# SIBO-now what?



## wigglesmom (Dec 12, 2002)

I am quite sure that I have SIBO. I have been experiencing worse constipation than usual and have had a terrible pain in my neck and upper back along with bloating that is worse than I normally have. This constipation is different as I can hear the watery stool in my colon when I massage it, but am unable to get it out. My colon hydrotherapist removed an extraordinary amount of gas and mucous last week.

I am taking grapefruit seed extract as I know it helps with SIBO, and it seems to be alleviating some of the symptoms. I began Align yesterday too, but am now thinking I should hold off until I did myself of the SIBO.

I have obtained the SIBO test from my doctor and plan to take it in the next few weeks. I know that a round of antibiotics is usually prescribed when diagnosed, but is also know that this remedy often does not work. I am wondering if any of you have gotten rid of your SIBO without the antibiotic treatment.

I did a 2 day fast last week, and that also seemed to really help. I've read multiple articles online but wanted to get some additional opinions from folks I can have a dialogue with.

Thanks


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## Moises (May 20, 2000)

I did the Xifaxan and the elemental diet and it didn't help. I did the treatments before getting the diagnosis. But recently I did do the breath test and I was high for both hydrogen and methane.

The only thing that has helped me a little is restricting dietary carbohydrate.

My current experiment is using high-dose peppermint oil with biofilm-dissolving enzymes. Like almost everything else, it doesn't seem to be working.

But the biggest new SIBO treatment craze is resistant starch from potatoes. Google it.

There's no real hard data to back it up yet. But I have no doubt that it does help some of us. And you won't know until you try.

If you look at some of the google hits that come up a strong case could be made against using antibiotics. At least in some people, some antibiotics severely disrupt the microbiome.


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## wigglesmom (Dec 12, 2002)

Thanks so much. I am having the most luck with fasting for a couple days and then doing grapefruit seed extract and peppermint oil. What are your symptoms?

I need to do the breath test and am just trying to find some time in which I can fast and am free for three hours. Not exactly easy to come by in my life.


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## Prevent2 (Apr 28, 2014)

My naturopathic dr suggested I try 1 tablespoon of Apple Cider Vinegar with a wedge of lemon in warm water each morning and restricting my diet. No carbs, no breads, no fruit. It helped me.

I don't take any type of antibiotics anymore as they all seem to cause havoc with my digestive system.


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## wigglesmom (Dec 12, 2002)

I know that the probiotic strain in Align is helpful after ridding the body of SIBO. Has anyone tried this?


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## Nojokeibs (Apr 14, 2014)

I haven't tried Align, I'm a fan of VSL #3, but to each their own. Here's why I like it:

http://www.ncbi.nlm.nih.gov/pubmed/17263590

The ingredients (always check this if you go with any brand... some of them are different):

http://www.vsl3.com/discover.asp

Since it contains thermophilus, you can make yogurt from it.







An easy way to stretch the dollar.

It's cool that you fast too... I don't feel so alone. A recent book on the subject, in case you haven't seen it yet:

http://www.amazon.com/Fasting-Eating-Health-Medical-Conquering/dp/031218719X


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## Kathleen M. (Nov 16, 1999)

http://www.ncbi.nlm.nih.gov/pubmed/?term=bifobacterium+infantis+35624

Align is a particular strain of bifobacterium that also has a fair amount of research behind it. A lot of probiotics started adding any old B. infantis but it isn't know if they all work the same.

The main IBS study for it http://www.ncbi.nlm.nih.gov/pubmed/16863564

At least Align and VSL#3 along with Culturelle all have the clinical data published and are the strain(s) used in the study. Hard to know how many of the similar but unstudied strains have the same effects.


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## wigglesmom (Dec 12, 2002)

Thanks, everyone. I guess I am wondering if I should take the Align as I continue to attempt to rid myself of the SIBO or if I should wait until after I feel it's gone. One odd symptom that I believe I mentioned before is a terrible neck and back pain. This is relieved when I have a bowel movement yet comes back often after I eat. I wonder if this is a documented symptom of SIBO.

I am going to do the SIBO test in a couple weeks but dread it as I'll have to stop treatment so that it's present for the test so that I can obtain a diagnosis.


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## Nojokeibs (Apr 14, 2014)

wigglesmom said:


> Thanks, everyone. I guess I am wondering if I should take the Align as I continue to attempt to rid myself of the SIBO or if I should wait until after I feel it's gone. One odd symptom that I believe I mentioned before is a terrible neck and back pain. This is relieved when I have a bowel movement yet comes back often after I eat. I wonder if this is a documented symptom of SIBO.
> 
> I am going to do the SIBO test in a couple weeks but dread it as I'll have to stop treatment so that it's present for the test so that I can obtain a diagnosis.


My doctor a few years back told me that pressure against the diaphragm can lead to pain in the neck and upper back. Since there are no nerves in the lungs, the pain is referred right up. That would point to something causing upper GI gas maybe? I get burping during and right after meals. Well, I do now... it took a few cycles of fasting to get the burping response to come back. I was in bad shape when I started. I'm not sure how to get the burping response to come back other than fasting, which is the method I used. There may be other ways.


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## wigglesmom (Dec 12, 2002)

Thanks, nojoke. You seem to know quite a bit. What would you recommend for SIBO? It seems so complicated with so many traditional and alternative remedies out there. I'm wondering what works for others.


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## hayley3 (Aug 6, 2006)

I was put on the antibotics after the endoscopy came up positive for SIBO. However the endoscopy procedure made me worse. I had terrible bloating pain after the procedure and I'm assuming it was because of the anesthetic.

I did a 10 day fast before I knew I had SIBO (not a perfect one) and was much better after that. 10 days fasts are hard though. I am still messed up from the endoscopy and having a hard time going back on the restrictive diet I was on.

My hair stopped falling out though. Not sure if it was the antibiotics or starting B12 and kefir.

Cheryl


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## Nojokeibs (Apr 14, 2014)

hayley3 said:


> I was put on the antibotics after the endoscopy came up positive for SIBO. However the endoscopy procedure made me worse. I had terrible bloating pain after the procedure and I'm assuming it was because of the anesthetic.
> 
> I did a 10 day fast before I knew I had SIBO (not a perfect one) and was much better after that. 10 days fasts are hard though. I am still messed up from the endoscopy and having a hard time going back on the restrictive diet I was on.
> 
> ...


Well that's some progress 

Wigglesmom, if you can get a course of targeted antibiotics specific to the overgrowth of bacteria that you have (or yeast), then I'd try to do that first. But some doctors may be reluctant to do this. I'd still try first. However, if you do a course or two of antibiotics, this can re-trigger colon-IBS, so be sure to follow any antibiotic course with a hefty and long dose of kefir or yogurt that works for you.

When I had food poisoning the last time (about a year ago), I drank a cup of kefir three times a day and that worked perfectly. I kept it up for 3 weeks afterward just to be sure that nothing odd was going to happen, and then tapered off to once a day, now it's roughly once a day, but I am no longer in fear of forgetting it. I also use skyr which is a yogurt that does not contain bifidus. According to the SCD diet, bifidus can be a source of overgrowth. Only specialty stores like Whole Foods carry it.

The pill form probiotic I'd recommend is called VSL #3, and if you go to pubmed you can search on "VSL 3" and find lots of studies for what specifically it does. Lifeway kefir has a similar list of bacteria, but not exactly. Since it's so expensive, you might consider making yogurt from it, lots of websites have recipes for how to make yogurt.

There are also yeasts that are supposed to be in your gut, one of these is the common yeast you get from bread or beer. This one has lots of varieties and there's one that's more aggressive than the others called Saccaromycetes cereviciae var. boulardii. It can be found in Florastor probiotic or more simply, you can take whatever variety nature provides and eat lots of grapes for a few weeks. The yeast is specifically supposed to be in the upper part of your digestive tract. It's the only germ that I know of that is actually expected to exist outside the colon in anything like great numbers. This yeast has no relation to Candida yeast and will likely crowd it out.

So, now you're prepared to re-populate with good stuff after the storm of antibiotics.

If you can't get antibiotics, then I'd recommend fasting if you can possibly stand it. I can stand it, but I realize it's not so easy. It's not even easy for me. Mostly I go on 7-10 day fasts. I leave a lot of time between fasts. They are extremely effective at restoring the functioning of my GI tract. I used to fast for spiritual reasons, and later I fasted with my mom when she was ill, and now I use it for health. It's different to fast for different reasons, but there's a lot to learn from each type of faster. Many people on youtube post experiences and advice about fasting, it can be very inspiring. They don't all agree on how to do it and many of them aren't even aware of such things as ketosis and the danger of being deficient in an enzyme which leads to fasting failure (at least). But they are a testament to the strength of the individual.

Fasting puts you into a state of ketosis. For the first two days, your liver and muscles have stored glycogen they can use to fuel you with sugar. At all times in fasting, your blood sugar must be kept relatively normal by your body, so when this runs out, your body goes, uh-oh.. better switch to burning fat... the first time this metabolic switch happens, it can be very uncomfortable. And when you do reach ketosis you notice you don't feel so bad anymore, and you're less hungry. Some say not hungry but as the days go by, that turns into a myth. We're designed to find food and eat, that urge won't go away because of a lack of food. It's just not as sharp as it is after about 12 hours without food.

Some benefits can be had from just a simple 2 day fast if you only use water during that time. In fact, for SIBO you only want to use water because you want no nutrition to get to your gut. One exception I'd make if I thought I did not have Candida is (small amounts of) sugar or dextrose (glucose). If you need to do something like run an errand and it's unavoidable, you can raise your blood sugar a little, take care of it and go back to fasting. Honestly though, I've only ever done that while in ketosis, so I'm not sure of the effects of that if you're still in the first two days. Also be careful because while in ketosis, insulin does not work very well, it takes some time for your body to become sensitive to insulin again after a fast. It's pretty quick, but it's not like you can take a gulp of sugar water and feel instantly energetic, though you might feel instantly better as your body responds to the "food" and the higher blood sugar. On any fast, never take in more than 50-75 calories in any day for any reason. if you must, then just break the fast.

Breaking the fast: this is a point of considerable debate. In my experience you can eat literally anything after a fast as long as you chew very well or puree it. So the question is what's best? My choice is a meat-heavy small meal without removing extra fat because in ketosis I've been metabolizing fat. Then I slowly start adding more veggies and every day I add some sugar or fruit to a meal or drink. This is because to absorb fructose properly, it must be present in the gut. The gut will adapt to whatever it's given. If it gets no sugar, or fruit, it will stop making one of the factors that help you absorb fructose. Don't overdo it, but don't neglect it.

I limit my calories for the first week after a fast to about 800 calories a day, 200 calories 4x/day, or every 4 hours. Each meal is very high in protein. I add back about 200 calories per week until I'm not losing weight anymore, and I balance my meals as I go, a little more carb and starch the second week. I also add a probiotic immediately after fasting, and use digestive enzymes to get a good start and cover any mistakes I might make in the beginning. I avoid any of the 'papain, bromelain" enzymes and go for the straight enzymes. I use Enzymedica Digest Spectrum and find that it takes care of everything.

If you're only doing a 2 day fast, I wouldn't worry about what you eat afterward, it's not that big a deal.

For more information about how fasting works, check out:

http://www.amazon.com/Fasting-Eating-Health-Medical-Conquering/dp/031218719X

The point of fasting is to have the flora die down a bit, making an opportunity for the good bacteria to take over. In SIBO though, there shouldn't be bacteria in the upper tract or small intestine, so I'd definitely get some grapes or Florastor to begin with. Maybe for the first week after the fast, I'd only do that, then add the bacterial probiotics, yogurt, etc. Condense that to three days if you're only doing a 2 day fast. You might not get the warm fuzzy of ketosis for very long on a two day fast, but at least you can do it over a weekend.

Obviously nothing I am saying is medical advice or coming from a professional source. These are just my experiences and thoughts on what may help you. Also none of these ideas are meant to be followed to the letter. Listening to what is happening in your body is more important than anything I've said. If you start feeling too weak to stand and vomiting during a fast, it might mean you're deficient in a key enzyme required to make ketones. In that case, fasting may not be an option for you, and you will need to immediately get some sugar in your system, and then break the fast. Being seen by a doctor wouldn't be a bad idea either, he or she may be able to test for that enzyme and tell you for sure. But that deficiency is so rare, that very few fasters even know of it or bother to mention it. I mention it for safety's sake. Don't be hard on yourself, it may be uncomfortable, but it shouldn't be agony.

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Other things I've seen people use are Grapefruit seed extract which is basically an antibiotic. It's very strong, so you only need tiny amounts, I assume in water, to make it work. I haven't tried this method, but I take naringenin/naringin which is also an extract of grapefruit for motility. Any increase in motility should help reduce SIBO simply by moving the food out of reach of the bugs.

On the motility front: "prokinetic" is a great keyword to use on Pubmed, if you can handle jargon and don't mind googleing what you don't understand. I found ginger supplements, naringin and magnesium that way.


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## wigglesmom (Dec 12, 2002)

Thank you so much, Nojoke. I really appreciate all of this information. I have been doing a fast with lemon juice, cayenne and maple syrup but am now wondering if that's a no no as there's sugar involved.

I do my SIBO test on Saturday, so I will soon know if I do in fact have SIBO. I imagine I do due to my symptoms and the fact that I had very involved reconstructive biliary surgery about 25 years ago.

I have been seeing the term prokinetic quite a bit. thank you for reminding me of that.

Grapefruit seed oil has been giving me a great deal of relief lately. I doubt it is a long term solution, but I am glad that I have found it for the short term.

I am hoping that I do not have SIBO as I am an ethical vegan and don't consume meat or dairy products. The SIBO diets seem to focus on everything that I do not eat, and that will certainly be a challenge for me.

One step at a time, I guess.

I wanted to ask one other question. I go for colonics often. It is the ONLY thing that helps me when I am feeling awful (impacted, head and neck pain, bloated, unable to digest most foods). When I get my colonics, a great deal of mucous comes out. the last time, more mucous than I have ever seen in my 15+ years of colonics came out. The awful neck pain I was experiencing lessened dramatically. Any idea why so much mucous? I've tried so many natural remedies for it, but I just can't seem to make my body stop producing it.

Thank you.


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## Kathleen M. (Nov 16, 1999)

If you are making extra mucus to try to lubricate dry hard stools I don't know you want your body to stop so it would be even harder for your body to try to move the stool along.

For people who are passing stool regularly sometimes an antihistamine will reduce the mucus in the gut, but I don't know that in your case you want to dry up the intestines more than they already are. I don't know that any of the natural things people take for allergies would stop the mucus, either, or if they'd be any better about making you too dry in there.


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## Nojokeibs (Apr 14, 2014)

wigglesmom said:


> Thank you so much, Nojoke. I really appreciate all of this information. I have been doing a fast with lemon juice, cayenne and maple syrup but am now wondering if that's a no no as there's sugar involved.
> 
> I do my SIBO test on Saturday, so I will soon know if I do in fact have SIBO. I imagine I do due to my symptoms and the fact that I had very involved reconstructive biliary surgery about 25 years ago.
> 
> ...


You're welcome 

The vegan issue: I was an ethical vegetarian for almost 10 years and then a vegan for 8 months before my body became so painful I couldn't go on with it. Lots of people have similar stories. But for all that, I do think that vegetarianism can work for some people and the ethical aspect is valuable and an important form of self-expression. I think veganism needs more consideration because people seem to give it up about 10 years later, which is about when their body is out of fat soluble vitamins.

It might simply be because they are also eating low-fat, but I haven't spent enough time researching it. I just suspect that everyone scares vegans into eating more protein (where do you get your protein from?), and then they focus on carbs and proteins and leave out the fat in an effort to be virtuous and keep to a low calorie plan. The irony is that all fructose becomes fat in the body anyway, and the more FODMAPS you eat, the more fats are produced by the gut bacteria and those can be absorbed too.

That nutty durianking guy on youtube and the Bananagirl... they have a diet that's all bananas. There are people who gain tons of weight on that diet (there is an expose video also), and I keep wanting to point out that first of all they're both already skinny so their metabolism is different from the obese, and second their diet forms fats inside the body. The thing is, if your liver is forming the fat, then the fat soluble vitamins still can't be absorbed in the gut. Eventually that loss of vitamins will show up somehow, though it may take years.

If I had recommendations to vegans, it would be to get Udo Erasmus's book(s) and look online for information about omega-3 and how to get it from algae. Then make sure you're eating at least 30% fat in your diet. Those awesome vitamins in the veggies can't get into your body without fats. Another would be the phytates. There's a very good reason why raw vegans soak all their nuts before eating. Sadly they probably don't even know the reason themselves, because it's a very old tradition.

You're right that most of the advice for gut issues is counter to vegan food. But reversing some of the high fiber dogma should help a little. Try only using refined grains that are easily digested and eat a little less of them. Fill the space with a little more fat and more veggies like summer squash or whatever you like and works for you. The low-residue diet can help you decide on some more changes (ignoring of course all the meat suggestions, but focusing on which carbs you can eat for low-residue).

About mucus: My belief is that mucus occurs when a bacteria colony is under attack, possibly by the immune system, but it could be because of an unfriendly flora element. It may start to produce toxic substances that make you ill too. I find that I can calm my immune system with DHEA (I doubt there is a vegan source for that, despite their labeling that the capsules are vegan), but you never know, some bacteria may have been trained to produce it. I started at 100mg/day, then tapered down to 25 mg/day.

The dose should depend on your current age. I'm 40ish. As you get older, the amount you taper to may need to be higher. There is also no need to keep it up forever, I find that I just need to kick my body out of the "cortisol pumping" rut that it is in, and in a month or so, I can taper it to a stop. Try not to forget if you take it, or to stop suddenly, as it is a hormone and will definitely have an effect. There's some debate about whether or not it should be a "drug." It works very fast to stop the autoimmune response for me. If it ever stops working I don't know what I'd do.


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## wigglesmom (Dec 12, 2002)

Thanks again. So helpful. I will certainly pay attention to the fats. I eat flax daily, often eat hemp and try to eat lots of nuts. I also consume coconut oil. I'll read more about this as it makes sense.

I have DHEA at home but am not currently taking it. I am going to research this today.

The mucous is a real issue for me. It seems to come out in massive amounts whenever I get colonics, and after it's removed I feel such a dramatic improvement in my health and energy level. I am just wondering why it happens. I am rarely sick (other than the constipation, of course). Whatever is inflamed is a mystery to me. I was taking turmeric for its anti-inflammatory properties but am not sure it did much good.

I am frustrated as doctors just cannot seem to wrap their heads around the head and neck pain that I experience when constipated. The pain is intense and often relieved after a colonic. I know there's a direct correlation but convincing them of this is another story.

Have you had any luck with naturopaths?


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