Hi  – yes, I have helped clients with SIBO. There’s no set protocol per se, because sibo is a symptom of an environment that in itself can lead to other dysfunctions and disease dynamics. So each person’s case/protocol is unique.

So while I do believe you likely need an antimicrobial cleanse, it will only come back if the environment that allowed the overgrowth to happen isn’t corrected as well.

In your case, the right order is key. Gut healing is needed first and foremost. Supporting gut immunity and digestive function too. Only when these are in place for a good 60 days, can you then consider an antimicrobial cleanse.

Here are some root cause culprits for SIBO:
• Drugs – and it doesn’t necessarily have to involve long-term use! Especially NSAID use (damage mucosal layer), hormones (e.g. birth control pills, steroids) and those affecting serotonin (e.g. SSRIs), PPIs and others which suppress stomach acid, antibiotics by decimating endemic bacteria and lowering SCFAs and also increasing toxic bacterial release.
• Microbial overgrowth via byproducts which erode the mucosal lining
• Low levels of endemic, beneficial bacteria
• Low Vitamin D as well as other key nutrients such as zinc and Vitamin A
• Moderate alcohol intake
• Poor immune function. Nutrients above but also low WBCs, secretory IgA, etc..
• Intake of pesticides/herbicides and other chemicals, artificial ingredients
• Hypothyroid function
• Persistent stress. High cortisol increases permeability, impairs immune system
• Gluten consumption (may promote greater zonulin secretion)
• Poor Migrating Motor Complex function
• Poor digestion e.g. low stomach acid, pancreatic output or bile
• Poor Eating Hygiene
o E.g. poor digestive secretions due to sympathetic nervous system mode, poor motility, grazing or frequent meals limits MMC waves, overconsumption of water during meals can dilute stomach acid.

Regarding the abdominal bloating, I know you said that even bitters at this stage burn you, so have you tried carminative teas instead like peppermint, lemon balm, cinnamon, anise, fennel, ginger?

Have you tried eliminating the higher fodmap foods temporarily to see if that provides relief?

Have you also tried castor oil packs over your entire abdominal region? This can help stimulate motility/digestion without the use oral supplements/food.

 have you tried contacting Boxit4Me? I believe they offer mail forwarding services in the UK.

And yes, you can open up GI relief and empty contents into liquid.

Don’t try coming off acid blockers until after you’ve done a period of gut healing and digestive support. The weaning process should only happen once you’re in a stronger position, and must be done over an extended period of time. Coming off too quickly will cause a return of acid reflux symptoms and with vengeance, as the body tries to overcompensate.

Focus all your efforts at this stage on gut healing, digestive & immune support.

@Bernadette Abraham B. I was reading your answer, “ gut healing is needed first and foremost. Supporting gut immunity and digestive function too. Only when these are in place for a good 60 days, can you the consider an antimicrobial cleanse”.

So how can the gut heals while there is still SIBO/microbes?!

@KK when there is a lot of gut inflammation, I always recommend doing a period of gut healing and digestive support before doing any kind of “killing”. Think of it as “putting out the fire” before entering the battle ground.

@Bernadette Abraham I couldn’t find a protocol for SIBO.

@KK It’s on my list of upcoming programs to release in 2024. But in the meantime, the Gut Health Masterclass course has all of the information that will help. Supporting digestive health and ensuring there is good stomach acid, proper bile production and flow, and enzyme production is crucial. You can find separate videos for each of those as well:

Stomach acid support

Digestive enzyme support

Liver & gallbladder support

Once these are in place, a person may still need a cleanse, which you can find info on here:

The 5R protocol

The Fight – Antimicrobial

@Bernadette Abraham many of those with sibo have also h pylori. I guess here we skip the boosting stomach acid part. Right?

@KK correct – in that case, the order would be gut healing for minimum 30 days, then H Pylori cleanse, while supporting other digestive players (stomach, enzymes, bile). For stomach acid support with H Pylori, I usually recommend digestive bitters until H Pylori overgrowth has cleared. Hope that helps.

@Bernadette Abraham sure it does. I had pylori in august and directly I took antimicrobials and didn’t first “heal the gut for 30 days)