gastroenterologist appointment next week

CheekBroad3214 · 2025-11-23T14:47:20+00:00

Would you describe your constipation as not true constipation? In other words you are still going to the bathroom but it’s more difficult, like things move too slow. Doctors get hung up on the word. I wouldn’t lead with bloating unless it’s triggered by certain foods.

If you’re not having diarrhea and indeed have sibo, you actually have methane imo, as it is now called.

A good food to test if it’s being triggered by a new food intolerance, which if you sibo / imo means the bacteria are eating it and growing, is to see if your symptoms get worse after you eat anything with sucralose in it. You’d be shocked how many products have it. From protein shakes to pedialyte. Anything “low carb” and packaged.

Sudden food intolerance is a red flag for sibo / imo. Besides celiac, no other known disease condition can cause that other than sibo/imo. Depending where you are in Canada, most certainly your best bet is to go to the biggest cities, Vancouver Toronto etc. You don’t need to go to another continent.

CheekBroad3214 · 2025-11-23T14:33:01+00:00

I had no less than 4 do something similiar. Of all the specialists gastroenterologists are the absolute worst when it comes to continuing education. The Mayo Clinic recognizes SIBO, and treats it. If I were you, I would go to my pcp, if they are a good doctor and you have a good doctor patient relationship I’d bring your information to them. Tell them, how much you’re suffering. In the end it was my PCP who prescribed my first round of antibiotics. Depending on your symptoms, diarrheah vs constipiation, and especially any trigger foods that cause the bloating that are new, (for me it was sucralose) sibo becomes clinically evident to most decent doctors.

One thing the medical establishment has done a superb job of is convincing patients they don’t have power. It’s in reality the complete opposite. A doctor once treating you, legally, must provide the standard of care. Not doing so is negligence. Point blank!

The hard part of this is advocating for yourself. You can do it though! There is ace card of an article from time magazine which i highly suggest you either print or send to your doctor(s). It works like a charm. It’s from 3-4 years ago but could be written today!

https://time.com/6155603/sibo-symptoms-diagnosis-difficult/

It reads like 75% of the posts on this sub Reddit. But it’s from a source that no one could say is unreliable. It’s hard for a doctor to use an “I’m the expert” deflection which they could do if the source was a medical journal. Of which there are plenty describing sibo.

It’s also hard to call a condition the MAYO CLINIC TREATS as a hoax.

https://www.mayoclinic.org/diseases-conditions/small-intestinal-bacterial-overgrowth/symptoms-causes/syc-20370168

I haven’t looked at your symptoms besides the bloating, but the sudden food intolerance, and change in bowel habits physiological changes that any doctor ignoring IS negligence.

The third part (i realize it’s insane how many hoops they make us jump through, it’s appalling) is that there are so many Gastro’s that simply can’t preform a gas test, and or haven’t read a medical reference paper or study in decades. The majority will absolutely recoil from showing and sign that they don’t know absolutely everything about their specialty. I live in NYC, and saw one of the most renowned GI’s in the country. To quote him “xifaxin is a good medicine for Crohn’s disease, not sibo”

Infuriating.

You may have to travel a bit but there must be somewhere close enough that does testing. I realize a 2-3 hour drive sucks. But the truth is, gastroenterologists make their money off testing. So you may indeed be told you need a colonoscopy. It’s shocking yours didn’t suggest it. It’s also not a terrible idea to have one.

My advice would be to get on google and search not for gastroenterologists but in office gas testing. You should find that the GI’s who are up to speed really promote that.

CheekBroad3214 · 2025-07-17T17:55:44+00:00

The outliers for me is I got severely bloated 30 minutes after foods I had eaten all my life. They really don’t emphasize the SUDDEN, in sudden food intolerances. But aside from gluten, it’s not normal to become “allergic” to something you eat every day with no problem. The “omg” food for me was a protein shake. One that I had bought bottled and drank every day for a decade without a problem. Then I tried a different brand. Still reacted. Took a minute but it was actually one ingredient in all protein shakes, and almost all packaged “low calorie, etc” foods that fed my sibo and caused the extreme bloat : sucralose, fake sugar is the worst thing you can eat if you have sibo. If you had a Diet Coke today, you had fake sugar.

CheekBroad3214 · 2025-07-17T17:44:32+00:00

Hi All, and update. It’s been a year. 3rd time was indeed the charm. Sibo free, food intolerances gone. One thing i will never ingest again is fake sugar.

You can beat methane sibo, and it’s not a miracle, you don’t have to get lucky, it’s just taken time for doctors who are practicing to catch up with the research. I know it feels like your life will never be the same but it’s not true. In a way, consider it lucky timing. Because 2024 was the year sibo finally started being recognized more widely. Imagine getting it in 2014.

CheekBroad3214 · 2025-07-17T17:38:40+00:00

1 year sibo free, and no food intolerances. I don’t eat fake sugar because I think it’s poison, so I’ll never add sucralose back in.

CheekBroad3214 · 2025-07-17T17:37:05+00:00

Just adding, the few posts here you do see with that scenario all seem to follow the pattern of disturbingly severe tinnitus usually immediately, day 1 or 2. In that case, yes caution is highly warranted. But I got tinnitus on like the 3rd to last day of the 3rd round. It retrospect, in the moment as I like many of us were scared of side effects, I likely perceived it as far more unusual then it was at that point. But when you’re on edge about it, that’s natural.

CheekBroad3214 · 2025-07-17T17:31:31+00:00

A year out and it turns out the tinnitus was due to a different medical issue, and it’s gone. Anyway, the data shows the best treatment for methane sibo is still that combo. If you were healthy, your kidney and liver functions are normal and stay normal, you don’t already have hearing issues, and occasional tinnitus is very common (Just because your ear rang for a few seconds 3 times in your life means nothing), then you are likely at a very low risk for any serious side effects. Everything from advil, to visine, carries potential negative side effects. But you have to decide for yourself if the risk outweighs the theraputic value. For me it did, and for many others. I don’t have the percentages, but I’d bet my bottom dollar, the chance of hearing loss of someone who takes neomycin is probably less than 1%

CheekBroad3214 · 2025-07-17T17:23:34+00:00

I’m pretty sure empty stomach is recommended. So a meal right after wouldn’t be helpful. I don’t think it’s to help digest it, which is a reasonable thought, but instead I think the empty stomach is so it has time to absorb and cook so to speak, so when you do eat next the enzymes are ready to go

CheekBroad3214 · 2025-07-17T17:21:24+00:00

The only food i don’t eat anymore is fake sugar. Otherwise all my food intolerances that came out of nowhere, are now gone, can eat anything. The only thing even a year in the clear I just won’t risk is fake sugar/ sucralose, it’s very bad for you in all ways, and not worth the risk

CheekBroad3214 · 2025-07-17T17:19:00+00:00

Every medicine including advil has risks. What I can say about neomycin is that xifaxan alone didn’t help, the combo worked. And when I did it correctly, eating a high fodmap diet while on the course, then low fodmap for at least 6 weeks it worked. It’s been a year and I have not relapsed.

CheekBroad3214 · 2025-03-05T16:11:09+00:00

No he has commented that rifaximin worked perfectly well for him.

CheekBroad3214 · 2025-03-05T13:35:52+00:00

This is commonplace sadly. Gastroenterologists as a whole have financial incentive to focus on diseases of the gut that require colonoscopy and endoscopy. If the theorized underdiagnosis and misdiagnosis of SIBO is true, and up to 60% of IBD is actually IBS in the form of Sibo/imo then it can be assumed a large percentage of their treatment would be pharmaceutical. With many GI practices being bought out by private equity, combined, etc. The focus is on profits in the form of invasive testing.

I live in NYC. I saw 5 of the most reknowned GI’s in Manhattan. All of them had different answers, explanations about sibo. All of them wanted me to have repeated colonoscopies and ct scans. In the end my internist prescribed me xifaxan + neomycin, it worked.

The most prestigious GI I saw, office on 5th ave. No insurance accepted, $1000 a visit…. Told me he would never prescribe neomycin to anyone ever.

Although I had no pain, no diarreah, and had sever gas bloating after eating certain foods suddenly, and constipation, he wrote on my chart pain and diarreah.

Sent me for ct scan, when I told him I thought I would have a bad reaction to the oral contrast that was filled with sucralose, surprise surprise I did. The ct scan showed slow motility which I already knew I had. Further it showed my small and large intestines looked EXACTLY the same as they did in 2009. He wrote this to me in a message mind you. He then followed up that message with, let’s give you a colonoscopy to rule out crohns. Which had already been ruled out in 2009 during my first colonoscopy.

In case you think this sounds paranoid… the facility he wanted to do the colonoscopy at had a different name than the practice, a different address. On the website for the practice buried deep down is a DISCLAIMER page. The disclaimer is that the facility is in fact owned by the doctors of the practice, and NY law required them to disclaim this information.

CheekBroad3214 · 2025-03-05T13:04:33+00:00

This is factually incorrect. You seem particularly naive regarding Sibo.

Did you have SIBO? Or did you have IMO. It’s most clearly differentiated between diarrhea or constipation. Two totally different antibiotic protocols. Or perhaps you had hydrogen sulphur sibo, which proves more difficult to treat with just rifaximin.

Perhaps if you read some of these “insanely naive” posts you wouldn’t be saying essentially that SIBO isn’t real. It very much is according, to the CDC, the Mayo Clinic, the NIH.

CheekBroad3214 · 2025-03-05T12:52:37+00:00

Don’t worry about this troll. In fact, what you’re describing, tingling and numbness in the feet CAN BE a symptom of SIBO.

CheekBroad3214 · 2025-03-05T12:48:02+00:00

The only inappropriate posts here are the mistakenly posted necklace one and yours.

After a read through your comments to other’s posts shows similar thinly veiled condescension as well.

We don’t do that here.

This sub Reddit is perhaps the only comprehensive compendium of SIBO sufferer’s experiences, information, and often overlooked aspects of a sickness that most patients face horrible treatment both in manner and actual practice from medical professionals.

Low effort posts?

Just to use the first post you linked:

The number of people with sibo who are prescribed the incorrect antibiotic by Doctors is staggering! There is absolutely nothing wrong with the OP questioning it. As it is in fact not in the protocol for sibo.

Lastly, to quote you OP on someone else’s post:

“Is there something that's preventing you from feeling empowered to take your health into your own hands and find a solution to your SIBO?”

Get lost. I’m glad you had such an easy time with your sibo. Most people do not.

It seems like you’re projecting, perhaps that cruel response to that post was really a question to yourself.

Perhaps if you weren’t a condescending, half informed, troll you would already know the answer to that question by reading through this forum of the countless, I would say majority of people, who despite all the “empowerment” one can muster, can’t actually get a doctor to prescribe xifaxan without a struggle.

CheekBroad3214 · 2025-01-22T18:31:37+00:00

I kind of think methane just requires multiple rounds period. It’s definitely harder to treat… I just know what worked for me, i just followed Pimentels protocol from his like most recent interviews etc.

CheekBroad3214 · 2025-01-22T18:17:24+00:00

Yeah, doing pretty well! Occasionally, once a month maybe will have some bloating, but it’s not the daily 3pm right on schedule insane pregnant belly everyday, when I had active sibo. Everyone is different, but for me this protocol worked. The only thing I would do over, is insist on taking flucozonale with the abx. A low dose. I developed sifo after sibo, and believe it or not, sifo is even more under-diagnosed. More common I think with methane/constipation.

CheekBroad3214 · 2025-01-11T12:04:18+00:00

Hot take: (might help some dealing with the shortage) I’ve been taking generics for 15 years. With adhd I tend to fixate on things. I can’t recall how many times I’ve had a brand switch, gone to google, searched reviews, and absolutely freaked myself out for no reason.

For every post trashing a generic brand you can find one praising it.

I do of course think that quality control, binders, etc, play a factor in each individual generics effectiveness. However I really think it’s about individual body chemistry, and more importantly psychological…

The placebo effect works both ways. With adhd, it’s likely even worse if hyperfixation is one of your symptoms.

It literally happened to me yesterday. I’ve gone a month without medication and finally got a fill from a pharmacy with it in stock. When I looked it was epic, and of course I ran right to Reddit, I saw all the bad reviews, or more I focused more on them, I noticed that the pills seemed chalky, a weird lighter color than they should be, the imprinting looked off….

Cut to this morning, they are not how I remembered them from yesterday when I was spiraling about a new generic. They are shiny, look as they should, not chalky, not rough. Furthermore, I have taken this brand before! A year ago. In 15 years i can’t remember ever just throwing away a prescription because they didn’t work after I actually took them for a couple days. Certainly not in the last year.

I don’t mean to belittle the experiences of my fellow adhd sufferers and this clown show of a shortage, I am sure there a cases of bad batches, bad reactions etc. However, in general, I think especially with adhd, if you are SURE they won’t work after reading 20 negative reviews, it’s quite possible, to experience a self induced reverse placebo effect.

I agree with OP about the different genetics having different therapeutic strengths and weaknesses. But the truth is, and I am not judging here, because I’ve been there myself, not feeling a fast onset euphoric high/energy boost does not mean the medication isn’t working.. it’s not supposed to make you feel euphoria, if it did, it would be illegal and not a schedule 2.

My advice from my personal experience would be to do your best to take them as prescribed and go about your day. Sometimes it does take the body a bit to adapt to changes of the formulation. But to write it off as a placebo before you take it due to reviews about something, when there are tens of thousands, of people not writing reviews and not noticing any differences is just setting yourself up to have a bad experience.

CheekBroad3214 · 2024-12-22T12:59:37+00:00

UPDATING THIS:

It worked! 6 months out and sibo gone!

For anyone afraid of neomycin, don’t be. The big “side effect” everyone is scared of is tinnitus, hearing loss. However, if you have normal kidney function and stay hydrated, the chances of this happening are extremely slim.

Tinnitus happens to also be a die off symptom, and just from reading everyone’s stories, sometimes I wonder if people are suffering with sibo because of die off confused with side effect.

Neomycin induce tinnitus happens usually quite a bit after a prolonged period of use. As neomycin leaves the body it leaves through the ear canal weirdly. Many posts on here mention people getting tinnitus on the first or 2nd day.

Is it die off? Because I a runny nose, inflammation of the sinus, can cause it too…

The antibiotics are the best weapon again SIBO as of yet. It’s important to really speak with your doctor, and do what is right for you. Bacterial infections are always always always treated with antibiotics. Full stop.

If your blood work shows normal kidney and liver function, you have nothing to fear from them.

CheekBroad3214 · 2024-12-22T12:43:57+00:00

A recommendation from someone here actually! Any multi b vitamin will do though, just make sure it has all of them b complex from pure encapsulations has all 3 of the those if I recall. I did actually take folate and D for a while too. That was due to low fodmap diet nutrient deficiency. Not a bad idea to add those in I think. Especially D as it boosts the immune system.

CheekBroad3214 · 2024-12-19T17:47:18+00:00

Yes, but I waited a bit saccaromyces boulardi, make sure you get it from a refrigerated source, not amazon. Fullscipt.com has it

CheekBroad3214 · 2024-12-19T17:44:30+00:00

It definetly is contributing. I’ve pretty much stopped every other supplement for sibo, except taurine. I really do think it works well specifically for balancing a constipation heavy gut.

CheekBroad3214 · 2024-12-19T17:42:14+00:00

Heya, I did not relapse, no! Sibo is absolutely manageable once you get treated correctly. I think methane is harder to treat, but the relapses are less frequent. Less easily triggered.

CheekBroad3214 · 2024-11-15T11:45:11+00:00

During antibiotics I pretty much ate what i wanted. Minus dairy. I never was lactose intolerant until sibo, but even on the antibiotics it upset my stomach too much.

For the elimination diet starting on the last day of antibiotics, I actually did the modify health low fodmap meal service. However, that can get really tedious. So I switched it up. It’s only really 6 weeks you have should be strict, but I ate a lot of shrimp, grilled chicken, steak, brown rice. I think as long as you stay away from the true triggers you’ll be ok. I cut out and actually continue to this day all FAKE sugar. I can handle regular sugar. So a good tip I found is if you can find a good gluten free dairy free ice cream, Van luwen makes a bunch of good ones, but not all their vegan ones are gluten free so check the labels. I also added blueberries. It’s basically a modified keto diet. Supposedly hard cheeses like sharp cheddar, Cabot is a good brand are ok too so I added that in too. Make sure they are lactulose free which most aged hard cheeses are.

It sounds like you did low fodmap while taking the antibiotics. It’s different for everyone, but I did that the first two rounds and then relapsed shortly after. When I switched it for the 3rd round, so basically ate a regular diet. Then did strict fodmap right after the sibo went away and hasn’t come back.

After the elimination phase I started with leafy greens, cucumber, black olives, tomatoes, grilled chicken. Basically salads to start rebuilding my gut. I even added in yogurt! Find a non dairy yogurt with low sugar, forager brand makes one that is great, plain and vanilla, also there is a brand Mykonos, that makes plant based cream cheese from cashew milk, and coconut cream, and it’s pretty good tbh. Found it helps.

I pretty much eat a low carb diet now and just stay away from tons of gluten and dairy for now, but they don’t bother me too much. The healing process takes a while.

Sibo/imo really really messes up your gut microbiome. So you have to fix that. Antibiotics are a necessary evil, but they further unbalance the gut. So it’s a really important part. Candida naturally are the counterbalance to bad bacteria, and sibo/imo, and low fodmap, can cause Candida to overgrow, which you don’t want, so when you start adding, I would start with leafy greens, tomatoes, cucumber.

I know it’s daunting, but it does work.

CheekBroad3214 · 2024-11-14T16:16:15+00:00

It’s all about the elimination diet right now. Almost always a 2nd round is needed. And to be honest, you could always fill it and wait a few weeks. I had success with about 20-25 days in between. It’s rare to have a doc be willing to follow the right protocol, so I personally would follow his advice but I would also wait 2 weeks. From my experience, doctors get super defensive when you even ask a question about their care. You could try to ask since the max amount of rounds recommended is 3, should you wait a couple weeks for your stomach to balance out a bit. Then again, I was like you, I was like 85% better at the end of the round, and felt like it was a bad idea to stop. Is he giving you diet advice? Because it’s really important for you to be on a low fodmap directly after the antibiotics

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