Dr. Yousef Sadat Nejad, ND

Dr. Yousef Sadat Nejad, ND Naturopathic Doctor 🩺
Lifestyle Medicine, Prevention and Nutritional Science Fanatic

08/04/2026

SIBO testing is having a moment, and it is being recommended way too broadly.

So here is the honest version: when you should actually test, and when you should skip it. πŸ‘‡

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Not everyone with gut symptoms needs a SIBO test. Matching the test to your actual pattern saves you money, time, and a lot of unnecessary guessing.

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βœ… STRONG REASONS TO TEST

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β†’ Bloating that peaks 1–3 hours after eating (classic SIBO timing)
β†’ Chronic diarrhea, especially after food poisoning (post-infectious)
β†’ Constipation not responding to standard approaches (can point to methane / IMO)
β†’ A history of PPI use, opioid use, or gastric surgery (all raise SIBO risk)
β†’ Rosacea, joint pain, or fatigue alongside gut symptoms
β†’ An β€œIBS” label that has already failed multiple standard approaches

If several of these sound like you, testing is worth the conversation.

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🚫 WEAKER REASONS TO TEST

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β†’ Occasional bloating with clear food triggers (usually FODMAP intolerance, not SIBO)
β†’ General β€œgut health interest” with no significant symptoms
β†’ Testing just to feel thorough (a negative result does not rule out functional issues, and re-testing is expensive)

Testing blindly often creates more confusion, not less.

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πŸ§ͺ AND IF YOU DO TEST

Ask about the 3-gas breath test.

It measures hydrogen, methane, AND hydrogen sulfide.

The standard 2-gas test misses an entire subtype, which is one of the most common reasons people get a β€œnormal” result while still having symptoms.

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πŸ”‘ THE POINT

Match the test to your symptoms, not to the hype.

The right test at the right time gives you answers. The wrong test at the wrong time just drains your wallet.

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Not sure whether you are dealing with SIBO or IBS?

Take the free SIBO or IBS quiz in my bio. It helps you figure out which pattern fits you before you spend a dollar on testing.

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Save this for your next GP or GI appointment, and show them.

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Peptides are one of the most talked-about frontiers in gut health research right now.But here is what almost no one says...
07/29/2026

Peptides are one of the most talked-about frontiers in gut health research right now.

But here is what almost no one says out loud. πŸ‘‡

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This is educational only πŸ“š

None of these peptides are approved for SIBO. Most are investigational, several sit in a regulatory grey zone, and none should ever be started without a qualified practitioner supervising you.

With that said, the science is genuinely interesting, and understanding it helps you ask better questions.

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πŸ”¬ WHY PEPTIDES ARE BEING STUDIED IN SIBO

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SIBO is not just bacteria in the wrong place. It is linked to a damaged gut barrier, inflammation, oxidative stress, mitochondrial dysfunction, and slowed motility.

Researchers are exploring whether specific peptides could support each of those problems. Here is how they group together.

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🩹 REPAIR & MOTILITY

BPC-157 and TB-500 are studied in preclinical models for intestinal repair and gut motility.

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πŸ›‘οΈ ANTIMICROBIAL & IMMUNE

LL-37 and KPV are researched for antimicrobial and anti-inflammatory effects. Thymosin Alpha-1 is studied for immune modulation.

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⚑ MITOCHONDRIAL SUPPORT

MOTS-c and SS-31 are investigated for cellular energy and mitochondrial function, which may connect to the fatigue so many SIBO patients feel.

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πŸ”‘ THE HONEST TAKEAWAY

Most of the promising data so far comes from animal models, not human trials.

β€œPromising in research” is not the same as β€œsafe to use.”

These belong in a supervised clinical setting, not a supplement cart or an online peptide order. Self-sourcing investigational compounds carries real, documented risk.

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The future of SIBO care may genuinely look different from what we have today. But the science has to catch up before any of this belongs in a real treatment plan.

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Save this if you like understanding the research behind gut health, minus the hype.

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Always consult your primary practitioner before considering anything discussed here.

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Book a consultation with a naturopathic doctor focused on gut health, link in bio.

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07/27/2026

Two of the most useful tools for supporting a SIBO protocol are also the most misused. πŸ‘‡

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I’m a naturopathic doctor, and here is how I use digestive enzymes and activated charcoal actually fit into gut recovery.

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🧫 DIGESTIVE ENZYMES

Enzymes help break food down more completely, so there is less left over to ferment, and less bloating and gas.

But they support digestion. They are not a treatment for the overgrowth itself.

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⚫ ACTIVATED CHARCOAL

Charcoal is a binder. But it binds indiscriminately.

Take it near food, medications, or supplements and it binds those too.

That is why timing is everything:

β†’ Away from meals
β†’ Away from meds and other supplements
β†’ Used intentionally, not endlessly

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πŸ”‘ THE POINT

Neither of these clears SIBO on their own. They are support players in a bigger plan, and where they fit depends on your type and symptoms.

Wrong time, they work against you. Right time, they make a real difference.

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Educational only, always work with your own provider before starting anything.

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πŸ“… Book a consultation with a naturopathic doctor focused on gut health, link in bio.

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SIBO is not fixed in a two-week course.Here is what 120 days of proper treatment actually looks like. πŸ‘‡β €Most SIBO comes ...
07/22/2026

SIBO is not fixed in a two-week course.

Here is what 120 days of proper treatment actually looks like. πŸ‘‡

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Most SIBO comes back because treatment stops the moment the antibiotic ends.

But eradication is only one phase of four. It is a sequence, not a single prescription.

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🧫 PHASE 1: BIOFILM DISRUPTION (Days 1–30)

Bacteria hide inside biofilms that blunt antimicrobials. Breaking that shield first exposes the overgrowth. You cannot clear what is still hiding.

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πŸ«€ PHASE 2: LIVER & BILE SUPPORT (Days 20–50)

Bile is one of your body’s own antimicrobials. Sluggish bile flow lets bacteria survive. Supporting it rebuilds a built-in defence before eradication begins.

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🎯 PHASE 3: ERADICATION (Days 40–90)

The phase most people think is the whole treatment. With biofilms disrupted and bile flowing, the overgrowth is finally reduced the way it was supposed to be.

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πŸ”„ PHASE 4: RECOVERY & PREVENTION (Days 80–120+)

Where lasting results are made or lost.

β†’ Restore motility (MMC)
β†’ Rebuild the gut lining
β†’ Address the root cause

Clearing the overgrowth was never the hard part. Keeping it gone is. πŸ”‘

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If your SIBO treatment ended at the antibiotic, it was never finished.

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πŸ“… Book a consultation with a naturopathic doctor focused on IBS, SIBO, and gut health β€” link in bio.

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07/20/2026

The most important step in treating SIBO isn’t the antibiotic.

It’s the test that tells you which type you’re actually fighting. πŸ‘‡
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Most people are treated for SIBO as if it is one single condition.
It is not.
There are three distinct types, and treating the wrong one is one of the single biggest reasons SIBO keeps coming back round after round.
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πŸ§ͺ THREE TYPES. THREE DIFFERENT GASES.
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πŸ’§ HYDROGEN
Linked to diarrhea-predominant symptoms. Often responds to rifaximin alone.

🐌 METHANE (IMO)
Slows the gut down. Drives constipation and bloating. Resists rifaximin alone and needs combination therapy.

πŸ₯š HYDROGEN SULFIDE
Diarrhea with sulfur-smelling gas. Will not even show up on a standard breath test. It requires trio-smart testing specifically.
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Get the type wrong, and even the right-sounding antibiotic will not hold.
That is why testing comes before treating. Guessing is exactly how people end up on round after round with no lasting result.
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πŸ”‘ BUT HERE IS THE PART THAT ACTUALLY MATTERS

Clearing the overgrowth was never the hard part.
Keeping it gone is.

And that comes down to why it started in the first place:
β†’ Impaired motility and a sluggish self-cleaning cycle (MMC)
β†’ A past bout of food poisoning
β†’ Scar tissue or adhesions
β†’ Post-infectious changes to gut nerve function
Miss the root cause, and SIBO returns every single time, no matter how good the antibiotic was.
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This is the difference between managing SIBO forever and actually resolving it.

Test first. Identify the type. Find the root cause. Then treat.

That is the order that actually holds.
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If you are in Toronto and your SIBO keeps returning despite doing everything you were told to do, the missing piece is almost always one of these two things:

the wrong type was treated, or the root cause was never addressed at all.

You deserve a plan built on what your test actually shows, not guesswork.
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πŸ“… Book a consultation with a naturopathic doctor focused on IBS, SIBO, and digestive health β€” link in bio.
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Your IBS is not random.It is following your hormones. πŸ‘‡β €If your bloating, cramping, and bathroom patterns seem to shift ...
07/15/2026

Your IBS is not random.
It is following your hormones. πŸ‘‡
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If your bloating, cramping, and bathroom patterns seem to shift week to week for no reason, there is a reason. Four hormones are quietly running the show, and almost nobody explains this at a standard appointment.
⚠️ IBS is up to twice as common in women. That is not a coincidence. It is hormonal.
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🩸 ESTROGEN + PROGESTERONE
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In your luteal phase, progesterone rises and slows gut transit. That is the constipation and heavy bloating.
Then right before your period, both estrogen and progesterone drop sharply.
That drop triggers cramping, urgency, and diarrhea.
Up to half of women with IBS report their symptoms clearly worsen around menstruation.
You are not imagining the pattern. You are living it.
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⚑ CORTISOL
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Stress is not β€œin your head.” It is a hormone acting directly on your gut.
IBS patients show a dysregulated HPA axis and an elevated cortisol response.
The result: amplified pain signals and a weakened gut barrier.
This is why symptoms spike during stressful weeks even when your diet has not changed at all.
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🧠 SEROTONIN
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Around 95% of your serotonin is not made in your brain. It is made in your gut.
It directly regulates motility.
Too much serotonin signalling drives IBS-D.
Too little drives IBS-C.
This is the mechanism behind why the same diagnosis produces opposite symptoms in different people.
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πŸ”‘ WHY THIS MATTERS
Treating the gut without looking at hormones is only half the plan.
If your protocol ignores your cycle, your stress physiology, and your serotonin signalling, you are treating symptoms while the actual drivers keep running underneath.
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Track your symptoms against your cycle for one month. Bring that pattern to your next appointment. It changes the entire conversation.
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If you are in Toronto and your IBS or SIBO has never been assessed alongside your hormones, that gap may be exactly why nothing has held.
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πŸ“… Book a consultation with a naturopathic doctor focused on IBS, SIBO, and gut health β€” link in bio.
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07/13/2026

Your rosacea might not be a skin problem at all.

It might be a gut infection showing up on your face. πŸ‘‡

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If you have tried every cream, every topical antibiotic, every trigger-avoidance diet and your rosacea still will not budge, this is worth reading.

There is a documented connection between your gut and your skin. It is called the gut-skin axis. And the research on rosacea specifically is hard to ignore.

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πŸ”¬ WHAT THE EVIDENCE SHOWS

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In 2008, researchers tested rosacea patients for SIBO, bacterial overgrowth in the small intestine.

What they found was striking.

SIBO was dramatically more common in rosacea patients than in healthy controls.

But this is the part that changes everything πŸ‘‡

When they cleared the SIBO, the rosacea did not just improve.

In most patients it almost completely resolved. And it stayed clear at follow-up months later.

They were not treating the skin at all. They were treating the gut. The skin followed.

(Parodi et al., Clinical Gastroenterology and Hepatology, 2008)

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πŸ”₯ WHY THIS HAPPENS

Bacterial overgrowth in the small intestine drives systemic, low-grade inflammation throughout the body.

For some people, that inflammation surfaces on the face as rosacea, redness, flushing, and persistent flares.

Treating the skin topically calms the surface but never touches the source. That is exactly why the redness returns the moment you stop the cream.

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⚠️ THE SIGNS WORTH NOTICING

If your rosacea flares alongside:

β†’ Bloating after meals
β†’ Gas or irregular digestion
β†’ Discomfort or fullness after eating

Then the smarter question is not which cream to try next.

It is what your gut is actually telling you. πŸ”‘

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Skin conditions that resist every topical treatment often have a root cause deeper than the skin.

If you are in Toronto and your rosacea has never truly responded to topical treatment, especially if it flares alongside digestive symptoms, it may be time to stop treating the skin and start investigating the gut.

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Every meal you eat is either feeding your SIBO or healing your gut.Most people have no idea which side their plate is on...
07/11/2026

Every meal you eat is either feeding your SIBO or healing your gut.

Most people have no idea which side their plate is onπŸ‘‡
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If you are in Toronto dealing with SIBO, you have probably been handed a generic low-FODMAP list and sent on your way with almost no explanation of why, for how long, or what comes next.

That is not enough to actually recover.
Here is what the evidence actually says about food and SIBO.

⚠️ Diet does not cure SIBO on its own. But it directly impacts bacterial load, symptom severity, and how well your gut lining heals between treatment rounds.
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🚫 FOODS THAT FEED SIBO
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These foods are not bad for you. They are bad for your SIBO.
β†’ High-FODMAP grains (wheat, rye, barley)
β†’ Fructose-rich fruits (apple, pear, mango)
β†’ Fermentable fibres (legumes, onion, garlic)

FODMAPs are rapidly fermented in the small intestine, increasing hydrogen and methane gas production and driving the exact symptoms you are trying to escape.
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🌿 FOODS THAT HEAL THE GUT
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Your gut lining took a hit. These foods help rebuild it.
β†’ Bone broth: glutamine-rich, supports the gut lining
β†’ Oily fish: anti-inflammatory omega-3s
β†’ Well-cooked low-FODMAP vegetables: easy to digest, nourishing

Glutamine-rich foods support tight junction integrity and help repair intestinal permeability.
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⏱️ AND HERE IS WHAT NOBODY TELLS YOU

The SIBO diet is not forever.

Staying on a restricted low-FODMAP diet too long actually reduces beneficial Bifidobacteria and harms your microbiome diversity.

The reintroduction phase matters as much as the restriction phase.

Reduce fermentation. Reintroduce slowly. Rebuild diversity. πŸ”‘
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Food is a tool, not the whole treatment. The right food protocol, matched to your specific SIBO subtype and treatment phase, is where lasting recovery actually starts.
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If you are searching for a naturopathic doctor in Toronto who will actually explain your SIBO plan, sequence your diet properly, and treat the root cause instead of handing you a printout, this is what we do.
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πŸ“… Book a consultation β€” link in bio.
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07/09/2026

Your SIBO breath test came back.
But do you actually know what the numbers mean? πŸ‘‡
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Most people get handed a result, get told positive or negative, and walk out with a prescription or nothing at all.

Nobody explains the gases.
Nobody explains the thresholds.
Nobody explains that the gas type is not just a detail, it is the entire basis of your treatment plan.

Getting treated for SIBO without knowing the gas type is like treating an infection without knowing if it is bacterial, viral, or fungal.
The diagnosis sounds the same. The treatment could not be more different.

⚠️ This is one of the most common reasons SIBO treatment fails on the first attempt.
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πŸ”¬ WHAT YOUR NUMBERS ACTUALLY MEAN
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πŸ’§ HYDROGEN (H2)

A rise of 20 or more parts per million within the first 90 minutes of a lactulose breath test indicates bacterial overgrowth in the small intestine.

This is hydrogen-dominant SIBO.

Most responsive to rifaximin alone.
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🐌 METHANE (CH4)

A reading of 10 or more parts per million at any point during the test indicates intestinal methanogen overgrowth (IMO).

This is methane-dominant SIBO.

Methanogens are archaea, not bacteria. Rifaximin alone will not clear this. You need combination therapy typically rifaximin plus neomycin.
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πŸ₯š HYDROGEN SULFIDE (H2S)
Normal hydrogen and methane readings with textbook SIBO symptoms means one thing.

You may have hydrogen sulfide SIBO, and your standard breath test cannot detect it.

H2S requires trio-smart breath testing specifically. Most clinics do not offer this without being asked directly.
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The number on your test is not the diagnosis.
The gas type is the treatment plan. πŸ”‘
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Three different gases. Three different mechanisms. Three completely different protocols.

If your doctor handed you results without explaining any of this, you were not given enough information to make a decision about your own treatment.
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Save this post and bring it to your next appointment.
You deserve a result that is actually explained to you.
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πŸ“… Book a consultation β€” link in bio.
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44% of SIBO patients relapse.Not because the antibiotic failed.Because nobody told them about the one step that comes af...
07/06/2026

44% of SIBO patients relapse.
Not because the antibiotic failed.
Because nobody told them about the one step that comes afterπŸ‘‡
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Here is what most SIBO protocols look like in practice:
You test positive. You get rifaximin. You finish the course. You feel better for a few weeks, maybe a couple of months.

Then the bloating is back. The fatigue is back. The brain fog is back.

You are back at square one wondering what you did wrong.

⚠️ You did nothing wrong. You were given an incomplete protocol.
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πŸ”„ THE STEP NOBODY EXPLAINED
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Your gut has a self-cleaning cycle called the migrating motor complex (MMC).
Between meals, it sweeps bacteria out of the small intestine.

In SIBO, the MMC is broken or sluggish.
Rifaximin kills the bacteria.

It does nothing for the broken sweep that let them in.
Without a prokinetic to restore MMC function, bacteria move right back in.
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πŸ’Š YOUR OPTIONS (EVIDENCE-BASED)
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PRESCRIPTION:
β†’ Low-dose naltrexone (LDN): prokinetic and anti-inflammatory
β†’ Prucalopride: serotonin-driven motility support
β†’ Low-dose erythromycin: motilin receptor agonist
HERBAL:
β†’ Ginger extract: stimulates MMC phase III activity
β†’ Iberogast (STW5): RCT-proven gastric motility improvement
β†’ Artichoke leaf: bile flow and small bowel motility support
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⏱️ THE PROTOCOL

Start prokinetics the night antibiotics finish.
Not a week later. That same night.
Continue for a minimum of three to six months.

The gap between finishing antibiotics and starting nothing is exactly where relapse lives.
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This is not fringe medicine.
This is standard in every leading SIBO clinical framework.

Drs. Allison Siebecker and Nirala Jacobi, two of the most cited SIBO clinicians in the world, both include a minimum three-month prokinetic protocol as non-negotiable post-antibiotic care.

Your antibiotic was not the whole plan. It was only the first step. πŸ”‘
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If you have been treated for SIBO more than once and it keeps coming back, the missing piece is almost always this.
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Ready to build a protocol that actually holds?
πŸ“… Book a naturopathic consultation β€” link in bio.
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