SIBO and J Pouch

I have had my J Pouch for 26 years. I have had 3 bouts with pouchitis in the first 15 years. I have been having bloating, vomiting, diarrhea, abdominal pain, weight loss & gain for 2 1/2 years. After being tested for gastroparesis and numerous other tests, it was determined I had small intestinal bacteria overgrowth. After antibiotic treatment, I was good for 4 months. Now its back and my gastrointestinal doctor said its back and has ordered another round of antibiotics. 

My questions are - is this going to be a lifelong illness, does anyone with a J-Pouch have simular problems, and will a low FODMAP diet be okay long term?

Thanks for any help. 

Original Post

How long was your first antibiotic treatment? SIBO is often treated with a three-month course of antibiotic. I used doxycycline, and managed to get through a bit over two months before the bellyache side-effect caused me to declare success. If undertreatment (too short a course of medication) is the reason you’re having a recurrence then there’s no reason to fear a life-long affliction. A low FODMAPs diet should be perfectly okay forever, if that’s what you choose. Whether it will be the thing that prevents SIBO from recurring is a tougher question.

Good luck!


My treatment was in Late August into September. I started having symptoms again late January of this year. It was last week that the symptoms got to be too much to handle. I have to wait for insurance to decide if they are covering the expensive medication. I hadn't tried a low FODMAP diet but am willing to start now.


The expensive medication must be Xifaxan (rifaximin). It’s really not the only antibiotic that can help, but it sure is the most expensive one. Even Xifaxan is sometimes stopped too soon. If the insurance company turns you down for Xifaxan you can ask your doctor about other choices.

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