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My doctor is treating me with ciprofloxacin for possible…

Greetings, My doctor is treating me...
Greetings,
My doctor is treating me with ciprofloxacin for possible SIBO/dysbiosis, and I am trying to get information about the prognosis. Have you ever treated SIBO, and what kind of luck did you have? I understand the relapse rate is high, but I would love someone elses experience.
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Answered in 9 minutes by:
3/26/2018
Connie Pennington
Category: Medical
Satisfied Customers: 233
Experience: Colorectal Surgeon at Colon & Rectal Surgery Consutants, PC
Verified

Hello. I am Dr. Pennington. I am a colorectal surgeon.

SIBO is a pretty strange thing to diagnose, and a little difficult to diagnose.

May I ask you how old you are and your gender?

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Customer reply replied 26 days ago
Hi Dr. Pennington,
I have been having GI issues on and off for a year, and all my tests are normal (including imaging and upper and lower GI). We did not officially diagnose SIBO (eg using breath tests) but my signs are compatible. I am a 56 year old female.

Ok, perfect. That 4 hour breath test is bit much and the results are often inconclusive.

Tell me all of your medications.

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Customer reply replied 26 days ago
That is why we went for trial antibiotics! I have been on Cipro for 3 days, nothing else

OK, well is the Cipro helping?

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Customer reply replied 26 days ago
I think so. I felt worse for the first two days, but today I feel better. I am just worried it is a fluke, and am also concerned about relapse. I was hoping that someone with experience treating this disorder could give me some perspective on that.
Customer reply replied 26 days ago
Not a liver fluke....:)

OK, well I have 16 years of experience, but the condition is quite bizarre.

First, I prefer to treat it with Xifaxin (rifaximin) 550mg twice daily for 3 days then once daily for up to 30 days. Pretty hard to get it approved unless you have failed other meds. We often have to appeal it.

Many people experience the return of symptoms after the medication is stopped.

This is where diet comes in. I highly recommend a Low FODMAP Diet.

There is a book "The Complete Low-Fodmap Diet" by Sue Shepherd, and Peter Gibson that is very good. It works. Hard to follow but works.

I also like a really good probiotic, like VSL# ***** at 900 billion once day. It is a prescription.

I am sorry you are dealing with this.

What else can I answer for you?

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Customer reply replied 26 days ago
Thanks very much for your thoughtful reply. Do you think some people clear it and move on? And how long does it take for symptoms to come back? That is probably why my doc put me on Cipro, so I didn't have to get rifaximin approved, but I would rather be on that, I think. And you have not found that the probiotics make it worse? I have been somewhat eating low FODMAP, but have heard that it is not healthy long term? Also, my symptoms have come and gone (for two weeks in France, my digestion was perfect), does that makes sense for SIBO?
Customer reply replied 26 days ago
Also, have your patients complained of intermittent hypoglycemia like signs in addition to GI signs?
Customer reply replied 26 days ago
could I possibly have done this to myself by performing abdominal massage with a Yamuna ball and messing up my ileocecocolic valve?

No, I doubt you have SIBO. In fact I take out many a right colon, where we remove the ileocecal valve, which should predispose to SIBO, but those folks never get it.

You probably have IBS. Dysbiosis. Bloating from dysbiosis.

I very much dislike Cipro because it kills off to much good bacteria.

I love probiotics, VSL#3 competes with bad bacteria for food, and they die. Bad bacteria release enterotoxins that make you feel bad, but short term. Keep taking the probiotic and this "die off" will stop in 3-4 days.

NO, you have not hurt you ileocecal valve at all! No worries.

Hypoglycemia should not be related, but needs to be checked out.

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Some patients also have fat malabsorption, and I add a digestive enzyme before meals and it makes all the difference in the world.

Here is a most excellent diet to "re-balance" the system

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Customer reply replied 26 days ago
OK, I will ask for VSL#3, and I have already asked that my antibiotic be changed. How does dysbiosis differ from SIBO? It stays in the colon but are the wrong bugs? And I don't know if I have hypoglycemia, but on a couple of occasions it has felt like that. Maybe because sometimes I am afraid to eat. I was also diagnosed with mild delayed gastric emptying, a prolonged half time (66 minutes, high normal 45) using oatmeal, so I thought my hypoglycemia might be due to dumping. What do you think? I don't know if my delayed gastric emptying is due to the intestinal problems or is causing them. Thank you for the diet recommendations. Is "rebalancing" usually successful?

I love VSL. You can get the 112.5 billion over the counter.

Dysbiosis is what we all experience from time to time based on how clean our diet is or is not. Dysbiosis usually is a colon thing, but can affect the small bowel. SIBO is a definate overgrowth of bad bugs in the small bowel. Have you tried some ginger tea for delayed gastric emptying? Works like a charm. Use fresh ginger. It is a natural motility agent.

I love the Elimination Diet. Studies show 80% of those with IBS are totally cured on it! I tell people to do seasonally or after vacation, to get back to normal! Re-balancing is super easy.

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Customer reply replied 26 days ago
Great, thanks! I have not tried ginger tea. Do you know Michael Stamos?

No, I do not.

I am happy to answer anything else that may concern you.

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Customer reply replied 26 days ago
He is a colorectal surgeon, a friend, and dean of UC-Irvine med school, so I was just curious.I think I am good for now, thanks for answering, and for your recommendations.

Sure thing, have a great day!

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Customer reply replied 26 days ago
Wait, I have Align, is the vsl3?
Customer reply replied 26 days ago
that
Customer reply replied 26 days ago
Also, should I take probiotics while taking Cipro? Is that defeating the purpose?
Customer reply replied 26 days ago
Also, I have mostly been high energy, but occasionally feel constitutionally yucky. Do you think dysbiosis could cause that?

No align is not vsl#3

VSL# ***** has 8 different named bacteria and comes in super doses 112.5 billion, 450 billion, and 900 billion.

As long as you do not take a probiotic at the same time as an antibiotic, it is ok. Space them 4 hours apart. Same with ginger, it is a natural antibiotic and will kill probiotics.

Dysbiosis definitely causes the yuckies! Try the Elimination Diet. It is easy to follow and works! Do it with probiotics and forget the antibiotics.

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Customer reply replied 26 days ago
Thanks!

You are welcome. 5 star if it was helpful as we work for stars! I will still be here!

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Customer reply replied 26 days ago
I already rated you!

Did you accept the question? It did not appear, but that's ok! I hope it was helpful to you.

Connie Pennington
Category: Medical
Satisfied Customers: 233
Experience: Colorectal Surgeon at Colon & Rectal Surgery Consutants, PC
Verified
Connie Pennington and 87 other Medical Specialists are ready to help you
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Customer reply replied 26 days ago
Am I supposed to rate each question? And just out of curiosity, what made you decide to work for Just Answers?
Customer reply replied 25 days ago
Hi again, Dr. Pennington,
I have a few more questions
1) functionally do you know the meaning of "mild delayed gastric emptying?" I think I told you that my half time was delayed by 20 minutes over the high normal reference interval, but my 3 hour time was normal. Could this be normal variation? Or could this be causing my symptoms? Or both? :) Is it likely to progress? I am trying to figure out what my life will be like from here on, and if I need to worry.
2) do your patients on rifaximin feel tired and/or nauseous? I have sort of a nauseous/weak/about-to-have-diarrhea feeling
3) I am just concerned that I will not get better, or may even get worse, trying not to worry.I have asked other doctors on here these same questions but I like to get lots of opinions. And I can't get in to see my doctor until June.Thanks for your time

I would not worry to much about mild delayed gastric emptying. If you had a series of tests over 1 year showing progression then we would address it. Totally normal variation. If you tested again, it might be totally normal.

Things people notice on rifaximin:

  • bloating, gas, stomach pain;
  • feeling like you need to empty your bowel urgently;
  • feeling like your bowel is not completely empty;
  • nausea, vomiting, constipation;
  • headache, dizziness;
  • tired feeling; or.
  • swelling in your hands, feet, or torso.

These symptoms are not to common but can happen. If the drug makes you feel worse than the potential SIBO, then stop it!

Try the diet and probiotics! It is simple, and no side effects!

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Customer reply replied 25 days ago
Yea so far I am feeling more nauseous and weak. Would dysbiosis make me feel nauseous?
Customer reply replied 25 days ago
Because I felt nauseated even before I started the meds

Dysbiosis will occur with antibiotics. Can make you feel bloated.

Get a good probiotic and take it separately from the antibiotic. Spaced out at least 2 hours.

I like VSL # 3 112.5 billion. You can get it over the counter at some pharmacies/groceries.

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Customer reply replied 25 days ago
I already ordered some. And do you think probiotics and an elimination diet will help my nausea? Do you think nausea could be a result of a food sensitivity?
Customer reply replied 25 days ago
why would I be losing weight?

The Elimination Diet is a great way to re-set!

Well the best way to get to the bottom of that is with food sensitivity testing.

You could be losing weight due to malabsorption. Possibly.

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Customer reply replied 25 days ago
Which food sensitivity test do you recommend? I am actually a veterinary clinical pathologist, so I am extra skeptical about test that have not been validated.
Customer reply replied 25 days ago
Here are my nutreval tests. Not sure if you got the other message, but here they are. I am happy to set up another phone call about these, although I do have an appointment with a functional medicine doctor for this Friday
Customer reply replied 25 days ago
you don't think I need to worry about being in pain or nauseated the rest of my life, or dying of some as-yet-to-be-diagnosed disease?

Oh wait, got it. Stand by.

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You are right, that NutraEval is pretty bad.

Your B1, B2, B3 were low. Omega-3's low. Cadmium high. Do you smoke? Horrible dysbiosis but no yeast. Not adsorbing protein at all. Terrible.

So, first of all we need to repeat the test. I would like a comprehensive stool analysis as well. And maybe a food allergy panel with spice panel.

Also a mold sensitivity.

Who did the Genova test for you? Can you see them again, for those tests?

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Customer reply replied 25 days ago
I do not smoke and never have. I do spend a lot of time in the barn! :)
I went to an ND, and I would prefer to see an MD with functional medicine training. I have an appointment on friday. Should I start a multivitamin? The ND said she was surprised I was not having symptoms at the time. I have had intervals where I have actually felt great, not sure why that would be

It is best to do a NutraEval not on vitamins for a true measure, so hold off. The body is quite mysterious, indeed.

Glad you are in with someone! Great!

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Customer reply replied 24 days ago
Do you have a literature source for livestock antibiotics altering the gut microbiome? I am trying to persuade my husband that we need to buy organic meat. The sources I found showed very little antibiotic residue in meat/milk/eggs.....

Let me know when you have new test results.

As far as functional medicine literature, much of it is the relationship to obesity and resistance to antibiotics in animals that cause resistance in humans and thus alters the microbiome. Indirect.

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Experience: Colorectal Surgeon at Colon & Rectal Surgery Consutants, PC

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