Why Do I Relapse After Taking Rifaximin
Efficacy of Rifaximin:
- Rifaximin effectively treats SIBO, with an 80-90% success rate.
- Patients often experience rapid improvement in GI symptoms, autonomic symptoms (like lightheadedness), and sometimes a reduction in anxiety within the first few weeks.
Reasons for Relapse:
- Relapses can occur quickly or after a long symptom-free period; they are often linked to events that slow down the gut, such as surgery, emotional trauma, or head injuries.
Underlying Issues with Motility:
- Chronic slow intestinal motility, possibly from previous brain injuries or persistent inflammation, is frequently a root cause for relapse when no specific event is identifiable.
Managing Relapses - The 'SIBO Fingerprint':
- The recurrence of initial symptoms, known as the 'SIBO fingerprint,' signals the need for another rifaximin treatment.
- Over time, with proper management including anti-inflammatory measures and stimulation of the vagus nerve, the interval between necessary treatments may extend as gut motility improves.
Distinguishing Relapse Types:
- Itβs important to differentiate between spontaneous relapses due to slow motility and those triggered by external factors like emotional stress.
- Repeated treatments with rifaximin may be necessary in case of relapses, and the medication remains effective despite these occurrences.
Dr. Nemechek underscores that rifaximin is working if initial improvements are seen and that relapses are part of the condition's nature, not a failure of the treatment. Regular monitoring of symptoms and subsequent treatments can help manage the condition effectively.