may cost upwards of $1,000 for a course of two weeks
If Neomycin or Metronidazole is added (in Methane-positive instances) people may experience more adverse effects of antibiotics.
Sometimes, multiple two-week courses are needed
Many of our clients would prefer an approach that is more natural

HERBAL antimicrobiologists

Antimicrobial herbs are a second alternative to treat SIBO. The broad spectrum of antimicrobial mixtures have been researched and tested successfully.

Common herbs utilized in SIBO treatment are oil of oregano, allicin Neem, and berberine. Numerous broad-spectrum antimicrobial mixtures have been extensively researched too. We select the most effective natural antimicrobial (or herbal mixture) in accordance with what we find from breath tests and the patient’s history of symptoms.

A typical herbal antimicrobial treatment can last between 4 and 8 weeks.

PROS:

Herbal remedies can also treat the imbalance of bacteria in the large bowel (in combination with SIBO) and are more extensive in this respect.
Certain herbal treatments are researched with some of the studies having proven an effectiveness rate similar to or higher than antibiotics.

CONS:

“Die-off” symptoms can be more important due to the fact that antimicrobial herbal remedies focus on both the small as well as large bowels.
The longer treatment duration is more time-consuming, as relative to both antibiotics as well as an essential diet
A diet that is restricted is usually suggested along with the treatment with herbal antimicrobials.

ELEMENTAL DIET

A liquid diet containing easy to absorb powdered nutrition that you drink to eliminate the overgrowth of bacteria while providing nourishment to your body.

A diet-based program that is essential to treat SIBO typically lasts between two and three weeks.

PROS:

The most efficient SIBO treatment (80 percent to 90% success rate over two to three weeks and 85% for the following period)
The treatment time is shorter when compared with herbal antimicrobials; comparable to the duration of antibiotic treatment
The best treatment option to lower extremely high gas levels. This could otherwise require several rounds of antimicrobials, herbal remedies or antibiotics
Broader-spectrum anti-bacterial activity than herbal antimicrobials and antibiotics.
Benefits other conditions in addition to SIBO including Inflammatory Bowel Disease, Rheumatoid Arthritis, Cystic Fibrosis and Eosinophilic Esophagitis
It is well-tolerated Many people receive fast relief from symptoms
It can be a nice moment to unwind from the kitchen and which dishes to prepare.

CONS:

It is typically $400 to $800 for two weeks; the price is determined by the calculation of your height, age and weight, as well as your activity level. (Remember that there are no cost of food items during this time and the majority of people pay hundreds of dollars for food in their usual two-week diet.)
It is not permitted to eat solid food for the duration of two weeks and could be difficult to handle psychologically for certain
Sometimes, people don’t like the taste of shakes
A lot of people who attempt an ED by themselves, with no guidance, will not achieve success.

What will happen after SIBO Treatment?

After completing any of the above treatments If we were to follow any of the above treatment options, we’d be able to perform the breath test for SIBO to confirm that the bacterial overgrowth was completely eliminated.

Any successful SIBO treatment strategies should be followed up with preventative measures to improve GI mobility and promote overall digestion health.