The Difference in Using Inulin vs Rifaximin for Bacterial Overgrowth (SIBO)

Hi, I’m Dr. Nemechek the inventor of the
Nemechek Protocol ™ and I want to talk to you a little bit about the use of inulin
versus Rifaximin (or otherwise known as Xifaxan in the United States), for the
reversal of bacterial overgrowth. So, many of you are familiar with my kind of
conceptualization of bacterial overgrowth. We understand that the
bacteria in the colon are very different fundamentally than the ones in the small
intestine. And furthermore, the concentration is very different, so for every one
bacteria by the stomach, you have a hundred million bacteria at the end of
the colon, and I’ve nominally just called these bacteria, the ones in the upper
intestinal tract “birds”, and the one in the colon “fish”, okay. And so, you have a
very different bacteria up here, very small numbers, very high numbers of
different bacteria down here. So, Inulin vs Rifaximin, alright. Inulin: what
that does is that, it’s, think of it as bird food, the bacteria that normally live up
here, because with bacterial overgrowth you have the “fish” bacteria living up
here, and now you have like a hundred thousand times the bacteria. Inulin feeds
the natural bacteria up here predominantly, alright, they produce
acids, these “fish” bacteria don’t like the acids, and through this fermentation
effect they regress, and so you get this separation of the bacteria, back more
towards normal. Now, in an adult this can help your intestinal symptoms some, it
might even make you feel a little bit better but in, the focus of my work
has been on trying to reverse chronic autonomic damage and inulin is
incapable of giving me enough of an effect there to actually get the brain
better. You can feel a little better but it’s not enough to help me get chronic
brain injury to recover, okay, I have to use Rifaximin for that case
and I’ll talk about that in a minute. In children under 10 (roughly), inulin does
a great job and it is enough to get the brain to start to recover. Now, then
between 10 – 20, or so, years of age it kind of shifts from the need of
inulin to Rifaximin. And why is this? I just
don’t know – that’s the honest answer. But on a practical level – now if I
have a kid say, who’s 14 on inulin, and they’re recovering very nicely and doing
well, I’ll leave them on there knowing though, it’s gonna quit working, you know,
at some point in time alright, and then we’ll eventually have to use
Rifaximin. So inulin is best in kids under 10, variable effect between 10 -20, and then over 20 – it doesn’t work – we have to use Rifaximin. Now, what’s Rifaximin? Rifaximin is a special antibiotic. It’s a very unique one –
it’s not like all the other ones that kind of damage the gut, alright.
Rifaximin’s been around for about 30 years. We’ve used it for a, predominantly,
for a liver condition called hepatic encephalopathy, and interestingly, this is
where you have the “fish” living up where the “birds”, in an adult with cirrhosis of
the liver, and there they produce a lot of ammonia and it makes people confused –
which is a parallel to autism, where you have the “fish” living where the “birds” are,
and they make a different chemical called propionic acid, alright. So there’s some parallels here. So we’ve used Rifaximin around
the world for about 30 years. Most of the adults who take it for this
condition have to take it twice a day, all year long, alrighty.
And the way this drug works is it has a couple features: 1) You don’t absorb any
in the bloodstream alright, which is good. Very few you know, limited side
effects. 2) Its only effective in the small intestine because of these things
called bile salts, and the bile salts are absorbed before they get to the colon so
the drug quits working in the colon, so the drug is only effective in the small
intestine, and it doesn’t get in the bloodstream at all. 3) It doesn’t harm the natural, you know, “bird” bacteria that normally live within the small intestine. 4) It only is targeted at the bacteria in the colon – but I just said it doesn’t work in the colon, it only works in the
small intestine – so in other words, those “fish” bacteria that normally belong in
the colon will only be affected if they’re up here, which is what we’re
trying to get rid of, alright. So in the Rifaximin you only have to take it
twice a day, for ten days – you don’t have to take it year-round, twice a day for
ten days. You sweep the “fish” bacteria out, you leave the “bird” bacteria behind, Voila –
you’re done! It is much more effective than most people think.
One of the reasons is, a lot of people think – “oh I took my Rifaximin and
I’ve still got some bloating, and some constipation” Well, those are actually autonomic symptoms, brain symptoms, not bacterial overgrowth symptoms. So it’s a different issue. Now, what about – why not use Rifaximin because it sounds stronger you know, it’s a medicine and all this kind of stuff,
why don’t we use those in kids? Well the advantage of inulin, over Rifaximin, is
that the inulin is much more durable if, say, a child needs some antibiotics for
an ear infection, alright. Because you’re taking it every day it helps
maintain this separation. If you use Rifaximin, if you HAVE to use Rifaximin, because you’re just old enough, or you didn’t get the response out of
inulin, alright, there’s nothing maintaining that, and now a course of
antibiotics, for instance, has the potential to cause relapse to happen
again – where you get bacterial overgrowth again – and you would have to
re-treat. Now, that’s not that big of a deal, but, if you can get away just with
inulin, you don’t have to worry about it, alright. Now, what about other fibers?
I don’t know, there may be other fibers out there? I’m a very practical guy. The
inulin works GREAT alright. It’s cheap. It’s readily available. So just stick
with the inulin. Don’t try to finesse it and coming up with
some other stuff, just keep the life, your life pretty simple. So, kids under 10 –
inulin is the way to go. Twenty years and older, you pretty much got to use Rifaximin if you want to get any degree of neurological recovery. And, between 10 and 20,
it’s kind of a variable transition, and you know, you can try inulin and start
there, and then if you get a response stay with it, if you don’t get a response
you step up to the Rifaximin alright. So this is Dr. Patrick Nemechek of Nemechek Autonomic Medicine in Buckeye, Arizona. Hope you find this
useful, bye.

33 Replies to “The Difference in Using Inulin vs Rifaximin for Bacterial Overgrowth (SIBO)”

  1. Thank you for explaining this so clearly. All your videos are very interesting and helpful. I am reading your book and also refer to your videos too.

  2. Does inulin need to be continued throughout the course of rifaximin treatment?
    Or follow on after rifaximin should rifaximin be needed?
    Many thanks.

    Your comments, Dr. Nemechek, on the use of the herbal products used in this study as an alternative to the antibiotic.

  4. After the 10 days for 2 x day of the Rifaximin, do you keep using it from time to time to protect yourself of relapsing for example using Rifaximin every 1-2 month or so for 10 days 2x a day?

  5. If an adult takes a course of antibiotics for a different issue, does he need to repeat the Riflaxamin to avoid relaps? Can Riflaxamin be taken multiple times throughout an adult life if necessary or once is sufficiently? Thank you

  6. I'm at the supermarket. Hellowater has 5g of inulin in each bottle. My son is eight with ADHD. I'm going to try this on him.

  7. Dr nemechek, I just bought your book hoping that it can help with my SIBO , what is the 1 most important advice you can give to restore peristalsis and migrating motor complex after damage by fluoroquinolone?

  8. I’m very very cautious about taking anything called an anti-biotic. I feel it will throw me back, perhaps by years, in my quest to balance my gut. (A lot if sacrifice and hard work I‘m not willing to squander lightly)

    What should I watch or read to convince me Rifaximin won‘t have unintended consequences?

  9. I do have IBS. I asked my doctor if he can give me rifaximin and one anti-fungal medicine but instead of giving me rifaximin and anti-fungal. He gave me Cipro 500 mg but I did not use cipro it is very dangerous one. Thank you doctor love you

  10. why do you think you get sibo after abx?..its alot more sense you mess up small bowels microbiota kill some good guys and bad strains are overgrowing from that microbiota. or colonic bacteria going up its still same thing…still bad overgrowth

  11. Hi! I'm reading your book and it's been a lot of help! I wanted to ask you what do you think about using inulin in a person with candida overgrouth? Becaus inulin feeds candida too. Could it be better if combined with a biofilm disruptor and antifungals? And what do you think about treating SIBO with antibacterial herbs? Thanks!!

  12. Hi, my son is 6 diagnosed – Global Development Delay with autistic traits. Mood issues, behaviour issues, NON verbal, drools, crys screams nearly ever day, coordinational issues, dummy, nappies zero toilet, flapping obsessed washing machines, frightened in new situations. These are lower but still there – mouth ulcers, self harm – head banging – hitting head with hands, reflux, used to be constipated.. He's in main stream school slower development compared to his peers. Things done bravo probiotics, b12 methylcobalamin, gluten dairy free, microbiome test ubiome. I believe his condition is gut related. I've come across sibo this could be his issue solution Nemechek protocol? Any tests Information looking to network?

  13. Greetings from Venezuela! Dr. My 7-year-old daughter with grade 2 or moderate ASD was prescribed by the pediatrician 400 mg of rifaximin: 200 mg in the morning, 200 mg at night for 10 days without using inulin before. After 10 days he prescribed 1/8 teaspoon of inulin, olive oil and Omega 3, but then I saw in a Facebook group that it should not be given inulin if rifaximin was given, so I suspended it and only got it to give for 4 days. What is your recommendation? Please

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