Patient 10: Severe Intestinal Methanogen Overgrowth in a Healthy, Active Woman with Constipation and Bloating
Patient Background
This is the case of a healthy 40-year-old woman who presented with chronic constipation, bloating, occasional heartburn, and frequent headaches. Her bowel movements were irregular — often skipping 1 to 2 days between eliminations — and she frequently experienced abdominal distension despite following a healthy lifestyle.
She was otherwise in good health:
- Exercised regularly
- Followed a mostly whole-foods diet
- Avoided processed foods and refined sugar
She had a known food allergy to shrimp, confirmed both by experience (near-anaphylactic reaction) and IgE testing, and carried an EpiPen for safety. Additional mild (Class 1) IgE food allergies were noted to avocado, egg white, and cow’s milk, although she generally tolerated these in small amounts.
On physical examination, her abdomen was moderately distended and had mild diffuse tenderness to palpation.
SIBO Breath Testing
Lactulose breath testing revealed:
- Hydrogen (H₂): 27 ppm
- Methane (CH₄): > 81 ppm — indicating severe Intestinal Methanogen Overgrowth (IMO)
This pattern was strongly consistent with chronic constipation.
Treatment: Implementing Dr. Rajsree’s Herbal Protocol for SIBO
She was placed on Dr. Rajsree’s Herbal SIBO Protocol, with emphasis on restoring motility, reducing methane-producing archaea, and improving digestion.
Phase 1-2: Promote Motility and Reduce Gas Levels
- Digestive Enzyme Pro (2 capsules after meals)
- Essential Magnesium (up to 4 capsules at bedtime)
- Motility Activator (1 capsule at bedtime)
Dietary Strategy:
She began a low FODMAP / low lectin SIBO diet, with specific instructions to practice meal spacing:
- Avoid snacking between meals
- Maintain 4–5 hours between meals
- Maintain a 12-hour overnight fast between dinner and breakfast
Phase 3-4: Reduce Inflammation and Herbal Antimicrobial Therapy
Addition of:
- Spore Probiotic IgG in AM on empty stomach
- Herbal antimicrobials:
- Berberine Pro, Oregano Oil, and Allicidin (1 capsule each after every meal) for 6 weeks
Follow-Up and Outcomes
After 6 weeks of herbal antimicrobials:
Repeat breath test showed:
Methane (CH₄): decreased from >81 → 11 ppm
Hydrogen (H₂): slightly increased to 43 ppm. Of note, a rise in hydrogen when we treat IMO is not uncommon since the methane producing archea convert hydrogen into methane. As we “kill” the methane-producing archea we see reduction in methane levels, and sometimes a rise in hydrogen levels.
Symptomatically, she experienced:
- Significant reduction in bloating
- Daily bowel movements with Essential Magnesium and Motility Activator alone
- No longer needed Aloe Pro
- Significant reduction in headache frequency and severity
Due to remaining methane level, we continued the herbal antimicrobials for an additional 6 weeks to ensure full eradication.
Post-Treatment Microbiome Testing
Following a total of 12 weeks of herbal antimicrobial treatment, she completed a GI Effects stool microbiome profile, which revealed:
- High protein in the stool (suggesting potential low stomach acid)
- No inflammation
- Excellent postbiotic markers (including short-chain fatty acids and butyrate)
- Robust levels of beneficial bacteria
- Undetectable Methanobrevibacter smithii — the primary methane-producing organism in IMO, which was really good news!
- No dysbiosis, no H. pylori, no parasites, no leaky gut
These findings are suggestive of successful eradication of Intestinal Methanogen Overgrowth (IMO) with a resilient and balanced microbiome.
Based on the elevated stool protein, we added:
- Betaine and Pepsin after meals to support gastric acid and protein digestion
- She was advised to start reintroducing foods back into her diet, which she tolerated well.
Maintenance Plan
To maintain her results and prevent relapse, she continued:
- Digestive Enzyme Pro and Betaine and Pepsin with meals
- Essential Magnesium and Motility Activator at bedtime
- Ongoing mindful eating, meal spacing, and whole foods
Key Insights
This case demonstrates:
- The remarkable efficacy of herbal antimicrobials in treating severe Intestinal Methanogen Overgrowth (IMO)
- That even patients with very high CH₄ levels can achieve symptom resolution and microbiome normalization through a natural, phased protocol
- The value of post-treatment stool testing to confirm microbial balance and identify subtle issues like low stomach acid, which can hinder protein digestion and long-term gut health
By following Dr. Rajsree’s SIBO Protocol, this patient transformed her digestive health — eliminating bloating and constipation, stabilizing her microbiome, and setting the stage for continued good overall health.
Patient Testimonial
"Dr. Rajsree is a wealth of knowledge, and the best part about that is she’s willing to share her knowledge via her informational YouTube videos! She is determined to get to the root of the problem. The office staff are extremely friendly and helpful too! Each visit is informative and beneficial in getting me closer to solving my gut issues."
Patient Background
This is the case of a healthy 40-year-old woman who presented with chronic constipation, bloating, occasional heartburn, and frequent headaches. Her bowel movements were irregular — often skipping 1 to 2 days between eliminations — and she frequently experienced abdominal distension despite following a healthy lifestyle.
She was otherwise in good health:
- Exercised regularly
- Followed a mostly whole-foods diet
- Avoided processed foods and refined sugar
She had a known food allergy to shrimp, confirmed both by experience (near-anaphylactic reaction) and IgE testing, and carried an EpiPen for safety. Additional mild (Class 1) IgE food allergies were noted to avocado, egg white, and cow’s milk, although she generally tolerated these in small amounts.
On physical examination, her abdomen was moderately distended and had mild diffuse tenderness to palpation.
SIBO Breath Testing
Lactulose breath testing revealed:
- Hydrogen (H₂): 27 ppm
- Methane (CH₄): > 81 ppm — indicating severe Intestinal Methanogen Overgrowth (IMO)
This pattern was strongly consistent with chronic constipation.
Treatment: Implementing Dr. Rajsree’s Herbal Protocol for SIBO
She was placed on Dr. Rajsree’s Herbal SIBO Protocol, with emphasis on restoring motility, reducing methane-producing archaea, and improving digestion.
Phase 1-2: Promote Motility and Reduce Gas Levels
- Digestive Enzyme Pro (2 capsules after meals)
- Essential Magnesium (up to 4 capsules at bedtime)
- Motility Activator (1 capsule at bedtime)
Dietary Strategy:
She began a low FODMAP / low lectin SIBO diet, with specific instructions to practice meal spacing:
- Avoid snacking between meals
- Maintain 4–5 hours between meals
- Maintain a 12-hour overnight fast between dinner and breakfast
Phase 3-4: Reduce Inflammation and Herbal Antimicrobial Therapy
Addition of:
- Spore Probiotic IgG in AM on empty stomach
- Herbal antimicrobials:
- Berberine Pro, Oregano Oil, and Allicidin (1 capsule each after every meal) for 6 weeks
Follow-Up and Outcomes
After 6 weeks of herbal antimicrobials:
Repeat breath test showed:
Methane (CH₄): decreased from >81 → 11 ppm
Hydrogen (H₂): slightly increased to 43 ppm. Of note, a rise in hydrogen when we treat IMO is not uncommon since the methane producing archea convert hydrogen into methane. As we “kill” the methane-producing archea we see reduction in methane levels, and sometimes a rise in hydrogen levels.
Symptomatically, she experienced:
- Significant reduction in bloating
- Daily bowel movements with Essential Magnesium and Motility Activator alone
- No longer needed Aloe Pro
- Significant reduction in headache frequency and severity
Due to remaining methane level, we continued the herbal antimicrobials for an additional 6 weeks to ensure full eradication.
Post-Treatment Microbiome Testing
Following a total of 12 weeks of herbal antimicrobial treatment, she completed a GI Effects stool microbiome profile, which revealed:
- High protein in the stool (suggesting potential low stomach acid)
- No inflammation
- Excellent postbiotic markers (including short-chain fatty acids and butyrate)
- Robust levels of beneficial bacteria
- Undetectable Methanobrevibacter smithii — the primary methane-producing organism in IMO, which was really good news!
- No dysbiosis, no H. pylori, no parasites, no leaky gut
These findings are suggestive of successful eradication of Intestinal Methanogen Overgrowth (IMO) with a resilient and balanced microbiome.
Based on the elevated stool protein, we added:
- Betaine and Pepsin after meals to support gastric acid and protein digestion
- She was advised to start reintroducing foods back into her diet, which she tolerated well.
Maintenance Plan
To maintain her results and prevent relapse, she continued:
- Digestive Enzyme Pro and Betaine and Pepsin with meals
- Essential Magnesium and Motility Activator at bedtime
- Ongoing mindful eating, meal spacing, and whole foods
Key Insights
This case demonstrates:
- The remarkable efficacy of herbal antimicrobials in treating severe Intestinal Methanogen Overgrowth (IMO)
- That even patients with very high CH₄ levels can achieve symptom resolution and microbiome normalization through a natural, phased protocol
- The value of post-treatment stool testing to confirm microbial balance and identify subtle issues like low stomach acid, which can hinder protein digestion and long-term gut health
By following Dr. Rajsree’s SIBO Protocol, this patient transformed her digestive health — eliminating bloating and constipation, stabilizing her microbiome, and setting the stage for continued good overall health.
Patient Testimonial
"Dr. Rajsree is a wealth of knowledge, and the best part about that is she’s willing to share her knowledge via her informational YouTube videos! She is determined to get to the root of the problem. The office staff are extremely friendly and helpful too! Each visit is informative and beneficial in getting me closer to solving my gut issues."
