I hear this question frequently in my office. I have been seeing patients with recurrent SIBO in my office regularly for the past 5 or so years. I am always hopeful about client's ability to conquer SIBO. There is so much more known about SIBO today than even 5 years ago. Some important questions that I aim to answer to ensure that we get the best chance of conquering SIBO and avoiding recurrences are as follows?
- What are the causes of SIBO in this particular individual? They range from GI surgery, antibiotic use, proton pump inhibitor medication, GI viruses and food poisoning and even stress. If we don't address the underlying cause then recurrence is more likely.
- Has the individual had follow up breath tests to determine if treatments have been effective? After every treatment, a follow up breath test should be done to determine how effective the course of treatment was in eradicating bacteria. If it is not effective or doesn't reduce the bacterial count significantly, then a different course of action is necessary.
- Does the individual have hydrogen and/or methane dominant bacteria? The treatment course is different depending on the type of bacteria. I always urge my clients to get a copy of the report.
- Has the individual modified their diet during or after treatment? Dietary modification is important but should be closely monitored by a skilled dietitian to ensure nutritional deficiencies don't develop and that the diet is not more restrictive than necessary.
- What types of dietary supplements is the individual taking during and after treatment? This is a very important topic. Probiotics, enzymes and amino acids are some of the most common supplements used for SIBO. However, supplements need to be carefully reviewed to ensure that they are helping and not hindering treatment results. Also, they need to be used at the appropriate time of treatment.