What to Know Before and After SIBO Treatment

Currently, the gold standard for the treatment of SIBO is a doctor-prescribed antibiotic. But how do you navigate questions around antibiotic use? What should you be asking your doctor?

Some questions might include: Are probiotics safe to take? What diet should I follow during antibiotic usage? Is there a chance that the SIBO will come back after the course of antibiotics?¹

It is important to understand the commonly asked questions about antibiotic treatment and diet for SIBO. Having a “cheat sheet” for you to advocate as a patient is vital for your care and health. Knowing which SIBO antibiotic medicines are typically prescribed can help you find the right questions to ask your doctor.

You can use the insights to guide your treatment, including choosing an antibiotic, weighing side effects, and making changes to your diet.

Speaking with your doctor

Unfortunately, in my clinical experience, most patients are given very little information about the antibiotic they are prescribed and why, what diet to follow, and similar. It can be frustrating, but let’s be very clear: The blame does not fall on the physician but rather our medical system as a whole.

The way our current system is set up is that the average time allotted per medical visit is only around 20 minutes. So much has to be uncovered and discussed in such a short amount of time. It’s far from an ideal system to obtain the quality of healthcare you need. The odds are stacked against you.

For that reason, you have to be prepared, strategic, and efficient. Understanding and documenting your symptoms and having your questions ready will help you maximize your time with your doctor. Ultimately, it will improve your care.

Consider asking why you developed SIBO in the first place. Is there any underlying condition or risk factor that needs to be treated as well?

The hydrogen breath test

Were you tested with a hydrogen breath test? This simple test measures the level of hydrogen gas in your breath. Your result can point to whether you have too much of certain bacteria in your gut that produce hydrogen. Doctors may use it to diagnose SIBO, irritable bowel syndrome (IBS), and lactose intolerance.²

Consider asking what your results showed. Were they very positive? Slightly positive? Negative? Ask your doctor or the nurse practitioner to briefly explain how and why they used the hydrogen breath test.

Antibiotics and SIBO

Ask your doctor about the medicine they have prescribed for you. Providers often prescribe antibiotics to treat SIBO. Treatment should depend on whether hydrogen or methane gas was elevated.¹

Questions to ask

• What kind of antibiotic was prescribed, and why?
• What is the dosage, and how long will you need to take it? Typically, this is based on the how bad they perceive your overgrowth to be, which you may want to know.
• Do they know of any common side effects? Remember, side effects can be uncomfortable, but they are usually temporary.
• Are there any health conditions you have that could be made worse by the antibiotic?

Tips on the cost of antibiotics and SIBO

• Ask about the cost of the antibiotic before it is prescribed.
• Ask your insurance company if it is covered.
• If it is not covered, can you pay for it out of pocket? If not, it could be worth discussing whether there are any other options with your doctor.

Diet and SIBO

Can you handle high FODMAP foods or foods that previously were triggering?

You should be able to tolerate any foods that felt fine to you pre-SIBO. Ask for a referral to see a registered dietitian who regularly works with people who have IBS and SIBO.

Still not feeling better after SIBO treatment?

If you do not feel completely better, ask your doctor about possible options for a different antibiotic. You could also ask about different underlying causes of SIBO.

For additional tips on how to come prepared to discuss your SIBO treatment with your doctor, I find the book Bloated Belly Whisperer by Tamara Duker Freuman very helpful for my patients.