All About Prokinetics for SIBO (PREVENT SIBO RELAPSE)

[@ConfluenceNutrition]

Thanks for watching! Do you have a question about prokinetics I didn't answer? Please ask here! And remember, if you're needing help resolving your IBS or SIBO, this is exactly what I help clients with inside my Calm Digestion Method program. You can book a free discovery call at confluencenutrition.com/contact to learn more.

[@gutmicrobiomequeen]

I'm really surprised you didn't talk about *herbal prokinetics* 😥There are so many great options!

[@ConfluenceNutrition]

Hi there Dr. DiNezza, it's just that I truthfully haven't seen them be very effective, and my ND, who treats a lot of patients for SIBO reports the same to me. But I would absolutely be open to hearing more about your perspective, and specifically what you've seen work well in practice with your clients. Many of my clients really don't want to use medications. Thanks for watching!

[@gutmicrobiomequeen]

@@ConfluenceNutrition it seems that the key is a bit of trial and error. When I initially tried prokinetics with my patients it was a big flop. But then, a few years ago, I started doing what I call "prokinetic speed dating." I've been collecting data on this for a few years with my patients and students and it works phenomenally! In doing this, I have found that 98% of IBS and SIBO patients respond well to at least one of the herbal prokinetics 😀

[@gutmicrobiomequeen]

@@ConfluenceNutrition I made a video about this (and my data collection) in the summer of 2020 🥰

[@ConfluenceNutrition]

@@gutmicrobiomequeen got it, love this idea of prokinetic speed dating!

[@ConfluenceNutrition]

@@gutmicrobiomequeen will check that out.

[@fredacharbel7510]

No one ever explain so thoroughly like you! And I am so great full to all the effort you put in! And I am very lucky to have found your Chanel! 🙏🏻🥰🥰

[@ConfluenceNutrition]

Thank you so much, Freda, I'm glad I'm helping you :)

[@missing1person]

You are a treasure. Thank you

[@ConfluenceNutrition]

Thank you so much for your kind words, and also for watching :)

[@marienovak3663]

Wich one is the best procanitake

[@michellebercoff1505]

Hi! I have a question. I used to take Mosapride (because one of my main SIBO sympthoms is nausea and delayed gastric emptying). It worked pretty well for me. But I relapsed. Now I did my 3rd round of antibiotics, while taking Prucalopride (because I also suffer from constipation). Can I take Mosapride before meals, as I used to, and Prucalopride before bed? Thank you so much.

[@andreamolinari8068]

Can we take escitalopram (I’m so depressed), and prucalopride? One is anticolinergic the other colinergic. But escitalopram helps me with my anxiety/depression of all this overwhelming situation.

[@MrIulianpt]

Hi. What about Domperidone? Regards

[@77gataloca]

My body got tolerant to Motegrity where it no longer works, then I tried Low Dose Erythromycin and I'm back to being constipated again. I'm afraid of getting Sibo back because the root cause of my Sibo was slow gut motility. What can I do? I also have gastritis so I can't do natural herbal formulas that use ginger.

[@ConfluenceNutrition]

Hi there, the key is to figuring out why you have slow motility in the first place. There can be a lot of reasons for this. Commonly, it can be scar tissue/adhesions from surgeries or injuries, history of food poisoning which can cause autoimmune damage to the small intestine, low stomach acid, and more. Do any of those resonate?

[@77gataloca]

@@ConfluenceNutrition I was taking a bowel formula with Cascara Sagrada for awhile after I stopped taking it, I had permanent constipation. I still need to know what I can do for a prokinetic when Motegrity stops working.

[@ConfluenceNutrition]

@@77gataloca this is a tricky situation. As a practitioner, I'm wondering what the root cause of this slow motility is, and would want to focus my efforts there. In terms of relief care, sometimes something as simple as magnesium citrate or vitamin c can be very helpful but not for all. This video has a little bit more...kzbin.info/www/bejne/pJiWlX2Eppqlpa8

[@77gataloca]

@@ConfluenceNutrition I used to do Mg Citrate as well as Vit C for constipation but they do nothing for Sibo. Now that I have gastritis I can't do either one of those. I think the root cause of the slow motility is the Cascara Sagrada did permanent damage to my intestines.

[@ConfluenceNutrition]

@@77gataloca definitely a challenge...it may be just a matter of "speed dating" motility agents to find which work best for you. If you develop tolerance easily, you may need to rotate them regularly...sorry I can't be of more help.

[@kiki-oh7hi]

Love your hair, Amanda! Much needed video and thank you. LDN was going pretty well for me, but I did have to stop for a bit due to a contraindication with another (temporary) med. I tried Motegrity but it resulted in terrible gas.

[@ConfluenceNutrition]

Hi Kiki, thanks for the compliment! And that's interesting about the Motegrity. I'm not sure how or why that would happen, but I suspect it has something to do with serotonin! Hope you're well!

[@jujuapple6706]

Have u tried Fixbiome and Fixsibo line? They have a prokinetic herbal.

[@ConfluenceNutrition]

Hi Juju Apple, I just took a look at these products. The motility product is simply herbal/essential oil antimicrobials. I'm not sure how these are intended to help motility. These are new products, and as far as I can tell, given what I know about the SIBO research, the active ingredients in these products are not reported to help SIBO. I'm open to being wrong, and I'm curious to learn more from the company, but I don't see how their prokinetic would work.

[@alejandrabuchelli]

How long should I take Reglan or any other prokinetic? Should I take it before meals or at night?

[@cframes]

I haven't seen any mention of Artichoke extract in the video or comments. Many of the natural prokinetics contain Artichoke extract as the main ingredient. How do you feel about this in comparison to prescription options? Does it work as well as ginger?

[@ahlaali7934]

Do you know what could help with chronic trapped gas? I tried everything but I always have trouble burping or passing gas! Tried gas x and miralax and still have a ton of trapped gas especially in my chest area! Thank you.

[@kiki-oh7hi]

I have this problem too! Thanks for asking!

[@ConfluenceNutrition]

Hi Ahla, I like to think about this question by wondering what's happening upstream. And in my mind, this leads me to wonder what you are eating that may be leading to excess gas. What is your diet like?

[@ConfluenceNutrition]

@@kiki-oh7hi I know that you, Kiki, are likely already eating a very healthy diet, but the same question I asked Ahla goes...thinking upstream, what is your regular diet made up of?

[@ahlaali7934]

@@ConfluenceNutrition I am eating the same kind of food I was eating for years. I am a picky eater and afraid of trying new foods. However; this issue started months ago! There were days when I didn’t even eat for days and I still had gas putting pressure on my chest. My diet consist of carbs usually.

[@ConfluenceNutrition]

@@ahlaali7934 have you had a recent case of food poisoning?

[@philroberts8146]

Do you recommend probiotics during antibiotic treatment?

[@omniortiz1963]

What about Linzzess? what can you tell us?

[@ConfluenceNutrition]

Linzess apparently works by increasing the secretion of chloride and water into the bowels, and so is not really considered a prokinetic for the purposes of reducing SIBO relapse. It is, however used to soften stools and increase bowel movements for people with constipation. Different mechanism. Again, the intended effect of the prokinetic is to enhance and increase the natural cleaning waves in the small intestine.

[@omniortiz1963]

@@ConfluenceNutrition Thanks

[@ConfluenceNutrition]

@@omniortiz1963 You're welcome :)

[@kevinjoseph517]

I wake in morning with lots of gas. why?

[@ConfluenceNutrition]

What do you eat at dinner time, what time do you usually eat dinner, and what time do you go to bed?

[@brandonmcclendon9327]

do I have to be on prokintec forever or just a short period of time ?

[@rosegraham7045]

Where do you order digestzyme?

[@ConfluenceNutrition]

Hi Rose, it is available in my online dispensary, I'm not sure where else one could find it. Here's a link to my dispensary, if you'd like to check out the product there. You will have to create an account to see the product. us.fullscript.com/welcome/confluencenutrition

[@emilysakuma]

I used motil pro and it seemed to work for a while but then after a couple months it no longer seemed to have any effects. Does the body just get used to prokinetics?

[@ConfluenceNutrition]

Like any medication, it's possbile to build up a tolerance. Sometimes doing a pulsed dosing can help with this, if okayed by your doctor. My ND often suggests using medications and supplements 5 days on, 2 days off, or alternating days, or varying the doses of things, depending on the medication to help with this. Also, after a few months, it is worth coming off the medication (with your doctor's ok) to see if you still need it. I hope that helps!

[@lucalorenzo7065]

Which one is the best prokinetics after antibiotics sibo treatment?

[@davidbell6164]

Prucalopride .5mg 4hrs after eating at night

[@ConfluenceNutrition]

There's no one "best" one, it will depend which one works for your body...if you need help, discuss with your doctor, ND, or other health professional.

[@pablohidalgo798]

Just use ginger. Does it serve as a prokinetic?

[@ConfluenceNutrition]

Ginger is indeed a prokinetic, and the MotilPro product active ingredient is ginger. However, many people get heartburn from the dried ginger supplement, and you would need to eat a very high amount of fresh ginger to get a therapeutic effect. When I asked my Naturopath the same question, since I didn't want to to take a medication if I could help it, she said she didn't see the same effect with the herbal supplements. Basically, they are less effective, and provide less relapse-free time than medications. Each person will have to decide how to navigate that process on their own.

[@yorrgh]

Are prokintetics also prescribed during your Rifaximin treatment or is it always encouraged to be post treatment? Are probiotics also related to a post treatment with prokinetics? Thanks a lot!

[@ConfluenceNutrition]

Prokinetics are always in between or after treatments for SIBO. Probiotics are recommended on a case by case basis. Some people don't tolerate them, even after treatment, while others do well on them. I always advocate for my clients to listen to their bodies to know which path is right for them.

[@xeniahernandez9535]

I am on motilpro after SIBO treatment but I don’t feel it working at all! I am so bloated and it’s causing me to be constipated sometimes. What’s another natural prokinetic that I can try? I don’t know if the ginger is causing me to feel inflamed

[@ConfluenceNutrition]

Have you retested your SIBO levels after treatment? Keep in mind that not everyone tolerates every supplement. Sometimes you need to trial different things to find the right perfect option.

[@lindapelle8738]

I heard from others, that they get constipation from multiple pro, which is not good for me, since I have a paralyzed: after food poisoning, and nothing works. Unfortunately, I did buy the motilPro not knowing this before hand.

[@xeniahernandez9535]

@@lindapelle8738 have you tried any other motility agent? I actually decreased the dose of the motilpro because I was taking the highest dose. I feel so much better now that I decreased the dose and no more contipation

[@xeniahernandez9535]

@@ConfluenceNutrition i can’t afford to get retested right now. :( I’m deff feeling better and I noticed a difference (positive) after treatment.

[@ConfluenceNutrition]

@@lindapelle8738 Hi Linda, one could really say the same about any supplement at all. We never know how a person will react. This is why I teach my clients a method for starting new supplements, so they can see how that supplement affects themselves. You might not experience constipation from it, even though your friend did.

[@zahra9075]

Whats safe to use if somene is on anti depressants?Also how do you know if prokinetic works?

[@ConfluenceNutrition]

It will ideally be one of the medications or a supplement that does not contain 5-HTP, as this is sometimes contraindicated for use with antidepressants. You know the prokinetic is working if you continue to maintain your SIBO symptom relief, and have normal bowel movements.

[@zahra9075]

thank you for your response.@@ConfluenceNutrition

[@AmzMusic11]

Hi, im half way through my 8 week course of antimicrobials to treat methane sibo. (Oregano and Allicin) i'm not seeing any difference to my main symtom of bloating. (No pain). Would it be okay to start prokinetics now or should i wait till the oregano and allicin are finished?

[@ConfluenceNutrition]

Hi there, typically the recommendation is to use them only between treatment courses and after. It can take longer with the herbs to see noticeable relief...but if there really was no improvement, this would suggest there is a separate cause.

[@AmzMusic11]

@@ConfluenceNutrition Thank you so much for responding. Over the last few days I've actually seen quite a big difference just by changing one thing...meal spacing! I now only have breakfast lunch and dinner and this has really improved my main symptom of bloating. I'm going to stick with using the prokinetics just after my treatment now which finishes on aug 22nd. Hopefully they will help with the last bit of bloat I have remaining. 🙏🤞

[@ConfluenceNutrition]

@@AmzMusic11 great work figuring out what really makes a difference! Meal spacing really can encourage gut motility, and it's free! Good luck!

[@raewise6345]

I am following Dr Rajsree protocol for treatment. (She follows Dr Alison Seibecker >Dr Mark Pimentel) Prokinetics are used the entire time. Before, during and after the "kill phase"😊Most of these experts advise to use them long term, as well.

[@abhinavvenkat3269]

Hai madam, I'm Abhinav lives in india.im suffering from ibs diarrhoea from past 2years, recently i did hydrogen breath test it was negative (normal).but I had sibo symptoms,I'm confident I'm thinking I had hydrogen sulfide sibo,but in India there is no gas test for methane and hydrogen sulfide.i watched your videos and Dr mark pimentel videos , i want to use rifaximin 550 mg and busmuth,where should I buy in india.i don't the drug names in india.please help me.and the worst thing in Indian doctors are saying that they don't know sibo,and they saying ibs is causing due depression and stress it's very annoying me.what should i do

[@ConfluenceNutrition]

Hi there, I'm not sure where you can find these drugs in India, or how you're able to access them. The drug is called rifaximin. You can ask at your pharmacy. For specific treatment protocols, check out siboinfo.com, and use the info there to request the needed prescriptions from your doctor.

[@abhinavvenkat3269]

@@ConfluenceNutrition TQ

[@ConfluenceNutrition]

@@abhinavvenkat3269 you're welcome :)