TSS – EP 003 – SIBO Treatment Explained: Antibiotics, Herbals & Relapse Prevention | Dr. Allison Siebecker, Part 2 – Transcript

[Shivan Sarna] (0:00 – 0:39)

In this part two with Dr. Allison Siebecker about SIBO and IBS, we go into more depth about the three treatments, the elemental diet, ways that you can actually figure out how to treat your SIBO, small intestinal bacterial overgrowth, once and for all. This is a not miss episode. Dr. Siebecker is so special and a true world-renowned expert. I hope you’ll tune back in for the first one if you missed it, and certainly stick with us right now so you can hear the rest of the story about SIBO. Very unsexy sounding condition, I gotta say. Okay, so let’s move on to another one of the treatments.

[Dr. Allison Siebecker] (0:39 – 3:52)

Let’s talk about pharmaceutical antibiotics. Most people are familiar with those. So the elemental diet works on all the different types of SIBO, and I just was briefly mentioning them before, but for pharmaceutical and herbal antibiotics, our treatment of the individual medicines are by the type of SIBO.

So let me just quickly mention the types of SIBO. When it’s hydrogen as the gas that’s positive, that’s SIBO. When methane is the gas that’s positive, that has a new name now, and that’s intestinal methanogen overgrowth or EMO.

We used to just call it methane SIBO, but it has its own name now. And the reason why is because, well, these are archaea or methanogens. So the B in SIBO for bacteria is not technically correct.

So just like nomenclature-wise. And also, these bugs can overgrow in the large intestine. The hydrogen ones are just in the small intestine.

So we had to distinguish that with a name. When the gas is hydrogen sulfide that’s positive, that’s intestinal sulfide overproduction, ESO. That has a new name.

Similarly, that it can overgrow, they can overgrow in small or large intestine. And then if there’s mixtures of these gases, we just call it mixed, you know, mixed SIBO, basically. Or, you know, you could say, oh, it’s SIBO plus EMO, that way as well.

All right. So for the antibiotics, we have one main antibiotic called rifaximin. In the U.S., it’s zyfaxan is the name of the drug or the, I mean, of the medicine, the brand name. And rifaximin, we actually use it for sort of all the types of SIBO to target the hydrogen producers because when there’s methane or hydrogen sulfide, hydrogen is actually getting converted by other, the other overgrown bacteria into the methane and hydrogen sulfide. So that’s kind of a key thing that many will miss is that you need to target, you know, all these different groups of bacteria depending upon what’s overgrown. So rifaximin is used for the hydrogen overgrowth.

And then if there’s methane, we use either neomycin or metronidazole combined with rifaximin. And if there’s hydrogen sulfide, we use actually bismuth, like in the form of like Kaopectate or Pepto-Bismol, or you could get it compounded. And there’s also another product called Biofilm Phase II Advanced that we use that has bismuth.

Or we can use high-dose oregano. So when it comes to hydrogen sulfide, we sort of mix antibiotics with other supplements. And you can also use, this is a new thing that Dr. Pimentel, new treatment he’s been researching, is sustained release NAC. So what he’s been researching is his own drug, it’s not on the market yet, combining NAC and rifaximin in a special sort of formulation where the NAC, first of all, gets transported down to the small intestine, kind of like a delayed release. And the NAC releases first, it dissolves the mucus in the small intestine, then the rifaximin releases. So it’s, you know, it’s a special preparation not available yet.

But in the meantime, what people have been doing is getting sustained release NAC, taking it maybe an hour before their rifaximin to try to approximate this medicine. And Dr. Pimentel has been finding it’s been working really well for hydrogen sulfide.

[Shivan Sarna] (3:52 – 4:10)

You know, I don’t know when you’re watching this, but if he has the new drug out, I will put that in the links below, because I don’t want you to be like, oh man, I watched this and it’s old. No, this is all really relevant. And if he’s got the cure, we’re gonna put it in the links below.

And I’ll be like, he got it. Here it is.

[Dr. Allison Siebecker] (4:10 – 5:22)

This will be a timeless session that we’re doing here, Dr. Seebecker. I just have to mention this, you’re probably going to ask me anyway, to tell people about rifaximin, because it’s special. So many people are very concerned to take antibiotics, rightly so.

Some people feel their SIBO was brought on by antibiotics. But rifaximin is very different than regular antibiotics. And it has very, very beneficial effects.

And it’s been shown not to harm the large intestine microbiome or the small intestine microbiome. And actually, it helps it. So it increases bifidus and other beneficial bacteria after its use.

So it’s extraordinary. It’s anti-inflammatory. It’s been shown it doesn’t cause yeast overgrowth.

And on and on it goes. I have a slide in my courses with just, you know, like 15 beneficial properties. We don’t need to be concerned about it.

Now, if we are adding neomycin or metronidazole, those are standard antibiotics. And unfortunately, if you have methane, that is required. It’s not very effective to just use rifaximin alone when you have methane.

And also, Dr. Pimentel has studies showing that after the use of rifaximin with SIBO, it actually restores the small intestine microbiome back to normal.

[Shivan Sarna] (5:22 – 6:57)

I have some very wonderful friends that are like terrain medicine specialists. You could consider the terrain to be the spaces between your cells, the interstitium. There’s a lot of terminology for it.

The microbiome is a terrain. There are a lot of ways to look at it. One thing that I wanted to reiterate here, and Dr. C. Becker knows this is one of my favorite points, and I’ve asked Dr. Pimentel about this no less than three times. The studies that he has done when he’s mapped with Dr. Ali Rezai and the microbiome of the small intestine is that when the bad players that are overgrowing are removed from the neighborhood, removed from the garden, removed from the microbiome, it allows the good players to come back online to bloom again, to fill out the garden beds, all the analogies you want to do, go for it, to rebuild the terrain.

So, you don’t need to repopulate it. You don’t need to reseed it. You don’t need to, you know, snort kombucha or any of that.

I’m all for a good fermented food. Don’t get me wrong, I’m not slamming those. I’m just like, there’s timing here that’s involved.

With those bad players gone, the garden comes back online in terms of the microbiome, the terrain does. Yes, you can do some things to support it, but there is an obsession with that that I have found. There are currents of that running through the community.

And I just wanted to address that and let you take that burden off of your mind because your microbiome is very, very smart. And when the bad players, the gang members are gone, the neighborhood watch, you know, kicks them out because you’ve done the treatment, it comes back into harmony.

[Dr. Allison Siebecker] (6:57 – 7:19)

It’s pretty revolutionary information that he has these studies that show this. Everyone’s been thinking, oh, you have to take probiotics or fermented food with probiotics after any kind of antimicrobial treatment. And here he is showing that that is not necessary and the microbiome turns back to perfect state.

It’s kind of revolutionary.

[Shivan Sarna] (7:19 – 7:54)

It’s incredible. And we are both fans of probiotics. We’re agnostic.

We’re just like, if it works for you, great. You have a snowflake microbiome. So a probiotic that Dr. Seebecker takes might wreak havoc on my microbiome because I already have enough of it and I don’t want to overload that. So it’s all of this balance, individuality and persistence, resilience, education, all the things that we’re so committed to, to helping you all. I had someone write me a random Facebook post saying, I don’t need more education. I need a cure.

I’m like, okay, I appreciate that.

[Dr. Allison Siebecker] (7:54 – 7:55)

I really, really do.

[Shivan Sarna] (7:56 – 8:45)

And, and you need to be educated so that you can educate the practitioners out there. Okay. Because you’re going to need some support and also practitioners.

I love you all so much. Thank you so much for all of your good works. If you want to become very competent when it comes to SIBO, please check out Dr. Seebecker’s ProCourse. It is a masterpiece. You do get CME credit. It is so organized.

We hear all the time about people who have tough cases or like, oh my gosh, I didn’t realize I didn’t get this right with the last patient. You know, she does these Q and A’s or case reviews with you. So check it out.

That’ll also be in the links. This is part of the mission is to get everyone well, and that comes patient up and practitioner down. Okay.

Thank you.

[Dr. Allison Siebecker] (8:46 – 10:56)

Last treatment. Here we go. Okay.

Last treatment is herbal antibiotics. And so like pharmaceuticals, we choose the herbs based on the different types of SIBO and the gas types. How did we figure this out?

I mean, we talked to other experts in, you know, herbal and botanical medicine experts. And then we did before and after testing. We also, you know, had our own ideas, but then we did before and after testing for years.

We, I worked at a, we created a SIBO center. We only saw SIBO patients. And so all day long, every treatment we gave, we did tests after.

So this is how we know that these things work with PERF. We know for hydrogen that berberine, neem, and oregano will decrease those bacteria and that gas. For methane, we know it’s allicin, which is an extract, antibacterial extract from garlic, but it’s not the fermentable part of garlic.

Most people tolerate it very well. And that’s sold as Alimet or Alimax Pro. Also Atronteal is another three or small three herb combination that has been studied.

And we also used it and found it decreases methane. And then as I mentioned already for hydrogen sulfide, we use bismuth. We can use high dose oregano.

Actually, it’s a different dose here. Or we can use that sustained release NAC that’s newer to all of us trying that. So what we do is we typically use two herbs.

We have found that using more than two herbs doesn’t produce a better result. So that’s good to know because we do need to save herbs for or, you know, and also other treatments for our next rounds. We can talk about that next.

So the way you would do it is you would choose, you know, let’s just, as an example, you do berberine and neem together. Let’s just say it could be any of the three for hydrogen. For methane, it would be, let’s just say, for example, berberine plus allicin or neem plus atronteal.

You see you’re using one hydrogen herb, you’re using one methane herb. If hydrogen sulfide was there, then you use, you know, say berberine plus bismuth or something like that. So you’re just combining usually two and making sure you’re treating each thing that’s there.

[Shivan Sarna] (10:56 – 11:09)

I think it was Pam or Michelle, somebody in small group coaching this week who was like, can I do elemental diet formulation and herbs at the same time? And antibiotics. And antibiotics.

[Dr. Allison Siebecker] (11:10 – 12:04)

I’m so glad you brought it up. So Dr. Pimentel actually established that we don’t add anything when we’re doing elemental diet because it sort of brings the bacteria into bit of a hibernation state because they’re not getting the food that they normally would get. And when they’re hibernating, they’re not replicating.

And for antibiotics and herbal antibiotics to be able to work on them, they need to be replicating. So it’s sort of it’s just a waste. It’s just a waste of money and a treatment.

So it’s not recommended, specifically not recommended. You do one or the other. Now, we can combine antibiotics and herbal antibiotics, like for instance, in the case with hydrogen sulfide, where you could do rifaximin plus bismuth or, you know, or rifaximin plus oregano or something like that.

And sometimes people can’t take neomycin or metronidazole for various reasons. So they might use the allicin with rifaximin. So that can be done.

[Shivan Sarna] (12:04 – 13:07)

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It’s in the links below. And it is one of the best ways to get your supplements delivered to your door. And remember, exclusive pricing.

Okay, see you there. One thing that I wanted to ask you here is that if my breath test is not that high, but I still have terrible symptoms, is that typical? I mean, we talk to people all the time, they have a really high breath test, their symptoms aren’t that bad, and vice versa.

So I want you to address that too, because there’s a lot of confusion around that.

[Dr. Allison Siebecker] (13:08 – 16:37)

Absolutely. Yeah. I mean, personally, what I find is it’s about a 50% where it’s going to match and 50% where it’s not going to match.

It doesn’t always go together. The severity of the actual overgrowth and the gas on the test with the symptoms, very important to know. So somebody can have really terrible symptoms with extremely mild, barely borderline positive SIBO.

Where the gas PPMs matter to us is it helps us figure out how many treatment rounds we think we’re going to need. And that’s something that I did want to get into. It’s one of the most important things to know.

Oh, by the way, I didn’t mention that antibiotics is two weeks as a normal round, or we could go to three. And herbal antibiotics is four weeks, or we could go to six. So herbal antibiotics take a little longer to get the same effect.

They are just as effective as antibiotics. And all three of these methods are equally effective, with the small caveat that elemental diet can reduce more gas in the same sort of time frame. But back to this multiple round thing.

Unfortunately, for most people, not all, but most, more than one treatment round is needed to get the breath test negative, to get their symptoms, you know, 90% or more better. You know, I’ve heard Dr. Pimentel talk about it, but it’s, you know, in his way of speaking about it, it’s because it isn’t actually an infection the way we typically think of an infection. It’s something a little different.

It’s an overgrowth of, you know, bacteria and archaea that normally are there. So it just like we just basically keep treating until we get the effect. Now, what what everybody wishes we could do is you just take one treatment and do it for a really long time.

And over that time, it would reduce it all the way. But that doesn’t work out for most people. I mean, I’ve seen a handful of cases like that.

It’s quite rare. Most of the time, a treatment just peters out. It’s effect, it has an effect in that two to three weeks or four to six weeks.

And then you’re not going to get any more effect. It’s done doing what it can do. So you you stop and reassess, you know, is it gone or not?

And if it’s not gone, then you move on to another treatment round. And most cases need, I’d say, you know, two to four treatment rounds, three, you know, three or four treatment rounds on average, the patient without knowing this will do the first round and not really feel much better. You know, it’s often not until the second round that somebody really notices symptoms going down.

It can happen in the first round for sure, but more common not. So then they take one round and they go, well, the treatment didn’t work. Now, if you have a retest, you would see the gas has come down, let’s say from 100 to 65.

That’s excellent success, but we’re just not there yet. We now need another round to bring it from 65 down to whatever it’s going to come down to. So that’s one of the most common mistakes.

I hear it even from educated people who have even studied this. They’ll go, well, it just well, it didn’t work. And unless you have a retest, you cannot say that it didn’t work.

You have to track the gas is coming down. So this brings us to another question is how often do you have to retest? I understand, of course, there’s budgetary issues and things like that.

And there’s logistical issues. You could, if you still have symptoms, you could go on to a second round potentially without retesting. But after that, you really need to retest.

[Shivan Sarna] (16:37 – 18:25)

As you can see here, she’s taking you through the protocol. There are a couple more parts that we still need to talk about, but I want to just interject something here, which is that each one of these portions, testing, treatment, diet, which we need to talk about, preventing relapse, Dr. Seebecker has created a masterclass on each one. And it is a SIBO solution series that you can pick up one of those classes if you want, or you can get the whole series.

And depending on the time of year, when you’re watching this, there may be some live Q and A’s that you can attend, or you can listen to the recordings of the live Q and A’s that have already happened. But what’s also really cool about this, not only, once again, they’re an hour or two hours max each for the materials. You can use the AI that we have in our Simplero account to search the content and to get your answers very quickly.

Or if you watch it and then you’re like, wait a minute, where was that part about which prokinetic? You can just ask it and it comes up. So it’s a bold, wonderful new world.

I should act like I’m not surprised by this and seem cool, but I am. I’m thrilled. It’s like, to me, one of the best uses, kind of like if Facebook is great for reminding people about your birthday, this is where I really love AI in these searches.

So I wanted to let you know about that because people are craving the correct information. And few things, many things make me frustrated and mad, but one of the big ones is the misinformation that’s happening or the partial information that’s happening about SIBO out there in social media land. So please do check it out and invest in that education because it will be the key to your success.

[Dr. Allison Siebecker] (18:26 – 19:44)

You know, on that note, something that I want to just mention is many people are aware of these particular herbal combination formulas that were studied for SIBO. I can mention these. It’s the Candibactin AR and BR and F-Cytol and Dysbioside.

And it was a wonderful study done on SIBO, but something that we need to know here is that primarily these work on hydrogen. And so that was not mentioned in the study. So this is a problem that many people run into is they simply know about those formulas and they take them for SIBO and they have disappointing results.

And in fact, even for hydrogen, we have found that the doses are often too low of some of the individual herbs that are in those formulas in the way it was studied. You know, the study had good success, but at our specialty center, we saw just droves of people that it was not a success for. So if you are one of those people that you’ve tried that and these herbs don’t work or something like that, there are dosing considerations and you really do need to match it to the gases.

So I would recommend actually just following along with the herbs that I’ve mentioned. Those are even more successful. And you can find more information about that, of course, on my website and in all these courses.

[Shivan Sarna] (19:45 – 19:45)

Okay.

[Dr. Allison Siebecker] (19:45 – 23:24)

So next up, we were going to talk about prevention of relapse and diet. So diet can be done anywhere in the whole treatment journey. You can start it right away before you even really know you have SIBO with a test, although I would recommend waiting till after your test.

But you could do it, you know, while you’re waiting for your test results to come back or along with your antimicrobial treatment, or you could wait till after your first round of antimicrobial treatment. The point of diet is really for helping symptoms. So, you know, if by chance we can, you know, you don’t have very high gas levels and you’re really maybe only going to need one or two rounds, or maybe, you know, elemental diet handles it in one two-week course or something, maybe you don’t need to go on such a strict diet to help your symptoms because you’ve already reduced the bacteria and your symptoms are reduced.

And then in which case you would go on maybe a more expanded SIBO diet so that you could just help in the prevention of relapse, which, you know, we’ll talk about a little bit more in a moment. But the main thing to use diet for is to manage symptoms. Many people have chronic underlying causes of SIBO that have no known cure at this time.

The food poisoning underlying cause of SIBO is an example of it. It causes chronic SIBO, and there isn’t a cure yet, but there will be, right? But some people have other conditions, you know, scleroderma, or they’ve had part of their intestine removed, and they have short bowel syndrome, and they’re not getting that back, and they’re going to continue to have SIBO because endometriosis, you know, did you mention that one?

I can’t remember who did, but there’s… Psychically, I did. Okay.

I sent the message. This brings up what you said earlier where some people are just like, I need a cure. So we just need to be understanding, and this is where education helps and realistic.

If we can get rid of what is causing SIBO, the underlying cause of SIBO, then there’s your cure. And some people are not in that situation as to what we just mentioned. So for them, diet is going to be really helpful long term because, you know, we can continue to treat SIBO with antimicrobials, and we’ll get in a good place, but it helps to use diet in that sort of remission period for people who have chronic SIBO just to manage things because, you know, they might still have 10, 20 percent, maybe they have 20 percent of symptoms lingering around, and the diet can reduce that to almost nothing. Main thing I would want to mention here with diet is it’s really a patient’s best, and, you know, their own, like, home tool that they can use to manage symptoms. It’s remarkable at that.

But these are carbohydrate restricted diets. That’s what SIBO diets are. They’re reducing carbohydrates, which is plant food, so that we’re not feeding the food that the bacteria like to eat and ferment and turn that into gas, and it’s the gas that causes the symptoms.

So if we eat less carbs, there’ll be less gas, and there’ll be less symptoms. And here I’m speaking of gas filling the intestine. I don’t mean flatulence as a symptom.

I mean the production of gas by these bacteria, hydrogen, methane, hydrogen sulfide. So it’s an incredible tool. It’s highly effective, especially if you customize a diet, and that’s my general advice.

Just pick any of the SIBO diets, but then customize it to yourself. That would mean you’re going to be eating some foods that the diet says you shouldn’t, because you tolerate them just fine, and you’re probably going to be eliminating some foods that the diet says are fine, because you just don’t tolerate them. That’s how it goes in the world.

We’re all individuals.

[Shivan Sarna] (23:25 – 25:10)

Exactly. Here’s why I put the balloon with the intestines on the cover of my book, which is, like, I literally have worked with an artist to design this, because that’s your inflated intestines. And then in the back of SIBO, here’s Dr. Seebecker’s SIBO-specific food guide. It has been modified, because I’m a vegetarian, and so it doesn’t have any meat products on it. Before you freak out, let me tell you something. And then there are loads and loads of great recipes here.

Yeah, that’s like half cookbook right there. It’s so good, if I do say so myself, just because this is a book I wish that I’d had when I was, you know, in the beginning. And Dr. Seebecker read every single word, and I appreciate it so much. And then she wrote the foreword as well. So thank you. There’s a review on Amazon that was like, I don’t even know what it said, but it didn’t give me a good review.

And overall, the book has great reviews. And at this point, 20,000 have been sold, which is so exciting. But they were like, oh, it’s vegetarian.

The diet’s vegetarian. I say in the book, and I’m saying it now, freaking A. Put whatever protein on there that you want.

The hard part is the vegetables in SIBO diets. That’s right. You can eat whatever meat, poultry, fish, egg you want.

Do you. These are the dishes to go with your favorite protein source. Thank you.

Amen. Hi, I’m Siobhan Sarna, and this is The Siobhan Show, health, wealth, and wisdom. Be sure to hit subscribe as well as ding that bell so you get notifications every time a new show drops.

Let’s train the algorithm together to make sure you get this incredible transformation information that’s not just more data dubbing, but can actually change your life for the better. Thanks for being here.

[Dr. Allison Siebecker] (25:10 – 29:04)

Okay, so now let’s talk about the other prevention of relapse that you were alluding to, which is the prokinetics. Prokinetics are either like pharmaceutical or natural herbal. They can be either or that stimulate the migrating motor complex.

That’s what they do. So we have a whole bunch of them. Let me just mention some percalipride is, you know, the star of the whole category that is a prescription and it’s sold as Motegrity in the US.

It’s Resilor or Resitrans in many other countries. It’s amazing and has also very many beneficial effects as well. We have things like low dose erythromycin or low dose naltrexone LDN.

We have things like ginger root and Iberogast or IBS shield. And then those sort of herbal products usually come in formulas with other supportive herbs and supplements like maybe 5-HTP that are in prokinetic formulas. So, you know, there’s a whole bunch of these wonderful sort of natural formulas.

One thing to know is that what we have found clinically that the prescription options, particularly the percalipride and the low dose erythromycin are stronger than generally across the board than the natural ones. I have seen the natural ones work really well for many cases. But if somebody has a particularly tough case of SIBO with a really difficult underlying cause, we might need the prescription one.

So do keep that in mind. But what these are doing is they’re prolonging remission. Dr. Pimentel did a study where he compared low dose erythromycin with another prescription prokinetic that’s off the market now but that percalipride has replaced and it’s very much safer and found that you could get anywhere from five to eight months additional remission if you add it in a prokinetic. So that’s why we do it. And when do we use these? We start them right after you finish your first treatment round.

And that’s something else I didn’t mention, the timing and spacing between treatment rounds. I don’t advise going longer than about two weeks just because when you’re not finished clearing a condition and this condition in particular, at about two weeks it’s very common to sort of backslide. You know, you might have already made some progress in symptoms but then you start to see them returning at about two weeks.

So it’s best to get on to your next round before two weeks is out and then in that two-week period you want to be on a prokinetic to just sort of keep you where you’re at. And then the other time for it is when you’re done, when you have eradicated SIBO or you’re 90% better. And many people who have chronic underlying conditions are on them long term, you know, all the time, basically continuously.

But generally what we say is you want to be on it for at least three months once you’ve gotten your SIBO clear. Why is that? Because at least at first, a common time shown in studies as well as clinically for relapse is at about two, two and a half months, about two and a half months.

By taking a prokinetic for three months you get yourself past that vulnerable time period. And then, you know, you could always just stop a prokinetic at any time, the only risk is relapse. But most people do not want to stop it because they can, they feel it’s helpful for them.

Oh, that’s one other thing. You don’t typically feel it since it isn’t a laxative. This is a big confusion people have.

Don’t think that it’s going to give you a bowel movement. It’s not. Some of them could if you take them in really high dose.

And of course, there’s always just the odd person that has a side effect from whatever medicine that might affect them in that way. But you’re not going to really feel it. You have to know what it’s doing.

And you’re taking it with compliance, understanding that the studies show that it just helps you to prevent SIBO from coming back. So you won’t feel it.

[Shivan Sarna] (29:04 – 29:30)

And don’t be afraid to take it if you have the hydrogen type of SIBO and you have diarrhea, and you think, oh my gosh, it’s going to make my diarrhea worse. That’s not what this is. And it’s a different concept, right?

It’s just like having to do multiple rounds. It’s a different concept. When I did my first treatment, I was like, oh, two weeks and I’m going to be done.

This is amazing. Not only did I have a weird type of SIBO where it reversed.

[Dr. Allison Siebecker] (29:30 – 29:32)

It started converting to different gas types.

[Shivan Sarna] (29:32 – 32:55)

Yeah. It was a very busy garden, my microbiome. But anyway, so don’t be afraid of it.

Don’t be afraid of anything. The hypervigilance and the anxiety that comes with SIBO is real. Once I started to relax about it back in the day, a lot of things got a lot better for me, like my overall being about it.

I had so hyperfixated on it because it was so confusing and I didn’t feel well. And I also had mold exposure at the same time. And it was just, I used to call it a second job.

It was just really overwhelming me. And once I was like, you know what? I’m going to find the people who know about this.

I knew people existed like just innately in my soul. I knew people existed who knew how to deal with this after spending $10,000 trying to fix it and just beating my head up against the wall. And then through a lot of diligence and resilience, I found Dr. Seebecker. We’ve had millions of people watch our work together. Millions. So the quest continues.

Share this with someone who you think may benefit from it. Maybe they’re bloated. Maybe they’re, you know, the ones with the tummy troubles and, you know, it’s vague, you know, the ones that are really suffering, right?

Or you can tell they are, but they don’t want to talk about it. The beer bellies, you know who they are. Okay.

Share the love. Share this information. Let’s get you all well.

Let’s get everybody aware of this condition and let’s get off the treadmill or the hamster wheel of confusion and frustration because you can get your life back. And like I always say, a chronic condition when properly managed can make you feel 100% better than a chronic condition that is not managed. And I don’t like to over identify with chronic conditions.

Like I see people on Instagram saying, hi, I’m a chronic condition, sick early. Like that’s not my vibe at all. I just want to be in the truth.

I want to be in action. I want to have a balance between activity and relaxation and be actively relaxed and relaxed activity. That’s what Dr. Seebecker and I really wish for you all is we wish you the best of health and we wish you so much hope and accomplishment and the persistence to reach your goals. So if we’ve played a role in that in any way, past, present, or future, I know that that heals our heart and makes us feel really, really satisfied and blessed to be able to be a part of your healing journey. Dr. Seebecker, thank you so much. Thanks so much, Yvonne.

Love you. Love you. Thanks, everybody.

See you next time. So that’s a wrap on today’s episode. Thank you so much for being here.

It genuinely means everything to me. If something in this conversation sparks something for you, share it with a woman or a guy in your life who needs to hear it. That’s how this show grows, that’s how we heal the planet together, and that’s how we really connect.

For more resources, free tools, and everything we talked about today, head over to shivansarna.com. That’s S-H-I-V-A-N-S-A-R-N-A dot com. It’s all there waiting for you.

And until next time, keep asking the questions, keep finding the answers. You deserve the full picture and the very best. Namaste.

Show Notes:

SIBO Treatment Explained: Antibiotics, Herbals & Relapse Prevention | Dr. Allison Siebecker, Part 2

Successful SIBO treatment requires more than just antibiotics. In this in-depth conversation with Dr. Allison Siebecker, one of the world’s leading SIBO experts, we explore how to match treatment to your SIBO gas type, reduce relapse risk, and support long-term gut health and microbiome recovery.

If you haven’t watched Part 1 yet (links below), start there for a complete understanding of SIBO causes, symptoms, diagnosis, and the first of the 3 major treatment approaches: the Elemental Diet.

In Part 2, Dr. Siebecker explains evidence-based strategies for treating SIBO with rifaximin, antibiotics, herbal antimicrobials, elemental diet therapy, prokinetics, diet, retesting, and relapse prevention.

Key Insights:

✅ Why Rifaximin Isn’t the Whole SIBO Plan

✅ Your SIBO Gas Type Changes Everything

✅ Herbal Antibiotics Are Not One-Size-Fits-All

✅ Retesting Can Prevent the Wrong Next Step

✅ Prokinetics May Be the Missing Relapse Tool

✅ Diet Helps Symptoms — But It Won’t Cure SIBO Alone 

Chapters:

00:00 Why Antibiotics Can Work for SIBO

04:13 What Makes Rifaximin So Different?

05:22 Does Rifaximin Damage or Restore the Microbiome?

08:45 Do Herbal Antibiotics Really Work for SIBO?

10:56 When One SIBO Treatment Isn’t Enough

12:00 Fullscript Dispensary (Sponsor) 

12:48 What Your Breath Test Really Means

13:41 Why One Round of SIBO Treatment May Not Be Enough

16:37 The 3-Part SIBO Solution Strategy

17:59 The Biggest SIBO Myths That Cause Confusion

19:44 Why SIBO Comes Back — And How Diet Fits In

25:10 The Missing Step in SIBO Relapse Prevention

29:37 Why SIBO Treatment Doesn’t Have to Feel Scary

(Part 1) SIBO Explained: Why IBS, Bloating & Constipation Won’t Go Away
Apple:
Spotify:
YouTube: https://youtu.be/t_hop9SjC3c

💊 Dr. Allison Siebecker’s Fullscript Dispensary

Shop over 15,000 practitioner-grade supplements, explore Dr. Siebecker’s curated wellness plans, and enjoy exclusive pricing. 🔗 Access Dr. Siebecker’s Fullscript Dispensary: https://sibosos.com/podcast-fullscript

🦠 SIBO SOS

Looking for answers to bloating, IBS, constipation, diarrhea, or SIBO? Explore free resources, expert interviews, educational courses, coaching programs, and trusted recommendations to support your gut health journey. 🔗 Learn more about SIBO SOS : https://sibosos.com/podcast-sibosos

👤 Guest Info:

Healing SIBO Book: https://sibosos.com/healing-sibo-book/

Dr. Allison Siebecker’s YouTube: https://www.youtube.com/@allisonsiebecker4595
SIBO SOS Membership: https://sibosos.com/membership
SIBO Pro Course: https://sibosos.com/pro
ibsSmart & TrioSmart Breath Test: https://www.gemellibiotech.com/products (Use code Gut25 to save $25)
mBiota Elemental Diet: https://mbiota.com/joint87 (Use code SAVE25 to save $25)

👇 All the Good Stuff 👇

Shownotes & Resources: https://shivansarna.com/

Microbiome Labs home of MegaSporeBiotic™

Use code NOBLOAT15 to save: https://sibosos.com/podcast-microbiomelabs

PureO3 – Ozone at home and ozone beauty products

Use code 10SS to save: https://sibosos.com/podcast-promolife

The Women’s Health Rescue Summit: https://sibosos.com/podcast-whrs

Lymphatic SOS & Rescue Summit: https://sibosos.com/podcast-lymphsummit


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