I am about to end my 8-week protocol for eradicating SIBO so I’m back with a SIBO status update.

The last time I checked in was early July, right after I finished 28 days of Rifaximin. This was Life After SIBO Antibiotics.

I still maintain the position that I am done with the antibiotic for a very, very long time.

SIBO Status Update via sarahkayhoffman.com

SIBO Status Update

From the Life After SIBO Antibiotics post, these are the 7 things I said I would be doing:

  1. A fairly strict diet of Low-FODMAP + SCD + Paleo/Primal.
  2. Siebecker Herbs.
  3. HCL, HCL, HCL. 8 pills until I can get to 7, then 6, then 5, then 4, then….
  4. Apple Cider Vinegar every chance I get. (Along with many of the other things to increase stomach acid production.)
  5. Digestive Enzymes mainly if I eat starch.
  6. No tracking.
  7. Misc. supplements. I’m trying a few new ones to continue the gut healing process.

And here is how I’m doing with each of them:

  1. This one I never intended to start until after I finished #2, the full 8-weeks and the Siebecker herbs. So with that, in the coming days, I’ll scale back on all the FODMAPs, while being cognizant about how much, how often and the quantity at any single sitting on foods that are not SCD/Paleo.
  2. Nailed it. It was a chore taking them, 3 x’s per day, but I did it. In fact, if I relapse again, I might just try a round of these vs. even considering the antibiotic(s).
  3. I’m not eating as much meat and heavy protein meals these days (due to more variety) so the need to take them constantly has diminished. When I do, though, I’m still at 8 per sitting.
  4. I have been really good at incorporating Apple Cider Vinegar, and I think about the amount of stomach acid I’m producing daily. It just has to get better.
  5. I am finally taking the enzymes for meals that might require it. I believe they really help, but I also don’t believe that we should become dependent on them.
  6. No longer tracking has been a saving grace. It has given me so much peace and solitude for this journey.
  7. I take the Iberogast + Restore daily. I am constantly looking for other things that, without being a burden, will help me continue to heal.

Additionally, I have been practicing meal spacing (to help with motility). These days I tend to eat more of a lot of different foods at each sitting and then wait at least 4 hours until I repeat it all again. This one is sort of a catch 22 since I also have adrenal fatigue and I don’t believe that going too long without eating is an optimal healing approach for AF. But I do believe it’s right for SIBO, and quite honestly, SIBO is really the only thing that can make me feel absolutely miserable so my main priority and focus is on keeping SIBO at bay and healing my gut for good.

Finally, during these past 8 weeks, I have been experimenting with workouts and how they affect my everyday. In the rules of running, I told you that I didn’t think running makes SIBO relapse. I would still argue this, but what I learned is that when I run, I don’t know how to just run. In other words, even if I haven’t run in months, I tend to go all out. I’ll run fast and/or long, and in doing so, my SIBO seemed to flare on those days (and the couple days that followed).

But I’m absolutely not just picking on running. What I also learned is that this same thing applies for any and all workouts I do that are super intense and/or span for too long.

I am (currently) desperately seeking my perfect workout place and limitations. I am thisclose to being there. If you want the truth, here is what I think that looks like:

  • 1-2 days of 2-3 “cardio” circuits (about 5-8 minutes in duration each circuit) = not to exceed 20 or 30 minutes
  • 1-2 days straight lifting (I am currently working through Nia Shanks’ Lift Like a Girl program, and even though it’s for “fat loss,” that is not my goal. In fact some of the fat loss pieces, I skip. But her workouts are killer, sane and I can do them in our home garage we have been building.) = rarely exceeds 40 minutes
  • 1 day of Bikram Yoga (I have yet to start this.) = 90 minutes
  • Walking, walking, walking

Honestly? 3 days a week is probably the right amount, nothing more and nothing less (except for the daily walks, which are amazing for everyone, all the time).

SIBO Status Update: Is it All Working?

And for me, all of this is working really, really, really well. On day 14 of the antibiotic, all SIBO symptoms and misery lifted. That was about 6 weeks ago, and I am still on this high.

My bloat is 100% gone.

I am going to the bathroom like a completely “normal” person (well, with all the gut issues these days, there is no such thing as “normal”).

My energy is awesome!

I don’t constantly want to cry and crawl into a small hole.

So yes, yes it’s all working.

I pray that I can keep on this path.

And, of course, I will always pray the same for you.


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  1. Thank you for this update – wish it wasn’t your last as I was just diagnosed 2 weeks ago with SIBO but I will continue to visit your website and follow you on Instagram as I am a sister in Christ! God Bless You and thank you for your blogs

    1. Hi, Kate! Thanks for reading. There is a *ton* of SIBO information on my site if you search around:) I will continue to talk about healing, but just not the “how to do it” here, and more the inspiration behind it and living with it. That said, YES, I will still share more of the dailies and “how to’s” via my FB page, the newsletter and my next e-book:) Xo

  2. what is your opinion on the length of course of rifaximin. My doctor wont go over 10days 1650mg, because he says it will destroy my guy. However, everyone i read about has a reucurrence of sibo, and many have become immunte to rifaximin after trying multiple 10day-2week courses. I then read an theory from someone, sayhing they wish they jus did like 4weeks at once, because 2weeks didnt cure it enough. Recently i saw dr. Russio* i think his name is, talking about a study which shows patients respond better to 4-8-12 weeks of rifaximin. So at this point, idk what to do.

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