I researched a ton about Sibo for the past six months I thought I had it. I was obsessed with the topic.
Firstly, it’s important to get a diagnosis. For a diagnosis you can ask your GI doctor for a Hydrogen Breath Test. Make sure to get a Hydrogen Breath Test with Methane for greater accuracy. Basically bacteria produce Hydrogen and sometimes Methane and the test will measure the levels coming out of your intestines after you drink solutions that react with it. Unfortunately the Hydrogen Breath Test is only accurate maybe 70% of the time, however, and have a high false-positives and false-negatives. There are some bacteria that produce other substances that there are no current tests for.
There are other ways of testing if you have sibo at home, in cases where you are constantly bloated and have lots of heartburn, with many bad reactions to food. I saw a sibo specialist and he told me that a good test is to wait at least 8 hours after eating a meal and then eat a plain piece of chicken and nothing else as a meal, to see if your body reacts to it. If there is no reaction or bloating, then there is a good possibility it is sibo. If you do get bloating and a reaction then it is probably something else you need to look into.
You will need to be concerned with other possibilities for your discomfort. You might have an obstruction in your bowel or small intestine, for example. You could have an inflammatory bowel disease. You would need to get a colonoscopy for your bowel and further tests on your small intestine to cover that. Your GI doctor may also want you to do an endoscopy. This will be a lengthy process. I would suggest pushing your GI to do the colonoscopy and endoscopy at the same time. Those types of procedures are typically hard to schedule in a timely manner and you may be waiting for four months in pain, like I was. The breath test is also hard to schedule, and you might want to make some calls and shop around and ask about the waiting times for those tests. Unfortunately the GI doctor will usually want a consultation before signing you up for the test. I was able to get my primary doctor to call a GI doctor she knew and get me an appointment for the test the next week without a consultation.
For SIBO treatment I would look into the Rifaximin antibiotic. Sometimes GI doctors will give you the antibiotic treatment regardless of what the breath test shows, just to rule it out. It’s the only antibiotic for SIBO which is not absorbed by the body and stays concentrated in the gut on the surface. Check your insurance and see if they carry it in their formulary. It’s a very expensive drug – about $1000 for a 10 day course. Treatment for SIBO isn’t an FDA approved treament, and many insurance companies will deny you. Sometimes it goes through, however. My insurance formulary covered it and my cost was $90. There is also a co-payment coupon on the manufacturer’s website that will get you $100 off your copay. I was able to pick up my prescription for zero cost.
As per my own reaction to Rifaximin, when I got it I did not feel that it was being absorbed into my body as I’ve felt with other antibiorics. I agree with the assessment that it is the safest antibiotic out there.
Natural remedies would be enteric coasted peppermint. There is evidence that peppermint helps with SIBO. Make sure you get an enteric coated peppermint so that it survives the stomach into the intestines. I would suggest following the protocol and dosage in this study: http://www.altmedrev.com/publications/7/5/410.pdf
If you are serious about sibo, and want it treated today, I would buy enteric coated peppermint today as a small test for improvement. Regardless of results, I would follow up with a GI doctor.
Unfortunately, gathering evidence that you have sibo is only the beginning of your journey. After taking these supplements or antibiotics and seeing improvement, it very usually comes back after a few weeks to a few months. There is something wrong with your body that causes this overgrowth to occur. These overgrowths do not occur in a healthy gut. It could be low motility, low stomach acid, a neurological or muscular disease, partial or intermittent obstruction of the small intestine, Diverticuli (small pouches) of the small intestine that allow bacteria to multiply inside diverticuli. The only way to treat the cause, as far as I am aware, is to go to a traditional GI doctor for various tests.
The most important thing right now, however, is to figure out if you have SIBO or not. When doing your enema, do you ever see any yeast-type structures coming out of you? Have you seen it in the toilet after a BM? Yeast structures may be indicative of a candida overgrowth, since you’ve had it in the past.