The long-term use of daily inulin in children is very safe, inexpensive, and controls SIBO as long as it remains effective. Eventually, as the child ages, the inulin will likely fail, and bacterial overgrowth will return. At this point, the child will need to be transitioned to intermittent courses of rifaximin to control any symptoms that occur from bacterial overgrowth.
I recommend giving my patients 1/8 to 1/2 teaspoon of inulin powder, once daily. Beyond the dose of 1/2 teaspoons a day, it is rare to see any added improvement in symptoms and the higher dose has the potential to increase hyperactivity, hunger, thirst, anxiety, or aggression and may cause discomfort from excessive gas, cramping, or bloating. Members of the Nemechek Navigator can purchase Nemechek Blue inulin here at a 10% discount.
I recommend everyone starts at 1/8th tsp of inulin. Purchase discounted Nemechek-Approved Inulin here.
When switching from inulin to rifaximin, I recommend my patients start with monthly 10-day courses of rifaximin and assess the effectiveness over the next few months. If there is no evidence of neurological recovery after 3-4 months, the child is relapsing before the monthly cycle is even complete, and recommend that they move on to continuous.
There is a large amount of fraud within the nutritional supplement industry. We recommend brands known to be genuine and have a proven record of effectiveness.
I have found a wide variety of other supplements, herbals, etc., can prevent recovery and sometimes even cause children to lose recent gains dramatically. The brain is a very delicate environment, and the addition of many healthy-sounding nutrients might throw off the natural homeostasis required for the brain to recover. Other than the essential fish oil, olive oil, and inulin or rifaximin, I prescribe no other nutrients to my patients other than food.
Occasional use of Manuka honey should not cause any problems.
In general, I do not see any significant positive or negative effects beyond the natural physiological changes when an autistic child passes into puberty.
Regardless of diagnosis, I expect treatment is going to be for the next many years at least, and here’s why: The bacterial overgrowth in the intestine leads to the production of propionic acid (causes autistic behaviors- loss of eye contact, strange behaviors, suppression of cognition) and the leakage of LPS (a fragment of the ‘fish’ bacteria from the colon).nnLPS migrates to the brain and triggers a priming effect in microglia (white blood cells) within the brain. The primed microglia cause a permanent and long-lasting inflammatory response that prevents proper pruning (causes developmental delay) and brain repair (causes cumulative brain injury).nnStopping inulin or rifaximin will allow bacterial overgrowth to relapse and trigger a renewed increase in inflammation and the potential production of propionic acid. The reduction of olive oil and fish oil intake may lead to an increased inflammatory response within the brain from the primed microglia.
Persistent hunger, thirst as well as cravings for sugar and salt are common signs of low brain blood pressure from underlying autonomic nervous system dysfunction. The low blood pressure results in low brain oxygen levels which the brain does not like. The brain “learns” that sugar, salt and liquids will boost blood pressure and oxygen delivery to the brain, and increases the child’s cravings for these items.