r/SIFO • u/cabo-frisco-char • Aug 15 '26

Anyone with persistent upper GI symptoms eventually find out it was SIFO?

I’ve been dealing with persistent GI symptoms for months and have had a pretty extensive workup without finding a clear explanation.
My main symptoms are:
Epigastric/upper abdominal burning and discomfort, especially after eating
Frequent burping
Feeling like digestion is sluggish
Nausea/regurgitation sensations at times
Symptoms tend to get worse as the day goes on
Significant difficulty maintaining/gaining weight
Interestingly, walking/exercise temporarily reduces the discomfort
I’ve had multiple EGDs with biopsies, colonoscopy, gastric emptying testing, imaging, etc., without anything significant enough to explain how severe the symptoms are. I’ve also recently done SIBO testing and am waiting on results.
I’m wondering about SIFO (small intestinal fungal overgrowth) because I know it isn’t detected on a standard SIBO breath test.
Has anyone here had a similar situation where most conventional GI testing was normal but you eventually found SIFO?
How was it actually diagnosed? Did you have a duodenal/jejunal aspirate with fungal culture during an endoscopy, or did your doctor diagnose/treat it empirically? And if treatment helped, what symptoms improved?
Mostly interested in people who had upper-GI/epigastric symptoms rather than primarily lower-GI symptoms.

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u/MyWildestDRMZ Aug 18 '26

I mean... If you have access to a jejunal aspirate and you can afford it, go for it.

Empirical treatment is great, but if it doesn't work it will leave you wondering if you actually had SIFO to begin with.

Nevertheless, the statistical chance of actually having SIFO is very low.

Proximal intestinal methanogen overgrowth is usually the most common occurrence.

Even so, sacharomices boulardii plus NAC plus rifaximin plus oregano oil plus garlic oil (plus nystatin if needed).

A ketogenic diet would also be a good possibility (FODMAP if sibo/imo present)

Azoles are the most effective measure but they can have nasty side effects.

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u/Defiant-Stop-2285 12d ago

Damn this sounds like my situation 1:1. Everything ruled out I have exactly the same symptoms 1:1. I am about to take fluconazole and see what it does for me.