I've been prescribed Rifaximin, and while it seems that tinnitus is a low incidence with this drug, it seems, anecdotally, people with pre-existing tinnitus get a spike? I've taken my first this AM but going to stop if it spikes. Has your spike gone down yet?
Elemental diet would be my next step if this doesn't work. Pimentel has some great resources on SIBO in general.
I've read his book, and another SIBO book, tons of online resources, medical studies, etc. I've also consulted with 3 gastroenterologists, with another planned later this month. And two naturopaths, with another planned later this month. Before the last two years, I never went to doctors. Ear infection + cat bite and resulting antibiotics, which led to chronic gastro issues, have really screwed over a formerly very healthy person.
But anyway. I'm pretty obsessed with gastro health at the moment because my bloating and what I considered mild constipation led to upper airway reflux (LPR), in about 6 months. By the way, I also consulted a reflux expert -- literally the doctor who coined the phrase LPR -- she says this is much more common than most people think, and often has effects before people realize -- thus "silent reflux."
Anyway, the reflux can permanently damage hearing because it can get into the Eustachian tubes. I've had a few things lately that I think caused spikes (dental drilling and acupuncture). But I started thinking the reflux was the main problem because my tinnitus has been finally calming down until I ate breakfast one day this weekend, laid down immediately for a nap, then my tinnitus was raging soon after I woke up -- lying down too soon after eating worsens reflux so there was a clear connection.
The reason I mention all of this is most gastro doctors do not believe SIBO should be treated in the way that Pimentel and many naturopaths propose. The last gastro doctor told me that my bloating *might* be chronic constipation caused by antibiotics screwing up my microbiome and therefore my gut motility (she thought this even though I have bowel movements a few times a day-- the issue is whether there is "complete" evacuation). She says resolving the constipation could resolve the SIBO, if I don't actually have IBS.
She also said I don't need antibiotics.
I'm currently trying bowel cleansing supplements (Magnesium Oxide). This is a special brand. Anyway that might have caused a slight spike in my tinnitus but I'm pretty sure that will go back down. She wanted me to do a high dose cleanse, then maintenance doses of Magnesium Oxide "might be all you need." I'm just hoping the lower maintenance dose doesn't spike tinnitus. And that this works for bloating and constipation. She said if those go away, the reflux will eventually resolve on its own. (There were some differences because her opinion and the reflux doctor... I'm just trying to put them together to get a solution.)
As far as the Rifaximin, yes, that spike went down after a day or two. But I only took two pills. My guess is that any spike would go down -- but maybe take longer if you took more.
I consulted with a gastro doctor at "Planted Forward," if you wanted to hear another opinion.
I'm reserving judgment for whether SIBO is really something to treat. She said that I probably have SIBO but the root cause might be constipation -- which would remedy if I can fix that.
She was definitely pretty opposed to antibiotics for my symptoms. She said it's mainly naturopaths diagnosing SIBO, and Pimentel, who she said is smart but very controversial among mainstream gastro doctors.
But IF I were going to treat SIBO, I would do the elemental diet, *especially* if you have constipation because most supposed SIBO with constipation requires both Rifaximin and Neomycin, the second of which is known to definitely be ototoxic. But even Rifaximin, as important as these symptoms are to me, I would not take again. The elemental diet has equal success in treating it.
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