# Small Intestinal Bacteria Overgrowth



## ibsnewbie21 (Jun 8, 2013)

Does anyone have any experience of SIBO?

I've been told the likely diagnosis for my problems are severe IBS but I haven't had much help from my GP and GI consultant on what to do about it. My symptoms are nausea, fatigue, diarrhoea, flatulence, some bloating at times, and I always have very loose stools.

Having done some of my own research I decided to ask to be tested for SIBO. I've just heard back from my GI consultant who said it's so unlikely I would have SIBO that he won't test for it. This seems to contradict some of the stuff I've read.

Can anyone advise me on how common SIBO is, and if it is worth badgering my GP to get tested?

I've been tested for many other things like Crohn's, thyroid, iron etc., and I've had a MRI scan which came back clear.


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## Kathleen M. (Nov 16, 1999)

Well some of the initial studies with a highly selected population of people designed to find something came up with a pretty high percentage (like 80%)

Other people who test for SIBO regularly reported at the time it was about 5%.

The number is probably higher than 5% but probably, IMO, more in the 30 something percent range at best A recent study was in that range and found that those with type II diabetes or use of proton pump inhibitors were more likely to have SIBO, and they did find some SIBO in people without IBS. This used culture techniques which is usually considered to be more accurate than breath tests.

Classic SIBO (what they diagnosed before the year 2000) is highly unlikely in IBSers because people who get it from other diseases typically have additional symptoms that you don't usually see in people with IBS, even severe IBS.

You can have excess gas, pain, bloating from the colon bacteria when they are only living in the colon. You don't need them to be in the wrong place before that gas can add to symptoms.

Also it is known in Classic SIBO that even when symptoms are highly indictative of SIBO, often people on testiing don't have it.

So it isn't always clear cut and we still really need more studies before it is a solidly accepted part of routine IBS testing, and some doctors will need a lot more convincing.

Most people with IBS-SIBO find that even if they have SIBO and even if the antibotics help, the benefit tends to be short lived (a few months) and may be less with each round of antibiotics. So the clinical experience and experience of people on the board hasn't been that great.

You could try the low FODMAP diet (which is similar to a lot of what is recommended to try to extend the period where people feel better between rounds of antibiotics) and see if removing the fermentables from your diet helps. This can help whether you have some gas being made in the the small intestine as well as the much larger amount of gas made by the colon bacteria.

Often with SIBO the bloating is a lot more the issue than loose stools, so some bloating some of the time may make it less likely than severe bloating a couple of hours after every meal. For what it worth, lower carb diets (and low fodmap diet tends to be lower in carbs) often help with the loose stool symptom in IBSers.


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## ibsnewbie21 (Jun 8, 2013)

Thanks for the help. I was thinking about trying an exclusion diet, but waiting to see a dietician first. I've kept food diaries and cut out lactose, wheat and gluten, but it hasn't helped a great deal, and I've been unable to pin any other foods down as possible irritants.

I hear a lot about vegetable and fruit juice diets and fasting, have you heard of any successes for IBS sufferers?


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## Kathleen M. (Nov 16, 1999)

There can be really mixed results. Especially with fruits and veggies that can be high in GI irritants and Fodmaps and sometimes you can down a lot of something in juice form you wouldn't consume if you ate it whole.

Some juices can cause GI symptoms in healthy people if they take too much of it. Although many people assume diarrhea during a juice fast is a sign they are detoxing rather than consuming to much of a diarrhea provoking naturally occurring compound in the juice.

That being said, some people swear they help.


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## MaryAnn51 (Apr 3, 2010)

ibsnewbie21 said:


> Does anyone have any experience of SIBO?
> 
> I've been told the likely diagnosis for my problems are severe IBS but I haven't had much help from my GP and GI consultant on what to do about it. My symptoms are nausea, fatigue, diarrhoea, flatulence, some bloating at times, and I always have very loose stools.
> 
> ...


*Hi I have experience with SIBO ...unfortunately. I have had an IBS diagnosis since I was in my early 20's and I am now 54. Three years ago my IBS symptoms changed and I started, along with some new symptoms, to feel just generally ill. Never heard of SIBO before. I started having severe passing of gas - and I mean ALOT. I started with upper abd. pain; off/on nausea; stomach aches immediately after eating; floating stools; and more pain after having a BM than feeling relief. All different than my "normal" IBS symptoms. My MD did stool testing for parasites, etc. and also fat in my stools. I did come up positive for fecal fat, but no parasites. He then sent me for an abd. ultrasound which was negative. I kept telling him though that things were different and I felt just sick. Hard to explain. Then I went to my GI doctor who did bloodwork for celiac disease and sent me for an endoscopy and they did a biopsy also for celiac. I came back negative on both the bloodwork and biopsy. Then I was sent for a breath test and it came back HIGH positive for SIBO. I was given xifaxan for a month and saw the nutritionist. I also gave up white flour and refined sugar and it changed nothing. One the third/fourth day of the antibiotic I felt FABULOUS!!!!!!!!!!!! And the longer I was on it, the better I felt. After finishing, I felt good for about 3 mths and then the symptoms started coming back. So I was put back on the xifaxan and this time felt better faster and the course was shorter. Kept working with the nutritionist with diet, etc. Ended up on the xifaxan again like 8 mths later (was re-tested with breath test and was still positive) and then at that point I decided to try also going gluten free. Going gluten free and cutting way back on my sugars has helped me SO MUCH....I also suffer from fibromyalgia and my pain is substantially better. I felt great for about 8 months and then had a diverticulitis infection. ugh.... ran a fever for a few days ...I did a complete liquid diet for 4 days and bland for 2 weeks and somehow avoided any antibiotics. But some of the SIBO symptoms started creeping back in. I did another 2 week course of the xifaxan and now feel great again. Doctor said that alot of people with SIBO have to go on the antibiotics a few times a year because the symptoms never really completely go away. I just do my best to eat good and try to not let myself get too constipated - when all that stool stays inside too long it flares my SIBO symptoms up. I am never bloated anymore though - apparently I have a gluten intolerance because my body has responded so positive to the gluten free diet. Hope I helped some. I hope you can find a doctor that will test you further so you can start to feel better. Let me know if I can be of any further help. MaryAnn : )*


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## ibsnewbie21 (Jun 8, 2013)

MaryAnn51 said:


> *Hi I have experience with SIBO ...unfortunately. I have had an IBS diagnosis since I was in my early 20's and I am now 54. Three years ago my IBS symptoms changed and I started, along with some new symptoms, to feel just generally ill. Never heard of SIBO before. I started having severe passing of gas - and I mean ALOT. I started with upper abd. pain; off/on nausea; stomach aches immediately after eating; floating stools; and more pain after having a BM than feeling relief. All different than my "normal" IBS symptoms. My MD did stool testing for parasites, etc. and also fat in my stools. I did come up positive for fecal fat, but no parasites. He then sent me for an abd. ultrasound which was negative. I kept telling him though that things were different and I felt just sick. Hard to explain. Then I went to my GI doctor who did bloodwork for celiac disease and sent me for an endoscopy and they did a biopsy also for celiac. I came back negative on both the bloodwork and biopsy. Then I was sent for a breath test and it came back HIGH positive for SIBO. I was given xifaxan for a month and saw the nutritionist. I also gave up white flour and refined sugar and it changed nothing. One the third/fourth day of the antibiotic I felt FABULOUS!!!!!!!!!!!! And the longer I was on it, the better I felt. After finishing, I felt good for about 3 mths and then the symptoms started coming back. So I was put back on the xifaxan and this time felt better faster and the course was shorter. Kept working with the nutritionist with diet, etc. Ended up on the xifaxan again like 8 mths later (was re-tested with breath test and was still positive) and then at that point I decided to try also going gluten free. Going gluten free and cutting way back on my sugars has helped me SO MUCH....I also suffer from fibromyalgia and my pain is substantially better. I felt great for about 8 months and then had a diverticulitis infection. ugh.... ran a fever for a few days ...I did a complete liquid diet for 4 days and bland for 2 weeks and somehow avoided any antibiotics. But some of the SIBO symptoms started creeping back in. I did another 2 week course of the xifaxan and now feel great again. Doctor said that alot of people with SIBO have to go on the antibiotics a few times a year because the symptoms never really completely go away. I just do my best to eat good and try to not let myself get too constipated - when all that stool stays inside too long it flares my SIBO symptoms up. I am never bloated anymore though - apparently I have a gluten intolerance because my body has responded so positive to the gluten free diet. Hope I helped some. I hope you can find a doctor that will test you further so you can start to feel better. Let me know if I can be of any further help. MaryAnn : )*


Thanks for posting. It's good that you seem to be getting on top of it. I'm going to try a juicing fast first, then other extreme diets. If still no improvements I'll go back and ask again for SIBO test. Another thing that makes me think I've possibly got is SIBO is because when I was abroad last I picked up a really nasty stomach bug which I was prescribed antibiotics for. After a few days of taking them my IBS symptoms totally disappeared and for a couple of weeks I felt the best I have for years.


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## MaryAnn51 (Apr 3, 2010)

ibsnewbie21 said:


> Thanks for posting. It's good that you seem to be getting on top of it. I'm going to try a juicing fast first, then other extreme diets. If still no improvements I'll go back and ask again for SIBO test. Another thing that makes me think I've possibly got is SIBO is because when I was abroad last I picked up a really nasty stomach bug which I was prescribed antibiotics for. After a few days of taking them my IBS symptoms totally disappeared and for a couple of weeks I felt the best I have for years.


*Well I certainly cannot tell you what to do, but if you felt great after taking antibiotics, you most likely have SIBO. I am not saying it cannot get better with diet, but you really may need one or more courses of antibiotics. A juice fast may make your symptoms worse. The bacteria feed off of sugar - even natural sugar and usually carbs/sugars will make SIBO worse. Good luck to you.*


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## ibsnewbie21 (Jun 8, 2013)

I tried a juice diet, it didn't help, it actually made me worse. Had to stop after 5 days of drinking purely raw vegetable and fruit juice. My diarrhoea actually got a lot better but was replaced with sharp stomach pains and a general unsettled feeling in my stomach. Going back to my GP tomorrow to again ask for SIBO test and to be referred to a dietician.


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## laineyk (Jul 3, 2013)

Hi, I DO have SIBO (Hydrogen breath test) after having H-pylori (endoscopy with biopsy) and I can tell you the list of fruits and veggies you can consume, much shorter list than the list to avoid.

Fruits: Bananas, grapes, blueberries, all citrus

Vegetables: Carrots, Corn, Celery. Green beans, lettuce and tomatoes

so there you have it...very restrictive. I stay with within this list sometimes...but I cant help myself other times

let me know if you need anymore info...although Mary has been so helpful to me thus far.


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## ibsnewbie21 (Jun 8, 2013)

laineyk said:


> Hi, I DO have SIBO (Hydrogen breath test) after having H-pylori (endoscopy with biopsy) and I can tell you the list of fruits and veggies you can consume, much shorter list than the list to avoid.
> 
> Fruits: Bananas, grapes, blueberries, all citrus
> 
> ...


Thanks!


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## MaryAnn51 (Apr 3, 2010)

ibsnewbie21 said:


> I tried a juice diet, it didn't help, it actually made me worse. Had to stop after 5 days of drinking purely raw vegetable and fruit juice. My diarrhoea actually got a lot better but was replaced with sharp stomach pains and a general unsettled feeling in my stomach. Going back to my GP tomorrow to again ask for SIBO test and to be referred to a dietician.


*I had a feeling you'd be worse off with juicing....way too much sugar...your regular GP does the hydrogen breath test? I thought only GI doctors did that...best of luck to you.*


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## ibsnewbie21 (Jun 8, 2013)

MaryAnn51 said:


> *I had a feeling you'd be worse off with juicing....way too much sugar...your regular GP does the hydrogen breath test? I thought only GI doctors did that...best of luck to you.*


No, my GP is going to write to the GI regarding the test.


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## laineyk (Jul 3, 2013)

Ok I got a new one, today my GI told me, and I quote, "SIBO does NOT cause abdominal pain"!!!!!!! Is he nuts? He says its all from my IBS (which he last diagnosed me with last week.

I tested positive for SIBO back in June. Took Biaxin for a week and nothing has changed one iota since then.

had to press him for another HBT to either confirm or deny the presence of SIBO...so now I wait for him to schedule that.

but any of you who have had SIBO...just wanted to let you know that if you feel any pain from it,,,its not from SIBO







LOL


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## ibsnewbie21 (Jun 8, 2013)

After my GI having refused to test me for SIBO a few weeks back, I've asked my GP to write off to him again and ask for a test. I've also found an IBS specialist who takes NHS patients in my area, my GP is going to refer me. Cause for optimism maybe.


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## laineyk (Jul 3, 2013)

well after I feel out in tears on the phone my GI has scheduled another breath test to be done this coming Thursday







I am thankful, if I don't have SIBO I will be shocked and will have to except that all this is now due to IBS.

I will say that this whole last year has been a complete fail on my health aspect. praying for relief soon


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## ibsnewbie21 (Jun 8, 2013)

laineyk said:


> well after I feel out in tears on the phone my GI has scheduled another breath test to be done this coming Thursday
> 
> 
> 
> ...


I know what you mean, this last year I feel like my life's been on hold, just passing me by. I'm craving the simple things like work, sport and socialising. Still, getting a lot of reading done


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## laineyk (Jul 3, 2013)

being not able to work has been a huge burden on me...makes me feel so inadequate, thank God my Hubby is ok with it and we are able to make due.

I too read ALOT, surf the internet and take long walks or ride my bike (when my gut isn't killing me)

really anxious about getting the breath test done on Thursday and I know this sounds wrong, but am hoping its SIBO still so I can prove my GI to be wrong


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## ibsnewbie21 (Jun 8, 2013)

laineyk said:


> being not able to work has been a huge burden on me...makes me feel so inadequate, thank God my Hubby is ok with it and we are able to make due.
> 
> I too read ALOT, surf the internet and take long walks or ride my bike (when my gut isn't killing me)
> 
> really anxious about getting the breath test done on Thursday and I know this sounds wrong, but am hoping its SIBO still so I can prove my GI to be wrong


I've just heard back from the GI, he has begrudgingly agreed to the hydrogen breath test for SIBO (although he has stated that he thinks the test is pretty meaningless). Now have to wait for an appointment date.

Good luck for your test on Thursday. I know what you mean, I am also hoping it's SIBO for the same reason.


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## abbyladybug (Aug 1, 2013)

I have been placed on a low-FODMAP diet by my dietitian, and my gastroenterologist has given me two breath tests to take: one for SIBO and one for Fructose intolerance. My lactose intolerance is long-established, so I'm not doing that one. It's a pretty involved test that you bring home with you. I was going to take it this past weekend, but one of the requirements to take it is that I can't take any probiotics within 4-5 days of the test. For each test, I need to spend 12 hours eating basically rice, meat, and eggs only, then I fast for 12 hours, then I spend a 3 hour morning doing this: I breath into a tube and then seal the tube, then I eat some stuff in a packet and blow into a tube every 20 minutes until I have 10 tubes of breath samples for them. I then mail all this off to a company in Massachusetts, and then later, the results are sent to my doctor. I'm going to do the SIBO test this weekend, and then I'll do the fructose one next weekend. According to my doc, if I have SIBO, I go on an antibiotic, which will probably fix it. The fix may be permanent, but it might only last a month or two. The doc will then determine whether treating this SIBO is the way to manage my symptoms or not. Since I'm at the beginning, I don't fully understand how it all works, but it seems I'm on the right path.

Let me back up a little. My dietitian recommended these breath tests. They are also recommended by the researchers at Manesh University in Australian who do the low-FODMAP research and have an app for iPhone. Anyway, she didn't know where I could get the testing done. Neither did my primary care physician. I ended up contacting the company that makes these tests, Commonwealth Laboratories, Inc. I got them to send me a list of docs in my area who do that sort of testing. I cross-listed their list with the docs that are covered by my insurance. Voila! Found a great gastroenterologist who does the testing.

Now it's just finding the time to do the eating and the fasting and everything.


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## abbyladybug (Aug 1, 2013)

laineyk said:


> Ok I got a new one, today my GI told me, and I quote, "SIBO does NOT cause abdominal pain"!!!!!!! Is he nuts? He says its all from my IBS (which he last diagnosed me with last week.


From Wikipedia: "Bacterial overgrowth can cause a variety of symptoms, many of which are also found in other conditions, making the diagnosischallenging at times.[1][3] Many of the symptoms are due to malabsorption of nutrients due to the effects of bacteria which either metabolize nutrients or cause inflammation of the small bowel impairing absorption. The symptoms of bacterial overgrowth includenausea, bloating, flatus, chronic diarrhea, and constipation.[4]"

I think if your doctor is mostly saying you are crazy, it's time to get another doctor who might consider listening to you.


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## laineyk (Jul 3, 2013)

thanks abby, So you are doing the breath test at home, hmmmm doesn't sound accurate enough for me. when I had the 1st breath test done I too had to follow certain guidelines a couple days prior to test. Then NPO after midnight the night before

They gave me something to drink that was very sweet tasting (prior to that they took a "baseline" breath. I would breath into this machine. Then after drinking the stuff they gave me, I would have to breath into the machine every 15 minutes

I went from a 2 to 88 in 90 minutes....definitely SIBO

you are correct about having to take antibiotics, but most ppl will have it reappear after a short time. A lot of ppl I have spoke to have had to take antibiotics in cycles.

The test I will be doing is with a NEW machine that is supposed to be even more accurate, so I will see what it shows.


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## laineyk (Jul 3, 2013)

Going in for breath test this morning, wish me luck!!!! whatever that means


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## abbyladybug (Aug 1, 2013)

I'll be interested to see if you are sent home with a test or if they do it there. I'm set up to run test #1 (SIBO) on Saturday and test #2 (Fructose Malabsorption) a week later.


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## laineyk (Jul 3, 2013)

NO SIBO!!! I have to say, I was shocked to say the least. the machine never moved even past zero??!!

So I guess my GI was right and that the Biaxin killed the SIBO and now its all IBS making me miserable.

this test was different from the 1st one I took back in June. I drank 8ozs of some liquid at home an hour b4 test. 1st test I drank something like 30ml of lactulose at the office and then they started testing me every 15 minutes

so now heres the million dollar question, how will I ever know if its SIBO again since the symtoms are iidentical with IBS? anyone know the answer to this one?


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## ibsnewbie21 (Jun 8, 2013)

laineyk said:


> NO SIBO!!! I have to say, I was shocked to say the least. the machine never moved even past zero??!!
> 
> So I guess my GI was right and that the Biaxin killed the SIBO and now its all IBS making me miserable.
> 
> ...


Oh no, what's next? Have you tried the low FODMAP diet?


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## MaryAnn51 (Apr 3, 2010)

Hey Lainey - I am shocked as well that you don't have SIBO. But, its actually a good thing! Now maybe you can relax a bit knowing you don't have SIBO and stop worrying so much. Anxiety and worry - mind body connection - big problem for those of us with gut problems! Take a deep breath and know that worry is behind you. Again I forget but did you have an upper/lower GI series ? I think you said you had a negative endoscopy and colonoscopy right? Maybe your GI doctor could prescribe an anti-spasm medication for you. I had a BAD IBS flare a few years back and a few days on Levsin and I was back to normal.

MaryAnn


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## abbyladybug (Aug 1, 2013)

laineyk said:


> thanks abby, So you are doing the breath test at home, hmmmm doesn't sound accurate enough for me. when I had the 1st breath test done I too had to follow certain guidelines a couple days prior to test. Then NPO after midnight the night before
> 
> They gave me something to drink that was very sweet tasting (prior to that they took a "baseline" breath. I would breath into this machine. Then after drinking the stuff they gave me, I would have to breath into the machine every 15 minutes
> 
> ...


By the way, all those detailed instructions you mentioned? I had to do all of those. I was going to take the test last week, but I hadn't followed the guidelines, so I wasn't prepared. But this week, I was ready, and I took the test this morning. I'm not sure it's any less accurate. This is apparently how many physicians do it (sending people home with the test). That's what the makers of the test described to me on the phone when I called them, so I'm assuming the results will be accurate. I have a few days to UPS them back to the company that does them.

And might I say, What a pain! I am a big snacker, and I'm not a big meat eater, so I was DYING for produce by the end of the test. Got out my Kate Scarlata cookbook and made a big low-FODMAP meal while I was waiting. The second I blew into the last of the 10 tubes, I ate a big bowl of rice noodles with tofu, vegetables, and a spicy peanut sauce. I don't remember the last time I enjoyed food so very much!

The plan is to do the Fructose test next week. I'm foregoing the lactose test all together. The gastroenterologist said that since my lactose-intolerance is so well-established, there's really no point.


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## laineyk (Jul 3, 2013)

Maryann, I did have both. Colonoscopy was negative for anything...endoscopy was positive for H-pylori. That's what I was treated for 1st. after the treatment stool sample showed HP eradicated but I was still suffering.

so HBT test taken in June and positive for SIBO.. took Biaxin 10 days....still suffering, but this last HBT showed no SIBO so its IBS

I do know that my stress makes it worse, going back to p/doc in 2 weeks to see what we can do about changing my meds

pepto bismol gives me relief and the GI sais it was perfectly safe to take as needed.

Abbylady, I pray you don't have SIBO, it is not fun but will say that it mirrors all the symptoms of IBS, so either one is not good news. please let us know what you find out when you get the results


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## MaryAnn51 (Apr 3, 2010)

Keep in touch Lainey - Ask the doc for Levsin or a similar anti-spasmotic ... it could help you alot.


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## erialc1 (Aug 21, 2013)

*ANY ONE ON THIS SITE WITH INTESTINAL PROBLEMS YOU MUST CHECK OUT 'THE SPECIFIC CARBOHYDRATE DIET'!!*

This is a diet formulated for people with intestinal problems, all of these problems are caused by intestinal bacteria, these bacteria feed on...sugar, lactose, starches, among other things. In order to kill the bacteria you must starve them of their food.

There are thousands of people in the USA and UK following this diet.

There is no point in taking Rifaximin or any other drug that kills the bacteria if you are still feeding it at the same time.

SEE THE BELOW LINKS.

http://www.breakingtheviciouscycle.info/

groups.yahoo.com/group/SCDUK/

Claire


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## rmiller1985 (Sep 13, 2011)

I agree with erialc1, although I'd also point out that no one approach works for absolutely everyone.

For me, the SCD has worked amazingly well. After two and a half months on the diet, I feel like I've experienced a 95% reduction in my symptoms. I attribute this to a) starving the bad bacteria, and







adding a lot of good bacteria via SCD yogurt (cooked longer, and at a lower temperature, than regular yogurt so that the good bacteria eat all of the lactose).

Cheers,

Rich


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## erialc1 (Aug 21, 2013)

I agree Rich that no one approach will work for everyone and if you can try and hit the bacteria from several angles at once all the better. I am on the SCD diet which is helping but i'm also trying to get hold of some Rifaxamin to hit the bacteria even harder and in an attempt to get better quicker.

I think whatever else you try the diet should be imperative, this will ensure you stop feeding the bacteria.

Claire


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## ibsnewbie21 (Jun 8, 2013)

Finally got an appointment for the SIBO test - 15th October. Saw an IBS specialist too, she put me on the low FODMAP diet, which I started last Monday. No benefits yet but it's early days.


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## ibsnewbie21 (Jun 8, 2013)

rmiller1985 said:


> I agree with erialc1, although I'd also point out that no one approach works for absolutely everyone.
> 
> For me, the SCD has worked amazingly well. After two and a half months on the diet, I feel like I've experienced a 95% reduction in my symptoms. I attribute this to a) starving the bad bacteria, and
> 
> ...


Hi Rich

How long were you on the SCD diet before you started to see some results?

Thanks

Gary


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## rmiller1985 (Sep 13, 2011)

Hi Gary,

Well, I started to see "results" within a couple of days -- but they weren't completely positive. My BMs changed, but the diarrhea didn't disappear overnight. I went from a lot of urgency and 4-8 BMs a day that were a 5 or 6 on the Bristol scale to less urgency and BMs that alternated between 4s and 7s on the scale. It was a bit unnerving for a week or two, as I was unconvinced that the diet was "working." I've since learned that ANY change to your BMs is generally good, as it indicates that your body is "recalibrating," for lack of a better term.

After a couple of weeks, things settled down, and my BMs were less frequent and more well-formed. But there was still quite a bit of alternating diarrhea/normal. Because there was a positive change, I decided to stick with the diet, although I had my moments of doubt.

I added the homemade yogurt at two months, and things got markedly better: virtually normal BMs, once or twice a day.

I'm now experiencing a bit of a flare, but I'm attributing it to a peanut butter/almond flour experiment over the past couple of weeks. I've decided that it's still too early for me to eat nuts and peanuts, and I'm expecting things to settle down again.

Cheers,

Rich


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## ibsnewbie21 (Jun 8, 2013)

I had my Hydrogen Breath Test for SIBO last Tuesday, I am still waiting for the results from my GI as the nurse didn't understand what the readings meant. My base level was 10ppm. After drinking the lactulose solution and testing every 15 minutes for 2 hours after, the results were as follows: 9,8,7,6,6,7,9, then the last reading went right up from 9ppm to 20ppm. the last 20 minutes of the test I started to feel nauseated and once I got home I had diarrhoea. I'm sure if the test continued for any longer my levels would have gone up further. It does appear to me that I have SIBO, would anyone agree?


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## Kathleen M. (Nov 16, 1999)

With SIBO usually it is not IF the numbers go up at any point, it is if you get TWO increases in amount of gas rather than just one.

The numbers should go up when the lactulose hits the colon bacteria in the normal place. Usually with SIBO you see a smaller hump of gas earlier on then the large increase at the end (which would continue high for awhile as there is a lot more bacteria in the colon than ever live in the small intestine.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1856094/figure/fig4/ shows the usual two peaks and around the 2 hour mark seems to be when the second peak starts up.


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## ibsnewbie21 (Jun 8, 2013)

erialc1 said:


> I agree Rich that no one approach will work for everyone and if you can try and hit the bacteria from several angles at once all the better. I am on the SCD diet which is helping but i'm also trying to get hold of some Rifaxamin to hit the bacteria even harder and in an attempt to get better quicker.
> 
> I think whatever else you try the diet should be imperative, this will ensure you stop feeding the bacteria.
> 
> Claire


Hi Claire

Just curious, did you try the Rifaxamin?

Cheers

Gary


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## ibsnewbie21 (Jun 8, 2013)

Kathleen M. said:


> With SIBO usually it is not IF the numbers go up at any point, it is if you get TWO increases in amount of gas rather than just one.
> 
> The numbers should go up when the lactulose hits the colon bacteria in the normal place. Usually with SIBO you see a smaller hump of gas earlier on then the large increase at the end (which would continue high for awhile as there is a lot more bacteria in the colon than ever live in the small intestine.
> 
> http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1856094/figure/fig4/ shows the usual two peaks and around the 2 hour mark seems to be when the second peak starts up.


Oh I see, thanks. So as I didn't get the early increase then I probably haven't got SIBO?


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## Kathleen M. (Nov 16, 1999)

From my understanding that is more of a probably don't than a probably do result.


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## ibsnewbie21 (Jun 8, 2013)

Kathleen M. said:


> From my understanding that is more of a probably don't than a probably do result.


OK thanks.


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## lookingforcure (Mar 27, 2012)

Hey everyone taking the SIBO breath test: please keep in mind that this is not a particularly accurate test. I can't remember the numbers offhand (you can google them if intested), but the sensitivity and specificity of the test is only something like 70%. So just because your breath test says one thing it does not necessarily make it so.


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