Clinical Service
CustomGut Clinical Services
Persistent GI symptoms associated with SIBO, dysbiosis, and microbial imbalance call for a targeted, individualized approach. At Customicro, our pharmacists apply the 5R framework—Remove, Replace, Reinoculate, Repair, and Rebalance—to develop personalized therapies that support a healthier gut environment and long-term digestive wellness.
What is the Customgut Clinical Service?
The Customgut Clinical Service is a targeted approach to managing gut infections, SIBO, dysbiosis, and microbiome imbalance complicated by biofilm. Biofilm-protected organisms in the gut are notoriously resistant to standard antibiotic therapy, making recurrent or persistent gut infections difficult to resolve with conventional treatment alone.
Using molecular diagnostics, our pharmacists identify the specific organisms present in the gut environment and provide clinical interpretation to guide treatment. This allows for a precise, personalized compounded prescription designed to disrupt biofilm, clear the infection, and restore balance to the gut microenvironment.
How it works
Our PharmD i3 process (Identify, Interpret, Intervene) guides every clinical service engagement:
- Identify: Molecular diagnostics pinpoint the specific bacteria, fungi, and resistance genes present in the gut environment.
- Interpret: Our pharmacists provide clinical interpretation of diagnostic results to support your provider in selecting the most appropriate therapy.
- Intervene: A personalized TargetedRx is compounded to disrupt biofilm, treat the identified infection, and support restoration of the gut microenvironment.
Who is this service for?
This service is designed for patients and providers managing:
- SIBO, dysbiosis, or gut infections that have not resolved with standard antibiotic therapy
- Recurrent gut infections with suspected biofilm involvement
- Patients with chronic GI conditions such as IBS, IBD, or persistent bloating and motility issues
- Providers seeking a pharmacist-guided, diagnostics-driven approach to gut infection management
What is SIBO?
The term "SIBO" stands for "small intestinal bacterial overgrowth." SIBO is a general term given to over colonization of specific bacteria, usually from the colon, into the small intestine where it doesn't belong. The emptying of food contents from the small intestine into the large intestine is an important cleansing mechanism. If this mechanism is slowed or impaired, the bacteria in the small intestine have more time to breed, and the bacteria in the large intestine may begin to creep upward.
As this bacteria builds up in the small bowel, symptoms of bloating, gas, and abdominal distention can occur and lead to unwanted changes in bowel function. The bacteria also consume proteins and vitamins meant for us, and bile salts that help digest fats, leading to poor fat digestion and poor absorption of nutrients, especially calcium and fat-soluble vitamins.
SIBO is often a component of different chronic diseases such as Irritable Bowel Syndrome (IBS) or even fibromyalgia. Some studies indicate up to 80% of patients with IBS have SIBO.
What causes SIBO?
Low stomach acid
Reduces the body's ability to moderate bacterial growth. Factors include H. Pylori infection, prolonged use of antacids or proton pump inhibitors, and gastric bypass surgery.
Small intestine dysmotility
Food contents are retained too long in the small intestine, allowing bacteria to multiply. Dysmotility disorders include gastroparesis, intestinal pseudo-obstruction, and hypothyroidism.
Structural problems in the small intestine
Inhibit motility and create extra nooks for bacteria to accumulate. These can result from GI diseases or surgical complications, including small bowel diverticulosis, obstruction, and abdominal adhesions.
Overuse of certain medications
Can upset the normal balance of flora, including antibiotics, narcotics, and gastric acid suppressants.
Risk factors
Advanced age
Associated with lower stomach acid and motility levels, as well as higher use of medications that may encourage SIBO.
Medical interventions
Abdominal surgery and radiation exposure can cause structural problems in the small intestine and damage the mucosal lining, affecting immunity.
Immunodeficiency disorders
Can affect intestinal immunity to certain bacteria.
Certain gastrointestinal conditions
- diabetes
- lupus
- celiac disease
- inflammatory bowel diseases
- IBS
- pancreatitis
- colon cancer
- scleroderma
- chronic renal failure
- cirrhosis of the liver
When is SIBO treated?
The decision to treat SIBO relies on severity of symptoms and what other chronic conditions exist where the overgrowth has been determined to adversely affect a patient's health. Common diagnostic tests include:
Breath testing
A noninvasive test measuring hydrogen or methane exhaled after drinking a glucose-water mixture. A rapid rise in exhaled gas may indicate bacterial overgrowth in the small intestine.
Small intestine aspirate and fluid culture
Doctors pass an endoscope through the upper digestive tract to the small intestine, withdraw a fluid sample, and test it in a laboratory for bacterial growth.
Whenever possible, doctors treat SIBO by addressing the underlying problem (including surgery if a structural issue is identified) along with treating the overgrowth itself and its complications.
SIBO recurrence rates following standard antibiotic therapy alone reach up to 44% within 9 months, largely because treatment does not address the underlying motility dysfunction, biofilm formation, or dysbiotic environment that allowed overgrowth to develop in the first place.
Lauritano EC, et al. Small intestinal bacterial overgrowth recurrence after antibiotic therapy. Am J Gastroenterol. 2008;103(8):2031–2035.
More than 70% of patients with irritable bowel syndrome (IBS) test positive for SIBO, suggesting that bacterial overgrowth and associated gut dysbiosis are a primary driver of chronic gastrointestinal symptoms rather than a secondary finding, underscoring the need for targeted, personalized gut reset protocols.
Pimentel M, et al. Eradication of small intestinal bacterial overgrowth reduces symptoms of irritable bowel syndrome. Am J Gastroenterol. 2000;95(12):3503–3506.
Customgut Gut Health Program
The Customgut Gut Health Program offered at Customedico Pharmacy + Wellness is a comprehensive, on-going initiative to remove and prevent biofilms, treat an infection with a topical TargetedRx, and restore any imbalance to the microenvironment.
Learn MoreConnect with us
Customicro Clinical Services is partnered with Customedico Pharmacy + Wellness, an independently owned compounding pharmacy dedicated to the provision of personalized medications to meet the unique needs of our patients.
Reach out to learn how Customicro Clinical Services can support your patients.
10900 N. Scottsdale Rd #403, Scottsdale, AZ 85254
480-946-1345
