# Do you think I might have SIBO?



## 14486

I am at my wits end. I've had digestive problems for two years. The first year they would come and go and were mostly heartburn and indigestion. Then I had my gallbladder out, went on several meds and the problems went away for awhile. Last July I started having symptoms that included abdominal pain after meals (not always immediately) and terrible gas. It has continued daily for almost a year. I am ok if I eat a small amount of food early in the day - breakfast and lunch, but by dinnertime I have pain everyday and if I eat dinner the pain becomes excruciating and the gas follows for hours in the evening so bad I can't sit or stand up. I have had a lot of tests done, including 3 gastric emptying scans. The middle one came back delayed and the other two normal. My current GI doctor (I've already been to three of them) thinks that the one came back delayed because I was on an anxiety med that slows motility at the time. None of these doctors have ever mentioned the possibility of SIBO, and I am so desperate to get my life back. Do you think my symptoms fit this? What tests should I have done, and does a GI doctor need to do them or can my family doctor do them? Every time I ask my GI doctor to do another test he tells me I need to go off my anxiety meds and go to therapy. I've been in therapy and on and off meds for years and nothing has helped. I'm even doing hypnotherapy with no results so far.


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## Kathleen M.

From what I understand from the people who do the tests here guessing who has SIBO and who doesn't based on symptoms is not clear cut. I don't think there is a clear set of symptoms that says this is SIBO. Your symptoms could be IBS without SIBO, so it's hard to make any predictions.The tests that are done are usually a hydrogen breath test. They have you drink a sugar solution (which sugar varies from lab to lab) and they measure the amount of hydrogen in your breath at various times. You should only see an increase when the sugar hits the colon (one peak). If they see two peaks there may be bacterial activity in the small intestine.The other test is to go down the throat and into the small intestine and take a sample and culture it to see if there are bacterial levels that shouldn't be there.Larger research or teaching hospitals seem to be the ones more likely to do these kinds of tests.K.


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## 14486

I do see a gastroenterologist at a teaching hospital: Temple University. He's my third gastroenterologist and I drive several hours to see him. At this point he has told me I have IBS and I need to do therapy, which like I said I've been doing for years and see no improvement. He has never mentioned these SIBO tests. I don't know how I'm going to pursuade him to do them. I do have a new family doctor. She seems willing to try to be the go between and I hope she can convince him to do the tests. I see her on Thursday. I'm willing to try anything and pay any amount of money at this point to get some answers. My symptoms are so much different than what I read from a lot of people, so I'm so skeptical that it is just IBS. I suspect part of it is that I don't have a gallbladder anymore, but I'm not sure.


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## Kathleen M.

Some people do get diarrhea issues after gall bladder removal (have you seen LNAPE's calcium threads? other people use Questran for that)Abdominal pain after meals is really common with IBS. The colon will be more active after a meal and that is a common time for IBS symptoms. Pain with IBS can be really severe. Some people do have more problems with dinner, especially if you are eating more because you didn't eat much all day. Some people will do 4-6 smaller meals rather than 3 larger ones. Sometimes letting yourself get really hungry makes it worse. The colon becomes more active in the hour or so after a meal (the exact timing varies)SIBO is a relatively new thing in the IBS world, and it is not clear if it will be widely accepted. Some doctors may be watching and waiting to see if it fizzles or not. A fair number of people have had doctors who will try the antibiotics just in case and that doesn't tend to work out that well. It works for some, but not a lot.K.


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## 14486

I don't usually get a lot of diahrrea. Just pain on the left upper side where the stomach is all the time. Then after I eat the pain gets worse and I get full quickly, bloated and gassy. I find I can only eat a couple of times a day no matter how little I eat at one time because sometimes I have the pain starting hours later and then if I eat even a little bit it gets worse. It just seems like things just aren't digesting correctly. Something isn't happening right and it seems to be more in the stomach/small intestine area because I don't usually have a lot of problems lower down except gas releasing. I just don't know how to keep surviving like this. I can't eat much, and everything gives me problems. I don't know how I will ever be able to get the nutrients I need. I can't take multivitamins. They make me nauseous. I will try to get the SIBO tests, but if the antibiotics aren't proven to work, then I'm not too hopeful.


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## Kathleen M.

One of the issues with the antibiotics is that if you aren't tested you are kinda shooting in the dark.Sometimes medications can make me feel bloated and have the eating problems you describe.I found taking a dietary supplement with pancreatic enzymes (not the all plant based digestive enzymes) taken at the start of the meal seemed to help. There was a small study with the prescription version of them with bloating. It doesn't seem to be that they digest the food, but how they effect signalling in the gut (which is why you need the ones that you produce, not the ones plants use).The upper left pain can be colon, not stomach. The colon has a bend there and it can be really problematic. The colon gets more active after we eat (in every person, not just IBSers) and that can cause pain in the colon as the activity increases. K.


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## 13931

Kathleen M. said:


> I found taking a dietary supplement with pancreatic enzymes (not the all plant based digestive enzymes) taken at the start of the meal seemed to help. There was a small study with the prescription version of them with bloating. It doesn't seem to be that they digest the food, but how they effect signalling in the gut (which is why you need the ones that you produce, not the ones plants use).


Kathleen - This is interesting. I have tried plant based enzymes and they didn't seem to do anything. I had read that the pancreatic enzymes don't survive the acid in the stomach. Have you read anything about this issue. Are any of the pancreatic enzymes enteric coated?Thanks,Jean


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## Kathleen M.

I don't know, I don't think the ones that worked for me were.I think for the signalling function they don't have to last long. They aren't helping to digest anything.I know the prescription ones must work as they are for people who can't make pancreatic enzymes. I don't know if they are coated or not.It is hard to know how much of the dietary supplement stuff is real and how much is a sales pitch to get you to buy the more expensive ones.K.


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## 14486

Thanks Kathleen. I'm going to try some of those enzymes. I also did not know that the colon had a bend up that high. I seem to have such sensitivity to everything I eat. Even though I don't get diahrrea a lot, I'm afraid to go anywhere even hours after I've eaten and also afraid to eat at restaurants because I can't seem to find any "trigger" foods. I've been trying for years but just can't figure it out. You have been helpful.


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## 16759

I had the sibo test three time in a row. Two times positive. The problem with a sibo that most of the time it does not et absorb right. In my three time going the test i became allergic to it and before it enter my body i all ready had diarrhea and vomiting in small amount. I told my doctor she didn't even respond but she said she was going to call me to make a appointment for another colonscope. Cant wait because after being on antibiotics I still feel the same. You should try florastor I hear it very good with digestion and gas haven't tried it yet but tomorrow if i get a chance after my final exams i am going to buy some and let you know if they work.


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## mrlucky

mlr1969 said:


> I don't usually get a lot of diahrrea. Just pain on the left upper side where the stomach is all the time. Then after I eat the pain gets worse and I get full quickly, bloated and gassy. I find I can only eat a couple of times a day no matter how little I eat at one time because sometimes I have the pain starting hours later and then if I eat even a little bit it gets worse. It just seems like things just aren't digesting correctly. Something isn't happening right and it seems to be more in the stomach/small intestine area because I don't usually have a lot of problems lower down except gas releasing. I just don't know how to keep surviving like this. I can't eat much, and everything gives me problems. I don't know how I will ever be able to get the nutrients I need. I can't take multivitamins. They make me nauseous. I will try to get the SIBO tests, but if the antibiotics aren't proven to work, then I'm not too hopeful.


my friend has exactly the same problem and is looking for a place to get tested for sibolet me know if you find anything that helps you feel better after eating


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## dmg86

Hi, I've had similar symptoms with the excruciating pain/cramping after eating (sometimes with onset hours after eating) with pain and bloating that could last anywhere from 5-24 hrs. Usually when this happens I am in so much pain that I cannot stand. This has gotten progressively worse over the last 1.5 years. I also get full quickly and if I eat too much I will have "attacks" of extreme pain/diarrha. For me it was also really difficult to figure out "trigger" foods. Up until about 2 months ago I went to a gastroenterologist that was terrible, but he did manage to diagnose me with gastroparesis. My new doctor is amazing and she thinks that along with gastroparesis I also have IBS. You might want to look into gastroparesis, it's usually diagnosed with a gastric emptying test, but my new doc said it's not always accurate. At this point I'm still trying to figure out the right diet b/c for gastroparesis you should have low fiber so it's easier to digest and for IBS I need to up my fiber. I know you are from relatively the same area as me, have you tired RGAL in lancaster?


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## Flowby Jonas

mlr1969 said:


> I am at my wits end. I've had digestive problems for two years. The first year they would come and go and were mostly heartburn and indigestion. Then I had my gallbladder out, went on several meds and the problems went away for awhile. Last July I started having symptoms that included abdominal pain after meals (not always immediately) and terrible gas. It has continued daily for almost a year. I am ok if I eat a small amount of food early in the day - breakfast and lunch, but by dinnertime I have pain everyday and if I eat dinner the pain becomes excruciating and the gas follows for hours in the evening so bad I can't sit or stand up. I have had a lot of tests done, including 3 gastric emptying scans. The middle one came back delayed and the other two normal. My current GI doctor (I've already been to three of them) thinks that the one came back delayed because I was on an anxiety med that slows motility at the time. None of these doctors have ever mentioned the possibility of SIBO, and I am so desperate to get my life back. Do you think my symptoms fit this? What tests should I have done, and does a GI doctor need to do them or can my family doctor do them? Every time I ask my GI doctor to do another test he tells me I need to go off my anxiety meds and go to therapy. I've been in therapy and on and off meds for years and nothing has helped. I'm even doing hypnotherapy with no results so far.


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## Flowby Jonas

Get a new GI doctor. He thinks its in your mind. IBS of any sort has always been stigmatized. I can tell you from experience that if you feel better when you are on antibiotics, say like when the dentist gives them to you or say for a different reason, do you feel better? Chances are you have a SIBO, get a breath test and you will have a real good idea!


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