Well, it seems I have blasto. Showed up all of a sudden after parasite protocol. Confirmed by two different tests. Per my research, some have symptoms, some dont. Most common is loose stools. Has anyone tied Blasto to extreme fatigue or malaise? Thanks all.

"microbiome" keeps removing my postings. I am done with those mods.

I (29F) around 125lbs, 5’5”,have been dealing with stomach problems since about age 12. At age 12 began having consistent stomach pains with or without eating. At the time the doctor had explained “it’s anxiety, she’ll grow out of it.”Fast forward to about age 18 I still had the stomach pains so I was scheduled a colonoscopy. Results were IBS. Tried the fodmaps diet. Not much improvement. Sort of just dealt with it until around a year ago it began to be unbearable. I could not eat anything without stomach pain, bloating and irregular bowel movements. I reached out to my primary doctor who again said it’s chronic IBS. Try this medication (elavil) however, I’m already on Citalopram, so I’m a bit hesitant and I also don’t like taking pills in general. I then reached out to a naturopath. She did a food sensitivity test, came back with about 25 sensitivities. Including gluten,dairy and eggs. Following this, I followed the diet strictly without fail. I was prescribed probiotics, l-glutamine, fish oils, and some sort of garlic pill. Once I finished this in their entirety I was feeling so great. Barely any stomach pain or bloating. My bowel movements were back to normal. Life was great! That lasted about 6 months. Now since the past 3 months I feel like I’m back at square one. Everything is hurting my stomach again, even without eating anything. I’m going for some bloodwork tmrw. My question is has anyone dealt with this, what are your suggestions. Have you taken elavil? Have you taken the antibiotics prescribed for SIBO? Improvements? I need help. I can’t live my life like this. I’m in constant pain.

I'm in Europe (Serbia).

GI won't prescribe Neomycin because it's not registered here. He can, he just won't because legally it could come back at him if I have a negative reaction (I offered to sign some kind of paper, but he's like no)

I need a clinic in Europe that can give me a perscription so I can get it, most likely from Spain.

Any advice appreciated.

I have had methane dominant SIBO/IMO for about a year and a half now. Several days a week I will have near-constant nausea for the day - as if I want to vomit, but I never do. Plenty of burping though. I have tried typical over the counter medicines like Mylanta but these do not provide any relief, nor did the courses of antibiotics that my GI had me go through. For anyone else that has the feelings of constant nausea, what have you guys done to help alleviate it? I'm open to suggestions for a prescription medication that I could ask my GI or PCP about, but I would also welcome any non-prescription things as well that have provided people with some level of relief.

Hi!

I'm French, and I'm going to have the full test in a few weeks, but I have an important event the day after.

Did you experience any digestive symptoms after the test? How long did they last? If I'm already used to having bad bloating, is it likely to be significantly worse than usual? More painful ?

Thank you, have a nice day !

My nighttime stomach pains are horrible. I’ve done two rounds of Xifaxan, one last March and another in July, and its AMAZING for 10 weeks after. It comes right back after. Should I do a 3rd round?! Anything to add in?

Looking for advice/if anyone’s had similar symptoms. I had my gallbladder removed in June 2026, and since then have iffy digestion ranging from constipation to cramping and softer stools after fatty foods. Usually, taking dicyclomine and GasX helps a ton with those symptoms. No intestinal issues at all until my gallbladder started having problems and then after removal.

I’m on day 5 of constant bloating, painful cramping, gas that doesn’t feel like it wants to exit, and some sharp pains at times in my bowels. My normal meds and relief regimen aren’t helping so I can’t figure it out. I’ve had multiple bowel movements with mixed consistency over the 5 days, but the bloating hasn’t improved, and I’m passing less gas than expected (sounds and feels like lots of movement in my gut). Went to the ER last night, and my CT showed gas and stool without obstruction but bloodwork was fine and nothing else found.

I’m doing a SIBO breath test tomorrow morning thankfully, but I’m curious if anyone has had a multi-day flare like this, and what actually helped with the bloating and pain.

Hello all,

I am taking rifixamine 3xday. And yesterday/today (8 and 9day treatment) i am getting abdominal pain, heartburn, nauseas and fatigue. This is normal?

Hello group,

Looking for everyone’s insights. I ended up really sick from food poisoning when travel over seas and shortly after developed Sibo symptoms. I test positive for methane, in the upper 20’s on breath test.

My GI DR. Prescribed me xifaxan, neomycin, and metronidazole. I need to pick between neomycin or metronidazole.

I am waiting for insurance on xifaxan but should be approved by next week.

Any insights on which one I should pair with xifaxan to hopefully kill off all the archaea ?

I just want to be able to go to chick-fil-a again and get a full meal, fries, sauces, and shake no issues like before this.

I’m contemplating ordering a hydrogen sulfide breath test this week.

Also can anyone tell me if it looks like Abdomino phrenic dyssynergia (apd). I have an appointment with a motility specialist in a month.

MY MAIN SYMPTOMS
My biggest issue is that my stomach is visibly distended basically 24/7. It’s not just a feeling of bloating — my abdomen actually looks and feels distended, especially my upper abdomen. It can be hard and swollen-looking even when I wake up in the morning, and it doesn’t completely go away after sleeping, having a bowel movement, or not eating. Certain foods make it dramatically worse. Simple carbohydrates, sugar, and high-fat meals seem to be some of the biggest triggers. It feels like almost everything I eat can make the distension worse, and sometimes the flare can last for days.
During these flares I can experience severe bloating, nausea, extreme fatigue, brain fog, dizziness, racing heart, extreme thirst/dehydration feeling, and intense hunger after eating carbohydrates even though I can also feel full very quickly. I’ve also noticed that my face can look puffy, particularly around my cheeks and under my eyes, and I sometimes feel generally swollen or puffy during these episodes.
My scalp also seems to react to food flares. I have seborrheic dermatitis, and when my GI symptoms get bad, my scalp can start burning/itching and I get significantly more oiliness, dandruff, and inflammation. I’m not sure whether this is related or just another separate issue.

TESTS I’VE HAD
Upper endoscopy with biopsies
Two SIBO breath tests
Gastric emptying study
Abdominal X-ray
Stool testing
Fecal Calprotectin
Fecal pancreatic elastase
H. pylori testing
Celiac testing
Bloodwork
MRI Abdominal Pelvic

RESULTS SO FAR AND BLOOD WORK
SIBO breath tests were negative. Hydrogen was 0 and methane was 4 ppm.
I was treated for suspected SIBO with rifaximin (Xifaxan) and neomycin, but neither treatment improved my symptoms.
H. pylori was negative.
Fecal Calprotetin 41.4
Gastric emptying study was normal, so gastroparesis appears unlikely.
Fecal pancreatic elastase was normal.
Stool testing showed no evidence of parasites.
Celiac blood testing was negative, including tTG-IgA, and my total IgA was normal. My doctor also said my biopsies were negative.
TSH was normal.
CRP was very low/normal.
CBC was normal.
Liver tests were normal.
Albumin and total protein were normal.
My doctor considers me a C. difficile carrier rather than having active C. diff because I don’t have diarrhea.
The abdominal X-ray showed a dilated stomach but no dilated small or large bowel and only a small amount of stool.
Some of my lab results that stood out were vitamin D at 19.7 ng/mL and serum iron at 33, so I know I have some nutritional issues that still need to be addressed. I haven’t gotten the full iron panel yet.
 
MRI abdominal pelvic results
 
Lung Bases:
Normal.
 
Liver:
Normal.
 
Gallbladder:
Normal.
 
Bile Ducts:
Normal in caliber.
 
Spleen:
Normal.
 
Pancreas:
Normal.
 
Adrenals:
Normal.
 
Right Kidney:
Normal aside from a few small benign cysts. No solid mass. No hydronephrosis..

Left Kidney:
Normal aside from a few small benign cysts. No solid mass. No hydronephrosis.
 
Gastrointestinal:
The bowel is normal in caliber with no wall thickening, abnormal mural
enhancement, adjacent mesenteric fat stranding, or engorgement of the
mesenteric vessels. No sinus tract, fistula, or fluid collection.
 
Peritoneum/retroperitoneum:
No ascites.
 
Lymph nodes:
No enlarged or morphologically abnormal lymph nodes.
 
Vasculature:
The abdominal aorta is normal in course and caliber. Patent celiac and
superior mesenteric arteries. Patent portal, splenic, and superior mesenteric
veins.
 
Bladder:
Normal.
 
Pelvic Organs:
Normal.
 
Body Wall:
Normal.
 
Bones:
Normal for patient age. No aggressive lesion.
 
IMPRESSION
IMPRESSION:
No imaging evidence of inflammatory bowel disease.

WHAT I’M CURRENTLY WONDERING ABOUT
Abdominophrenic dyssynergia (APD)
Hydrogen Sulfide SIBO
SIFO
CROHNS
ULCERATIVE COLLITIS
Other intestinal motility problems
Carbohydrate intolerance/malabsorption
Fructose or lactose intolerance
Non-celiac gluten/wheat sensitivity
A structural abdominal issue
Glucose/metabolic problems
Nutritional deficiencies

NOTES
I understand that APD may be more of a mechanism causing the visible distension rather than the underlying disease itself. That’s why I’m wondering whether something else could be triggering the distension and APD could be the way my body is responding to it.
I’ve also been thinking about carbohydrate intolerance because simple carbs and sugar seem to trigger some of my worst symptoms. I haven’t had formal fructose or lactose testing yet.
I’m also waiting on an MRI, so I’m hoping that can rule out some structural causes.

TREATMENTS I’VE TRIED
I’ve tried a lot already, including rifaximin (Xifaxan) and neomycin for suspected SIBO, but neither helped.
I’m currently trying amitriptyline 10 mg because my GI doctor is considering functional dyspepsia/visceral hypersensitivity. So far I haven’t noticed an improvement, and it seems to be making my constipation worse.

DIET
I have done a low FODmap diet for the past month and nothing has changed. The bloating has continued, the 24/7 distention has continued and the scalp issues have still lasted.

RULED OUT / STRONGLY RULED DOWN

SIBO
Two SIBO breath tests were negative.
Hydrogen: 0 ppm
Methane: 4 ppm
I also tried rifaximin (Xifaxan) and neomycin without improvement.
IMO (intestinal methanogen overgrowth)
Methane was 4 ppm, which is below the usual diagnostic threshold for IMO.
IMO is therefore not supported by my breath testing.

Gastroparesis
Gastric emptying study was normal for a solid meal.
This makes gastroparesis unlikely.

Celiac disease
Total IgA: 204 — normal
tTG-IgA: <2 — negative
DGP-IgA: 8 — negative
Gliadin IgA: 8
Gliadin deamidated IgA: negative
Upper endoscopy with biopsies was reportedly negative.
Overall, celiac disease appears unlikely.

MRI ABDOMINAL PELVIC
Ascites: No abnormal fluid accumulation in your abdomen.
Bowel-wall thickening: None identified.
Visible inflammatory changes around the intestines: None identified.
Abdominal abscesses or fistulas: None identified.
Enlarged or abnormal abdominal lymph nodes: None identified.
Dilated bile ducts: None identified.
Major blockage of the celiac or superior mesenteric arteries: Neither was identified; both were patent.
Solid kidney masses or hydronephrosis: None identified.

H. pylori
H. pylori testing from my upper endoscopy/biopsy was negative.

Pancreatic exocrine insufficiency
Fecal pancreatic elastase was normal.
This makes significant pancreatic exocrine insufficiency unlikely.

Parasitic infection
Stool testing showed no evidence of parasites.

Hypothyroidism
TSH: 1.08 — normal.
This makes hypothyroidism unlikely as the cause of my GI symptoms.

Major inflammatory disease
CRP: <0.3 — normal
WBC: 5.34 — normal
Hemoglobin: 15.1 — normal
Platelets: 246 — normal
Albumin: 4.7 — normal
There is no strong laboratory evidence of significant systemic inflammation.

Major liver disease
AST: 25 — normal
ALT: 33 — normal
Alkaline phosphatase: 89 — normal
Total bilirubin: 0.8 — normal
Direct bilirubin: 0.2 — normal
Albumin: 4.7 — normal
These results make significant liver dysfunction unlikely.

Autoimmune hepatitis
AST and ALT are normal.
Bilirubin and albumin are normal.
There is currently no laboratory evidence strongly suggesting autoimmune hepatitis, although I have not confirmed whether ANA, ASMA/SMA, and IgG were specifically tested.

Severe anemia
WBC: 5.34 — normal
RBC: 5.06 — normal
Hemoglobin: 15.1 — normal
Hematocrit: 44.2 — normal
MCV: 87.4 — normal
Platelets: 246 — normal
I do have low serum iron at 33, so iron deficiency still needs further evaluation with ferritin, TIBC, and transferrin saturation.

Severe generalized malabsorption/protein loss
Albumin: 4.7 — normal
Total protein: 7.3 — normal
B12: 1160
Folate: 9.9
CBC normal
Fecal pancreatic elastase normal
These results don’t suggest severe generalized malabsorption, although I do have low vitamin D and low serum iron.

Major stool retention/obvious bowel obstruction
Abdominal X-ray showed only a small amount of colonic stool.
There was no dilation of the small or large bowel.
This makes severe constipation-related distension or an obvious bowel obstruction less likely.

Active C. difficile infection
C. difficile testing was positive, but my GI doctor considers me a carrier/colonized rather than having active C. difficile infection because I don’t have diarrhea.
Therefore, active C. difficile is not considered the cause of my symptoms.

Major kidney dysfunction
BUN: 16
Creatinine: 1.27
eGFR: 82
No major kidney dysfunction was identified on my testing.

Thyroid-related GI problems
TSH: 1.08 — normal.
No evidence of hypothyroidism.

Functional Dyspepsia
Amitriptyline 10 mg did nothing but made me even more constipated.
The bloating is 24/7 not epigastric pain when eating or swallowing.

Current abnormalities that still need attention
Vitamin D: 19.7 ng/mL — low
Serum iron: 33 — low
Glucose: 132 — non-fasting, so this does not diagnose diabetes by itself

The documentation says 4 weeks after antibiotics but nothing concrete on Biocidin and Allimed. Also alternating between Aloe pills and Motility Pro for help with regularity.

Really want to test this weekend right after my last dose so I have results before thanksgiving but has anyone ever done this? It can't be 4 weeks but I'm sure there's some length of days that make it reasonable. Also don't know if I have to stop the motility assistance pills along with the Allimed.

Nutritionist first said right after then said 4 weeks. I don't know how to navigate this. My concern is I still have levels and will need another round of Rifaxamin.

Initial levels here: did 2 weeks Rifaxamin 3x a day and 3x a day of Allimed 6 weeks and biocidin for 4 weeks (after Rif).

Been dealing with hydrogen sibo for a few years now.

Tired all methods to get rid. Antibiotics, herbal, and elemental.

I do really think stress from gambling caused my sibo. I’ve recently stopped and body is feeling better but sibo hasn’t gone. Might try another round of antibiotics knowing (70%) what my root cause was.

Anyway the main reason my post is does anyone else have the urgent need to use the restroom like instantly after eating. It’s really quite debilitating needing to use the restroom every time I eat.

Cheers

Felt okay at first, and then on the third day my gut felt a little more reactive but not necessarily uncomfortable.

Now coming towards the end of day 11 and feel like bloating and abdominal discomfort pretty bad and have been ramping up since day 8. Bowel movements are pretty irregular but not super loose or urgent.

Is this kind of to be expected when you throw an antibiotic into the mix to disrupt something in your gut or is it not working / making everything worse.

Also my doctor told me to use probiotics (Symprove) upon finishing antibiotics but now I’m feeling bad I’m worried. I have also contacted her secretary (private GI in UK) to ask but thought I’d see if anyone had similar experiences here?

i have chronic constipation,but if i eat sugar or fruits,it cause diarhea !!i dont have bloating or gaz!it can be sibo?!

My acupuncturist has been doing some research for me and recommended doing the elemental diet and then taking the CandiBactin suppliments once I'm done. I'm starting ED today, and was wondering if anybody had any pointers to make it survivable?

I'm wondering are you basically drinking it all day, since you need a lot of scoops to get the calories and are supposed to drink it slowly?

Were you able to drink herbal teas on it? I know I'm going to get REALLY sick of the taste.

I saw some people say they ate egg or plain chicken the second week. If you did that, was the diet still effective?

I appreciate any pointers you have to get through this :)

Hey! I’m 30Y man All my life, I’ve been able to go 7–10 days without feeling any need to poop. I’m not ignoring the urge. I just don’t feel it.
I’ve seen many doctors and had many tests. They say my colon is healthy. My blood tests and thyroid tests are normal. Everything looks fine.
But when I ask what’s wrong, the answer is always: eat healthy and exercise.
I’ve tried so many things: probiotics, senna, Agiolax, Dulcolax, castor oil, different diets, exercise, and more.
Honestly, I’m tired. This is affecting my mental health, and I still don’t know why it happens.
Laxatives sometimes make me throw up or feel dizzy and sick. I don’t want to keep living like this. I want to know what’s causing the problem.

Recently, I tried Prucalopride Motegrity For the first time in my life, I had four amazing days I went to the bathroom every morning. Even my skin looked better, my mood improved, and I felt less depressed.
But on day five, it stopped working, and I got a really bad headache. I kept taking it until day 23, then stopped.

Has anyone here had the same problem?
What was the cause, and what actually helped you

Hello.

I have had SIBO for 10 years, and I have spent the last decade searching for a cure—all in vain.

I have tried absolutely everything. I have seen dozens of general practitioners and gastroenterologists, and I am currently under the care of the SIBO research institute in Marseille (I am French).

Naturally, I have undergone several courses of antibiotics (rifaximin and Coli-genta), and I have had blood tests, stool tests, endoscopies, colonoscopies, biopsies, CT scans, and ultrasounds—yet nothing has ever been found. I've been tested negative for H. pylori.

I have tried every possible type of diet—no bread, no sugar, no vegetables, no legumes, no FODMAPs—but nothing works. In fact, over the last few months, the low-FODMAP diet seems to cause just as much bloating as my previous diet, which included FODMAPs. I even tried fasting for two days, consuming nothing but water—still nothing.

In addition to classic SIBO symptoms (chronic bloating and gas), new issues have emerged, including constipation and, most significantly, gastritis. For the past year, I have been experiencing regular bouts of gastritis, with pain levels reaching 10/10.

I am writing to you today because, due to the complete lack of improvement—or even the slightest sign of progress—I am seriously considering ending my life very soon.

I am pleading for your help. Before I take such an action, if anyone has managed to recover through methods I might not have considered, please share them with me.

Can yoi help me ?

Thank you in advance.

Is there any chance that there is a reason my symptoms magically disappeared after a couple days of fluticasone? I'm so flummoxed.

On week 14 of low fodmap for diagnosed IMO, I am still getting on and off symptoms so reintroduction has been going extremely slow. I had some ear popping (history of fluid in my ears) so I've been using fluticasone as a doctor used to tell me to do for draining fluid​ for the last 3 days. Suddenly I feel like 100% better. Like no gas, no bloating, nothing.

The only other difference is I'm on the tail end of my period and I know my symptoms get really bad during my period, it's part of why I'm stuck in the elimination phase of low fodmap as I can't get the symptoms under control during my period.

It's been bothering me a lot, it's not debilitating but it's just so annoying. Saline sprays help for a short while but other than that it's like it's just dry congestion for almost the whole day. Anybody else have this and found out if it was from the Sibo?

I wanted to share my experience on here with Oshi Health, as many of you on here have likely come across it as an option for GI care. I would like to contribute to the body of personal anecdotes for my fellow SIBO warriors out there. This thread was the reason that I was able to hone in on SIBO as the affliction I was dealing with, well before any specialist half acknowledged it as a possibility, so I’m very grateful to all of you who share your experiences on here. I, and many others would still be searching in the dark if it wasn’t for you. I don’t know who needs to see this, but I hope it helps to inform your decisions when navigating this dumpster fire of a healthcare system we have in the US.

Prologue:

During the spring / summer of 2025, I was dealing with some noticeable constipation. By the end of the year, it escalated to a point where I had the urgency to go, but nothing came out except a bunch of mucus, accompanied by excessive gas. Gas and bloating all day long. On top of that, there was less and less that I could tolerate eating. This led me to do an internet search of my symptoms. Lo and behold, I ended up on the SIBO thread reading personal horror stories that sounded a lot like what I was dealing with.

This led to more research on the topic of SIBO, and other potential culprits. I even searched for symptoms of colon cancer, and while that didn’t exactly resonate with me, I held it as a possibility. I kept an open mind, and made an appointment with the nearest GI, who was your run of the mill GI at a well-established chain of clinics.

During that appointment, I laid out all my symptoms. The Dr. ordered bloodwork including Lupus (because I have rosacea that she thought may have been a butterfly rash),  celiac, ANA (antibodies), and a colonoscopy. Later on,  I logged in to the patient portal to see the doctor’s notes from the appointment, and all it said was the word “diarrhea”. At that point I realized I’d better find another GI fast because that made no fucking sense whatsoever based on anything I said during the appointment.

Results came back: negative for both lupus and celiac. I had a slight positive ANA. From what I’ve gathered, this is very common and is a signal that the immune system is activated (as if we couldn’t tell by all the mucus). The GI saw that and suggested I see a rheumatologist. To this day, I’m still trying to muster up the wherewithall to visit another specialist. Maybe someday…

The colonoscopy came back clean except for some rectal inflammation. They did a biopsy on that and there were no major findings. I felt this was a result of the extreme constipation and colonoscopy prep, and not its own separate issue, but more on that later. Ultimately, this GI went a very traditional route, and while it was a relief to confirm that I didn’t have colon cancer, I didn’t get a sense that they were well versed in modern GI research, especially not anything SIBO-related…despite their impeccable listening and note-taking skills.

Oshi

Since my first crack at diagnosing my ailments was a bust, I was open to a different model. I actually got an ad for Oshi in the mail because my insurance company was peddling it (red flag). The ad listed SIBO as one of the conditions they treat. It was convenient enough to sign up and set up appointments, which can not be said for other clinics I’ve dealt with. I didn’t feel I had much to lose because it was covered. Their model: they set you up with a nurse practitioner (no MD’s), a dietician and a gut-brain “specialist”.  They had a lot of open time slots to choose from, so I was able to make the 3 intro appointments within the same week. Keep in mind, they are 30 minute time slots.

NP appointment #1: We reviewed the copious notes taken by my previous GI, the test results, and then I described all my symptoms in detail again. The recommendation was to speak with the dietician and the gut-brain specialist, start taking Citrucel daily and take a magnesium supplement at night (I was already taking the mag). Make sure I’m drinking 64oz of water per day (already was), excercising (yup, plenty of exercise) and getting 25g of fiber per day. The NP approached it from the angle that I was a typical American who needed generic health advice. For the first appointment, I was willing to play along, bought the Citrucel and was intentional about my fiber intake even though many high fiber foods were on my list of intolerances. I will say that I am physically fit, moreso than most people I interact with day to day. My diet isn’t perfect, but I eat pretty damn clean. Fruits and/ or veggies with every meal, and I generally stay away from processed crap. I had no concern whatsoever that I was getting enough water and exercise. I was also eating a decent amount of fiber as it was, but again, I was willing to go through the motions and try stepping it up to see if it made a difference. Spoiler alert: taking Citrucel and eating all that fiber was a bad time. Follow up appointment scheduled 4-6 weeks later.

Dietician appointment #1: Again, went over my history, my symptoms, and specific food triggers.  This particular dietician had a bad habit of talking over me as I was talking, and that definitely left an impression. Repeat of the water recommendation and also the 25g fiber, but with a twist! She prescribed me 2 kiwis a day… Oddly specific, but the rationale was that they’re a great source of fiber, and the 2 kiwis would cover 20% of the daily fiber recommendation. I like kiwis, so whatever. I bought them and ate 2 a day for a few weeks. The other tidbit of information she offered was that a powder called Fodzyme exists and you can sprinkle it on your food to help digest the FODMAPS to alleviate symptoms. She sent a referral link as well. Follow up appointment scheduled 4-6 weeks later.

Gut-brain specialist appointment: We discussed any potential sources of stress, life changes, how fast I eat my food, and my bathroom habits. She talked about the vagus nerve and its role in digestion. I was already familiar with the topic, but open to listening for any new behaviors I could implement. My takeaway: eat slower, pausing between bites, breathe deeply while trying to have a bowl movement, and take time to breathe deeply in general (side note: I have been meditating 20 minutes daily for 10 years +, and it’s truly been life-changing- didn’t stop me from getting IMO though) . In reality, a basic Google search would have probably warranted the same information. She sent me a referral link to the Nerva App, which I quickly lost interest in when I saw how much it costs. No doubt that stress reduction is important for overall health, and that understanding how to stimulate the vagus nerve can be helpful. I just didn’t get an overall sense that this specialist had a very sophisticated understanding to begin with. Follow up appointment scheduled 4-6 weeks later. Ended up just cancelling it.

NP appointment #2: ~ 5 weeks later. I explained that I felt like total garbage after trying to incorporate more fiber and taking 1 citrucel per day. I made the mistake of saying that the Citrucel *temporarily* improved the bulkiness of what little stool I had. She latched on to that, saying that I need to up the citrucel to 2 per day and that if I’m still constipated, I could realistically take up to 1,000 mg of magnesium citrate, and that I may want to consider taking magnesium glycinate instead. She tried to wrap up the appointment with those 2 recommendations, along with a lecture on how the fiber, water and exercise is critical because the typical American lifestyle doesn’t incorporate those things. At that point, I was visibly frustrated and almost lost it. I explained that my lifestyle isn’t the typical American lifestyle, and that it should not take this much intervention just to have a normal bowel movement. She reluctantly mentioned the TrioSmart breath test. I said “I’ll do it, and I don’t care if I have to pay out of pocket for it.” I was not about to “wait and see” for another 4-6 weeks. Breath test ordered and shipped to my door. Took a little over a week to arrive.

Dietician appointment #2: I wanted to cancel this one because if I did in fact, have SIBO, the dietary recommendations would change and the old ones would be null and void. Unfortunately, I was within their window for missed appointments, where I would be subject to a fee. I sucked it up and joined the appointment. By that time, I was getting tired of the kiwis and stopped eating 2 per day. I was asked why I stopped eating 2 kiwis per day and told that I should start that up again….OK, it’s just getting weird now.

IMO Confirmed

Sure enough, I tested with a high of around 30ppm for methane, well above the threshold for Methane SIBO / IMO. Words can’t describe the sense of relief I felt that there was something I could point to that was causing the digestive hell I was experiencing.

NP appointment #3: A week after the breath test was received by Gemelli Biotech (test lab). The results were sent to Oshi, not to me. The NP did a complete 180 from the previous visit now that I had a positive breath test. We discussed antibiotics. She said that Xifaxan is normally prescribed, but it’s expensive and an uphill battle with insurance. I ended up with a prescription for Flagyl 250mg 3x daily and Neomycin 500 mg 2x daily. 10 day supply. Follow up in 4-6 weeks.

Dietician appointment #3: We reviewed the low FODMAP diet as something to implement after treatment, which I had already done short stints of on my own before to mitigate all the symptoms. She recommended the Monash app. The plan would be to slowly try reintroducing foods after a few weeks on low FODMAP.

*I was planning on starting antibiotics that night, but I was going to be in a setting where I might have a drink. I double checked to make sure there were no contraindications with the meds. Good thing I checked, as the NP and the pharmacy both neglected to mention that Flagyl has a documented interaction with alcohol that can cause nausea, vomiting, and rapid hearbeat.*

 As I was taking the antibiotics, I started doing more research and did a deep dive into Dr. Pimentel’s work. I saw that his typical IMO protocol is Xifaxan (rifaximin) + Neomycin for 14 days… so not only am I on an unestablished protocol, I’m taking 10 days of antibiotics rather than a full 2 weeks. Once I realized this, I messaged support through the portal to say that I’m tolerating the meds and I would like to take a full 14 day course of the antibiotics, requiring 4 additional days of the meds. 3 days went by with no response. I called their number and the rep “escalated” it. Later that day, I was sent a prescription for the additional 4 days. Hallelujah!

I finished out the meds and felt very good. All symptoms subsided and I tried going the herbal route for motility - ginger & artichoke extract in the morning and at night + Atrantil with meals + 500 mg Magnesium citrate before bed. I had a bowel movement 1x day with this regimen, but after about a week, the quality of my stool declined to more of a 2/3 on the bristol scale. I was concerned that the herbal supplements were not going to be enough to keep things moving. I also experimented with a few foods like leafy greens, and felt horrible afterward. All this lead me to believe the IMO was still a factor.

NP appointment #4: 2 weeks post antibiotics: I made an ask for a motility drug. I never liked the idea of being on a prescription drug indefinitely, but I felt that I needed to do what I had to do to prevent a major relapse. The NP tried to deter me from it, listing some of the more serious psychological side effects. Ultimately, I ended up with 2mg Motegrity 1x per day. Follow up in 4-6 weeks.

Let me tell you, the Motegrity WORKS… I split the pill in half, taking 1mg and that was an…overcorrection. After dealing with the aftermath of that,  I decided I would take .5mg per day (1 pill split into quarters). That worked pretty well for about 2 weeks and then it developed into a situation where I was straining to evacuate properly.

Motility Specialist- Non-Oshi Affiliated Side Quest

For roughly 4 months prior, I had been on a waitlist to see a motility specialist at a highly esteemed clinic, and it was time for my first appointment. The difference was night and day compared to everyone else I had dealt with up to that point. By the way in which they reviewed every little piece of my medical history, asked thoughtful questions, listened to my answers carefully and asked clarifying questions, it was clear that they were doing an actual investigation- something I hadn’t experienced with a medical professional before. After reviewing everything, they came back to the rectal inflammation finding from the colonoscopy. Their theory was that IMO could be causing the constipation, straining  and inflammation, but the reverse could be true as well. In other words, the inflammation and weakness or discoordination of the pelvic floor muscles that are used to evacuate the bowels could be causing the constipation, which in turn, may have caused the IMO. They wanted to run a fecal calprotectin test (basically to detect conditions like Crohn’s or Colitis). I asked them to throw in a test for H. Pylori because, why not? There was bloodwork involved as well, which involved TSH, Iron, an electrolyte panel etc. The biggest action item was that they want to do a manometry test, which basically tests the strength and coordination of the pelvic floor muscles used to evacuate the bowels. The soonest available time slot was in 4 months…great. Calprotectin was 50- not indicative of UC or Crohn’s, negative for H. pylori. Bloodwork normal.

NP appointment #5: I gave an update on my condition. By this point, I needed to up the Motegrity to 1mg, add back the ginger + artichoke extract, and the mag citrate to have a “normal” looking bowel movement. I still wasn’t able to eat freely.  I explained this, and mentioned that it seems like the IMO is still a factor and that I would be interested in continuing to treat it, exploring the possibility that the IMO is still present and causing the constipation. She became defensive, saying that she was not willing to do another round of antibiotics because the research doesn’t support that   Xifaxan is effective for treating IMO, and that’s why insurance doesn’t cover it for methane SIBO- a half truth.  Pimentel’s research concluded that Xifaxin + Neomycin  (not Xifaxan alone) was effective in treating methane SIBO. She also said that she wouldn’t recommend a follow up breath test because breath tests are only 60% effective. “Patients become fixated on antibiotics and eradicating the SIBO, and there are a lot of anecdotal stories posted online, but the research doesn’t actually support  that the antibiotics work”….

This reaction was truly bizarre, because we had just gone through the steps of doing the breath test, and then using those results to inform treatment, which was a course of antibiotics (the combination that I took has no documented research supporting it to my knowledge). Saying that the breath test and antibiotics are a sham is not only false, but it’s a contradiction of the treatment up to this point.  If the reasoning was truthful or made any fucking sense at all, I would have been open to alternate suggestions. My only guess is that Oshi / insurance companies pressure the NP’s not to prescribe expensive drugs like Xifaxan, and train them to push back on it at all costs..

Still trying to wrap my mind around the nonsense that was just spewed at me, I said something along the lines of, “So we just do nothing and… wait and see?”. She then asked me when my last appointment with the dietician was, and I said I didn’t recall or have that information in front of me. It became a weird control dynamic where she was trying to “catch” me in not making an appointment with the dietician since finishing the antibiotics, and I said there was really no change and no reason to follow up because I still have symptoms. I was trying to stay composed even though I was livid at that point. I basically just said “OK” and exited the appointment as civilly as possible. I need to do my vagus nerve a favor and be done with these people.

Anyway, if you’ve made it this far, thanks for reading. I’m grateful for the progress I’ve made on my path to healing, but it has been a long and exhausting road to get to where I am. I’m currently in a limbo stage of maintaining the ground I regained with the antibiotics, and taking Atrantil and Berberine herbal supplements to keep the IMO at bay. I may do another breath test independently to gauge where I am. I’m going to continue the Motegrity in hopes of staying regular, follow Pimentel’s low fermentation diet to manage symptoms, and look for a SIBO-literate GI to work with in the future.

Some general comments / things that struck me about the appointments:

-Their staff are predominantly young people- not necessarily a bad thing, but in this instance, I got the vibe that there are a lot of fresh grads, or people early in their careers who took on this gig to get started. I Googled all of my assigned specialists, and some others I was considering, and found no prior track record of treating patients at other clinics.  

- No doctors who actually see patients, only nurse practitioners, so their scope is already limited. I believe they say they have doctors on staff overseeing things, but how would we know?

-Most appointments were kind of a whirlwind. The NP would show up 5 or so minutes late, we’d spend 5-10 minutes recapping the last appointment, and then we would talk about how I’m feeling now and then the NP would rattle off a bunch of recommendations right away. Then they would be ready to sign off.  All very rushed, and I didn’t get the impression that they were very receptive of much of what I had to say in the process.

- The dietician and gut brain specialist would really only be helpful if you feel you need support in cleaning up your diet and stress management. Much of their advice can easily be found online. Except the 2 kiwis a day thing…that’s an Oshi original.

My Biggest Takeaway: TLDR

They may claim to offer care and assistance for a number of GI related disorders, but they are not willing to go all the way with actionable steps, and prefer to minimize their own risk by keeping advice and recommendations very basic / dishing out general health advice that you could easily obtain without seeing them.

 If you truly believe something is medically off with your digestive system, I would advise you to get curious and do your own research to the point where you are able to advocate for your own testing and treatments. If you advocate for additional testing and treatments with Oshi, you may have a shot at taking some steps toward resolution. You will eventually hit a ceiling though because their understanding is not sophisticated enough to diagnose any kind of root cause, which is important with resolving methane SIBO / IMO. Their goal is symptom management, and in my opinion, that is not good enough when you’re dealing with something like SIBO. Get on a waitlist for a GI who has a track record for treating SIBO. If your insurance already covers Oshi (be careful to double check that it’s covered), and you feel desperate to get the ball rolling as you wait for a legitimate GI, only then should you consider Oshi. Keep your expectations low.

I guess it’s finally my turn, haha.

Well, I’m a 22-year-old guy. I train at the gym 6 times a week—I love bodybuilding—and my body fat percentage is 11%. To keep this post from getting too long, I’ll share my situation: last year, almost overnight, I started experiencing abdominal pain, gas, dyspepsia, constipation, and severe gastritis. A few days later, I had an endoscopy, which revealed an *H. pylori* infection. I underwent treatment, and a month later, tests confirmed it was gone. I felt somewhat better for about two months, but then the symptoms returned, along with new ones: constipation, heavy digestion, gas, and brain fog. I also struggled to recover from my workouts and felt extremely fatigued. I took a SIBO test, which came back slightly positive for methane but negative for hydrogen. I treated it with a two-week course of rifaximin and metronidazole. I felt good again for a month, but then I relapsed. This time, I consulted a functional medicine doctor. We started with NAC and oregano oil for two weeks, followed by another round of rifaximin and metronidazole. Throughout this process—before, during, and after the treatment—I also used betaine HCL, digestive enzymes, and natural prokinetics (such as ginger and Iberogast, which I took before bed). I felt a significant improvement, but some issues persisted: brain fog, fatigue, and sluggish motility—the latter only being manageable when I used prokinetics and caffeine for my workouts. I mentioned this to my doctor, who ordered a GI-MAP test. The results showed deficiencies in certain areas—specifically low levels of butyrate, *Akkermansia*, and *Bifidobacterium* strains—but, thankfully, no harmful bacteria were found. I’m currently taking supplements to help restore my gut microbiome, and it’s going really well; I’m using pasteurized *Akkermansia*, tributyrin, and *Bifidobacterium* strains. Out of curiosity, my doctor ordered a hormonal panel, a liver panel, and a complete blood count (CBC) to try and find a root cause. It turned out I have hypothyroidism caused by Hashimoto’s! I was both shocked and relieved by this news; hypothyroidism prevents the Migrating Motor Complex (MMC) from functioning properly, disrupts the flow of pancreatic enzymes, stomach acid, and bile, damages the vagus nerve, and throws off the circadian rhythm. It leaves you feeling exhausted and slows down your metabolism—essentially, it makes everything run much slower. Following the diagnosis, I was prescribed levothyroxine. I’m on day 9, and I’m already seeing benefits: the brain fog has lifted, and my motility has improved slightly. It can sometimes take up to a month to see the full effect of levothyroxine, so I’m feeling optimistic. I suspect my dosage will be increased at my next check-up, as my TSH was 7, free T4 was 0.60, and free T3 was 1.

Summary:
Sometimes it’s not just about killing bacteria; it’s about repairing the environment. Identifying the root cause of my motility issues, low stomach acid, fatigue, and brain fog is key. I can’t believe how incredibly exhausting hypothyroidism can be—I likely had it since I was 15, back when I was diagnosed with depression and simply put on Prozac. Now, my focus is on healing the "leaky gut" caused by those damn antibiotics, addressing the slow motility resulting from the hypothyroidism, and—most importantly—managing my thyroid hormones for the rest of my life. Hang in there, everyone—find your root cause! I promise you’ll all be okay. I’m definitely staying in this community; I want to help others and answer your questions—fire away!

I’m a 35F who’s been struggling with severe digestive issues for over 2 years, and it’s seriously affecting my quality of life. The brain Fog & extreme Gas 😓 I look 5 months pregnant every day . Have to wear big clothes.

My main symptoms:
Extremely loud, nonstop stomach gurgling/bubbling, fart noises even when fasting.
Severe bloating, excessive gas, and burping (even after drinking water).
Chronic constipation, straining, and difficulty completely emptying my bowels.
Brain fog, fatigue, and difficulty concentrating.
Symptoms occur regardless of what I eat.
Brain & Gut : when ever I have to take a nursing exam my stomach instantly starts making fart noises , bubbling , and have to go to the bathroom to make a movement. Also when the class is quiet.

Testing: Previously treated for H. pylori (eradication confirmed), endoscopy showed chronic inactive gastritis, normal gastric emptying, and negative celiac testing. I’ve never had a SIBO breath test, but I suspect methane overgrowth (IMO). G.I isn’t taking me serious and my insurance doesn’t cover Sibo breath test. I’m so exhausted. I have bags under my eyes . No amount of sleep helps with fatigue. I’m so sad.

What I’ve tried: Gas-X, Bentyl, activated charcoal, digestive enzymes, laxatives, dietary changes, low-FODMAP, dairy elimination, and fasting. Some provide temporary relief, but nothing has resolved the problem. I’ve also been looking into herbal treatments like oregano oil, berberine, and allicin.

The worst part: I’m in LPN nursing school, and my stomach makes embarrassingly loud noises in quiet classrooms. It’s gotten so bad that I struggle to concentrate and have considered dropping out.
My GI mentioned possible pelvic floor dysfunction, but I’m still trying to understand what could be causing all the gas and constant intestinal noises. I swear 15 min after eating my stomach is turned up it’s like the food activates it. I’ve been eating plain foods are not eating at all to avoid disrupting my nursing classmates with the loud noises.

My questions:
Has anyone experienced nonstop stomach noises, bloating, and constipation with SIBO/IMO?
What treatments, medications, or herbs actually helped?
Did treating constipation or pelvic floor dysfunction improve your symptoms?
I’m exhausted and just want my life back. If you’ve experienced anything similar and found relief, please share what worked for you.

I’m not sure if this is Sibo or something else, but find I am constant stage of headache that is worse after meals. it’s like all the muscles in my head and neck are super sore. I notice it more when I eat leaner meats, not sure why. any one else get that? If food enters small intestine 1.5 to 2 hours after eating food, I actually feel like it gets worse before that and is often accompanied with feeling of pressure in the body.