SIBO Treatment and Swinging From IBS-C to IBS-D

You may already know which one you are, IBS-C or IBS-D, or perhaps you are a mixture of the two with IBS-M. Any IBS type is difficult to manage and they all come with their challenges and recently I got to experience the other side.


I’ve always been predominantly IBS-C and with that I’ve experienced the bloating, discomfort and abdominal pain, the frustration of being unable to go, of straining, of feeling like I’m not quite finished, of hard lumpy stools, of needing to go to the toilet at odd times of day (or many times a day), of fatigue, of occasional diarrhea and of always thinking that it would be really, really nice to just be able to “go” regularly like normal people.

What changed?

Well I got my wish, now I can go! At times it’s been awesome, but at other times, oh my, it hasn’t been pretty. Almost three months ago I began treatment for SIBO (small intestine bacterial overgrowth). The aim of the treatment is to reduce the number of microbes in my small intestine that have taken over and in doing so reduce my IBS symptoms.

My treatment (prescribed by naturopath) involves taking a number of different herbal antimicrobials in order to kill off the microbes. I was warned that things may get worse before they better due to a “die off” reaction otherwise known as a Herxheimer reaction. Essentially it means that the process of killing the microbes can produce toxins that cause an inflammatory response. For me it included extreme fatigue, irritability and brain fog, almost constant abdominal pain and discomfort and of course came the loose stools and diarrhea.

Thankfully most of the symptoms were reduced after a few weeks except for the loose stools and diarrhea. And so I welcomed in the new era of swinging to the IBS-D side. In the beginning it was just a relief to finally be able to go daily. I mean, I’ve waited years to have regular bowel movements and it kind of felt good, even if they were looser than ideal.

But along with this, then came the fear of being in a public space without access to a public toilet, of being stuck on a train with nowhere to go and of dealing with the pain and fatigue that comes with a bout of diarrhea. For those of you with IBS-D that have had to manage this on an ongoing and daily basis, my heart goes out to you. It really can take over your life and make a simple act like going to the supermarket a terrifying ordeal.

The balancing act

I took myself back to the naturopath and talked about the symptom changes and we made some adjustments to my diet and the antimicrobial treatment. Thankfully the diarrhea has lessened and I’ve actually been feeling pretty good for the most part, though at times it will swing towards IBS-C and then back to IBS-D, all without warning or cause.

I’m due to get another breath test to see if the microbial levels in my small intestine have decreased to see how well the SIBO treatment is working, this will then determine how much more treatment I need. I’m looking forward to hopefully finding a new kind of normal, something in-between the “C” and the “D”, and perhaps without the “IBS” attached to it, and wow what an awesome day that would be!

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This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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