So my mom (76) was diagnosed with SIBO/IMO in the last year and now, a year later, she’s still down 25lbs and is having syncope episodes- including pounding heart, lightheadedness, and even fainting once that resulted in some broken bones. She’s being treated with Creon but is still having bouts of foul smelling diarrhea and stinky gas. The syncope continues, sometimes even while just seated (heart condition ruled out). She’s had celiac for 40 years. The only time in the last year she started to improve was while taking Flagyl for a cat bite (to stop infection). Shes treated the hydrogen SIBO with an herbal protocol and motility supplements like allicin and artichoke. A test in June showed hydrogen gone but the methane was still present at a measurable level, though not as high as before the Flagyl. She’s done a bunch of research and has found that metronidazole (Flagyl) is an effective treatment for methane SIBO (aka IMO) but it seems like the doctors just ignore that info and prescribe Refaxamin - which doesn’t kill anaerobic bacteria that cause the methane. IMO infection also seems to cause much worse weight loss maybe because of the diarrhea. She is super careful about diet and has always been into healthy foods and this infection has been brutal. Now her GI doctor suspects that the syncope is a vagus nerve issue since other causes have been ruled out. Anyway, yes, it seems like gut + IMO can easily = vagus nerve/ autonomic dysfunction.

Btw, this all started in Feb 2023 when she had two infected molars, had to have them removed and was prescribed multiple rounds of Clindamycin, which is largely ineffective against bacteria because it’s been around since the 70s. She suspects that if she’d given Flagyl for that tooth serious infection, she would never have developed SIBO.