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I m suffering of I B S as Dr told me. As he suggested, I m taking "Refraximin 200" twice a day since apx last 8 months. If I discontinue in between
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Digestive Health
Question #10463
267 days ago
366

I m suffering of I B S as Dr told me. As he suggested, I m taking "Refraximin 200" twice a day since apx last 8 months. If I discontinue in between - #10463

Prakashbhai shah

Is it advisable to take/continue "Refraximin 200" an antibiotic for prolonged periods or life long ? I m afraid of it's side effects, but couldn't stop it as symptoms again develops immediately. Pl explain me deeply. Iff possible, suggest me for alternate remedy having no adverse side effects.

Age: 72
Chronic illnesses: prakashbhaishah53@gmail.com
Stomach ache
Indigestion
Gastric problems
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Doctors' responses

Dr. Shayeque Reza
I completed my medical degree in 2023, but honestly, my journey in healthcare started way before that. Since 2018, I’ve been actively involved in clinical practice—getting hands-on exposure across multiple departments like ENT, pediatrics, dermatology, ophthalmology, medicine, and emergency care. One of the most intense and defining phases of my training was working at a District Government Hospital for a full year during the COVID pandemic. It was chaotic, unpredictable, and exhausting—but it also grounded me in real-world medicine like no textbook ever could. Over time, I’ve worked in both OPD and IPD setups, handling everything from mild viral fevers to more stubborn, long-term conditions. These day-to-day experiences really built my base and taught me how to stay calm when things get hectic—and how to adjust fast when plans don’t go as expected. What I’ve learned most is that care isn't only about writing the right medicine. It’s about being fully there, listening properly, and making sure the person feels seen—not just treated. Alongside clinical work, I’ve also been exposed to preventive health, health education, and community outreach. These areas really matter to me because I believe real impact begins outside the hospital, with awareness and early intervention. My approach is always centered around clarity, empathy, and clinical logic—I like to make sure every patient knows exactly what’s going on and why we’re doing what we’re doing. I’ve always felt a pull towards general medicine and internal care, and honestly, I’m still learning every single day—each patient brings a new lesson. Medicine never really sits still, it keeps shifting, and I try to shift with it. Not just in terms of what I know, but also in how I listen and respond. For me, it’s always been about giving real care. Genuine, respectful, and the kind that actually helps a person heal—inside and out.
267 days ago
5

Rifaximin is not meant for lifelong use. Cyclic therapy with probiotics and diet correction is safer and more sustainable If symptoms persist, a gastroenterologist consultation is essential for targeted therapy (e.g., motility agents, bile acid binders, etc.)

Not advisable for lifelong or very prolonged use without re-evaluation May alter gut microbiota, potentially leading to:

Resistance Fungal overgrowth Nutritional imbalance Risk of relapse after stopping suggests underlying chronic issue (likely SIBO, IBS-D, etc.)

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Dr. Neeraj Agarwal
I’m an MBBS graduate with a deep commitment to providing meaningful, patient-first care. My clinical training has given me a solid understanding of how to assess and manage a wide variety of health conditions—both common and complex. But beyond just clinical skills, I’ve always believed that the heart of medicine lies in listening. That’s what I try to bring into every consultation: not just treatment, but genuine attention to the person in front of me. I have gained experience across general medicine, paediatrics, emergency care and preventive health. I have treated patients of different age groups and backgrounds, which has helped shaped a more flexible, to diagnosis and management. Whether someone comes with a new symptom or a routine check-up, I aim to deliver evidence-based treatment, explained clearly and tailored to the lifestyle. I’m especially focused on making care accessible and comfortable. Too often, patients feel rushed or confused when they leave a doctor’s office—I try to do the opposite. Taking time to explain options, risks, or even just what’s going on in simple terms is something I take seriously. Communication, I think, is just as important as any prescription. I actively stay updated with current medical guidelines and research, and I’ve been exploring areas of holistic care and preventive medicine too. The more we can do to catch problems early—or better yet, avoid them—the better the outcome for everyone. I’ve seen how small lifestyle changes, when supported properly, can make a big difference to long-term health. There’s still a lot to learn, of course. I think every good doctor keeps learning. But every patient I see teaches me something new, and I carry those lessons forward—with honesty, empathy, and the intent to keep improving.
267 days ago
5

Rifaximin is NOT safe lifelong — even if “mild,” it can cause resistance and gut imbalance

Recurrent symptoms suggest underlying SIBO/IBS or motility issue

Long-term plan should include:

Short bursts of antibiotics (if needed) Probiotics + gut motility agents Diet + herbal options Re-evaluation of cause

Why Symptoms Return When You Stop It? This usually means there’s an underlying problem that’s not being addressed, such as:

SIBO recurrence due to: Poor gut motility (e.g., post-infection, diabetes, hypothyroid) Structural issues (adhesions, diverticula) Diet triggering regrowth (high fermentable foods)

Alternative

Prokinetics (improve gut movement)-Levosulpiride Probiotics Dietary therapy- Low FODMAP diet, lactose-free, avoid fermentable sugars Herbal antimicrobials (safer for long term) Berberine, Neem, Oregano oil

Stress & gut-brain axis: Yoga, meditation help IBS/SIBO flare-ups

Post-meal walking: Stimulates peristalsis

Spacing meals by 4–5 hrs: Prevents constant fermentation

Sleep and hydration: Influence gut motility

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Rifaximin, commonly used for irritable bowel syndrome (IBS), isn’t typically meant to be taken indefinitely. Extended use of antibiotics generally raises concerns about resistance, alteration of gut flora, and other side effects, so it’s crucial to reassess long-term use. Continuous reliance on rifaximin might indicate its role in maintaining symptom relief but it’s also necessary to consider alternative modalities and a broader management plan for IBS. It’s worth discussing potential alternatives with your healthcare provider. They might explore options like dietary adjustments to identify exacerbating foods — a low FODMAP diet is often recommended. This diet focuses on reducing specific carbohydrates that could potentially worsen symptoms. Probiotics are another avenue, where strains like Bifidobacterium and Lactobacillus might help balance gut flora, though the efficacy varies individually. Stress management techniques, such as mindfulness or cognitive behavioral therapy, are also shown to benefit IBS symptoms, since stress can influence gut health. Additionally, ensuring you have a diverse and balanced diet, adequate sleep, and regular physical activity can support gut health. It’s best to engage your doctor to regularly monitor and adjust your treatment plan, assisting your transition to approaches that minimize antibiotic dependence. Ultimately, a comprehensive plan that incorporates lifestyle changes, dietary adjustments, and psychological wellbeing, in consultation with your physician, is key. If symptoms persist despite such modifications, revisiting your therapeutic strategy with your healthcare provider is advised to avoid potential complications from unchecked IBS progression or antibiotic overuse.

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