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Suffer from Intestinal or Digestive Distress ?

Suffer from Intestinal or Digestive Distress ?
July 4, 2015 Patrick Nemechek, D.O.


Got Sibo 2Do you have intestinal distress (constipation, diarrhea, frequent urination), excessive bloating or cramping after meals, food intolerance, anxiety, skin disruptions (eczema, rosacea), chronic pain, or recurrent UTI/bladder/strep infections?

Or do you have a sour stomach if you miss meals, wake up feeling nauseated, get heartburn after certain foods, or have unusual patterns of hair loss (alopecia)?

You may have a bacterial overgrowth in your intestinal tract that is igniting inflammation and silently wrecking your health.

Our intestinal bacterial story starts at our birth. When we are born our intestines are colonized with a bacterial blend from our mothers, with the exceptions being people born by C-Section or if we spent time in intensive care.

In our first year our bacteria matures and is influenced by a number of things, including whether we are breast-fed and when we start eating solid foods. It is particularly influenced by medications.

A single course of antibiotics in our first year seems to permanently change intestinal bacteria so much it can be detected 7 years later. Repeated exposure to antibiotics during childhood continues the changes.

During our lives our intestinal bacterial blend changes with our diet, medications, anesthesia, surgeries, vaccines, and infections.
Once our bacterial balance is disturbed many of us do not regain our healthy balance, we live with an altered blend that may be detrimental to our health. Many of us now develop Small Intestinal Bacterial Overgrowth (SIBO).

SIBO may start after damage to the Autonomic Nervous System slows our intestinal tract and allows bacterial migration from the lower regions of the colon upwards into the small intestines.

Autonomic damage may happen after a physical injury (sports, concussion), an emotional trauma, or after the use of products that alter the movement of our intestinal tract (medications, anesthesia, vaccines).

In a twist, studies have shown that the bacteria themselves can directly impair Autonomics. The bacteria have learned to send signals to the brain via the Vagus Nerve. These signals alter our Autonomics and slow digestion.

The bacteria have learned the first rule in real estate; location is everything.

The bacteria move up to a better neighborhood (small intestine) where nutrients help them replicate and survive. The invading bacteria digest the nutrients and release gases, toxins, and waste products that give us symptoms.

Those symptoms of the bacterial overgrowth are heartburn, food intolerance, ā€˜low blood sugarā€™, morning nausea, excessive hunger, intestinal distress (cramping, bloating, constipation, diarrhea), eczema, and hives. The bacterial overgrowth may also trigger recurrent strep infections, bladder and urinary tract infections.

SIBO may also cause the Autonomic disturbances of frequent urination, fatigue, lightheadedness, insomnia, and anxiety.

SIBO is one of the major factors in the development of Autism and Attention Deficit Disorder.

We are accustomed to temporary fixes for those symptoms. But taking antacids for heartburn, fiber for constipation, or anti-spasmodic drugs for intestinal cramping only mask the surface symptoms of SIBO.

Some dietary changes like gluten-free products and paleo style eating, or products like probiotics, temporarily shifts the available nutrients for the invading bacteria but people may lose the benefits once the bacteria can replicate and continue their migration upward.

None of those temporary fixes solve the underlying bacterial imbalance and thus none decrease the resulting systemic metabolic inflammation.

The bad news is that the metabolic inflammation is our real problem. The bacterial overgrowth damages our intestinal wall and leaks a substance (LPS; lipopolysaccharide) into our tissue. Our white blood cells react to the LPS and release inflammatory cytokines into our blood. We call this ā€œLeaky Gutā€.

Researchers have also demonstrated that elevated LPS can lead to Type 2 Diabetes and obesity in mice. Depression and hypertension are also associated with elevated LPS and inflammation.

Those studies demonstrated that rebalancing the intestinal bacteria reverses the brain dysfunction and normalizes hormone production.
In my medical practice I see that SIBO contributes to almost every modern disease we face today.

By treating SIBO and repairing Autonomic dysfunction, I have facilitated the improvement, remission, or reversal of not just common ailments like diabetes and hypertension, but also autism, heart failure, cerebral palsy, anxiety, PTSD, POTS, PCOS, ADD, dyslexia, seizure disorders, narcolepsy, and Takotsubo cardiomyopathy.

I have found that in order to maintain healthier bacteria one must also restore neurological control over the intestinal tract. You must repair and maintain both the intestinal tract and repair and maintain Autonomic function.

SIBO and Autonomic treatment often involves short-term medications to restore a better bacterial blend, core nutritional changes to support neurological repair and stem cell production, and long-term dietary changes.

Controlling SIBO and maintaining Autonomic Nervous System balance is not easy, but it is also not impossible. The process takes work and it is your personal health marathon; each day your efforts, foods, and medications either support or endanger your recovery and your health.

I am an internal medicine physician and my private office is located in the greater Phoenix, Arizona area.

For more information on SIBO and the Autonomic Nervous System you may call my office at 623-208-4226 or learn from my website

Ā© 2015. Dr. Patrick Nemechek and Jean R. Nemechek. All Rights Reserved


  1. Sergey 12 months ago

    Hello Dr. Nemechek. Is there any chance to control SIBO in adult using inulin only? I don’t have too many GI symptoms, and inulin seem to agree with me, just started 3 days ago. Are there any symptoms which could tell that inulin is not working and I need a course of rifaxinim instead? I definitelly have ANS dysfunction.
    Thank you!

  2. Emily Shannon 12 months ago

    Hi Dr. Nemechek,
    My 11 month old has many food allergies, GERD, chronic diarrhea (leaks stool all throughout the day) and a recent scope revealed chronic gastritis. Doctors have him on Ranitidine and a few weeks ago, we started him on a spore-based probiotic that has helped immensely. Less spitting up, no more diarrhea or intestinal distress, and far fewer food intolerances. I just found your protocol yesterday, and learned about how damaging probiotics can be – but this particular probiotic has helped SO much! My question is – are all probiotics bad? Even spore based which are proven to help with intestinal permeability?
    …..His food “allergies” seem to me to be more likely dietary endotoxemia vs real allergies, so I am hopeful that your protocol can help free him from these problems and the meds! After how long on the protocol would you suggest experimenting with stopping the ranitidine and probiotic?
    …..One last question (I am dealing with many health issues too, including narcolepsy, full-blown histamine intolerance and debilitating constipation and bloating). Do you discourage adults from using digestive enzymes or is that discouragement exclusively indicated in cases of autism?
    Thanks in advance!

  3. Coleen 1 year ago

    Hi Dr. Nemechek,
    What is your opinion about and/or experience with herbal antibiotics (such as Metagenics and Biotics Research from the 2014 study) in comparison to rifaximin? I need to do a round of antibiotics for SIBO, but am not sure that my insurance will cover rifaximin.

    • Author
      Patrick Nemechek, D.O. 1 year ago

      I have better results using rifaximin

  4. Ashwini 1 year ago

    Dear Dr. Nemecheck,
    My son is 3.7 years completely nonverbal. We started the protocol 2 months ago. We got his OAT test done couple of months back and we found out he has yeast overgrowth . Also he has zero concentration (attention) in any activities. Please help. Dosage: 1/4 inulin, 2ml FO, 5ml evoo in his cooking.

    • Author
      Patrick Nemechek, D.O. 1 year ago

      Stick with the protocol.

      The results from the OATS test are meaningless and your son doesn’t have yeast overgrowth (no such thing).

  5. Carla 1 year ago

    My aunt is on long-term antibiotics for a lung condition. Can someone on long-term antibiotics go on the protocol?

    • Author
      Patrick Nemechek, D.O. 1 year ago

      I don’t recommend treatment with rifaximin while taking other antibiotics. On the other hand, fish oil and olive oil are generally compatible will all other medications.

  6. Maria 1 year ago

    My daughter is 10 weeks pregnant and is having a SIBO flare: foul smelling stool, gas and bloating after eating and drinking, cramping and intestinal pain. What can she take while pregnant, as Rifaximin is not an option while pregnant?

    • Author
      Patrick Nemechek, D.O. 1 year ago

      Inulin is generally considered safe dusting pregnancy. Have her get her obstetrician’s clearance before starting it.

  7. ROHAN JOSEPH 1 year ago

    Hello Dr. Nemechek,
    My son is 3.5 years old. Its been 15 days since we started the protocol. Inulin 1/8, EVOO – 5ml , Fish oil – 1ml.
    Three days back we started giving him 1ml EVOO directly to drink. Now from last two days he has extreme Diarrhea (10 times a day). We are bit worried. Please suggest / advise if we have stop the protocol for few days and what could be the underlying issue. We have read your book but thought we will post here to get some clarity.

    Thanks in advance,

    • Author
      Patrick Nemechek, D.O. 1 year ago

      Just stop the EVOO and use it only for cooking.

  8. Sheree 1 year ago

    I have just two weeks ago done rifaximin.
    I have been battling am ear infection for about 6weeks and have to have antibiotics.
    Usually my stomach gets so sore. Obviously they suggested probiotics. Could I use inulin while on the anti biotics. It’s going to be a long healing for my automatic system as I suspect that is what my tummy issues are rooted in. I’m feeling bummed as I do think want a set back.

    • Author
      Patrick Nemechek, D.O. 1 year ago

      Don’t use inulin or probiotics with the antibiotics. They can make thing worse.

  9. Andrea 2 years ago

    Dr. Nemechek,
    I just finished your book, ordered inulin and fish oil, and I’m hoping your protocol will help my 6 year old speech delayed son as well as the rest of my children who suffer from eczema and food allergies. I have 2 questions. Firstly, it appears that my children must have inherited their issues from their parents to some extent. I have suffered from anxiety and insomnia that I keep under control with anti inflammatory supplements like tumeric. My symptoms seem pretty mild. Would you suggest I try inulin first or does every single adult you’ve treated need a round of ribamaxin? Secondly, has your protocol every helped anyone with asthma? My husband has suffered from asthma since he was 3 and I’m wondering if the protocol might help him as I’ve been told asthma can be related to gut bacteria imbalance. Thanks so much.

    • Author
      Patrick Nemechek, D.O. 2 years ago

      I recommend rifaximin for all adults because eventhough inulin might help with some digestive issues, I cannot get autonomic recovery in adults by just using inulin to control SIBO.

      In addition, I have not seen asthma improve unless it was actually just reactive airway disease from acid reflux (GERD).

  10. Mary Caroline Pabatao 2 years ago

    Hi! I have a son who is 18 years old. He has Downs syndrome and with Global developmental delay and borderline Asperger Spectrum Disorder. He has a lot of medical issues like hypothyroidism, asthma, hidradenitis supperativa, juvenile idiopathic arthritis, low TCELL, eczema, psoriasis. Has OCD, challenging behaviour and hearing sensitivity. Can i use inulin, evoo and omega3 for him? UK doesnt prescribed rifaximin. Also, is omega 3 ok to use ? I introduce omega to him twice his joints becomes inflammed. He is also has constipation and walking on toes on occassions which Rheumatology team cannot give me any rationale about it. Any suggestion will be a great help to help my son. I am struggling with everything as a single parent and need to give up my job as no one would like to look after him due to his challenging behaviour. Thank you for your time. God bless!

    • Author
      Patrick Nemechek, D.O. 2 years ago

      The protocol should help with many of these conditions but the rifaximin instead of inulin is much more effective in a 18-year old.

      Since he is probably on several medications, run the protocol elements by your managing physician.

    • Mary Caroline Pabatao 2 years ago

      Thank you for your time. Just ordered the Nemcheck Protocol Book. My son has aggressive behaviour, self harm and been very destructive couple of times since mid June 2018. I am scared with the awakening ….

    • Author
      Patrick Nemechek, D.O. 2 years ago

      Read the book and watch my YouTube video on aggression and anxiety.

  11. Brian Dey 2 years ago

    I got my xifaxan prescription from my gut doctor yesterday, insurance denied it so i paid cash, $686.00, with coupon. I got 30 550mg tablets, 3 a day for 10 days , your book states 2 a day for ten days, should i follow your dosage and save 10 tablets for another partial treatment if i relapse ?

    • Author
      Patrick Nemechek, D.O. 2 years ago

      I’m sorry I can’t give advise about medication doses online.

  12. Anusha Das 2 years ago

    Hello Dr Nemecheck,
    I started the protocol for my 7 year old ASD son a month back. I currently give 1.5 tsp inulin, 15 ml EVOO and 2 NOW DHA capsules. Even before starting the protocol, my son hysterically laughs and touches his penis area while urinating as if he has discomfort there. He is non verbal. I assume he has pain there. We checked for UTI but the result is negative. This issue is still there. Any reason for this? Is this also ANS dysfunction?

    • Author
      Patrick Nemechek, D.O. 2 years ago

      Could be something related to ANS but it is hard to say.

      Since there is not UTI, there is no harm in waiting and I bet this resolves.

  13. Ubr 2 years ago

    Dr Nemecheck I write you from Spain. I would like to know how to recovery the Autonomic Nervous System. Also, can i find out if my sibo comes from gastroenteritis episode or Ā«emotional traumaĀ»? I have no possibility to do the IBScheck from Pimentel (a blood trst) because it is not available in my country. And a last question, do you know any person who has cured its sibo permanently?
    Thank you very much.

    • Author
      Patrick Nemechek, D.O. 2 years ago

      Thanks for writing. Unfortunately the publication of our adult autonomic recovery book is behind schedule because of the overwhelming positive effect our protocol has on children with autism and developmental issues.

      I recommend reading the autism book to understand the mechanisms behind the development of chronic autonomic dysfunction and how SIBO plays a role in this. The adult autism treatment protocol is the same protocol I start my adults with autonomic dysfunction on.

      There is no permanent cure for SIBO at this time.

  14. Gypsy Garner 2 years ago

    What do you use for SIBO if your insurance company will not pay for Rifaximin?

    • Author
      Patrick Nemechek, D.O. 2 years ago

      Some of our patients have bought the Rifaximin overseas.

  15. Mary 2 years ago

    Thank you so much for replying so soon, when you say adjusting the dose- do you mean add a bit more and try that out?

    • Author
      Patrick Nemechek, D.O. 2 years ago


  16. Mary 2 years ago

    Hi Dr.N,
    We have been doing your protocol for 2 weeks now. My son is 2 years 10 months and ASD. We are on 1/8 inulin in the am and 1/8 in the afternoon. 1/2 capsule of now dha omega 3 (recommended dose) and we use evoo for every meal. My son has a ton of inflammation and his stomach is still very distended. Do you think that maybe inulin is not enough for him or is it too soon to be thinking that. I want his stomach to be flat and I was wondering if maybe rifaximin might be better for him. Just wanted your opinion if I should be giving it more time to see the tummy go back to itā€™s normal size. Thank you

    • Author
      Patrick Nemechek, D.O. 2 years ago

      You might consider adjusting the inulin dosage.

  17. Monica Lujan 2 years ago

    Hi Dr. Nemechek,

    Thank you for this article. I am breastfeeding my 11 month old son. I want to put him on the the protocol. My concern is if I, myself have SIBO do you think he will continue to be reinfected with SIBO from my breastmilk even if he follows the protocol? Do I need to take refaximin to avoid “reinfecting” him with SIBO via breastmilk. Note- I avoid omega 6 oils in my diet.

    Thank you so much for your time!

    • Author
      Patrick Nemechek, D.O. 2 years ago

      There is no evidence that you can trigger SIBO in a child by breast feeding.

      Also, the inulin in the protocol will control bacterial overgrowth and prevents relapses as long as the child continues to receive inulin.

  18. M 2 years ago

    Hello Dr Nemechek,
    I have been doing the protocol since the second week of January. My overall symptoms are digestive problems(diarrhea), and the bigger ones are brain fog, lack of focus, spaced out feeling and possible related depression and fatigue. At 1/16tpsp inulin, 1.5 to 2 tbsp evoo with cooking in coconut oil and 3g FO(ProDHA 1000 in the past few weeks after NOW for the first 8 weeks or so. I did Rifaximin and finished it a couple of weeks.back.

    My symptoms keep coming and going, the one positive being that I have gained weight. I feel very spaced out, with mornings being the worst (which was usually the case anyways, the intensity of the spaced out, dont care is newer)

    I would really appreciate any suggestions on what I should change. I wasnt expecting a full recovery, thought Id atleast feel better.

    Thank you in advance Dr Nemechek for all your help . God bless.

    • Author
      Patrick Nemechek, D.O. 2 years ago

      I don’t recommend inulin in the treatment of SIBO in adults.

  19. S 2 years ago

    Hello Dr Nemechek!!
    Will it be useful to take Partiallly hydrolyzed Guar Gum with Rifaximin as per this paper?

    Also, the dosage recommended by the GI was 550 mg, thrice a day for 15 days? Should I limit myself to twice a day for 10 days?

    Thank you in advance, and thank you for answering the questions and helping all of us out!!

    • Author
      Patrick Nemechek, D.O. 2 years ago

      Rifaximin alone works fine with my patients, and dosing for twice daily for 10 days or three times daily for 14 are both acceptable regimens.

  20. M 2 years ago

    Hello Dr Nemechek,
    With the Rifaximin, would it be beneficial to take natural probiotics(without extra added strains), like kefir(to have some good, even if transient strains) or kombucha(to prevent yeast overgrowth) or saurkruat?

    I am doing SIBOFix, the Rifaximin generic from India.

    Thank you!!

    • Author
      Patrick Nemechek, D.O. 2 years ago

      Naturally fermented foods will not increase the natural bacterial biodiversity of your intestinal tract nor will they help prevent relapse in the future from something such as antibiotic or general anesthesia.

  21. Mukul 3 years ago

    Thank you!

    Is inulin something you recommend continuation for adults after a Rifaximin regimen? Is it OK to take something like Pysillium husk to solidify stools?

    Thank you again:)

    • Author
      Patrick Nemechek, D.O. 3 years ago

      Never. Please read the protocol.

  22. Mukul 3 years ago

    Hello Dr Nemechek,
    I have IBS-D, with brain fog, lack of focus and fatigue, food intolerances and just general malaise. it has been ongoing for a long time and I have tried various treatments. I have been treated with Rifaximin for SIBO, it did not help. I do have another prescription of Rifaximin sitting at home which I can use.

    I have been following your protocol for these issues. 2 tbsp California Ranch EVOO, walnuts or NOW flax oil 1000mg, 1/4tbsp of NOW Inulin, and 3000mg DHA plus 1500 EPA of NOW fish oil. It has been about 3 weeks, and I see a bit of a change. I do try to stick to a light diet.

    Is that enough or should I do the Rifaximin (dosage) again, and continue the protocol after? Should I increase inulin? Should I start eating everything? I would really really appreciate your help and an answer. Its pure misery.

    Thank you in advance:)

    • Author
      Patrick Nemechek, D.O. 3 years ago

      Intestinal symptoms from IBS-D come from 2 sources, SIBO and autonomic dysfunction.

      Rifaximin helps with the SIBO portion which often results in less frequent diarrhea and a resolution of food intolerance to specific foods such as tomatoes, spices, bananas, coffee or chocolate.

      The remainder of the symptoms are from autonomic dysfunction and will slowly but consistently improve over the next few months. If food intolerances or the diarrhea returns, the rifaximin if often required again. Relapses will decrease as the autonomics recover.

  23. Pr 3 years ago

    The counterintuitive approach to using Inulin in children/adults is interesting, but inulin makes me feel TERRIBLE. I can’t even eat things like Kind bars that have inulin in them without having terrible gut reactions. Are adults on the protocol expected to feel this way when first starting? What do you recommend? Do you think Xifaxin/herbal antimicrobials are necessary to initially eradicate SIBO?

    • Author
      Patrick Nemechek, D.O. 3 years ago

      You have a very unusual reaction to inulin.

      In order to get a full response from adults, I treat them with rifaximin (Xifaxan in the U.S)

  24. Jan 3 years ago

    Does inulin help adults with SIBO? I have taken a couple rounds of Rifaximin. and it helped a little i have one more round to take. I have had SIBO for ten years or more and I really would love to get rid of it one day if thats possible I feel like I’m fighting a losing battle.

    • Author
      Patrick Nemechek, D.O. 3 years ago

      Inulin can help some symptoms of SIBO but I have not found it potent enough to reduce the inflammatory process that impairs brain function.

      Rifaximin is very effective at eradicating SIBO but relapses are frequent if there is significant underlying autonomic dysfunction as seen in IBS for example. Once I’m able to get the autonomic nervous system to recover, the relapse rate of SIBO after rifaximin seems to drop significantly.

      Using inulin for now might help your discomfort but the long term answer is in restoring autonomic function.

  25. Anonymous 3 years ago

    Dear Dr. N, My 7 years old autistic kid following your protocol and doing good. I’m breastfeeding (plus supplementing with formula) my 2 months old baby and afraid I may have SIBO too. Can I follow your adult protocol with Inulin? What effect will it create in breastmilk and what will happen once I ween her off from breastfeeding? I don’t want to supplement her unnecessarily. Thanks in advance!

    • Author
      Patrick Nemechek, D.O. 3 years ago

      These are good questions for which we don’t have much guidance.

      The few studies done seem to suggest inulin supplementation is safe when given to infants in their formula as well as pregnant or breast-feeding mothers. The inulin ingested by the mother will not appear in the breast milk. It is digested by intestinal bacteria and turned into healthy short chain fatty acids.

      From a practical standpoint, onions and garlic which are commonly eaten during pregnancy and while breast-feeding contain large amounts of inulin naturally, and at least historically are nor routinely avoided by mothers.

  26. Aviva 3 years ago

    Thank you for your quick response. Don’t you think he may have any benefit at all with inulin+omega 3 only?

    • Author
      Patrick Nemechek, D.O. 3 years ago

      Many kids benefit from inulin and omega-3 only

  27. Aviva 3 years ago

    Hello Dr. Nemechek,
    I am a Naturopath and GAPS practitioner from Israel. I read your articles with great interest since I work with autistic children as well.
    I’ve been wondering about a patient of mine: he is 34, has been on psychiatric drugs for 17 years and stopped the drugs by himself 3 years ago. He has high histamine intolerance, issues with brain fog and finding it impossible to think and concentrate. His brain is Much better since he started Gaps a few months ago. Still, he can’t eat vegetables or any fruit at all (only cucumbers) and has only animal foods. Finds all supplements unbearable, including vitamin C and all probiotics. He says everything makes him bloat and immediatly has a white cover on his tongue and sometimes has head aches.
    I think he has SIBO as well as histamins intolerance.
    What is your opinion on this? I don’t think I can persuade him to go to a doctor but who knows…

    • Author
      Patrick Nemechek, D.O. 3 years ago


      I believe the benefits that occur in autistic patients after starting any diet that restricts carbohydrates (GAPS, FODMAPS, gluten, casein, etc) is from a relative, non-specific decrease in the overall bacterial load within the gut.

      The bulk of gut bacteria thrive on carbohydrates, and a decrease in bacterial counts occurs with a decrease in dietary carbohydrates. As I see it, lower bacterial growth leads to a decrease in the production of propionic acid with a resulting improvement of symptoms.

      Inulin fiber has the particular effect of increasing the acidity within the small intestine lumen leading to a more specific decrease in propionic-producing colonic bacteria, and improves symptoms much more than commonly seen with the dietary restrictions. Rifaximin essentially clears out the propionic-producing bacteria via a direct antimicrobial effect.

      Most of the food intolerance and histamine issues you see are related to bacterial overgrowth in the small bowel and can completely resolve in younger patients with inulin and older patients with Rifaximin.

      Hope that helps.

  28. Liz 3 years ago

    Dr N.,
    after reading all about SIBO, it is obvious that my daughters and myself have this issue. I have started my oldest on your recommended 2 fiber choice dummies and nordic naturals supplements. What dose is appropriate for myself?

    • Author
      Patrick Nemechek, D.O. 3 years ago

      Fiber isn’t nearly as effective in adults and the omega-3 dose is much higher.

      You can read about my approach in some of my more recent posts.

      Dr. N

  29. Ben 3 years ago

    Hey Dr. N,

    Have you ever heard of bile reflux being an issue with someone with SIBO? While there are many medical explanations for bile reflux, yet for a patient with no gastric/abdominal surgery, no liver/gallbladder problems, or any other GI issues- would this be a possible explanation? Following the logic that GERD could be associated with SIBO due to what you explained in one of your videos, I could see it being so. A physician (head GI in academic Chicago hospital) once told me bile is completely normal in the stomach. I beg to differ. Any opinion?

    • Author
      Patrick Nemechek, D.O. 3 years ago

      I think SIBO is one of the things that could make bile reflux a problem.

  30. Anonymous 4 years ago

    Dr N, Do you know if SIBO can cause chronic anxiety and panic issues? I am curious as I have anxiety and panic issues for last 10 years with no full improvement from SSRI’s..

    • Author
      Patrick Nemechek, D.O. 4 years ago

      Yes, SIBO absolutely can contribute to anxiety and panic attacks. Usually it is a combination of effects, anxiety fromSIBO and anxiety from unresolved brain trauma that also cause anxiety. 2 separate sources of abnormal anxiety at the same time. See my screencast at on SIBO.

      Dr. N

  31. Stephanie Myers 4 years ago

    Dr. N

    My son’s 3 month prescription for heartburn was up and I had started him on the prebiotics you suggest a week or more before then. He hasn’t needed to go back on the medication. He has been vomiting way less and I started taking them and noticed my heartburn as well was decreasing. I’ve increased his fiber in take with the prebiotics but also in other ways and finally got him potty trained but still on 1.5 tsp of miralax/day. He just started 3 yr old pre k this week so I don’t want to wean him off miralax just yet but in the next few weeks. Any suggestions on doing that? Ive read many articles and going to do it slow but thought I’d ask in case you knew any tricks. Also curious how long you suggest taking the prebiotics. I’ve noticed he is SO much more pleasant and happy since starting those. Could be the combo with the pooping more regular and on the potty but I am so grateful I found your website and now follow you on Facebook. It’s been a blessing. Thank you.

    • Author
      Patrick Nemechek, D.O. 4 years ago


      I’m glad to her he (any you) is doing so much better. A response to inulin is an indication your both have SIBO.

      Keep him on the inulin fiber and be patient about the Miralax, and just slowly decrease the amount. You may want supplement with some some good quality omega-3 fatty acids from fish oil as these will help reverse any of the inflammatory stress the bacterial overgrowth caused. We discuss this in the autism post.

      Dr. N

  32. Stephanie Myers 4 years ago

    My son is 3 and it took me 1.5 years to figure out he had a egg allergy and one doctor says milk allergy the other says intolerance. He has had issues with constipation from day one that we still struggle with. He’s been on Miralax for 1 year and every time I try to wean, it fails. Also recently got him on acid reflux medicine that has helped so much with his issues with vomiting, coughing, sneezing etc. I’ve been trying to avoid the acid reflux trigger foods along with avoiding the allergies and it’s hard! I’ve done probiotics as well. I saw on your website to try Fiber One gummies for the natural source of prebiotic. I’m wondering if that will help him. I have a friend who is a Dietitian who has been the only one to help me associate his issues to repairing his gut. Ive also requested an appointment with a GI doctor but so far have done all this on my own with little help and assistance from his pediatrician and it’s exhausting, frustrating and so sad because I can’t explain to my child why he won’t stop throwing up “safe” foods and why he always has to have medicine to help him poop. I’m thankful I found this website. Actually shocked I haven’t found it before with all my research. Any assistance or advice would be appreciated!

    • Author
      Patrick Nemechek, D.O. 4 years ago

      I think he may have SIBO and if so the Fiber Choice could help a great deal. Let me now how things go.

      Dr. N

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