PERSONALISE YOUR PROTOCOL FOR SIBO

First of all, we want to re-iterate that SIBO is a complex condition and its successful treatment involves finding the root cause.

For this reason, SIBO is not always a straight forward treatment. If you do not see improvement in your symptoms after following the Clean Up Protocols 1-3, we strongly recommend getting extra support.

The Clean Up Protocols #1 to #3 are a fantastic treatment for SIBO. However, we've included below some important information and other treatment options that are specific for people with SIBO.

PARTIALLY HYDROLYSED GUAR GUM- aka - PHGG

One research study showed that taking PHGG while treating SIBO with antibiotics enhanced the effectiveness of the treatment. You may choose to include it during Protocol #3. However, it's not necessary, and some people do react to it negatively as it's a prebiotic, which is why we haven't included it in our main protocols.

PROKINETICS

Prokinetics are especially important to prevent relapse! It is recommended to take a prokinetic for at least 3 months post-treatment - so after doing Protocol #3. However, there is no harm in starting it before you finish the treatment.

Natural Options (available without prescription)

• Iberogast (available OTC in most countries): 30 to 60 drops at bedtime
• Ginger root (such as Ginger Supreme by Gaia Herbs): 1000mg dry herb equivalent at bedtime
• Motilpro by Pure Encapsulations (requires a prescription by health practitioner in some country): 2-3 capsules at bedtime.

Prescription-only Options

• Low-dose Naltrexone (LDN): 2.5 mg for diarrhea type and 5 mg for constipation type, at bedtime. It also has immune modulating effects, which can be a great bonus.
• Low-dose Erythromycin: 50-62.5 mg at bedtime
• Low-dose Prucalopride: 0.5 mg at bedtime (can increase up to 2mg if needed)

Transcutaneous Auricular Vagus Nerve Stimulation (TaVNS): is a special technique that can also help stimulate the migrating motor complex and reduce the effects of stress and trauma. However, it might not be enough on its own, so we would still recommend one of the options above as well. Learn about TaVNS here.

SPECIFIC RECOMMENDATION FOR METHANE SIBO (IMO)

• Allicin (such as allimax) is the best treatment option for methane SIBO. 1350-2700mg per day split in 3 doses. Take the highest dose tolerated. Tip: keeping in the freezer will reduce the 'garlic' smell and taste.
• Biogaia protectis (Lactobacillus reuteri DSM 17938) can be very helpful as it reduces methane production. Consider adding it as part of your treatment. Many people find it very helpful to reduce constipation.
• Atrantil is another option for methane. Take 6 per day split in 2 or 3 doses

ANTIBIOTIC OPTIONS (PRESCRIPTION ONLY)

HYDROGEN DOMINANT SIBO:

Rifaximin is an excellent treatment option for SIBO. The great thing about rifaximin is that it only acts in the small intestine, so it will not have similar side effects to other antibiotics. It has also shown to have anti-inflammatory benefits.

Dosage: the recommended dosage is 550 mg 3 times/day for 14 days.

You can enhance the treatment by also taking PHGG (see above) and a biofilm buster such as Interfase Plus or Biofilm Defense by Kirkman, all available on either iherb or Amazon.

* If you choose this option, we strongly recommend continuing with the recommendations in this program after the course of antibiotics to ensure success and prevent recurrence. You may want to do the clean up Protocol #1 after your antibiotic treatment to reduce the chances of relapse.

METHANE DOMINANT SIBO (IMO):

You'll need a combination of Rifaximin (see above) AND another antibiotic or anti-microbial if you have methane dominant SIBO.

Option 1: Antibiotics

RIFAXIMIN + either Neomycin or Metronidazole

Neomycin: 500mg twice per day for 14 to 21 days

Metronidazole: 250mg 3 times per day for 14 to 21 days

Option 2: Anti-microbial/natural option

RIFAXIMIN + either allicin or Atrantil

Allicin: 1350-2700mg split into 3 doses per day

Atrantil: 2 caps 3 times per day

USING THE ELEMENTAL DIET AS A TREATMENT FOR SIBO

You can successfully treat SIBO with the Elemental Diet alone (without any antibiotics or anti-microbials).

In fact, the Elemental Diet is the most effective treatment for SIBO and can be the fastest way to reduce bacterial overgrowth – seeing visible reductions in numbers in your test results after only 2 weeks.

To learn more, visit the Elemental Diet section.

DIET

It's important that people with SIBO stay on a low FODMAP diet for at least 3 months after finishing their treatment.