SIBO requires special antibiotic protocols for the eradication of unwanted bacteria in the small intestine. With the average length of the small intestine in an adult human being 20 feet long, there is a lot of space for bacteria to hide deep inside the gut leading to overgrowths like Small Intestine Bacterial Overgrowth.
Traditional oral antibiotics are designed to be absorbed by the body into the blood stream and circulated throughout the body in order to reach the infected area such as the ears, sinuses, lungs, skin, and urinary tract. But SIBO is a different story.
Small Intestine Bacterial Overgrowth is characterized by an imbalance of the gut microbiome. This means good bacteria, wanted bacteria for the colon, moves into the small intestine and takes up residence where it is not helpful or wanted by the body and the body does not get rid of it properly. SIBO overgrowths live in the small intestine usually deep inside but can reach up to the stomach. Traditional antibiotics may help SIBO located high up in the small intestine near the stomach before the antibiotics are absorbed but most often traditional antibiotics are absorbed into the blood stream and out of the small intestine long before reaching the bacterial overgrowth. The intentional mechanism of traditional antibiotics makes them largely ineffective. However, tiny amounts of antibiotics may indeed make it back to the small intestine allowing insufficient portions of the bacterial colony to be targeted, and thus provoking the bacteria, even triggering the bacteria to create a biofilm. It is like hitting the Death Star in the Star Wars movie series. Enough to make it hesitate, then throw up a shield and increase the fight. This is often why people who have SIBO feel a little bit better while on antibiotics but then worse after the antibiotics wear off.
In order to treat SIBO, antibiotics must travel unabsorbed through the small intestine and all of the way to the colon. Herbal antibiotics because of their fibers as well as one pharmaceutical antibiotic called Rifaximin or Xifaxan will travel through the small intestine largely undigested. This means in order to treat SIBO special antibiotic protocols are required.
Herbal antibiotics include oregano, cinnamon, berberines, neem, allicin from garlic, peppermint and more. Both singular and combinations of herbs are used in the treatment of SIBO and recommended herbal protocols are updated every year. Herbal antibiotics are often used for longer periods of time (3-6 weeks) and are recommended by doctors and researchers for those who are also fighting Small Intestine Fungal Overgrowth (SIFO) or Candida. Many herbal antibiotics are also anti-fungals
Rifaximin is used for shorter time periods (1-2 weeks) and is often administered in conjunction with Neomycin. For some people, Rifaximin is a very effective treatment, although it can be costly and not all insurance companies or plans will cover it. However, as many of you know, most insurance companies in the United States will cover Cipro for SIBO or require it before covering Rifaxmin. Cipro is a strange exception. For some SIBO patients Cipro is effective, HOWEVER, SIBO researchers warn it is a one time try. If Cipro works for SIBO it will only work one time. That means if the SIBO returns a different treatment will be necessary.
Each person has their own, unique microbiome that has been built up and knocked down over time. The human microbiome begins at birth with exposure to mother, family, and environment. Microbiomes change over time as environment changes, stresses and illnesses occur, food and water sources change, and carbohydrate intake varies. Because each microbiome is unique SIBO can include different strains with different levels of resistance and strength of bacteria. This means there is truly no one-size fits all treatment for SIBO. For some SIBO patients Rifaximin works better than herbal protocols and others vice versa. Establishing the first best course of action for treatment is up to you, your symptoms and situation, current research, and your doctor. If one treatment does not work then trying another is often helpful. Most SIBO patients (2/3) require more than one treatment.
Now, please remember that I am not a doctor so I will not and cannot give advice on which antibiotic to take or how to administer them. Nor can I prescribe them. If you would like to find out more information on dosage, and how to use SIBO antibiotics you can visit SIBOinfo.com.
If your doctor prescribes an antibiotic not listed on SIBOinfo.com, please ask for the specific, recent studies on SIBO they are using as references to help treat your SIBO. Traditional antibiotics will often make SIBO symptoms worse and I do hear from YOU, my readers, of doctors mis-prescribing antibiotics and making SIBO symptoms worse.
It is important to treat your SIBO right. Please take care of yourself well, and know your best options for success!
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Janis says
I had colon resection years ago for twisted colon …for 20 yes had sibo and can’t find anything to help …tried fodmap diet , antibiotics, xifaxin , when they did colon reaction the ilium was taken out ( the flap that causes backwash to go up intestines ) have any ideas for me on how to control it ???
Elena Wistey says
Hi Janis,
There are several different ways to compensate for the lack of an ilium or for refluxes. Making sure the MMC and vagus nerve are working properly under the guidance of a doctor who is a SIBO Specialist is the best place to start.
Good luck!
Maddison says
Hello,
I am just wondering you experience with the drug Cipro? It has been suggested to me, but I am a little nervous due to its side effects.
Thanks so much!
Elena Wistey says
Hi Maddison,
If you don’t feel comfortable with a treatment, please ask your doctor for a different option. I think your intuition or gut feeling is always worth heeding. I have heard of doctors using Cipro for the first round of treatment because it isn’t as harsh as Rifaximin. So, if you have a mild case of SIBO, it could be helpful. However, I don’t hear cases of the experts using Cipro. It would not be my first choice.
Elena