SIBO INFO Blog

This video focuses on the challenges and methods for diagnosing intestinal yeast overgrowth, including Small Intestinal Fungal Overgrowth (SIFO).
Key Diagnostic Approaches:

• The Gold Standard Procedure:
  • The most accurate method involves an inpatient or outpatient procedure using endoscopy to place a tube into the small intestine.
  • While considered the gold standard for studies, this method is not practical for typical circumstances.
• Practical Diagnostic Tests:
  • Urine Organic Acid Test:
    • This test can indicate yeast overgrowth within the intestinal tract, whether in the small or large intestine.
    • It does not differentiate between the two, but it is useful for detecting yeast overgrowth in the small intestine, which is relevant to SIFO.
  • Stool Test:
    • This test is limited to identifying yeast overgrowth specifically within the large intestine.
  • Blood Test (Candida Immune Complex Test):
    • This test evaluates the immune system's reaction to yeast.
    • It checks if the body perceives a problem with yeast, even if there might not be a significant overgrowth. The immune system may be reacting to the presence of yeast.

Recommended Practice:

• The speaker typically recommends running two, or often all three, of these tests to gather comprehensive information for a diagnosis.
• The choice of tests can also depend on practical considerations such as cost and patient preference regarding the number of tests performed.
  

This video addresses patient's concern regarding treatment options for high methane SIBO after initial attempts with Xifaxan (Rifaximin) and Neomycin were unsuccessful.
Key Discussion Points:

• Initial Treatment Assessment:
  • It's noted that rifaximin alone may not be sufficient, as combination therapy is typically required for effective eradication.
  • The patient is understood to have effectively undergone only one round of necessary treatment, and more rounds are likely needed.
• Addressing "Very High" SIBO:
  • Cases with "very high" readings often require a more intensive approach.
  • Typically, four rounds of - two-week antibiotic treatments (like rifaximin and another agent) are recommended, or four weeks of herbal treatment.
• Recommended Next Treatment Options:
  • Antibiotic Combination: The suggestion is to begin a second round of treatment, potentially using rifaximin in combination with metronidazole. This is recommended as the patient previously used rifaximin and neomycin.
  • Herbal Alternatives: An alternative is to transition to herbal treatments. This would involve combining one of the following with Allimed (also known as Allimax Pro) or Atrantil:
    • Berberine
    • Oregano
    • Neem
• Importance of Retesting:
  • Given the likelihood of needing multiple treatment rounds, retesting is crucial to monitor progress and determine the effectiveness of the chosen therapy.
    
  • It is advised to compare test results consistently (e.g., using the same type of breath test, like the lactulose breath test) to accurately track changes, especially if a doctor is not facilitating necessary retests.

Products mentioned:
~ Antibiotics: Rifaximin (Xifaxan), Neomycin, Metronidazole (Flagyl)

~ Berberine: https://us.fullscript.com/plans/asiebecker-herbal-antibiotics-for-sibo (discounted at Fullscript), https://amzn.to/4a6pmEI (Amazon)

~ Oregano "ADP": https://us.fullscript.com/plans/asiebecker-herbal-antibiotics-for-sibo (discounted at Fullscript), https://amzn.to/3T94BSO (Amazon)

~ Neem: https://us.fullscript.com/plans/asiebecker-herbal-antibiotics-for-sibo (discounted at Fullscript), https://amzn.to/3RaPPIH (Amazon)

~ Allicin - Allimed/Allimax Pro: https://us.fullscript.com/plans/asiebecker-herbal-antibiotics-for-sibo (discounted at Fullscript), https://amzn.to/3Tg4bdb (Amazon)

~ Atrantil: https://us.fullscript.com/plans/asiebecker-herbal-antibiotics-for-sibo (discounted at Fullscript), https://amzn.to/3Gwd8Yh (Amazon)

~ FoodMarble SIBO test: https://foodmarble.com/shop?discount_code=SAVE16 (16% off Foodmarble at checkout)

This video delves into the nuances of prokinetics and their effectiveness, particularly in the context of SIBO (Small Intestinal Bacterial Overgrowth).

• Individual Variability of Prokinetics: The discussion highlights that prokinetic treatments differ significantly in their effects from person to person. What works wonders for one individual may have little to no impact on another.
• Low Dose Naltrexone (LDN) as a Prokinetic:
  • While not technically classified as a prokinetic, LDN has demonstrated prokinetic effects in studies, largely due to its influence on opioids in the body.
  • For some, LDN can be "phenomenal," leading to no relapses and offering additional benefits such as anti-inflammatory properties, immune system balance, and mood improvement.
  • However, for others, LDN may not be a strong enough prokinetic.
• LDN and Severe SIBO:
  • LDN is often not sufficient for individuals with severe or recalcitrant SIBO, especially when underlying conditions like Ehlers-Danlos syndrome or scleroderma are present.
  • In such cases, a combined approach using LDN alongside another prokinetic, especially pharmaceutical, is recommended.
• Pharmaceutical Prokinetic Options: When LDN is insufficient, stronger interventions are necessary:
  • Prucalopride (marketed as Motegrity in the US).
  • Low-dose Erythromycin
• Conclusion: The effectiveness of any treatment, especially prokinetics, requires individual assessment. Trying different options is key to finding what works best.

Products Mentioned:
Prokinetics (pharmaceutical):
~ LDN (low dose Naltrexone - low dose has very different effects vs regular dose)
~ Prucalopride (Motegrity)
~ Low Dose Erythromycin
​
Herbal Prokinetics list: (Fullscript here)