Medical

Have medical questions? Ask a doctor online!

Ask a Doctor,
Get an Answer ASAP!

This answer was rated:

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.
Show More
Show Less
Ask Your Own Medical Question
Answered in 9 minutes by:
3/26/2018
Connie Pennington
Category: Medical
Satisfied Customers: 565
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?

Ask Your Own Medical Question
Customer reply replied 3 months 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.

Ask Your Own Medical Question
Customer reply replied 3 months 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?

Ask Your Own Medical Question
Customer reply replied 3 months 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 3 months 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?

Ask Your Own Medical Question
Customer reply replied 3 months 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 3 months ago
Also, have your patients complained of intermittent hypoglycemia like signs in addition to GI signs?
Customer reply replied 3 months 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.

Ask Your Own Medical Question

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

Ask Your Own Medical Question
Customer reply replied 3 months 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.

Ask Your Own Medical Question
Customer reply replied 3 months 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.

Ask Your Own Medical Question
Customer reply replied 3 months 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!

Ask Your Own Medical Question
Customer reply replied 3 months ago
Wait, I have Align, is the vsl3?
Customer reply replied 3 months ago
that
Customer reply replied 3 months ago
Also, should I take probiotics while taking Cipro? Is that defeating the purpose?
Customer reply replied 3 months 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.

Ask Your Own Medical Question
Customer reply replied 3 months ago
Thanks!

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

Ask Your Own Medical Question
Customer reply replied 3 months 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: 565
Experience: Colorectal Surgeon at Colon & Rectal Surgery Consutants, PC
Verified
Connie Pennington and 87 other Medical Specialists are ready to help you
Ask your own question now
Customer reply replied 3 months 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 3 months 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!

Ask Your Own Medical Question
Customer reply replied 3 months ago
Yea so far I am feeling more nauseous and weak. Would dysbiosis make me feel nauseous?
Customer reply replied 3 months 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.

Ask Your Own Medical Question
Customer reply replied 3 months 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 3 months 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.

Ask Your Own Medical Question
Customer reply replied 3 months 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 3 months 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 3 months 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.

Ask Your Own Medical Question

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?

Ask Your Own Medical Question
Customer reply replied 3 months 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!

Ask Your Own Medical Question
Customer reply replied 3 months 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.

Ask Your Own Medical Question
Was this answer helpful?

How JustAnswer works

step-image
Describe your issueThe assistant will guide you
step-image
Chat 1:1 with a doctorLicensed Experts are available 24/7
step-image
100% satisfaction guaranteeGet all the answers you need
Ask Connie Pennington Your Own Question
Connie Pennington
Connie Pennington
Connie Pennington
Category: Medical
Satisfied Customers: 565
565 Satisfied Customers
Experience: Colorectal Surgeon at Colon & Rectal Surgery Consutants, PC

Connie Pennington is online now

A new question is answered every 9 seconds

How JustAnswer works:

  • Ask an ExpertExperts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional AnswerVia email, text message, or notification as you wait on our site. Ask follow up questions if you need to.
  • 100% Satisfaction GuaranteeRate the answer you receive.

JustAnswer in the News:

Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.

What Customers are Saying:

I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me from a serious, even life threatening situation. I am very grateful to the experts who answered me.

Susan O.USA

I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much

Corrie MollPretoria, South Africa

I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well!

ClaudiaAlbuquerque, NM

Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion.

KevinBeaverton, OR

Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
I feel better already! Thank you.

ElanorTracy, CA

Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem.

JulieLockesburg, AR

You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions.

John and StefanieTucson, AZ

< Previous | Next >

Meet the Experts:

Family Physician

Family Physician

Doctor

2,592 satisfied customers

Emergency Medicine and Family Practice for over 26 years

Dr. Ketch

Dr. Ketch

Board Certified Physician

76 satisfied customers

Medical Degree, Former Assistant Professor at School of Medicine at Yale University

DrRussMD

DrRussMD

Board Certified Physician

51,788 satisfied customers

Internal Medicine--practice all of internal medicine, all ages, family, health, prevention, complementary medicine, etc.

Dr. David

Dr. David

Board Certified Physician

224 satisfied customers

Treat children/young adults, former chief resident, multiple publications

Dr. D. Love

Dr. D. Love

Doctor

18,060 satisfied customers

Family Physician for 10 years; Hospital Medical Director for 10 years.

Dr Chip (M.D.)

Dr Chip (M.D.)

Doctor

16,284 satisfied customers

20 yrs. in practice, including surgery, general medicine, addiction medicine and pain.

Dr. Arun Phophalia

Dr. Arun Phophalia

Doctor

14,060 satisfied customers

MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist

< Previous | Next >

Related Medical Questions
I am the one who wrote to you yesterday about possible SIBO
Hi again, I am the one who wrote to you yesterday about possible SIBO and delayed gastric emptying. I got the doc to switch me to rifaximin and took the first dose last night. I am wondering if this s… read more
Dr.Saleem
Dr.Saleem
Consultant Cardiologist
Doctoral Degree
866 satisfied customers
I have had on and off nausea, GERD, change in bowel habits,
Greetings, I have had on and off nausea, GERD, change in bowel habits, low appetite, and abdominal pain for a year now. All tests so far are normal (upper GI endoscopy, CT, ultrasound, blood work, fec… read more
Dr. Sohaib
Dr. Sohaib
Fellowship in Medicine
3,350 satisfied customers
Very debilitating GI issue. All functional disorders
Very debilitating GI issue. All functional disorders elinatinated. Relegated to IBS. Also been diagnosed fructose intolerant SIBO and c.dif. Lymes went undiagnosed for 2 years. First medical problem w… read more
Dr.Saleem
Dr.Saleem
Consultant Cardiologist
Doctoral Degree
866 satisfied customers
My daughter has had many tests and scans but no one is
My daughter has had many tests and scans but no one is helping her. They all tests are negative. But she has bloating and gas and cannot move her bowels. She is in great discomfort and has lost about … read more
Dr. D. Love
Dr. D. Love
Doctor
Doctoral Degree
18,060 satisfied customers
Dr.Phil, following up with you. All heart test came back
Dr.Phil, this is Mike following up with you. All heart test came back great so no issues there. I did mention to my GI, per your request about the SIBO. It took them about 3 days to respond but they a… read more
Dr. Phil, MD
Dr. Phil, MD
Internal Medicine Physician
Doctoral Degree
2,841 satisfied customers
I have had issues with gas backing up into my chest and it
I have had issues with gas backing up into my chest and it feels like I'm going to have a heart attack. Sometimes it even blows my stomach up. … read more
Dr. Phil, MD
Dr. Phil, MD
Internal Medicine Physician
Doctoral Degree
2,841 satisfied customers
My husband is severely overweight, has severe af, chest
Hi.My husband is severely overweight, has severe af, chest pains, spells, diabetic, has had a brain stem stroke 5 years ago. He is very weak and sleeping a lot. He also has sleep apnea and now high th… read more
Dr. Arun Phophalia
Dr. Arun Phophalia
Doctor
Post-Doctoral Degree
14,060 satisfied customers
Is it recommended to take 2 or 3 cyclical rounds of xifaxan
Is it recommended to take 2 or 3 cyclical rounds of xifaxan (1650 mg daily for 2 weeks) to get the best results for small intestinal bacterial overgrowth (SIBO)?… read more
Robert Fernando
Robert Fernando
Consultant
MBBS
595 satisfied customers
I have a similar question to this person. I am male, 64, and
Hi Doc .... I have a similar question to this person. I am male, 64, and travel in India regularly. for the last year I have had loose or soft stool, urgent movements in the morning, and frequently, b… read more
DrRussMD
DrRussMD
Board Certified Physician
51,788 satisfied customers
My 12 year old son has had unrelenting nausea for 10 days.
My 12 year old son has had unrelenting nausea for 10 days. Anti nausea med has no effect. He can eat a little bit but nothing like his usual appetite. A stool test was positive for e coli 0157 but he … read more
Dr. Phil, MD
Dr. Phil, MD
Internal Medicine Physician
Doctoral Degree
2,841 satisfied customers
I have just done my cortisol tests and taken my benzadryl as
Hi Doctor. I have just done my cortisol tests and taken my benzadryl as directed. My doctor here looks at me a little strangely when I make such specific and apparently well informed requests. I don't… read more
Dr. Phil, MD
Dr. Phil, MD
Internal Medicine Physician
Doctoral Degree
2,841 satisfied customers
Dear Doctor. Having trouble getting onto the site again so I
Dear Doctor. Having trouble getting onto the site again so I am trying a new string. My girlfriends hair loss continues terribly fast. She tried to go back onto the jasminelle and it did not work and … read more
Dr. Phil, MD
Dr. Phil, MD
Internal Medicine Physician
Doctoral Degree
2,841 satisfied customers
Coach, sorry to both you with this. Will give another bonus.
Hey Coach, sorry to both you with this. Will give another bonus. I hope you can see the last thread. I'll post results below just to be sure. But I had a stool test come back with all kinds of bad bac… read more
Coachrobmd
Coachrobmd
Physician Examiner
Doctoral Degree
1,720 satisfied customers
My brother became very ill and went to the hospital and was
My brother became very ill and went to the hospital and was diagnosed with double pneumonia. He wasn't healing so they did more tests. They found out that he is HIV positive. What are his chances of s… read more
Ken
Ken
Post-Doctoral Degree
5,285 satisfied customers
My son was diagnosed with a Burkitt Lymphoma in May 2007 and
Hi. My son was diagnosed with a Burkitt Lymphoma in May 2007 and underwent a self bone marrow transplant at the end of his treatment. He was diagnosed at stage 3 of the illness and after 3 months chem… read more
DR MED MD
DR MED MD
CONSULTANT
Post-Doctoral Degree
1,579 satisfied customers
My sister is 55 and has smoked over 40 years of her life.
Hello, My sister is 55 and has smoked over 40 years of her life. She was diagnosed with lung cancer in Feb '11 she had surgery to biopsy the tumor. She received radiation and has had three treatments … read more
Ken
Ken
Post-Doctoral Degree
5,285 satisfied customers
Will bee sting therapy help with painful plantar fasciitis?
Will bee sting therapy help with painful plantar fasciitis? It was reported on The Animal Planet television show, and said bee sting venom is one thousand times more potent than Cortisone. I am desper… read more
DrRussMD
DrRussMD
Board Certified Physician
51,788 satisfied customers
I was dx n on hodkins lymphoma 4years ago I had a 10 month
I was dx n on hodkins lymphoma 4years ago I had a 10 month infusion of Rituxian follwed up by 2 years of maintence What is the survival rate of thi type of cancer?… read more
Vakul Aren
Vakul Aren
Consultant Physician
Post graduation (Liverpool, U.K.)
4,187 satisfied customers
Disclaimer: Information in questions, answers, and other posts on this site ("Posts") comes from individual users, not JustAnswer; JustAnswer is not responsible for Posts. Posts are for general information, are not intended to substitute for informed professional advice (medical, legal, veterinary, financial, etc.), or to establish a professional-client relationship. The site and services are provided "as is" with no warranty or representations by JustAnswer regarding the qualifications of Experts. To see what credentials have been verified by a third-party service, please click on the "Verified" symbol in some Experts' profiles. JustAnswer is not intended or designed for EMERGENCY questions which should be directed immediately by telephone or in-person to qualified professionals.

Disclaimer: Information in questions, answers, and other posts on this site ("Posts") comes from individual users, not JustAnswer; JustAnswer is not responsible for Posts. Posts are for general information, are not intended to substitute for informed professional advice (medical, legal, veterinary, financial, etc.), or to establish a professional-client relationship. The site and services are provided "as is" with no warranty or representations by JustAnswer regarding the qualifications of Experts. To see what credentials have been verified by a third-party service, please click on the "Verified" symbol in some Experts' profiles. JustAnswer is not intended or designed for EMERGENCY questions which should be directed immediately by telephone or in-person to qualified professionals.

Show MoreShow Less

Ask Your Question

x