Anyone tried Xifaxan (Rifaximin) for SIBO?

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You may already know this, if so forgive me, but there are different forms of sibo that requires different medications. Did you test for sibo or are you treating from symptoms?

I say this, as I just did a sibo test that came back negative. However, the GI map test (comprehensive stool) showed other overgrowth.
I was treating for my symptoms because I read it on some forums that there was some success and in books that SIBO could be a cause of multiple chemical sensitivities.

I was unaware there are different forms of SIBO, however, I am aware there are H2S dominant and CH4 dominant ones, is that what your referring to? Can you provide some good resources on the subject that I will read?

I did a stool test but it wasn't GI map and I don't think they tested for SIBO. I did Viome, kinda hit on some things such as knowing that pistachios make my MCS worse (they wrote I shouldn't eat it but didn't know anything about my MCS) but kinda miss because they wrote that I can eat bread but bread makes my MCS worse. I did another type of test and it showed I had too much candida. For my next test, I'll do GI map and Viome, would be interested to compare the two. I am in no rush now to do those tests because I haven't made much progress.
 

EddieB

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Some sibo information here,
https://chriskresser.com/an-update-on-sibo-research-with-dr-mark-pimentel/

If you saw an improvement with the xifaxan, then you may be on to something. It may mean you needed additional antibiotics with the xifaxan to be more effective. Or herbal/ supplements to support.

I did a stool test but it wasn't GI map and I don't think they tested for SIBO.
The GI map cannot diagnose sibo, but it can detect methogens and other bacterial imbalance and overgrowth.
It can also find candida, ebv, and h pylori.

Some people find Viome helpful, I did not.
 
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I will read the SIBO info

I had a similar effect with oral swish and swallow nystatin, oral amphotericin b, goldenseal, and oregon grape root. For the herbals, I made a tea from them, they are very strong in terms of bitter taste.

Viome is kinda weird, but the interesting thing is the interpretation changes with time as they get more tests from all the people doing the test. Kinda neat.
 

EddieB

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I tried xifaxan for my multiple chemical sensitivities because I thought it was caused by SIBO
You probably read this already, from earlier in this thread...
https://www.healthrising.org/blog/2...thers-chronic-fatigue-syndrome-xifaxin-story/

It shows the possibility, of how treating the gut can have an effect on these other, seemingly unrelated symptoms.

I had a similar effect with oral swish and swallow nystatin, oral amphotericin b, goldenseal, and oregon grape root
Again, this speaks to me that by shifting/ disrupting the gut bacteria, caused an improvement, that you are on to something.

Myself, despite dozens of attempts to treat, I have only had a few things that (by accident) seemed to cause a positive shift.
They were...
- colonoscopy prep
- antibiotics
- antidepressant
All of which could have a direct effect on gut bacteria.
As with you, the results were significant but temporary. And singular, I was not able to get the results a second time.

I am learning as I go. Looking for answers as everyone else is.
 

2Cor.12:19

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I am learning as I go. Looking for answers as everyone else is.
@EddieB - any answers for you yet?
I finally got my xifaxin from India - took forever due to their Covid crises.
I'm on day 4 and doing fine so far. (550 mg x 3). I ditched the low FODMAP till I'm done, per expert suggestions.

Surprisingly, my guts haven't done too bad considering the abuse their getting from junk food. LOL. They're actually feeling better already.

I ordered some Iberogast and will start taking it half way through. Since there shouldn't be any drug interaction problem I don't want to wait till I'm done with the abx to start it. It's probably hoping for too much, but I'm hoping between the Xifaxin and the Iberogast, I can try going off the PPI and maybe even the milk of magnesia, both of which I take every day. The PPI's just perpetuate the SIBO.

I've also ordered some Lion's Mane that I'll start after I've had a chance to see how these other 2 things work. I have anxonal polyneuropathy, which could very likely be the root cause of my SIBO. Lion's Mane has the potential to help regrow peripheral nerves - at least it did in mice. Ha!
 

EddieB

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@EddieB - any answers for you yet?
Hi there,
I’ve been trying tiny amounts of some supplements to see if I could get something to work. But not much success...
- berberine, worsened the reflux and nausea, couldn’t continue
- allicin, same, can only do tiny amounts for a day or two
- colostrum, bloating/ gas increased, which in turn causes more reflux
- neem, some nausea/ headache (maybe die off) but not too bad so far, trying to continue

I saw the gastrologist last week. He looked over all the tests, and is still convinced I have an overgrowth despite the negative SIBO tests. He’s really pushing the xifaxan, and said he will do a second 2 week course if needed.
I had a horrible experience with it a few years ago, so I am reluctant.

I have Atrantil here, haven’t tried yet.

I’ve also been looking into fructose malabsorption. I don’t eat anything with known fructose, but I have terrible trouble with sugars of anykind, so I am suspicious. There’s an enzyme product I’m going to try, Xylose isomerase.
It’s supposed to break down and aid with digestion of sugars. Figured it’s worth a try.

The gorilla in the room is the positive biopsy for enterovirus. Nobody wants to talk about that, as they don’t know what to do about it. Self experimenting with Oxymatrine sounds risky to me.

I can try going off the PPI
I gave that another try, failed again. The throat/ chest pain gets worse. I’ve got to reduce/ stop this night time gas/ bloating/ vapor thing first.

Sound like you are able to tolerate the xifaxan which is great. Please keep updating.
Thanks, E
 
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@EddieB I did have a stool test, it wasn't as comprehensive as the GI map, but they did find a yeast overgrowth even though I had already done nystatin and xifaxan. Thus, I never had an extensive SIBO test that differentiated between the various types but treated non the less. Do some versions of SIBO respond better to certain antibiotics and others dont? Feel free to put any interesting sources in a response.
 
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@EddieB - any answers for you yet?
I finally got my xifaxin from India - took forever due to their Covid crises.
I'm on day 4 and doing fine so far. (550 mg x 3). I ditched the low FODMAP till I'm done, per expert suggestions.

Surprisingly, my guts haven't done too bad considering the abuse their getting from junk food. LOL. They're actually feeling better already.

I ordered some Iberogast and will start taking it half way through. Since there shouldn't be any drug interaction problem I don't want to wait till I'm done with the abx to start it. It's probably hoping for too much, but I'm hoping between the Xifaxin and the Iberogast, I can try going off the PPI and maybe even the milk of magnesia, both of which I take every day. The PPI's just perpetuate the SIBO.

I've also ordered some Lion's Mane that I'll start after I've had a chance to see how these other 2 things work. I have anxonal polyneuropathy, which could very likely be the root cause of my SIBO. Lion's Mane has the potential to help regrow peripheral nerves - at least it did in mice. Ha!
One interesting thing I found out is that in some doctors offices, like ones that accept PPO insurance, they have 2 weeks worth of free samples of xifaxan, thus the doc could write you a prescription and give you the free samples instead of having to pay thousands of dollars. That is what happened in my case. Then you won't have the problem of second guessing the authenticity of your xifaxan purchase from India. Let me know if it helps.
 

EddieB

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Do some versions of SIBO respond better to certain antibiotics and others dont? Feel free to put any interesting sources in a response.
Yes. If you haven’t already, look up Dr Mark Pimentel. He explains how methane and hydrogen sulfide sibo needs to be treated additionally. Link from above,
https://chriskresser.com/an-update-on-sibo-research-with-dr-mark-pimentel/

Knowing exactly which form (hydrogen, methane) from tests would be nice, but I don’t think that it is always possible. My breath test was normal range, but the GI map showed other overgrowth.

I’ve yet to find anyone that eliminated SIBO with xifaxan alone, herbs/ diet/ supplements are probably necessary.

All my tests for candida/ yeast came back negative, but I’ve read it’s fairly common to develop a yeast overgrowth during SIBO treatment.
 
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neat, I've tried everything they mention in there except for the molybdenum which I will be trying soon anyways. This almost sounds like the time when I accidently got c diff. My mother got c diff and I kinda forgot about it and used the same toilet she did, turns out some of the water got up my bum, haha. I treated it 12 hours after that incident because I was starting to have some abdominal cramping and a sorta diahrrea feeling even though it didn't mainfest in the toilet. I did a coffee enema and oral drink, each containing a tea of berberines made from oregon grape root and goldenseal. I did that in the morning. In the afternoon I drank diatamecous earth. At night, I drank probiotics. I did all that for 2 days and felt back to normal.

My mother was getting worse with the treatments the doctors gave me, she got the c diff after taking an antibiotic and the antibiotic for the c diff made things better for a bit but then she got worse. Finally after 2 weeks of asking her to try what I tried, she gave in, her diahhrea and wait loss stopped for a few days, got slightly worse for a week, then she got better. She was drinking probiotics and prebiotics after the 2 day treatment. Interestingly, she was on 20mg/day lisenopril which is contraindicative because the berberines impede the cytochrome P450's responsible for breaking down the beta blocker, but I guess in her case it didn't have an affect. I really should have checked that beforehand, even though I did ask her for what medications she was on, I don't think she mentioned the lisenopril. Lucky she was fine.
 

EddieB

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it Is good that your mother got better. I think you and I share in, that we’ve been ill for a long time, and finding the right cures is going to be difficult.

Interesting that you mentioned the berberine and the P450 enzyme. In my case, I began having terrible acid while taking the berberine, I think it was blocking the PPI I’m taking.

Berberine inhibits certain cytochromes: CYP2D6, CYP2C9, and CYP3A4. These cytochromes are the targets of a large number of medications, and by using Berberine HCl with other medication, you run a risk of potential dangerous side effects.[4]
 
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2Cor.12:19

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Anyone’s have any xifaxan updates?
Hi @EddieB I was supposed to take it for 14 days but took it for 19 days because mine came with 100 pills. I was doing so well that I wanted those 5 extra days. I still have a 14 day supply left in case I needed it.

The Rifaximin worked wonders! I haven’t felt this good in ages! But that’s relatively speaking of course. No magic CFS cure. I did a few other things that may have helped.

I’d been on Nexium for 15 years and knew it could be causing problems so I wanted to get off. I replaced it with Iberogast, an herbal bitters. My GERD is almost gone! I tried the low FODMAP for a few weeks and illuminated the surger alcohols (xylitol, etc) But I can eat everything else.

Then at around the end of the rifaximin course I started taking 600 mg of befotiamine (B1-thiamine) and also Lions Mane. My energy improved some more.

For perspective I did all this while having to be away from home another state for my husband’s work. We were gone 10 weeks, which was pretty stressful, even though we were on a beautiful peaceful ranch.

When I got there I was pretty miserable with my ME/CFS and SIBO, and I got the rifaximin 3 weeks before we came home. When I came home after a two day drive I was able to get up and do yard work at 6 am the next morning! Crazy!! This is something I haven’t been able to do in years, much less after being gone so long and traveling for two days.

The rifamimin hasn’t cured my C though and I still get a pain in my right side - not sure what that is.

I’m just very grateful to be feeling better, and praying it lasts.
 

EddieB

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That is wonderful news. As I sit here with the bottle of xifaxan staring at me on my table...

I just know, from the last time I tried it, it’s going to make me very sick. It will be hard to know if it’s die off or just the wrong medicine. I’m trying to come up with a strategy of how to make it through. I don’t think reduced doses are possible.

I was reading about something called binders, a supplement that has charcoal and clay, to help clear out the die off. Also read that C is common with the die off, and some sort of motility help is needed. Maybe that’s the iberogast for you.

Something else I stumbled on. I tried using slippery elm to help my throat. The gas/vapor reflux is becoming unbearable. But it seemed to be making it worse. Found out today, slippery elm is a prebiotic and actually recommended to take WITH xifaxan to draw out and feed the bacteria for killing.

Again, so happy for your improvements, I hope and pray they will continue. Not sure what xifaxan will do to me.
 

2Cor.12:19

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Thanks @EddieB . If you haven’t tried Iberogast I can’t recommend it highly enough. It’s very soothing. It almost miraculously eliminated my GERD. But I have to take it faithfully - 3 x daily before eating. Unfortunately, it didn’t help with motility because my C is due to Polyneuropathy. I’m taking the Lions Mane and B1 in hopes they will help repair my nerve damage, which is quite severe. I have to use a cane to keep my balance. I suspect it’s the nerve damage in my intestines that’s contributing to the gut issues.
Maybe you won’t have such a bad reaction this time. Holding a good thought for you! Please keep us posted.
 

EddieB

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f you haven’t tried Iberogast I can’t recommend it highly enough. It’s very soothing. It almost miraculously eliminated my GERD.
I was checking into this, and it does contain alcohol. Did you have any troubles from it? With other tinctures and things I’ve tried, the alcohol got to me with the reflux. I may be able to put the drops into capsules to get them down without setting things off.
 

2Cor.12:19

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I was checking into this, and it does contain alcohol. Did you have any troubles from it? With other tinctures and things I’ve tried, the alcohol got to me with the reflux. I may be able to put the drops into capsules to get them down without setting things off.
@EddieB - I’m EXTREMELY alcohol intolerant. Even a tiny sip causes flushing so severe that the surface temperature on my face I immediately shoots up to 101. I’ve had Zero issues with Iberogast.
The amount of alcohol in Iberogast is so negligible that I suspect any reaction someone might have may be psychological.
It actually soothes the reflux.
 
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EddieB

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Updates anyone?

Not so good here. The Iberogast causes worsened throat/ stomach symptoms. I sooo wanted this to work, but it just doesn’t.

Tuesday morning of this week, I awoke at 3am with terrible abdominal cramping and pain. No diet change, nothing to indicate. But this happens from time to time. Usually the results of eating sugars. Then came the IBS-D, which lasted through out the day, into the next.

So Thursday, things had calmed down a bit, I decided to give the xifaxan a try. I already felt lousy, and perhaps the bugs were out in the open.

Within an hour, severe uptick in all symptoms, dizzy, nausea, severe upset stomach. It was same as 12 years ago, all over again. This shouldn’t happen, I thought these pills are coated, and don’t dissolve until the small bowl? Continued throughout yesterday, with worsening abdominal pain, cold chills (but no fever). Slightly relieved this morning, but still going.

I understand the “die off/ worse before better” theory, but sometimes worse means something just isn’t right. And after the prior experience from before, I don’t think this is the right course. I’m so glad xifaxan has helped some of you, but at the moment, doesn’t look good for me.

Something I came across while researching, that xifaxan actually causes an increase of lactobacillus. Which is fine, if a person is deficient, but if there’s already too much (overgrowth), could this explain a worsening of symptoms? Does anyone have knowledge if this is true? Probably wouldn’t apply to me, since I only took one pill, but something to consider if true.

Clinical evidence shows that Xifaxan decreases inflammation and increases tight junction proteins in the gut(7, 8). It also increases the abundance of Lactobacillus in the ileum. This is great if you have a pathogen invading the ileum. Not so much if you have an overgrowth of Lactobacillus there. This may explain some of the differential responses to Xifaxan

https://hackyourgut.com/2016/10/17/amazing-hidden-side-effects-of-xifaxan-you-need-to-know/
 

ljimbo423

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I understand the “die off/ worse before better” theory, but sometimes worse means something just isn’t right.
The way Rifaximin works, you shouldn't get die-off symptoms, yet some people do. It works not by killing bacteria in the gut but by preventing them from multiplying.

Therefore, not increasing the level of lipopolysaccharides (LPS) that get into the bloodstream and causing die-off symptoms. killing bacteria in your gut directly would increase the level of LPS getting into your bloodstream because LPS are in the outer cell membrane of gram negative bacteria.

So when they are killed off, there LPS can get into the bloodstream, up-regulate the immune system and cause "die-off" symptoms.

Maybe by preventing some of them from multiplying, this causes shifts in the levels of other bacteria and that's were the die-off symptoms come from.

Whatever is happening with you, I agree that Rifaximin doesn't seem like the right medication for you.

I have also heard it can increase lactobacillus but as you say, I don't think you took enough to make your lactobacillus level increase. I think that would take at least a few days or longer.