One hundred and four patients who tested positive for newly diagnosed SIBO by lactulose breath testing (LBT) were offered either rifaximin 1200 mg daily vs herbal therapy for 4 weeks with repeat LBT post-treatment. The objective was to determine the remission rate of SIBO using either the antibiotic rifaximin or herbals in a tertiary care referral gastroenterology practice. A growing number of patients are interested in using complementary and alternative therapies for their gastrointestinal health. Present treatment of SIBO is limited to oral antibiotics with variable success. Patients with small intestine bacterial overgrowth (SIBO) have chronic intestinal and extraintestinal symptomatology which adversely affects their quality of life. 9 The Johns Hopkins Hospital, Department of Internal Medicine, Division of Gastroenterology, Baltimore, Maryland (Dr Mullin), United States.8 The Johns Hopkins Hospital, Department of Internal Medicine, Division of Gastroenterology, Baltimore, Maryland (Mr Tomakin), United States.7 Trinity Health Center-Department of Internal Medicine-Division of Gastroenterology, Minot, North Dakota (Dr Justino)., United States.

6 The Johns Hopkins Hospital, Department of Internal Medicine, Division of Gastroenterology, Baltimore, Maryland (Dr Koh), United States.5 University of Texas Southwestern, Department of Internal Medicine, Division of Gastroenterology, Dallas, Texas (Dr Dunbar), United States.4 The Johns Hopkins Hospital, Department of Internal Medicine, Division of Gastroenterology, Baltimore, Maryland (Dr Roland), United States.3 The Johns Hopkins Hospital, Department of Internal Medicine, Division of Gastroenterology, Baltimore, Maryland (Dr Clarke), United States.2 The Johns Hopkins Hospital, Department of Internal Medicine, Division of Gastroenterology, Baltimore, Maryland (Dr Dhalla), United States.1 University of Pittsburgh Medical Center, Department of Internal Medicine, Pittsburgh, Pennsylvania (Dr Chedid), United States.

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