u/Imaginary-Buy-6676

Hey everyone, looking for some advice or shared experiences from anyone who’s used Traditional Chinese Medicine (TCM) and acupuncture for gut and anxiety issues.

I started seeing a TCM practitioner back in October last year (so about 10 months now) specifically to address SIBO (Small Intestine Bacterial Overgrowth), along with high stress and anxiety.

The Progress So Far:

• What’s improved: My burping has decreased quite a bit, and my bowel movements are definitely more regular.
• What’s still lingering: My tongue is still consistently coated white, I’m dealing with heavy fatigue, my anxiety/stress is still lingering, and my gut makes a lot of digestive noise/gurgling.

The Herbal Formula Conundrum: Since day one, my practitioner has kept me on the exact same two herbal formulas:

• Xiang Sha Yang Wei Wan (typically for warming/strengthening the Spleen/Stomach and transforming dampness/stagnation)
• Jia Wei Xiao Yao Wan (typically for clearing Liver Qi stagnation, Heat, and supporting Spleen)

Here’s my dilemma: whenever I try to taper off or stop taking the pills, my symptoms flare back up and I feel worse. So they are clearly doing something to manage the baseline, but I really don’t want to be reliant on taking these exact same pills every single day forever without making further actual progress.

My Questions for the Community:

1. Is it normal in TCM to stay on the exact same herbal formulas for 10 months straight? My understanding was that as the body shifts, the formulas usually adapt to target the remaining pattern (like the persistent white tongue coating/fatigue).
2. Has anyone with SIBO/gut issues successfully transitioned off long-term herbal maintenance, or modified their protocol to hit that last layer of stubborn fatigue and dampness?
3. Should I bring this up directly to my practitioner to ask for a custom or modified formula, or is it time to get a second opinion from another practitioner or functional medicine doctor?

Would love to hear your thoughts, experiences, or any questions I should be asking at my next appointment! Thanks in advance.

Hey everyone, looking for some advice or shared experiences from anyone who’s used Traditional Chinese Medicine (TCM) and acupuncture for gut and anxiety issues.

I started seeing a TCM practitioner back in October last year (so about 10 months now) specifically to address SIBO (Small Intestine Bacterial Overgrowth), along with high stress and anxiety.

The Progress So Far:

• What’s improved: My burping has decreased quite a bit, and my bowel movements are definitely more regular.
• What’s still lingering: My tongue is still consistently coated white, I’m dealing with heavy fatigue, my anxiety/stress is still lingering, and my gut makes a lot of digestive noise/gurgling.

The Herbal Formula Conundrum: Since day one, my practitioner has kept me on the exact same two herbal formulas:

• Xiang Sha Yang Wei Wan (typically for warming/strengthening the Spleen/Stomach and transforming dampness/stagnation)
• Jia Wei Xiao Yao Wan (typically for clearing Liver Qi stagnation, Heat, and supporting Spleen)

Here’s my dilemma: whenever I try to taper off or stop taking the pills, my symptoms flare back up and I feel worse. So they are clearly doing something to manage the baseline, but I really don’t want to be reliant on taking these exact same pills every single day forever without making further actual progress.

My Questions for the Community:

1. Is it normal in TCM to stay on the exact same herbal formulas for 10 months straight? My understanding was that as the body shifts, the formulas usually adapt to target the remaining pattern (like the persistent white tongue coating/fatigue).
2. Has anyone with SIBO/gut issues successfully transitioned off long-term herbal maintenance, or modified their protocol to hit that last layer of stubborn fatigue and dampness?
3. Should I bring this up directly to my practitioner to ask for a custom or modified formula, or is it time to get a second opinion from another practitioner or functional medicine doctor?

Would love to hear your thoughts, experiences, or any questions I should be asking at my next appointment! Thanks in advance.

Having difficulty finding a PER answer, could someone help please.

I have submitted an employment and that entry now says 'submitted for sign off'. Is that now with the manager? (or do I have to submit my full PER before anything goes for approval?)

I've frustratingly tested positive for H-pylori after successfully erradicating it 5 years ago.

Last time I minimised symptoms of antibiotics with prebiotics and probiotics. I now have SIBO in the mix (methane/hydrogen) and don't want to complicate or flare things - my question is are there any probiotics that could help? I'm reading I could try s.boullardi as it's a yeast, but to start small incase it flares SIBO, and PHGG if I start very small.

Really need help and advice please 🙏.

I successfully erradicated h-pylori years ago (confirmed via endoscopy and stool tests).

However, it's back.

I've been trying to manage down my SIBO numbers recently so, I'm very apprehensive of doing antibiotics that could make things worse but my symptoms are bad and last time all the natural stuff didn't work.

My question is what do I do about probiotics?

These minimised antibiotic side effects last time round, but at the same time I don't want to flare my SIBO.

I'm in the UK which generally just gives triple therapy.

It worked for me last time but I've been reading adding bismuth adds to the success rate.

Could anyone elaborate on if I should buy some over the counter and how often I should take?

Does it help minimise symptoms?

Could someone help me understand why H-Pylori keeps coming back, when I've tested negative in previous years. I've erradicated after antibiotics, and tried ayurveda and chinese medicine.

Quick timeline:

2017 - tested positive. Used Metronidazole Clarithromycin. Don't think it worked, they wouldn't retest.

2020 - tested positive again. Used Amoxicillin and Clarithromycin (after using mastic gum, brocolli seeds and black seed capsules).

2021 - Endoscopy confirmed negative.

2022/23 - Stool tests and GI Map confirmed still negative.

2026 - Tested positive again - same symptoms.

Anyone have experience in treating these?

I've tried a practitioner, and many ayurvedic herbs (avipattikar and others).

I've never fully recovered or being able to manage them well - I have health organic diet, don't drink alcohol/coffee etc.

Don't really know what else to do.