When to Start Prokinetics for SIBO? Are They Taken with Antibiotics

Highlights:

• Prokinetics timing and use for SIBO Prevention:
  • Prokinetics are used between treatment rounds to prevent relapse, which is common around two weeks after treatment.
    
• SIBO Management:
  • Recommendations on the use of low-dose naltrexone (LDN) and its gradual titration to manage side effects
  • Insights into whether continuing prokinetics during treatment rounds affects outcome
    
  • Discussion on the financial aspect of continuing medication during treatment rounds.
    

Key Takeaways:

• Prokinetics are often used as a preventive measure against relapse in SIBO treatment.
• Retesting is crucial to determine the necessity of continued medication.
• LDN is recommended to be continued due to its gradual titration and potential side effects.
• The decision to continue prokinetics during treatment should consider both clinical outcomes and cost implications.
  

Conclusions:

• Prokinetics are taken between SIBO treatment rounds and also after SIBO is eradicated for prevention of relapse.
  
• Once started, prokinetics can be continued during the next antibacterial treatment round, but it's not necessary.
• Due to needing to titrate LDN up, it is typically continued during antibacterial rounds, once started.

Products mentioned:
– LDN (low dose Naltrexone - Rx)
– Herbal prokinetic options (exclusive pricing at Fullscript)