# SIBO and Vivonex Plus fast



## Brownish72 (Aug 26, 2012)

THE FOLLOWING IS MY 1st and 2nd experience fasting. This thread elaborates on the fast, with including info on SCD diet as well. Refer to my new new thread for my latest updates on Vivonex: http://www.ibsgroup.org/forums/topic/161750-vivonex-plus-fast-and-sibo/

Hi all,I'm new to this forum, and have kept my story fairly quiet, until today when I am jumping up and down from excitement.A very short background of the last 3 years.I was traveling abroad, had lived with IBS most my life, suffering from cramps and frequent bouts of diarrhea. However, the IBS was rarely bad enough to make me nervous to travel or continue on in life, it was just embarrassing, but I never took the time to think of ways of "curing" my IBS. I wanted a pill to treat symptoms, and to live on with my life.3 years ago, while traveling, I had a bout of travelers diarrhea, and took ciproflaxin to curb it. When I took it, within hours I felt immediate relief, so much that I thought I had found a miracle drug for IBS. I didn't know this was an antibiotic, nor did I realize the seriousness of antibiotics. So i didn't take it as it was written, but took it on and off for 4 months, living almost 100% IBS symptom free. Then one day, it stopped working. So did all my other tricks, like drinking white tea, eating a healthy salad, or anything.I came home w/ having to run the bathroom 10-15 times a day, w/ a pure liquid D. This went on for about 16 months, and I finally adressed it. Bounced around docs', and found one that truly listened to my story, others told me it would just one day disappear, and she asked me if I had been tested for SIBO. I said nope, and BAM got a result, I had it. I was so happy walkin' outta the doc's office thinking another antibiotic, woohoo, this should do the trick. The drug was call Rifaxamin... $1000 later, b/c insurance wouldn't cover it, I was stuck in the same spot. I did this same treatment 3 times over the course of 2-3 years. Well it never worked. I followed the Specific Carbohydrate Diet, and still do actually, for 6 months, gave rifaxamin one last try a month ago. I thought the diet in combo with medicine would work. Sadly,, not for me. Luckily, my symptoms on the SCD diet were so minimal at this point, and i was VERY strict, that I am medication free for 4 months now, and although diarrhea would come back here and there, my symptoms were under control. However, the diet itself was wearing on me soo bad, I had to go to the extreme.I got Vivonex Plus, and diet made by Nestle. Costs a fortune, luckily I got this one paid for







. I have fasted for the last 16 days, and went in for a breath test today. I lasted the entire 90 minutes, and was officially diagnosed @ the end with NORMALIZING MY HYDROGEN BREATH LEVELS!!! It took me three years to reach this step on the latter. Im so happy, I could cry. I was convinced this wouldn't work for me, because nothing else has, and this did. Its unbelievably comforting knowing that I have found something that knocked this infection out. I am also comforted with the fact that if it comes back (and I accept that this is likely), I have found a safe way to knock it out again. If people are interested. I could post a day by day summary of my events, to motivate people to do the same. But first, I don't even know if this will interest anyone. I am going to stay on a low carb , grain, and gluten free diet for now because its just become a part of my life. I may one day stop, but I dont think i will anytime soon. But all I have to say is WOW. Thanks for readingAndy


----------



## Brownish72 (Aug 26, 2012)

Just wanted to add:almost 48 hours later and I've eaten all solid foods todayNo bloating, gurgling, gas, or D. In fact, my only BM was so small, but normal, I wouldn't even count it as anything.Pretty interesting these last few days. Im still way nervous, yet excited to see how I feel in one month, and in 6 months. etc.Andy


----------



## Brownish72 (Aug 26, 2012)

still feeling great one week later. Little D this morning, could be related to all the fruit I ate yesterday, and before going to bed. Also have tried some soy, sugar, and wheat today for first time. 3 hours later.. no symptoms so far!


----------



## kathyrd (May 27, 2012)

Brownish72 said:


> Hi all,I'm new to this forum, and have kept my story fairly quiet, until today when I am jumping up and down from excitement.A very short background of the last 3 years.I was traveling abroad, had lived with IBS most my life, suffering from cramps and frequent bouts of diarrhea. However, the IBS was rarely bad enough to make me nervous to travel or continue on in life, it was just embarrassing, but I never took the time to think of ways of "curing" my IBS. I wanted a pill to treat symptoms, and to live on with my life.3 years ago, while traveling, I had a bout of travelers diarrhea, and took ciproflaxin to curb it. When I took it, within hours I felt immediate relief, so much that I thought I had found a miracle drug for IBS. I didn't know this was an antibiotic, nor did I realize the seriousness of antibiotics. So i didn't take it as it was written, but took it on and off for 4 months, living almost 100% IBS symptom free. Then one day, it stopped working. So did all my other tricks, like drinking white tea, eating a healthy salad, or anything.I came home w/ having to run the bathroom 10-15 times a day, w/ a pure liquid D. This went on for about 16 months, and I finally adressed it. Bounced around docs', and found one that truly listened to my story, others told me it would just one day disappear, and she asked me if I had been tested for SIBO. I said nope, and BAM got a result, I had it. I was so happy walkin' outta the doc's office thinking another antibiotic, woohoo, this should do the trick. The drug was call Rifaxamin... $1000 later, b/c insurance wouldn't cover it, I was stuck in the same spot. I did this same treatment 3 times over the course of 2-3 years. Well it never worked. I followed the Specific Carbohydrate Diet, and still do actually, for 6 months, gave rifaxamin one last try a month ago. I thought the diet in combo with medicine would work. Sadly,, not for me. Luckily, my symptoms on the SCD diet were so minimal at this point, and i was VERY strict, that I am medication free for 4 months now, and although diarrhea would come back here and there, my symptoms were under control. However, the diet itself was wearing on me soo bad, I had to go to the extreme.I got Vivonex Plus, and diet made by Nestle. Costs a fortune, luckily I got this one paid for
> 
> 
> 
> ...


----------



## kathyrd (May 27, 2012)

So, to be clear , was the Vivonex part of the fast? Was it helpful? Or just mainly the low carb, grain free, gluten free?Thanks!I am a dietitian who has found relief from my own IBS through GF diet and low FODMAPS.


----------



## Alfan (Sep 12, 2012)

I'm just curious on how they tested for SIBO?!Ps great to see someone with D finding some relif it sucks big time!Ps what is Vivonex Plus? googled it and it looks like some form of pulver that gives u nutrients when ur on a fast ?







or am i wrong?


----------



## Brownish72 (Aug 26, 2012)

kathyrd said:


> So, to be clear , was the Vivonex part of the fast? Was it helpful? Or just mainly the low carb, grain free, gluten free?Thanks!I am a dietitian who has found relief from my own IBS through GF diet and low FODMAPS.


Hi,I guess when I said "fasted" I mean to say, I didn't eat anything, I drank the vivonex shakes. I found a low carb, grain free, gluten free diet to be HIGHLY effective, but I still tested positive with SIBO after 1/2 a year on the diet, and I was getting tired of being so picky. I had read a study that by doing a 14 day fast on this stuff, it was highly effective in normalizing Hydrogen Breath levels, and ultimately attacking the problem of SIBO for me. Not only did I need to get rid of the bacteria, I needed to heal my intestines. By not "eating", I personally believe this is achievable. The shakes provide essential nutrients, vitamins, and minerals for energy, and yet these same nutrients are needed for cellular regeneration. Its only 10 days or since i've started eating. I feel my symptoms coming back, yet nothing like it was before. Right now, Im having about 1-2 BM's each day, and I would give them a 6-7 out of 10, if 10 was the best. However, I am eating bread, sugar, and even had a beer tonight. All of which, if I did before, would of caused me a liquid D, and terrible, TERRIBLE crampingSo in writing this down, I actually realize that i am much better off now, than I was than. I also know, that if I had to do it again, I would do it in a second. It was safe, and worth every day of struggle to hear those results. Also, while on the fast, I wasn't hungry. The shakes provide 300 calories per packet, and after having 1-2 packets, I was literally "full"Hope this helps, feel free to ask more questions!


----------



## Brownish72 (Aug 26, 2012)

Alfan said:


> I'm just curious on how they tested for SIBO?!Ps great to see someone with D finding some relif it sucks big time!Ps what is Vivonex Plus? googled it and it looks like some form of pulver that gives u nutrients when ur on a fast ?
> 
> 
> 
> ...


Hello!I was tested for SIBO by doing a Hydrogen Breath Test. During the Test, you drink a Complex Carb called Lactulose, not lactose. Every 10 minutes, for 90 minutes, you breath into a machine, and they test for levels of hydrogen. If the levels spike more than 12 Parts per millions (PPM) in 90 min, this shows strong evidence that there is a bacterial overgrowth present. That is because it is bacterial, not our bodies, that produce hydrogen or methane. If they were there, they would consume the carb, produce hydrogen, and it would show up in your breath.Vivonex plus is a product by Nestlé. It consists of essential nutrients, amino acids, and a form of carbohydrate derived from corn. All the nutrients are "predigested" or in other words, they do not require any digestion, and should be absorbed w/ in the first 2 feet of the small intestine. The idea behind the fast is to starve the bacterial, and wash them out. At the same time, it allows for intestinal healing, and hopefully can allow someone to return to normal health.My D is basically gone. I mean, GONE! Although, I've been getting some bloating lately. That makes me a little nervous, yet, like I just posted, if I had to do the fast again, I'd do it in a heartbeat for the benefits of how I feel now. Unbelievable to difference between how I was, and where I am. I was living in misery, Now, I just took a 9 hour flight to Paris, plus a train ride to Switzerland, and traveled about 20 hours, ate whatever food they gave me on the plane, and I'm fine. Pretty awesome!My hope is to share this news with a lot of people. Although I recognize that Dr Pimental out of California has written a book about this, I searched long and hard in google, and only found 3 others who had done this. There experience sounded so horrible that I was realllly scared to do this. To my surprise, it wasn't that bad, and although its not fun, its definatly nothing like the pain I was in.Hope this helps!


----------



## Alfan (Sep 12, 2012)

Thats brilliant, did you have to push hard to get ur sibo test, think ive been to like 10 specialist never done a test like that :SIm realy happy that you've found some light! I've expected that bacteria is the cause of my ibs. Gonna go try and get a sibo test assap thanks man!


----------



## Brownish72 (Aug 26, 2012)

Alfan said:


> Thats brilliant, did you have to push hard to get ur sibo test, think ive been to like 10 specialist never done a test like that :SIm realy happy that you've found some light! I've expected that bacteria is the cause of my ibs. Gonna go try and get a sibo test assap thanks man!


no i just asked... was pretty easy


----------



## Alfan (Sep 12, 2012)

hehe ok one would think they would do that without the paitent asking for oneOh well gonna make sure i get one done!cheers!


----------



## rudibear (Jul 28, 2012)

Alfan said:


> Thats brilliant, did you have to push hard to get ur sibo test, think ive been to like 10 specialist never done a test like that :SIm realy happy that you've found some light! I've expected that bacteria is the cause of my ibs. Gonna go try and get a sibo test assap thanks man!


I had abdominal surgery in January. Doctors think this triggered IBS. But have scheduled me for a CT scan (assuming insurance will pay) to check of diverticulitis. Have had all the other usual tests. If CT is negative my GI plans on treating me for SIBO without running a test. He says the tests are too unreliable. Maybe that's why doctors are hesitant to give them.


----------



## Brownish72 (Aug 26, 2012)

rudibear said:


> I had abdominal surgery in January. Doctors think this triggered IBS. But have scheduled me for a CT scan (assuming insurance will pay) to check of diverticulitis. Have had all the other usual tests. If CT is negative my GI plans on treating me for SIBO without running a test. He says the tests are too unreliable. Maybe that's why doctors are hesitant to give them.


As far as I've found, there are 2 ways to test for SIBO, one is a test of fluids from the middle of the small bowel via a tube passed through the nose. Although its very uncomfortable, its also not reliable because its hard to keep the sample from touching air. The second way is by this breath test I spoke about above. This is considered the "gold standard" as of now. I did have a stool test done that truly confirmed that I had SIBO, but as for now, this is the best most up to date way of testing for SIBO


----------



## Milly1 (Apr 6, 2011)

Hi Andy, Very interesting reading your experience with fasting etc. I have just recently watched a programme about fasting and how it really can be a miracle cure for so many things, high blood pressure, colesterol,heart disease, dymentia... the list goes on. The whole programme explains what happens to the body when you fast, it goes into 'repair' mode. It's a BBC programme called Horizon and is available on youtube to watch, just type in 'Horizon fasting' into a youtube search and you should be able to find it, so worth watching. It all makes sense really, we as hunter gatherers were never meant to eat the way we do now. Having said all that, obviously fasting is something that has to be considered carefully and not to just stop the intake of anything! Just covering myself here! Sarah


----------



## Brownish72 (Aug 26, 2012)

Milly1 said:


> Hi Andy, Very interesting reading your experience with fasting etc. I have just recently watched a programme about fasting and how it really can be a miracle cure for so many things, high blood pressure, colesterol,heart disease, dymentia... the list goes on. The whole programme explains what happens to the body when you fast, it goes into 'repair' mode. It's a BBC programme called Horizon and is available on youtube to watch, just type in 'Horizon fasting' into a youtube search and you should be able to find it, so worth watching. It all makes sense really, we as hunter gatherers were never meant to eat the way we do now. Having said all that, obviously fasting is something that has to be considered carefully and not to just stop the intake of anything! Just covering myself here! Sarah


Great response! I'll check out the video. And you're right, fasting does need to be done carefully. Of course its all you can think about while on the fast, and I was nervous at times, but reassured that the product I was taking was safe, used in all parts of the world, and in theory, you could live for months on it (although that truly would be awful)Thanks for your response. I'm still feeling pretty good! I eat what I want, but still stay away from a lot of sugar. I say no to candy, but slipped up yesterday and had some chocolate. However, its good to test these things too.-Andy


----------



## Milly1 (Apr 6, 2011)

Brownish72 said:


> Great response! I'll check out the video. And you're right, fasting does need to be done carefully. Of course its all you can think about while on the fast, and I was nervous at times, but reassured that the product I was taking was safe, used in all parts of the world, and in theory, you could live for months on it (although that truly would be awful)Thanks for your response. I'm still feeling pretty good! I eat what I want, but still stay away from a lot of sugar. I say no to candy, but slipped up yesterday and had some chocolate. However, its good to test these things too.-Andy


Hi again Andy, Have you read 'IBS a New Solution', I'm guessing that you have from what you've said...Interesting stuff. I have found that my IBS took a change after I'd taken a couple of proton pump inhibitors for acid, they really messed up what was already a messed up system! The thing I'm really having problems with now is wind (mmm, nice... not!), stomach gurgles away all day and by evening its unbearable. Not eating seems to really make it worse. And of course, the dreaded SUGAR! It's fructose that's the worse which of one of the things that is pointed out in the book. Am thinking of trying the fast with a product just to see if that does it! Sarah


----------



## Brownish72 (Aug 26, 2012)

Milly1 said:


> Hi again Andy, Have you read 'IBS a New Solution', I'm guessing that you have from what you've said...Interesting stuff. I have found that my IBS took a change after I'd taken a couple of proton pump inhibitors for acid, they really messed up what was already a messed up system! The thing I'm really having problems with now is wind (mmm, nice... not!), stomach gurgles away all day and by evening its unbearable. Not eating seems to really make it worse. And of course, the dreaded SUGAR! It's fructose that's the worse which of one of the things that is pointed out in the book. Am thinking of trying the fast with a product just to see if that does it! Sarah


I did read it. It was an interesting book. I also read "Breaking the Vicious Cycle". Thats an incredible book, and I highly recommend it. I have also done hours of research on sites such as PubMed, because I had access to such sites while I was still a student. All the information has come to together and allowed me to form my own opinions about the condition, how it works, and how to go about treating it.


----------



## Brownish72 (Aug 26, 2012)

Just as an update. I was worried my condition was coming back because these last 7 days, I have had a crazy amount of rumbling going on in my stomach, even diarrhea, however I tried taking activated charcoal, and to my surprise, I think it really curbed it. Yesterday I ate Chocolate, a sandwich, 3 coffees, and a nice tomato tuna "pizza" if you will. Today I not only feel fine, but my BM this morning was perfect, and I have 0 gas, bloating, cramping, etc..For those with SIBO, this is now almost 30 days after my fast, and in previous forums, people ask "how do you feel now that its been a few weeks". I can say so far, I feel great! I have had my setbacks, and my worries that SIBO was coming back. But honestly, its days like today that keep me motived and ready to continue my fight against all this.I highly recommend the fast to anyone. Nestlé does have a subsidy program available to those who cannot afford their product. I highly suggest looking into it. As Dr. Pimentel said as he has observed from his patients, the time and money spent are well paid off by the rewards of feeling better in the end. I can truly say, I feel better.-Andy


----------



## Milly1 (Apr 6, 2011)

Hi Andy, Great to hear that you're continuing with the improvement! I've had a major setback on my VSL, have had to start antibiotics again because of an eye AND bladder infection. Usually I tolerate Keflex well and have in the past had an improvement with stomach on these but this time, after the VSL, its been awful. Terrible gurgling and wind!







Really annoyed about this as I was just starting to feel that the VSL was starting to work....


----------



## Brownish72 (Aug 26, 2012)

Milly1 said:


> Hi Andy, Great to hear that you're continuing with the improvement! I've had a major setback on my VSL, have had to start antibiotics again because of an eye AND bladder infection. Usually I tolerate Keflex well and have in the past had an improvement with stomach on these but this time, after the VSL, its been awful. Terrible gurgling and wind!
> 
> 
> 
> ...


Have you every taken enzyme supplements before? They help with carbohydrate digestion and absorption, and its something I still take. Its safe, easy to find at the pharmacy, and something I noticed a huge improvement with when I took them even while I was still very sick.If you haven't, there are products out there that are free of starch, sugar, yeast, soy, wheat, corn, etc... And for people like us with stomach issues, thats great to know. It may be something worth looking into.


----------



## Milly1 (Apr 6, 2011)

Brownish72 said:


> Have you every taken enzyme supplements before? They help with carbohydrate digestion and absorption, and its something I still take. Its safe, easy to find at the pharmacy, and something I noticed a huge improvement with when I took them even while I was still very sick.If you haven't, there are products out there that are free of starch, sugar, yeast, soy, wheat, corn, etc... And for people like us with stomach issues, thats great to know. It may be something worth looking into.


Yep, have done enzyme supplements, made things worse. Into day two of antibiotics and am feeling human again, stomach soooo much better now!


----------



## Brownish72 (Aug 26, 2012)

I've noticed in previous posts about SIBO, that many people ask how the fast works months later. So as an update. I'm still doing much better than I was doing before the fast. I know this because I eat bread, drink beer from time and time again, and don't pay attention NEARLY as much to my diet as I used to. I do however continue to cook my own meals and stay away from processed foods. On the other hand...I do notice gas and cramping occasionally. But when I think about how extremely sensitive I was before the fast to how I am now, there is not even a comparison. My stomach and bowels are calm, at ease, and although bouts of IBS seem to come back, I'm so much better than I ever was. As of right now, I would say its safe to highly recommend a fast drinking Vivonex Plus for at least 14 days, and as always, discuss w/ your doctor.Hope this helps everyone


----------



## salvationishere2 (Jul 1, 2009)

Andy, fascinating story! How are you doing now? I have struggled with SIBO for the past 8 years! I even flew to Los Angeles 2 weeks ago to go to Cedars-Sinai and take the hydrogen breath test. It showed high methane levels. I plan on following the Vivonex Plus protocol. But what is this "activated charcoal" and where can I purchase it from?


----------



## Brownish72 (Aug 26, 2012)

So glad to here someone read my blog who struggles with SIBO, I really hope my story can be spread to others who struggle with it.Have you read Pimentel's "A new IBS Solution" . If not, you should get it. It will help explain the reasons and the science behind the diet. It also is comforting, because it reinforces in the book that the "fast" on Vivonex is safe, even though many times I kept questioning myself "Am i okay"? It's scary not eating for 2-3 weeks. And @ the same time, I couldn't stop questioning myself "Is this really working". I say this because throughout the fast, you experience a lot of physical and mental challenges. The physical ones are body aches, and headaches for the first few days. This is normal, because as explained in this book and much other research, its known as "die-off" or a "herx" reaction. And I still had bowel movements each day, so I thought maybe this wasn't normal, turns out it is for some. However, once I got to day 3, the physical challenges became mental challenges. I reallllly reallly like coffee, and it was tough to give up for 2 weeks. Things like that were hard. But I didn't loose much weight, I worked out daily and rock climbed a lot, but I didn't do cardio. I didn't wanna run my electrolyte levels down, that was personal choice. But just wanted to point out, I had a lot of energy. I can say that a lot of that fear for me was because I couldn't find anyone to talk to about the diet before I did it. So if you decide to do the fast, wanna ask me any question, I am more than happy to help you through it.The activated charcoal I am not sure about. I have seen products on Amazon, and there might be some at a natural foods store like Whole Foods or Trader Joes, Sunflower Market, etc... I now live in Switzerland, I moved 5 weeks ago, and the idea behind medicine here is much different. There is a much more natural approach. Charcoal here is a common remedy for diarrhea, and the product I am taking is called "CarboLevure". Its an activated charcoal in combination with a type of probiotic that work hand in hand. Its worth talking to a doctor or pharmacist about, and check it out for yourself on the internet. Im happy with the results, and its an old remedy the chinese have been using for centuries.Hope this helps. -Andy


----------



## salvationishere2 (Jul 1, 2009)

Andy:Yes, I have read that book. That was a good book, and I followed almost everything in that book except for this Vivonex medicine. But now I know I need to try the Vivonex. One thing that has stopped me before now was the cost. How were you able to get it paid for? My insurance doesn't pay for it because it is over the counter. Also, I left a voicemail for Renae Simmons (Nestle) yesterday but haven't heard back from her yet. (I am not on Medicare).What carbs do you eat now, post-diet? My condition was so bad, that I only eat about 10 different foods! I only eat lean beef, tilapia, cod, Whole Foods chicken, roasted almonds, roasted peanuts, dark roast coffee, and these items boiled: acorn squash, butternut squash, green onions, kale, collard greens, parsley. That is all! I avoid all carbs except I will occasionally eat a few corn chips. However, I have noticed that even peanuts have sugar in them and I am hyper sensitive to sugar. But in the past when I ate too many peanuts, this prevented me from sleeping well that night. This is all of the variety I eat! No dairy, pork, soy. And many items have preservatives that I am sensitive to also. Were you as sensitive as I am pre-Vivo?Anyway, I have very low body weight for somebody my size, mostly because without carbs I cannot consume enough calories. I weigh around 130 pounds and am 6'1". How does my story compare with yours? It's great to get your feedback cause I also feel like there's nobody else suffering the same condition. Sometimes I feel like I must be crazy!Thanks,Ryan


----------



## Brownish72 (Aug 26, 2012)

Post diet I haven't been very strict, actually almost not strict at all. I eat bread occasionally, chocolate, and have had a few beers to see how i'd feel. But not nearly every meal. I still follow a low grain, low carb etc.. diet when I'm by myself, but its tough because I'm living with a family right now, and I don't wanna force them to eat my diet. Before the fast, this would not have been possible....


----------



## Brownish72 (Aug 26, 2012)

It pains me to write this.. However my SIBO is back. I'd say my success lasted about 60 days.

My SIBO is not as bad as it used to be. I really suffered before, now its stomach rumbling with a less consistent, typically loose stool. However its rather controllable with small remedies, but as those with SIBO know, its not fun to live with. I'm too stubborn to live with it again. So I am going to fast again on Vivonex, and do more preventative measures after the fast this time.

I see some stuff about Prokinetic Agents, especially low dose azythromicin (50mg at night) , in fact the dosage is soo low, it doesn't even work as an antibiotic, and it has to be compounded at a pharmacy. It does however activate the Migrating Motor Complex, which are involuntary muscle movements in the Intestines. These muscle movements are "cleansing waves", and once I kick the bacteria back down again, in theory, the medicine should help keep it at bay (along with dietary measures) So I'm going for it.

As a side note, its comforting to know that Vivonex worked last time, and its much more encouraging going into this time. I'm not happy about it by any means, but support from people on this site, with friends and family at home, have made it much easier. Day one almost done, and to be honest, its been easy today. However, the real test is day 2-3. Here we go!


----------



## Milly1 (Apr 6, 2011)

Hi again Andy! So sorry to hear that its returned again.....have you thought about the regime of fasting for two days a week regularly rather than the full two weeks? I have heard good reports from friends that have done this.
I've just started a course of Rifaximin, brilliant for the first two days but I'm four days in and have started to suffer with terrible acid indigestion - really bad! I think I may be heading towards the fasting next! X


----------



## Brownish72 (Aug 26, 2012)

Milly, I watched that program you mentioned. Fasting is soo difficult, but its truly the mental challenge thats the hardest part. I'm starting day two. Im not happy, and I am at the same time. I'm happy this regime will stop the suffering I had before. Thats what keeps me pushing through.

I'm sure i'm going to think a lot about my post fasting diet. I'm going to keep this episode on the BBC in mind, because it makes sense. But I truly believe a much longer fast, of 2-3 weeks is needed before a regime like that could be started, as I am doing, only because of the healing that takes place during this time.

Rifaximin may work for you. Stick to it, and keep in touch with your doctor. Some people need to go on several courses for it to be truly effective. However, if it doesn't work, and you are truly sick of SIBO (which who isn't?!), I highly recommend looking into Vivonex Plus, without a doubt. Like I mentioned earlier, when my SIBO started 3 years ago, if I had known what this product could of done for me ( and each case is unique, maybe I just happen to find my trick) I would not of even hesitated. Not sure if Vivonex Plus is available in the UK, but Im sure you could find it on a site and ship it over, however it is expensive!


----------



## Moises (May 20, 2000)

Brownish72,

Sorry that you've had a relapse. I did rifaximin twice with no benefit. I then did two separate (more than 2 years apart) courses of Vivonex Plus, again with no benefit.

I am glad that it helped you and you now know that, depsite the difficulties, you could always do it again.

One of the big problems I have with Vivonex is the massive carb dose that it gives. Generally, I do better on low-carb diets. They do not reduce my symptoms to zero, but I do much much worse with higher carb quantities.

If I were ever to try an elemental diet again, I would find some kind of fat that I could tolerate and supplement the elemental diet with large doses of fat.

I am not a medical doctor. But I now know (didn't know at the time) that I have a tendency to get higher blood glucose readings when I ingest glucose.

Pimentel recommends a low-carb diet. If someone goes from low-carb to Vivonex, one will, with a very high probability, suffer all kinds of mental and emotional disruptions as one's blood sugar soars and crashes.


----------



## Brownish72 (Aug 26, 2012)

Hey Moises,

I read your blog about your Vivonex Fast a fews years ago that you did. Before putting my experience up here, it was the most recent one I could find on the web actually. I actually hesitated after reading it because I saw that it didn't work for you, and I was very nervous to start. Although I know SIBO is my problem, and I do not have any other GI problems (like so many on this site, i've been tested in and out, literally!). The only thing I haven't been tested for is to see if my "migrating motor complex" is working properly, which is while I will be taking a "prokinetic agent" after the fast this time. Each doctor's opinion changes, but I have found one who specializes uniquely on SIBO, and she has pointed out that a disabled/damaged Migrating Motor Complex could very well be the problem for relapse. Her name is Dr. Alison Siebecker, and her book on SIBO comes out this year!! I cannot wait! Here is her website, maybe you've stumbled across her before: www.Siboinfo.com. Any ways, her claims that this could be a reason for SIBO relapse makes sense actually. Especially since another doctor, Pimintel, found that these bacteria in the small intestine do just that: they disable these involuntary "cleansing waves" (aka Migrating Motor Complex), which happen maybe 10 times a day for a normal individual, but 3 times a day for someone with SIBO (I made those last figures up, but just wanted to point out that there has been a significant different found between the two).

Although this fast isn't easy, I'm working hard to stay calm...

I do notice on Vivonex that I have quick mood swings. I never associated them to the high carb count in the powder. However, as you know, getting angry will not make the fast any better. Actually, it will make it quite worse. So when something like that comes up, I calm myself down, even if its means doing a type of meditating for 1 min or 2, and then I get back to doing what I was doing.

Pimentel's diet was a low-carb diet, but still included complex carbs like starch which I was confused on? Although I'd love to admit eating potatoes would be easy to digest, it just hasn't been my experience since this whole SIBO endeavor.

Thanks for your support. This is day 3. Cruisin' on by!!


----------



## Milly1 (Apr 6, 2011)

Andy, Stick with it, you've done it before and you can do it again. A bit like stopping smoking I reckon - you just have to have those positive thoughts in mind of how much better you'll feel! Glad that you managed to watch the fasting programme, last weeks New Scientist also carried a small piece about the benefits of fasting too. Once I have completed the Rifaximin, I will definately be giving it a go. Am praying that this stuff will work over a longer term, have definately noticed a big improvement over the last few days, also have loads more energy and focus - despite the terrible nights sleep!


----------



## Brownish72 (Aug 26, 2012)

Thanks Milly, Like I said, support from others on this forum truly makes me feel better.

With that, I just want to say one thing:

YES!!!! Day 3 passed. Unbelievable how much easier, and better I feel from day 2. Now its days 4-10 which should be a breeze, like last time. But first 3 days are definitely a big challenge, and I'm proud of myself for pulling through. Am i having fun? Hell no!. ha. Am i going to better for all this work? You bet!


----------



## Moises (May 20, 2000)

Andy,

What you say makes sense. The elemental diet won't permanently solve the MMC problem. I had a lot of trouble finding the low-dose antibiotics Pimentel mentioned.

Thanks for the link. I did not know about it.

Sorry if my original Vivonex postings almost prevented you from pursuing something that proved to be quite beneficial. The reality is that there are no certainties. You have to play the probabilities.


----------



## Milly1 (Apr 6, 2011)

That's great Andy, keep it going, and just think about how great you'll keep feeling!


----------



## Brownish72 (Aug 26, 2012)

No problem Moises. I actually just stumbled across more SIBO fasting stories. I'm surprised I never caught them before because I did extensive searching, and besides your story, there was one other from 2004 I believe.

I'm don't have the book anymore, but I do know he suggested one low dose antibiotic, Zelnorm, which has been pulled off the market since. However it can be obtained under special circumstances. Actually, Zelnorm, according to Pimentel, worked better than what I'm going to try.

The one I plan on taking, Erythromycin, is quite common, but also could have serious side effects. However, at such a low dose (10X lower than the normal dosage), I'm not worried about it. I think i said it somewhere on this forum, but at levels of 50MG/day, its not even powerful enough to actually work as an antibiotic. So I'm not worried about creating some kinda mean resistant strain. And if its a necessary procedure to keep SIBO from coming back, I hate to admit it, but i'll do it. I'm very interested in "natural ways" of preventing SIBO (dieting, etc..), but it seems like whatever I do, I can't truly win. Temporarily relief is one thing, long term relief is the most important (as you all know).


----------



## Brownish72 (Aug 26, 2012)

One week down. Yes!

Any opinions on whether I should do an entire 3 weeks? If two weeks before was enough to normalize hydrogen levels, would there be a benefit of continuing an additional week?


----------



## Moises (May 20, 2000)

If anyone is following this thread they might be interested to learn of a new book in the SIBO literature that advocates self-treatment. _Fast Tract Digestion_ is by Norman Robillard who has written another book on heartburn, which has been reviewed previously on this forum.

I only learned of Robillard's new book last night, from a blog post by Michael Eades, a coauthor of _Protein Power_, among other books.

I stayed up late last night reading Robillard's book. He pays homage to Gottschall and Pimentel, as well as the FODMAP diet and others. He claims, like Gottschall did (she is no longer alive) that diet alone can cure SIBO. He eschews antibiotics, because of their potential side effects, as well as Vivonex, because it requires medical supervision (obviously, this is not correct, since I, and many others, have self-directed our Vivonex regimens).

I found the book of particular interest, because he gives the most detailed discussion of belching that I have ever read. As a sufferer from belching, it bothers me that almost no one (Pimentel being an exception) views it as a serious health issue.

It is also worth noting that Robillard acknowledges the promise that fecal transplant holds out to those of us with digestive diseases. Very few, if any, writers make explicit the connection between fecal transplant and SIBO. Many in the fecal transplant community do recognize that nasal gastric tube fecal transplant is often more effective than mere colonic fecal transplant. SIBO might be an explanation for that.

Robillard's big idea in this book is to use the Glycemic Index (GI) to distinguish good carbs from bad. Although I think it is a great book because of all the information about IBS and SIBO, I am sceptical of his invocation of the GI. I believe that individuals vary widely in how their blood sugar reacts to specific foods and the GI ignores this variation. Robillard claims that carbs that do not increase blood sugar, of necessity are not absorbed. If they are not absorbed, they are potential fuel for small intestinal bacteria. Hence, he argues that they GI can be used to rank the SIBO potential of all foods.

I grant that this is a very clever idea. But, as I said, in practice, I am sceptical that it will make useful distinctions. I thnk that it is better to avoid entirely classes of carbs that are known to fuel SIBO.


----------



## Brownish72 (Aug 26, 2012)

Hey Moises, could you clarify: Is he suggesting a Fecal Transplant as a way to help stop SIBO? I find that interesting, except the logic to me doesn't add up. Thanks for posting this, I didn't know there was a new book out about SIBO. Would you recommend the book now? Or is much of it a repeat of information that Gotschall and Pimentel have written (with the exception of the part about excessive belching)?


----------



## Moises (May 20, 2000)

Andy,

If you have amazon prime and a Kindle, you can borrow the book for free.

I think the book came out in April. Should you buy it? I can't really answer that for you. There is not a lot in it that is new. But, for someone like me who is uncomfortable everyday for a large part of the day, just reading a new perspective from someone who studies this stuff professionally is worth a few dollars. I learn more from this stuff than I do from a visit to a gastroenterologist, almost all of whom believe that aerophagia (air swallowing) is the only cause of belching.

What is new in this book is that he rates hundreds of food according to their "fermentation potential." This gives much more detail than Pimentel has in his book's list of forbidden foods.

Robillard does not go into much detail on fecal transplant. He just notes that it has helped some with IBS and it is something to keep one's eye on in the future.

So, I suppose the short answer is no, it is not urgent that you purchase it.

Regarding the logic of fecal transplant not adding up, I agree. But lots of things that Pimentel says don't add up and others have had trouble replicating his results. Perhaps I come across as somewhat wishy-washy, but no one has a completely satisfactory explanation of IBS. According to Pimentel's theory probiotics should not work. Pimentel's position is that IBS is a problem of good bacteria being in the wrong place. So, supplying the tract with more good bacteria should not help. Yet, obviously, probiotics do help some IBSers. Clearly fecal transplant is just a more intensive form of probiotic therapy.

One thing that I learned from Robillard's book is the distinction between SIBO and gastroenteritis. The difference is that with SIBO native bacteria are where they should not be. With gastroenteritis, the digestive tract contains microorganisms that it should not contain.

So, I could speculate that perhaps maybe some people have undiagnosed gastroenteritis, just like Pimentel claims they have undiagnosed SIBO. Perhaps probiotic therapy helps changed the lumenal environment so that it is less supportive of bad bugs.

This is why I will buy books like Robillard's even if they don't provide me with the final solution. They usually prompt me to think in new directions.


----------



## Brownish72 (Aug 26, 2012)

Great response. I appreciate it.

On a side note for those who are following this thread:

I decided today I'm going to only do 15 days on Vivonex. It lines up with the weekend, and I can't seem to see if fasting any longer will bring me longer benefits. I actually have scheduled a video interview via skype (since I live i Switzerland) with Dr. Siebecker from that website I showed you (www.siboinfo.com) . With how many times I've been on that site, I'm always surprised at the amount of information I find. I'm going to ask her if there would be any benefits to fasting longer. But at this point, I don't even have stool anymore. I was having some each day. But now its just basically water. I think I've truly cleansed myself out this time. In the meantime, 11 days down, I'm gearin' towards the end.


----------



## Moises (May 20, 2000)

Andy,

I assume you know that you should be taking the Erythromycin immediately, if you are going off the Vivonex.

Have you commenced the Erythromycin?

I am glad to hear that the elemental diet worked again for you.


----------



## Brownish72 (Aug 26, 2012)

I'm going to take Erythromyin the day I stop the fast. I actually don't have it yet. I have it ordered, and the pharmacy will be making it this week. I actually brought them a packet of Vivonex to mix in the with the medicine, because they were going to use Lactose or Mannitol because they just needed to add something in the capsule to fill it up. 50mg is so little, it basically was going to be like taking a sugar pill, and I thought: bad idea! They had no problem doing it with a vivonex packet.


----------



## Moises (May 20, 2000)

That's good information to have. Vivonex is mostly maltodextrin. You would think that a compounding pharmacy would have plenty of that lying around.


----------



## Brownish72 (Aug 26, 2012)

They may have had some. I actually didn't think to ask. Nonetheless, I'm glad they are taking good care of my "special" needs. I hate admitting that I need something like that to be made specifically for me, but its nice to know that they care and took time to listen to my concerns.

Days are going by soo slow!! ha. Day 13, almost there. At least I can manage to laugh about it. I've kept a journal of my experience this time, I plan on posting when I finish. I've really been on a roller coaster ride these last 2 weeks. Glad I'm near the end.


----------



## Brownish72 (Aug 26, 2012)

So day 14. I just got off a skype consultation with Dr. Allison Siebecker, from www.siboinfo.com. Although it cost me a lot of money ($50) for about 16-17 min., it was worth every penny. She is extremely educated on the subject, very welcoming, and I am so pleased that I decided to talk to her.

In the end, I will be finishing my fast after 14 days. It doesn't seem to have any impact on going longer than that (unless of course I was still having symptoms, but I feel awesome). Once I finish writing my day by day journal, I will post my experience on here (its going to be a long post!). I see its almost got 2000 views, which means there are a lot of people curious about this. Sadly, I know it can't work for everyone, but I'm confident it can work for many, and that's why I am so motivated to talk to people about my experience, and to help people over come there fears of trying it.

Thanks again to all for the support. Honestly, it helped a lot.


----------



## Brownish72 (Aug 26, 2012)

Vivonex Plus Fast

This is my second time doing a 14 day Vivonex Plus fast.

11/23/12: Day 1
I woke up around 9 am. I wasn't hungry throughout most of the entire day. In fact, at around 5 pm, I had only had 3 packets. Strangely around this time, I had a feeling of weakness, and started to get cold sweats. However, I stayed calm, drank two packets, and the feeling passed. In total I had 6 packets before going to bed. I didn't sleep that well, and had another small episode of cold sweats around 3 in the morning. However, I stayed calm, fell back asleep, and everything was fine. Two BM's today, most likely clearing out what I had eaten the day before. No headaches, energy was fine. Although I'm not enjoying this, it's much easier the second time than the first time I tried the fast.

11/24/12: Day 2
Woke up around 9am. I think I slept a total of 6 hours. No urge to go to the bathroom. No headaches. Energy is actually quite good. My mood is good as well. I'm trying to avoid thinking about how long I have to go, and instead am telling myself I already have 2 days down. One BM: No liquid, very small stool. Remembering that stool is mostly dead bacteria anyways, this can explain why I am getting stool in the 1[sup]st[/sup] place. Last time I fasted, on day two I woke up with terrible D. I also had terrible headaches, and my mood wasn't great. I would say I was experiencing a severe die-off, or "herx" reaction on my first fast. Today: None of that. It _really_ helps that I'm forcing myself to think of positive things. Instead of being upset about fasting, I'm lucky that there is a way of treating my condition, no matter how tough this treatment is.

11/25/12: Day 3
Woke up early, between 7-8 AM. I am an early-riser, but not that early on a Sunday morning J. I slept better than the night before, and got between 6-7 hours. My mood this morning was awesome. Full of energy, I was happy, and ready to start the day. I had one really small BM this morning, and then later on in the evening when I basically emptied my bowels. I think I must of lost ½ a liter of fluid (almost like when one preps for a colonoscopy). However, there is an instant feeling of good that follows. No pain, urgency associated with BM's, just thought I'd try and go, and that all came out to my surprise. I helped a family move today, lots of lifting and movement, and got a little weak after an hour and half of nonstop movement. But a shake later, and a little 10 min nap, and I snapped right back into things. Fasting is not fun, but glad I'm able to keep up the good thinking, and days 1-3 are typically the toughest. WOOHOO. I made it! I also have slowly weaned off coffee. Black coffee has no carbohydrates, protein, etc, and when I drink coffee, I literally drink only 1 oz of espresso. However, it is a part of the protocol to drink only Vivonex. Last time, I started with 3 espresso shots throughout the day (What I usually drink to make it through the day), to two the 2[sup]nd[/sup] day, to one on the 3[sup]rd[/sup] day: and ended up with successful results in the end (actually want to note: My hydrogen levels were extremely low when I took my hydrogen breath test, not even near the 20 PPM spike that needs to be seen to be classified as a Bacterial Overgrowth). I did not want to quit coffee cold turkey while fasting; the headaches from the two would be unbearable. I followed my same protocol as before on my first fast, and today I had my last small espresso, and will continue through the rest of the diet without coffee.

11/26/12: day 4
Today was pretty rough. Actually, today has been the worst. Woke up at about 3 am, really weak, and quite a bit of diarrhea. I also thought I was going to throw up. I don't think I've ever felt so terrible in my life to be honest. I drank a shake (was barely able to shake the bottle), laid down, and in 10-20 min I felt better. No coffee wasn't easy, still suffering from the headache. I really look forward to this being over. 3 BMs total, first was bad, but offered lots of relief followed by the next two, much smaller but still liquid like. So far, this has been the toughest day. Glad its over.

11/27/12: day 5
Last night I didn't sleep well at all. In total, 6-7 hours, much of it tossing and turning. However, there was a good period of sleep between about 3 -7 am. I cannot contribute all of these symptoms to Vivonex because where I am staying, there is a new cat at the home, and I am having some allergy problems, and I don't think the two go that well together. Today, I am at home, and with my allergies gone, I feel much better. Today went by really quick, thankfully. It's true that the days seem to go by slow. I took a nap; Energy is great, no head-aches, about 2 BMs; no liquid, and both very small. I'm going to up my intake from 1800 cal/day to at least 2100 cal/day starting tomorrow. I think that will help me feel a little better. So far, today was much easier than all previous days. Keep on truckin'!

11/28/12: day 6
I slept EXTREMELY well last night. Luckily got about 9 hours in of straight sleep. Only one BM, lots of small stool without any liquid. My energy was extremely great today, even went to the gym for a little bit. Overall, today was the best day. Only needed 6 packets instead of 7. I find it easier to drink two packets at once (so 600 calories) to hold me off for most of the day, instead of spreading it out throughout the day. Overall, today was the best day yet.

11/29/12: day 7
Today was great. Same as yesterday, however I did drink a seventh packet. One early morning, two @ noon, two @ about 6 o'clock, 2 more before bed. Went to the gym again. Absolutely no feeling of hunger at all. One small BM

11/30/12: day 8
I feel the same as the previous few days; awesome! Slept really well, one BM this morning, no liquid. I was walking in town and drank an espresso shot (dangit!!). I'm going to see how it reacts, and not drink any more coffee throughout the fast (I know I said this earlier) but now would truly be the time to see if I have a reaction to coffee. If so, stomach rumbling, etc..would come back. However, hours later, other than the good buz I got from the little 1oz coffee, I feel no difference. I'm glad that I'm having such a great outlook on the fast, it was MUCH more difficult the first time. I also find that 6 packets is consistently enough. My first time around, I was sometimes drinking up to 8 a day. I was really worried I was going to lose weight. This time, I'm not really losing weight. I feel REALLY good.

Side note: Never felt a negative reaction to my coffee slip-up

12/1/12: day 9
Once again, great energy today. One BM, however there was some liquid in it this time. I went snow shoeing today, it really helps to stay productive to keep my mind off the fast. I think this fast is almost more of a mental challenge than physical. However, my mood is kind of "blah" because I'm bored of this diet! Glad today is almost over, although it was beautiful to see all the fresh snow today while snow shoeing!

12/2/12: day 10
Today was interesting. I had one BM today. It was a thick, yellow, liquid. I would like to emphasize thick. I hate to write such detail, but it was by far one of the strangest stools I have ever had. Yuck. Interestingly enough, it was the EXACT same thing on day 10 on my first time fasting on Vivonex. As unpleasant as all that sounds, I felt great today. I went ice skating actually to get my mind off of the fast. I watched two movies (what can I say, it's Sunday! Day of work/school). Whether I do 14 days, or longer, I'm rounding the corner towards the end. I'm very much so looking forward to the end. This worked wonders for me last time. I feel the 2[sup]nd[/sup] time, I will hopefully achieve even better results.

12/3/12: day 11
Today went by okay. 3 BMS, all very small, mostly liquid. I felt great today. No headaches, energy was fine. I'm defiantly glad it's my last few days on the fast. I decided to do 14 days total unless something strange happens. On a side note: either I'm having a reaction to the cat at the house, or I'm getting some type of respiratory problem, but I'm having a little trouble breathing. It's strange because I have been around the cat the last 3 days without any issues. I'll know more for certain when I leave to my place tomorrow where there are no animals.

12/4/12: day 12
Today didn't start out the best. I had a terrible night sleep, however this may have nothing to do with Vivonex. I had severe respiratory issues, and there is most likely a strong connection with the cat that my girlfriend just bought.. I've been in my own apartment since this morning, and I'm still struggling. I got a good 4 hour nap in, felt great after. At the beginning of the Vivonex fast, I experienced similar respiratory issues. I have coughed up some flem, and feel much better. Hopefully this goes away soon. Ellain Gotschall does mention a strange connection between respiratory problems and the SCD diet after about 90 days. This is just my idea, but maybe days 10-12 on a vivonex plus fast is enough to really kill these bacteria, which is why each time I've experienced some extreme conditions on days 10-12 both times I've done vivonex. One BM this morning that was quite big (in the sense, lots of quantity of stool), no liquid involved. Really surprised. Energy is great, mood is okay, super stoked to be done with this though. I've really just reached a point where I'm bored with the fast.

12/5/12: day 13
I almost forgot that I was fasting today! Not that I wasn't thinking about it, but I mean I never was hungry, and I actually had to remind myself of having a shake before going to bed. I had between 0-1 BM, and I say this because the little BM I had was a trace amount of liquid and the smallest drop of stool, but other than that, nothing today. The taste of Vivonex is starting to get to me. I slept incredible last night, respiratory problem has subsided, and I think its safe to say that is mostly due to the cat at my girlfriends apartment. There may be a small link between me fasting and the respiratory issues I was having, but I can't be definitive on that. All and all, today went great!

12/6/12: day 14
All I could think about today was "Is this it? Or am I going to do another few days?". After talking with a GI doc, I decided today I was going to only go 14 days, simply because I feel great, and there doesn't seem to be any particular reason to continue. I'm extremely happy right now. Why? Well, I finished the fast, but more importantly, I proved to myself what I am capable of doing by staying positive amidst a rather unpleasant experience.

In total, I think I lost about 2 kilo's, or about 4.5 pounds.

Would I do it again: Yes, without a doubt. Anything is worth feeling good. I was sick for so long, I forgot what it was like to feel good. But the period following my first fast reminded me of this feeling, and its great once we get there. Do I look forward to the day if I have to do it again: No! Sibo has a high reoccurrence rate, and I accept that, but I'm going to do whatever I can in my power to prevent it from coming back. Last question: Was it the worst thing in the world: No, living with SIBO is much worse.


----------



## Moises (May 20, 2000)

Robillard's book discusses respiratory infections. The small instestine is infected. With GERD, there is reflux from the small intestine into the stomach. Then there is reflex from stomach up the esophagus. So the infection can spread out of the small intestine.

Of course this is different than Gottschall's point. But Robillard cites research showing GERD sufferers have higher rates of asthma. He claims that it also increases the probability of pneumonia and sinus infection.


----------



## Milly1 (Apr 6, 2011)

WOW! Well done! Hope the improvement continues......


----------



## Brownish72 (Aug 26, 2012)

Interesting point Moises, the real test for me I guess will be when I return to my girlfriends place and see how I react to her pet at the home, and see if I start having trouble breathing. But I've lived with cats for over 20 years without any issues like that. So I believe there is a connection between SIBO and why I was struggling so hard to breath. But I can't be certain...

Thanks Milly. Hope your Rifaxamin treatment worked out for you and that your starting to find some relief.


----------



## Milly1 (Apr 6, 2011)

Hi again Andy, Well.... initially the Rifaxamin seemed to be working well. I had first week, all ok but needed to fill another prescription and the chemist (Boots) told me that they couldn't get it and that it had been discontinued.... I had to ring the makers to confirm that it hadn't and go to the docs to get another prescription and then wait for another chemist to order it in, which amounted to four days off it. By which time the symptoms had returned and it seems to be taking longer to work this time. It doesn't seem to be working anywhere near as well as Keflex was which makes me wonder if there is an infection elsewhere that is causing the problems. Had my SehCat done which was fine but I'm still convinced there is a problem with my gall bladder or something of the like......


----------



## Brownish72 (Aug 26, 2012)

Almost a week later:

Actually I'm a little unsure of my results. I feel amazing, and that's the most important of all. Finally gaining weight, lots of energy, i look great, and my mood is really great. I'm happy a lot of the time, and I'm very happy in this moment actually

However, one thing: I can't kick the soft/loose stools. They won't go away. I didn't have them for 2 days following the fast, then they came back, and I feel like they are here to stay (except I just went and it was the best it's been in the last 5 days).

I'm taking a prokinetic agent, and I definitely feel its effects within an hour to two. I hear my stomach start working, followed by gurgling and work in my intestines. I take them 2 hours after eating, right before going to bed. So the pill is doing its work. However, I wonder if a prokinetic can also give someone loose stools? My thought being that it is pushing things through the intestines quicker than what I am used to, not allowing for complete digestion, but there is no scientific reason behind this, just logic in my head.

I have seen a recent study where prokinetics were used to get rid of SIBO when I patient didn't react to antibiotics. My fast most likely got rid of my SIBO (although I did not follow up test this time, didn't feel it was necessary). So these prokinetics can't give me SIBO again ( I wouldn't think), but I wonder if they are contributing to symptoms.

Anyways, feels good to feel good. Just the loose stool is beyond frustrating. I feel like I'm climbing mount everest sometimes, and I'll never get to the other side. However, I have come a long way, and I"m thankful for that.

Comments, Suggestions?

Thanks all


----------



## Brownish72 (Aug 26, 2012)

almost 3 weeks passed

I had a rough patch there 2 weeks after the fast.

I am feeling awesome. The prokinetic I am taking was most likely causing my symptoms of soft, flakey stools. Things were simply being pushed through too quickly by the medicine.

I decided, although I really didn't want to, to take immodium too see how I'd react. In 2011, I had previously taken immodium for over a year, sometimes up to 8 pills a day (the max dosing), but i still got had loose, watery BM's. Eventually the medecine litererally lost it's effect of me, SIBO had won once again. I personally feel Immodium will little by little make SIBO worse, with how the drug is designed to act, however this is a personal opinion, and has no medical / scientific backing

So now, for 5 days I've taken an immodium in the morning, and either I do or don't take one with my meal at night. Two hours after eating at night, right before bed, I take 1/2 the dosage of the prokinetic I am taking. I'm hoping for the long run here, but my results so far are awesome. I am also staying active, trying for 20 min. of cardio a day to encourage proper digestion. Also, low carb meals, or "Simple" carb meals. However, I had a sandwich the other day, and some rice the last two days. Quite surprised, but I know that I can't indulge in pasta by any means. But so far, as I did with the first time I tried Vivonex, *I've truly found relief.*

Hope others struggling with SIBO can use this blog as courage to undertake such a task. My SIBO was so bad, it controlled my life. IBS is still on my mind, I think about what I am eating all the time, etc.. but I hope I can continue to say it is ME is who controlling my IBS.


----------



## kenbkb (May 21, 2011)

Hi Brownish,

Caught up to your posts here and thanks for all the sharing.

1. What prokinetic are you taking now? Or is it technically ethromycin or zelnorm that you are on?

2. Isn't a prokinetic technically also an anti nausea med (in addition to a motilty agent)?

3. I did a three week run of Augmentin for which I got 50% relief as a two year IBS sufferer.

4. Soon after stopping the Augmentin most of my symptoms returned.

5. We then tried Cipro for a week but found that to be too harsh (the runs).

6. So my doc at Loyola in Chicago is recommending another 2 week run of Augmentin. Two weeks on and then two off.

7. I had done Rifaxin twice over the past two years with no results.

8. Am considering the Vivonex but am very concerned about weight loss as I have lost 25 pounds off of 185 pounds.

9. The SCD with no grains and no starch seems so extreme. I am aware of Pimentel's book and his diet recommendations.

Am thinking a prokinetic to keep things moving and for the nausea is a good way to approach things. Appreciate your insights....thanks. Ken


----------



## Brownish72 (Aug 26, 2012)

Hello!

The prokinetic I am taking is Erythromycin, 50/mg @ night. But I am now taking only about 25 mg/night. I open the capsules and empty about 1/2 the medicine out, I seem to tolerate the lower dosage much better.

The SCD diet is by no means extreme. Actually, quite "easy". I say "easy" because its an extreme habit changer, but once those habits are changed, it seems strange eating things that you've spent so long avoiding. I highly recommend this diet. I still follow many parts of it (homemade 24 hour yogurt, bone broth almost every day, etc...)

As I mentioned with Vivonex, I didn't lose much weight, about 2 Kilos. I have since put on about 4-5 kilos after coming off the fast! Something I just couldn't do when SIBO was ruling my life. Finally back up to 73 kilos, and I hope I keep putting on some weight. I'm active, go rock climbing, lifting, running, etc.. and I don't eat a lot. But what I do eat, I make sure the calories count, and I feel that is truly helping. Coconut oil / butter is incredible stuff. I try and eat it , it small quantities with my meals. Research "Consuming Raw Coconut Oil" if you don't know much about it. I also will eat some, mixed with apple sauce, yogurt, or just a little honey, if I'm looking for a snack mid-day. A small spoonful, and I'm no longer hungry. I measured the small spoonful I took this morning, weighed it, and in just one small spoonful, it was over 300 calories! Awesome (for me). Don't over do it by any means, you can feel quite sick if you eat to much (so I've read) but eating it on a daily basis seems very safe, and very healthy.

I've never heard of a prokinetic for nausea, but there is such a strong connection between the gut and the brain, I wouldn't be surprised.

I highly recommend the Vivonex fast. Its a hard task to undertake, but it's safe, some people literally live on this stuff in hospitals, it's easy to obtain (quite a pretty penny to get though!) and it's logical why it works. On top of fasting, the nutrients from the shakes allow for true healing (in my opinion). As you can read from my experience posted above, there are times when the fast is no fun, but arriving at the end is worth every day of struggle.

Hope that helps! Good luck, and hope you find some relief soon!


----------



## kenbkb (May 21, 2011)

Thanks, Brownish. Good stuff. Thanks for taking the time.

By the way, what do you do for breakfast without cereal and toast? Seems a bit of a hassle to make eggs everyday, so what else can cure the hunger pangs? Or do you make bread from almond flour?

I am going to check out the RAW COCONUT OIL.

I got sick in Munich a couple of years ago when my IBS flared. The doc not only gave me an IV but an anti-nausea med which is also a prokinetic (according to the med description). When thinking back to that experience, I had attributed feeling well to the IV, but in actuality it was probably the anti-nausea drug. I still have the bottle (I am actually from Chicago). it was called Paspertin Tropfen.


----------



## Brownish72 (Aug 26, 2012)

Hello!

This morning, for example: I had yogurt (homemade, and don't be intimidated by the homemade part, yogurt is extremely easy to make, and its something I make once a week, and I have enough for the week.) I then mixed apple sauce in the yogurt (again homemade, but all I did was cut up 5 apples or so, cook them in a about an inch of water at the bottom of the pot, added some coconut oil, cinnamon, and blended everything together when it was soft, put it all in a jar, and now I have enough for a week or two. Healthy, easy to make, and no added sugars / preservatives). So recap: I mixed yogurt with apple sauce, added a little cinnamon, with a tea / coffee.

If you don't want to cook eggs in the morning, buy hard boiled eggs at the store, and even better: save money and just hard boil them yourself

Other options are scrambled eggs, bacon, ham , all that (just look to make sure there is no added carb in the meat, bacon is particularly tough to find, but its out there). If you really get into SCD, you'll even find out there are ways of making waffles, pancakes, etc. I have memorized easy recipes, and make these on the weekends. Pimentel even suggest white bread as being okay, but if you have celiacs, obviously stay away. Pimentel's diet is interesting, and definitely merits attention. I think its great he points out that the starch in potatoes is easily broken down, and digested high up in the intestine, yet maybe the starch from another plant, say jicama, is not. He and his medical team suggest eating under 40 grams of carbs a day, and not only that, but particular carbs too, not just any carb.

The most important thing to note is each person in unique. Vivonex works great for me, but unfortunately, it doesn't work for everyone. The SCD diet , or any low carb diet for that matter, needs to be adjusted to fit the individuals needs as well. Some tolerate honey really well, some need to lay off honey for a while. Others can eat lots of veggies, as long as they are cooked, I however needed to slow down with the veggies at first. Its a trial and error diet, yet it truly is effective, and for scientific reasons too.

I recommend checking out this website www.siboinfo.com Here you will find quite a bit about SIBO, and maybe it could lead you into the right direction. There are other diets out there than SCD that claim to attack SIBO better than the next, this website points that out. Best of all (although its $$) you can skype call this doctor, and she is fantastic. I called her, here from Switzerland where I live, and it was truly a motivational, uplifting skype consultation. If you have questions, she truly is a SIBO expert. Its unfortunate that it is soo expensive, but at the same time, she is a doctor , and does these consultation on the side with her busy life, and that needs to be respected.

I think what is a hassle at first is accepting all the changes. I remember, when I started SCD, I was frustrated as hell. I was thinking "What the heck can I eat?! But it soon becomes such a habit, I truly enjoy the cooking part. And I impress people with the dishes I make. But besides all of that, I asked myself: Would I rather eat cereal with milk, and feel sick later? Or scramble some eggs, and feel great later? The physical feeling of feeling good is the biggest motivation in undertaking any of this, whether it be the diet, fast, or any other measure to overcome SIBO.

Hope this helps!


----------



## Moises (May 20, 2000)

Brownish72,

It's great to hear that you are so much better. Keep it up!

You are absolutely correct to say that there is a lot of inidivuduality with respect to food sensitivities.

The SCD permits some fruit juices and nuts. That is going to provide a lot of problems for many with SIBO. It will leave a lot of "residue," or undigestible carbs that feed the small intestinal bacteria.

Pimentel's diet was much much better for me than the SCD. What Robillard does is try to come up with general rules to establish why Pimentel's diet works.

I was amazed the first time I read Pimentel and he talked about white bread being OK. For years, I thought white bread was up there with Genghis Khan, Ivan the Terrible, Stalin, and Hitler. But one piece of white bread per day really helped a lot with my diarrhea.

I no longer take the white bread because it will have too large an effect on my blood sugar. But, if you are not gluten-intolerant it is worth a try. White bread for me was as good as Imodium.

If you are on the SCD, white bread is strictly verboten.

I find it so interesting how different antibiotics work for different people.

Back to your case. Taking Imodium and a prokinetic seems like a formula for disaster. Essentially you are taking a prokinetic and an "antikinetic" which should cancel each other out.

But, in fact erythromycin is said to have its prokinetic effects on both the small intestine and loperamide (Imodium) has its effect on the large intestine. So, the erythromycin

1. stimulates the housekeeping waves that keep the small intestine clear of bacterial overgrowth, and

2. (possibly) stimulates colonic contractions that create the undesired consequence of diarrhea.

The loperamide cancels out the effect number 2, above.

http://en.wikipedia.org/wiki/Loperamide

http://gut.bmj.com/content/33/3/397.full.pdf


----------



## kenbkb (May 21, 2011)

Brownish and moises,

First of all Merry Christmas to you and yours.....

I feel like I am receiving input from two doctors, and yet I also know sometimes the degree of your suffering is borne out in the depths of your research and subsequent knowledge.

1. I will most certainly employ the Coconut Oil. I like the idea of adding it to cooked applesause.

2. As to the SCD or the Pimentel Simple Carb diet, I am leaning towards a mix of the two and will let my body tell me which way to go. Right now I am Day number 7 of the Augmentin, with 7 to go. Then two weeks off. During the time off is when the true tale of the tape, so to speak, will be exposed. I may not have mentioned, but I believe my doc's plan is to employ this regimen for months now to see if it takes all that to knock this out.

3. I am very open to both diets as I have mentioned, and the Vivonex as well. Scared? For sure. But I also know from the depths of the misery of IBS/SIBO and how you have no life. In many ways, I have no choice.

4. Very good stuff in both replies. I have read them each several times.

5. Here is a description of the med the German doctor gave me while I was flaring on a vacation to Munich. Again, the med was in liquid form and called Paspertin Tropfen:

*"Paspertin drop" is used in*

- Motility (movement) of the upper gastrointestinal tract,
- Sickness, nausea and vomiting (for migraine, liver and kidney diseases, skull and brain injuries, drug intolerance)
- Diabetic gastroparesis (stomach muscle weakness in diabetic patients).

So there IS a med for motility and nauseasness it appears. And admittedly this confuses me as well. It does seem this is working AGAINST itself. As I noted earlier, I had thought it was the IV that had made me feel better, but indeed was it the Paspertin?? And so brownish, you have loose stools but you still use the Erythromycin? Can you please give a little more clarity then as to why you need a motility med? Or why Pimentel thinks it is necessary? I happen to think it could be a missing link for IBS/SIBO patients and am wanting to understand more.


----------



## Moises (May 20, 2000)

From Richard K. Bernstein. Diabetes Solution. 4th Edition (388-89)

"In people without gastropareses, erythromycin can cause nausea unless taken after drinking fluids. I ask my patients to drink two glasses of water or other fluid before each dose. . . . We start with 1 teaspoon of the 400 mg/tsp concentration, and increase to several teaspoons if necessary. . . It is also wise to consume one 150 mg fluconazole tablet once a week to inhibit the growth of fungi in the GI tract or vagina. *I have not found erythromycin to be especially effective for treating gastroparesis, despite published studies. *However, mixing a few drops of *peppermint spirits* into a glass of water before eating has helped a few of my patients with mild gastroparesis." [italics and bold in original]

So, kenbkb, if you can find a prokinetic that is as effective as Pimentel claims it is in inducing MMCs, and which not only does not induce nausea but combats nausea, that is great!

And, kenbkb, brownish is following the Pimentel protocol. That protocol states that bacteria that are native to the large intestine are residing in the small intestine where they do not belong. In a normally functioning gut, the small intestine has rhythmic, peristaltic contractions, also called migrating motor complex (MMC), or housekeeping waves, which periodically clear the small intestine of its contents.

In SIBO colonic bacteria have passed through the ileocecal valve to enter the small intestine from the colon. The Vivonex Plus diet that brownish put himself on starved the bacteria to death. But, he needs to reestablish his housekeeping wave. Hence, he uses the prokinetic erythromycin to stimulate that wave.

It appears that an unfortunate effect of that wave for brownish is diarrhea. So he is taking loperamide to slow down his colon, while the prokinetic continues to speed up his small intestine. He is fine-tuning the different components of his digestive tract.


----------



## kenbkb (May 21, 2011)

Makes perfect sense, moises. You laid that out really well.

Note that the med I noted is German as obviously I was in Germany at the time. I am going to run this by a pharmacist friend to see if he knows any meds here that may have similar qualities, ie., fights nausea and is also a prokinitec. I admit it sounds strange but this is what the description of it says.

I also saw where brownish once took immodium for a year....so this can work for him.

Similar to brownish, whilst on my second run of Augmentin, I have found that tweaking the amount of immodium can help me as well as far as fighting the side effects of the antibiotic.


----------



## Brownish72 (Aug 26, 2012)

Thanks Moises,

I was going to respond yesterday, but got caught up.

Everything Moises explained is on the dot. I followed Pimentel's suggestion of fasting of Vivonex for 2-3 weeks. I personally did 2 weeks, on 2 different occasions. I follow dietary restrictions as outlined in "Breaking the Vicious Cycle" by Ellaine Gotschall.

I am taking a prokinetic for the "cleansing waves" of the small bowel that moises mentioned above, or in more technical terms, to stimulate the Migrating Motor Complex.

I noticed however that I was sensitive to the drug, and kept getting soft, watery stools. This makes sense because food may have been pushed through too quickly. So I lowered the dose, symptoms got better, but I was still getting these loose stools. And i was really really frustrated. I was thinking my fast was unsuccessful, but I wasn't sure how, because it worked so great the first time. And, unlike antibiotics, bacteria cannot become resistant to Vivonex. The main principal behind the diet is to feed you, not the bacteria.

If you decide to do the fast, I understand why you would be scared. But, as you can read from my post above, by staying calm, positive and calm really made the fast much easier, and there were days where I "forgot" i was fasting. Of course I knew I was on the fast, but I wasn't "suffering" or in pain by any means, and I had great energy.

Anyways, I decided to see what would happen if I took loperamid during the day to slow things down, but mainly: to cut down on the amount of water in the stool, one of the key features of immodium/loperamid. I actually surprised at how well it worked. Loperamid did not work for me in the past. Maybe because my SIBO is "gone" (I sure feel it is after the fast, although I did not follow up with a breath test to confirm results).

I then take the prokinetic at night, to make sure things to stick around in the small bowel, and they get moved along. I'm trying to find a balance between the two. So far, day 7, and I've had great BM's for the last week doing this. I must say I don't like taking meds, but, if I can truly fine tune what i need to do to keep SIBO gone and feel good, and if that means taking med's for a little while, I then be thankful for my health, and happy that I feel better.

@Moisis - I talked to a doctor about my idea of Loperamid during the day, Erythro @ night. His response was : go for it! We understand how SIBO works, but treating SIBO is tough. A lot of it is trial and error as you know. So I'm trying to combine research from multiple sources, and devise something that works for me. So far the combo of the two is working, but the real test is the long run. I'm looking forward to seeing how I feel in a few months, even how I'll be next week! SIBO is so damn frustrating, one day your awesome, but that can change in literally the same day. So we all just need to keep on going, and hopefully we will find relief someday.


----------



## kenbkb (May 21, 2011)

OK, brownish, all good stuff. Your input and that from moises has been invaluable. My sense is that eventually you will work your way off the immodium if your trend continues like it has. I would guess at some point down the road also you will wean off the ethromycin? Or at least would like to?

As to the vivonex, I am at a tipping point with my weight. Anymore weight loss and I believe my overall health would suffer. I wonder if either of you or anyone else have noted or received any input from anyone on Vivonex who added a snippet of food per day from the SCD? Would that be TOTALLY counter-productive to the intentions of the Vivonex??

And last question for the both of you. I presume you both have done antibiotics? If so for how long? Thanks again.....


----------



## Brownish72 (Aug 26, 2012)

Hey,

If you do go on Vivonex, I recommend you follow the diet as laid out in the protocol. As for me, I did drink very small amounts of coffee at the beginning, to not have a crazy headache @ the beginning as well as the headaches that come with the first day or two associated with the fast. However, I did not eat a thing.

Bacteria don't just use carbohydrates, but amino acids as well for metabolic funtion. Protein, which is a chain of amino acids, is broken down mainly in the stomach, although digestion also happens through out the small bowel. So EVEN if you ate just meat, and the shakes, you could still be providing "food" to the bacteria, thus rendering the diet less effective (or maybe not even effective at all? I'm not sure). Vivonex is loaded with amino acids, but they are amino acids that are already broken down, meaning they are absorbed really high up in the small bowel, realistically absorbed before the bacteria infection with gets worse as it gets closer to the large intestine.

Moises and I have both done Vivonex, twice each. I truly didn't lose much weight, and the weight I did lose, I have gained back quickly because I am finally absorbing my nutrients. Plus, instead of doing 6 shakes a day, one could always do 7 or even 8 to get more calories. I was taking between 1800 - 2100 calories a day. Before the fast, I used to get a lot of undigested food in my stool. Literally, whatever I ate would just come out in my stool. Now, not at all. Sometimes if i eat too many almonds for example, I will see them in my stool, but other than that, I no longer have this issue after the fast.

I tried antibiotics a handful of times. Flagyl once, cipro more than once, and rifaxamin 3x . Never got long term relief, only temporary relief, sometimes lasting only a day or two.

And you are right, the goal for me is by no means to stay on immodium, nor erythro for me. Actually, there is a new prokinetic available here in Europe and Canada, but not the US, which is not an antiobiotic, with very promising results. I may try it. I am simply taking the prokinetic to restore the Migrating Motor Complex, which gets damaged (according to a few doctors) from SIBO. Although it is not known why, it is has been observed that patients with and post sibo have less "cleansing waves" of the small bowel than normal individuals. I even read a study where prokinetics were used to get rid of sibo with success in patients that did not respond to antibiotics.

How long have you had SIBO. What's your main symptoms?

I highly recommend Vivonex. According to Dr. Pimentel, it has the highest success rate. Also, I feel that the fast allows the intestines to heal. Microvilli in the intestines get damaged from these bacteria. Think of it like have a sore on the gums on the inside of your mouth (a canker sore, or maybe from biting your gums out of bad habit, etc..). At first it scars over, its really sensitive, but you if you dont touch it, it will heal, but it takes time. 1-2 weeks even. Cellular regeneration is fast, but it takes time. If you had the same sore in your mouth, but could take a medicine to heal it, but continued to irritate the surface of the sore, would healing truly take place...?

I feel (and this is a personal opinion), but if the microvilli are damaged (which is an observed condition of SIBO), than these damaged microvilli need to be shed and new ones will grow. It's no different that getting a scrape on the knee. A scab forms, dead skin sheds, new skin forms. In taking antibiotics, I feel it may get rid of the bugs, but as one continues to eat, food is still rubbing across an already disturbed, possibly inflamed surface. A surface, which requires vitamin b12 and folic acid for regeneration, however one may not be getting these nutrients if intestinal lining in damaged. Both of these, plus many more nutrients, are found in vivonex, in a pre-broken down form, ready for quick absorption thus not only providing the necessities for healing, but also providing a good moment where the intestines can relax and heal.

But don't get me wrong, there are people where antibiotics work quite well. And if SIBO comes back, and quick 10 day treatment is all they need. I just have yet to meet anyone like this, but then again, the people on this site are most likely people who are sick. When you feel good, you don't write long stories asking for help!

Hope this helps!


----------



## kenbkb (May 21, 2011)

Thanks brownish.

You said...."

I tried antibiotics a handful of times. Flagyl once, cipro more than once, and rifaxamin 3x . Never got long term relief, only temporary relief, sometimes lasting only a day or two.

Do you mean that you only got this day or two of relief AFTER you stopped, or during the whole time you were on antibiotics. If it was after you stopped, what does Pimentel (or you perhaps) feel it is the reason it keeps returning so quickly? Is that the MICROVILLI explanation you gave above?

You also said...."I even read a study where prokinetics were used to get rid of sibo with success in patients that did not respond to antibiotics.". I have stated this before. It is my humble opinion that prokinetics may be the missing link here. Remember that German med I used for nausea AND motility? Something to this. And I feel this strongly but keep in mind I have yet to use one for SIBO.

As to my symptoms, I'll be brief and not bore you to death. I have had them for two years. Came back from a vacation to the Amalfi Coast and was never the same. Had a terrible bout of constipation over there. I get the runs, I get constipated, bloated, etc. I get flatulence that can last for 10 hours. I get worse as the day goes on, the more I eat the worse I feel. I generally feel better in the AM. So therefore my doc thought bacteria. NO QUESTION the antibiotics do help, ESPECIALLY with the flatulence. But I have one more week on Augmentin, then we see what happens after I stop!!

I am very open to the Vivonex. Am not sure I have the bodily weight and strength to do it though. But if I do, I will post here like you did as well.

And you're right, if you are feeling well, you probably do not come back here. So that is why we are thankful for you. By the way, compare how you feel now compared to your pre-SIBO days. Is it similar????


----------



## Brownish72 (Aug 26, 2012)

Hey,

I took full courses of antibiotics, usually 10-14 days long. My relief was typically during the treatment, and sometimes lasted a few days after the treatment.

Pimentil believes prokinetics are the missing link, although this is not proven. It is why I am taking a prokinetic, to prevent SIBO from relapsing.

The microvilli is my own opinion. Just from reading so much material and taking personal notes, it what I believe. However there is so much to learn about SIBO, that maybe what I said doesn't merit any meaning. However, it's logical, and I truly believe it.

Keep people posted on your progress if you find relief (which we all hope you do). This forum has been a great tool for me to not only talk about my story, but ask so many people other questions.


----------



## Moises (May 20, 2000)

I hope you don't mind my making a comment in your thread. If you do, let me know and I'll start a new one.

But you inspired me, brownish, to try again to find low-dose erythromycin. I tried to get some about 5 years ago and no pharmacy could obtain it. Today, I tried something new and I think I will be able to get some pediatric oral suspension.

I figured I would give it a try because studies have shown that it has helped people with GERD. Robillard's thesis is that GERD is just SIBO. The small intestinal bacteria produce gas. The gas goes backwards into the stomach and forces stomach acid up the lower esophageal sphincter (LES).

My problem is, theoretically, the same. Only I have gas being forced up the LES instead of stomach acid. So, if it helped people with GERD, it might help me.

My doc was very concerned about C. diff. so he agreed to do this only for a very limited time period.

I know that this is not in accordance with any protocol. Pimentel only introduces erythromycin after the infection has cleared. But, there is evidence that erythromycin alone has helped people with GERD so I am giving it a go.


----------



## kenbkb (May 21, 2011)

Moises-brownish,

I am on day number 10 of my Augmentin and believe I may have hit the tipping point as far as my body being able to tolerate the antibiotic. It has helped with my SIBO symptoms to a 50% degree again (less flatulence, bloating, straining etc.) but the side effects of the runs and nausea are now negating the positive effects. Did either of you have to resort to Immodium or an anti-nausea drug to make it through your course of antibiotics? I too wonder if 10 days will make a difference but it does appear I will have to stop as I am typing this in the middle of the night in Chicago as I am unable to sleep due to side-effects. And again, my weight loss becomes an issue in the side effects.

And for clarity, I wanted to offer up something and perhaps get an understanding. I never presume so I want to first make sure you are familar with the terms HYPERDEFECATION or FECAL URGE? These are the names my doctors have given to the feeling of INCOMPLETE ELIMINATION which so many IBS/SIBO patients experience. Of course, there is seldom enough stool to "normally" trigger this feeling but the increased VISCERAL HYPERSENSITIVITY of the bowels lend to that feeling.

These doctors feel that the bacteria may contribute to this HYPERSENSITIVITY. Anyway, are motility drugs, which are supposed to make the small intestine contractions stronger, also intended to help with this HYPERDEFECATION or FECAL URGE. Or are these two completely separate issues?

Finally, as to this VISCERAL HYPERSENSITIVITY (VH), my doctors feel that the bacteria are literally sending signals to the brain that are false or have been misconstrued by the brain (I am simplying what they have explained to me as I am not educated enough to explain it differently) and lend to this VH. The doctors tell me something has to be done (antibiotics, starving the bacteria, etc.) to BREAK THIS CYCLE OR SIGNAL THE BACTERIA IS SENDING TO THE BRAIN. I thought this was particularly interesting as it did make sense to me.


----------



## Brownish72 (Aug 26, 2012)

Hey Moises,

Glad my blog was able to help you out. As I mentioned, I read your's very closely (multiple times) before going on Vivonex.

I wouldn't think you should need to worry about c-diff from taking a low dose erythromycin. Although, "low-dose" is quite ambiguous, so I should clarify , 50 mg/erythro is not even strong enough to work as an antibiotic. I'm looking where I found that this on the internet, but can't, however I have confirmed it with my doctor. C-diff, as I understand, is a bacterial strain that is quite mean, and we all contain it in small numbers, but once on an antibiotic is used, these "mean" bugs can populate the colon quicker than the microbes we would like to populate the gut. However. since the erythro is not wiping out a broad spectrum of bugs because of it's weak dosage, I wouldn't think this would be of concern.

I also listen to medical talks about the gut from time and time. One doctor talked about a statistic worth more studying where c-diff in hospital patients was reduced by something like 90-99% simply by administering a probiotics two hours after taking the antibiotic. Try making yogurt again, and eating small amounts with each meal, maybe a spoonful or half a spoonful at first. Or simply take a supplement, however that can be $$ and homemade yogurt is soo easy to make, with high counts of bacteria that you know are living because they just made the yogurt! I do feel this is a very important step.

The one are I think most go wrong with homemade yogurt is by eating a lot, all at once. I know I made this mistake. Maybe it's obvious info, maybe not, but lactobacillus typically has low growth #'s in IBS patients. One reason is because many IBS people (myself included) don't drink milk. Milk is the "pre-biotic" to Lactobacillus. I got this information from one of Dr Pimentel's continuing education medical talks. Before listening to this, i had an extensive stool test done, it was pages long, but one of the interesting things that was found was that of all the types of bacteria growing in my stool, I had 0, thats right, zero growth of lactobacillus. Other studies point out that lactobacillus is one of the strains that shows improvement in patients with IBS. "Improvement" again is ambiguous, that could mean less diarrhea per day, but not "curing" the diarrhea.

After fasting, I have made a lot of changes to my everyday habits. I've also read / listened to more literature to prepare myself to to combat SIBO. I am now several weeks after the diet, but 8 days without any diarrhea, only 1 or 2 BM's a day, no gas, no cramping, nothing. I'm praying this keeps up: I feel (as many SIBO sufferers) that I have truly traveled from Hell and back when I think of the life I was living in before. With that said, I cannot pinpoint one thing that is working the best, but rather point out what I am doing, and maybe if could help.

Obviously. low carb meals the majority of the time. In addition to these foods, almost 100% of them are homemade meals too. I definitley make bonebroth often, as it contains vitamins, minerals, and most important of all: collagen. Collagen is literally like a protective layer on the inside of the body, nourishing and healing the body. Research it a little bit, here's a great article, and it talks a little about GERD and home made broth:

http://bodyecology.com/articles/bone-broth#.UNwpYonjmfM.

I make yogurt with lactobacillus strains, and eat it in small amounts with each meal. I remember listening to another talk where the researcher mentioned that probiotics with each meal was the key. So i figured, why not try it? I drink a fair amount of water, and recently have been into herbal teas, trying to cut down on coffee (and I love coffee). Coconut oil ever day, small amounts, but consuming it raw everyday as well as cooked. Also, if your able to, any cardio exercise. I wanna stress the exercise one, because we can take all the pills in the world to try and heal, but cardio stimulates the MMC, and on top of the actual benefit of exercising for the body, it is obviously a safe, non-invasive way of stimulating the MMC.

I feel like I write a book every time I comment on this board! Just wanted to stress, I'm not one of those people that is out there preaching "eat natural, blah blah", but I truly believe food is the best health insurance for our well being, and SIBO made me realize this. I was not like this at all pre-sibo.

Other than the habits above, I take 2 immodiums in the morning, and I either do or do not take one with my evening meal. I try not too. And than, of course, about 25 mg of erythro/night before bed with a big glass of water.

Moisis, the erythro is typically at such a low dosage, it has to be made at the pharmacy. If this is your case, ask them what they will be mixing with the drug, explaining your concerns, and hopefully they will be able to work with you to find a solution.

Hope this all helps.


----------



## Moises (May 20, 2000)

Hey Brownish,

Good post.

I actually did acquire the erythro finally. I believe you are still in Europe, right (even though you avatar is labeled 'SLC United States)?

Anyway, the easiest way, that I have been able to ascertain, to administer low-dose erythro in the US is to prepare an oral suspension from the pediatric form of erythro.

My insurance wouldn't cover it, so I paid like $140. I haven't started taking it yet because I really have to find the correct instruments to do this correctly. Once the powder is reconstituted with water, it must be refrigerated continuously and it expires in 10 days.

Since I am taking such a low dose, I want to stretch this out and make tiny batches at a time. Of course it is not made for this kind of use. It is expected that the entire bottle of powder will be reconstituted with water in one go.

I don't know what Pimentel uses. I do know that years ago I tried to get the oral suspension erythro no pharmacist could obtain it.

The stuff that I have has NDC # 24338-134-02.

I am supposed to add 77ml of water to make 100 ml when mixed.

It is called E.E.S. Granules. I have the weakest strength which is 200 mg per 5 ml when reconstituted.

Since I only want 50 mg per night (or maybe I will try 25 mg, like you did, Brownish) I only need 1.25 ml. I plan on using a eye-dropper sold in drug stores in the infant supplies section.

The full bottle makes 100 ml and is good for 10 days.

If I take 50 mg for 10 nights, I need 500 mg. So, in theory I would be reconstituting 12.5 ml every ten 10 days. The bottle is good for 100 ml. So, I need a way to divide the powder into eighths. It seems like the easiest way to do this will be by volume.

I take 1/8 of the powder by volume and mix it with 9.6 ml of water.

These are tiny amounts. I have to make 2 teaspoons of liquid last 10 days.


----------



## Brownish72 (Aug 26, 2012)

Hey Moises,

I do live in Europe, in Switzerland. Moved to other side of the world on the fly! So far, happy about my decision, but I miss the States!

Good luck with your treatment. I hope you find some relief with it.

I'm still getting moderate to great results. I was doing awesome for those first two weeks with the immodium, erythro combo, and I'd say I'm still doing pretty close to awesome. There have been minor changes in my BM which aren't of any worry as for now. I'm considering doing a 2-3 day fast with a good bone broth and coconut oil for a fat, with Erythro @ night to help keep bacterial levels in check. I'm curious if something so minimal could keep me feeling so good?. So far, 2nd time fasting, and I'm having really hopeful, positive results. I still wouldn't dare drink a beer by any means, and the carbs I do eat adhere to either the SCD and/or Pimentel's diet, and if I do eat bread as Pimentel suggests, I limit it to a small piece. No need to be eating an entire baguette or anything 

Glad you could get the drug. If you still had any vivonex left, I wonder if doing the two for a few days could help?


----------



## Moises (May 20, 2000)

Browish,

That's great that you are continuing to do well.

It's funny you mentioned doing another elemental diet regimen. I bought some real expensive protein powder a few years ago for a home-made elemental diet. Then it just sat around. Finally this weekend, I used it, even though it technically had expired in November 2011.

I bought some duck fat at the store and had the protein powder. It was disgusting. I quit aftr 5 "meals."

From now on, I am sticking to the Gottschall-Robillard concept eating real food.


----------



## Brownish72 (Aug 26, 2012)

This posting has almost become too long!

30 days later:

Feeling great. Still getting well formed BM's, but for some reason, about once a week, I get either diarrhea, or a very soft stool.

As for now, I AM taking immodium, 1-2 in the day time, and my prokinetic @ night. Although I have had setbacks, the combo of the two have truly made this 2nd time, post-vivonex, better.

I have expanded my carbohydrates a little bit. A little sugar, I have had bread about 2-3 times (in small amounts), and I chewed it really well.

I tried a mini bone broth "fast" where I didn't eat anything for about 24 hours. I wonder if something like this could be beneficial to prolonged healing and success??? Any opinions on this? I came across an article of someone who got rid of SIBO, and was fine for about 5 years. Mostly, I see people being fine for about 1 year if they are lucky. I'm gonna try and be one of these "lucky" people.

Coconut oil, my new friend  Just research it for those who are interested in it.

I decided to order some vitamins and enzymes from giprohealth.com. I paid quite a bit for the two, and should have enough for 2-4 months depending on how I take them. I chose there website because they make great SCD / GAPS / Paleo etc..approved products. Also, the enzymes they sell are quite a broad spectrum, and I'm interested in testing them out while I am slowing adding back carbohydrates into my diet. I live in Switzerland, and OUCH the shipping hurts to send it here. I sent them to a family's place @ home in the states, and will have them forwarded here for much cheaper.

I'll update again in about month if I don't see anything. So far, I'm still giving my success a 9/10 because I do have these strange days where the symptoms just hurt. But they strangely clear up very quickly, rarely lasting longer than 1/2 a day. If I could live like this forever, I'd accept it. But, for now, I'm gonna try and keep improvement happening.


----------



## frustrated21 (Jan 7, 2013)

Hi Brownish and Moises,

Thank you both for all the posting you have done regarding Vivonex. As someone who is currently in the throws of this issue, I found it more helpful reading your posts than talking to my doctor. The short version of my story is that I've had symptoms of SIBO now for about two years (gas, bloating, rumbling). I was finally diagnosed with it by a gastro this summer after I insisted on getting a breath test. She put me on 10 days of xifaxan and also had me talk to a nutritionist about eating a low FODMAP diet. I started FODMAP about 5 days into the antibiotic. My symptoms felt a little better after the course but only for a few days. Then they came back in full force.

I started the Vivonex Plus diet 4 days ago. Since you both have done it twice, I'd love to hear your answers to some questions I have. I have "Breaking the Vicious Cycle" and "A New IBS Solution" on the way to me but I figure that you both are experts with all the reading you have done!

1. Day 1 on Vivonex was fine. Days 2 and 3 and today, I'm experiencing watery diarrhea after each shake. I called Nestle and they said that this is not normal. Can either of you speak to this and whether it stops at some point or if it is to be expected for the entire time I'm on it. I'm drinking 70 ounces of water a day plus three shakes (900 calories total) so I hopefully won't become dehydrated.

2. I used a small amount of Crystal Light on Days 2 and 3 to flavor it but am not a fan of aspartame. Plus, I thought that the aspartame might be causing the diarrhea so today I didn't use any Crystal Light but still had issues. I believe one of you mentioned that you flavored with Sutton Bay flavorings. I just ordered 3 of them and they will arrive in 2 days. I just wanted to double-check that is it okay to use them since they are sugar-free and gluten free. The ingredients list artificial flavoring but no sugars of any kind.

3. Brownish, it looks like you did vivonex and were symptom-free for 60 days. I'm curious why the bacteria came back? I never had an issue before 2 years and so I'm wondering if I successfully kill the bacteria by using vivonex for 3 weeks, they why can't I return to eating normally? I will stick to a very low carb, low sugar diet afterwards but I'm wondering why and how your bacteria came back. Any ideas?

4. Brownish, I know you use a prokinetic at night. My gastro wants me to start Nortriptyline at 10mg per day after I finish vivonex. She said it is an anti-depressant at a very low dose (1/10th the dose of a normal prescription for depression). She said there is a strong connection between brain and gut and that this low dose will help the pain go away. I don't know. Any ideas about this guys? I'm not a fan of taking medicine but if it helps, I'll try anything at this point!

4. Do either of you use a daily multi-vitamin or supplement to get all the minerals and vitamins that one needs from vegetables? Curious if there is a good one out there that doesn't upset your stomach.

THANKS for any info and for posting your stories!


----------



## Brownish72 (Aug 26, 2012)

Hey there.

read page 3, i posted a day by day summary of how each day went. I too experienced bowel movements, Some people DO get them while on an elemental diet. Moises did as well.

I will post more later, but keep your spirits up, and stick with it. Be careful with the "no sugar" sweetener you talked about. "no sugar" can be quite ambiguous. Ill post about that as well.


----------



## Brownish72 (Aug 26, 2012)

Okay. Lets see what I could help answer here:

1: I got BMs almost every day. Both times I fasted, I had watery stool that was not confortable at all to pass the first few days, then it stopped. Eventually, they became "solid", but always very yellow. Bowel Movements are made up of 50% , sometimes more, of dead bacteria. SIBO can also dammage microvilli in the intestines, and these dead cells, it is theorized, are shed during the fast. So, while fasting, one can have bowel movements, keeping in mind that it could simply be dead bacteria and dead cells I would say, without a doubt, this *is* the case because I had a breath testing following my fast that verified I had significantly lowered the bacteria present in the small bowel. The ONLY thing that I had changed in my life was simply fasting on Vivonex.

2. Stick with crystal light. Some "zero" sugar sweeteners can still provide energy to the microbes we are trying to rid ourselves of. I can't find what is in Sutton Bay flavoring, BUT, if it is something OTHER than aspartame, or sodium saachrin, I wouldn't do it. The fast is already a challenge, and what a mental defeat it would be if it didn't work simply because of a sweetener. I personally just drank the shakes straight, and rinsed / brushed my teach after.

3. Why my symptoms came back?? Well: SIBO comes back, and that is one of the mysteries of the "illness" . One theory is because people with SIBO, currently or previously, show signs of a damaged Migrating Motor Complex. Why this is, it is unknown. The Migrating Motor Complex is a group of muscle that sweeps through the intestines every 1/2 hour or so, and it pushed food / bacteria down into the large intestine, and it is the body's natural defense of keeping SIBO at bay, or everyone would get it. This is why I am taking a prokinetic every day, because a prokinetic stimulates the Migrating Motor Complex, and it can help the body get back on schedule.

Keep in mind, some people stay symptom free for years, some only months, some only weeks. Each person varies.

3. I can't say much about anti-depressants. I have tried them, never much success, but I also did not take the regularly. There is a new post on this forum about SSRI's, don't know what that means, but it is referring to anti-depressants. I have heard that with some, it is a life saver. Dr. Pimentel, in "A New IBS Solution" talks about this approach to IBS.

4. Supplements: Freeda Vitamins. The offer an SCD Vitamin which is GREAT, I highly recommend it. I just ordered Vitamins and Enzymes from www.giprohealth.com . They have SCD , GAPS, PALEO supplements. Never tried there Vitamins, but I'm gonna give them a shot. While on vivonex, this shouldn't be necessary, since Vivonex is literally a vitamin, mineral, amino acid shake. All in broken down, easily absorbed forms. After, however, they could be a good idea. I highly recommend the enzymes from giprohealth.com

Good luck, Stick to it. Stay positive,I cannot stress that point, even in the toughest of times it truly helps, and Vivonex just might be your door out of SIBO like it is mine.


----------



## Moises (May 20, 2000)

I used the Sutton Bay flavorings. Later on, I discovered that even aspartame can give me diarrhea.

The Sutton Bay flavorings seemed to be fine.

During my first regimen of Vivonex Plus I bought the manufacturer's flavorings. During my second regimen, the original manufacturer's flavorings were no longer available, so that is why I made my own with aspartame and Sutton Bay.


----------



## kenbkb (May 21, 2011)

Were both of you working with a doctor while taking the Vivonex? I recognize that all of us have doctors but was there a doctor walking you this way or were you acting on Pimentel's protocol?

I have finished my second run of Augmentin and am now several days beyond. Did not quite get the improvement the second go around as I did with the first. The Augmentin was pretty harsh on my intestines so often times it is hard to tell if I had improvement as I had the runs a good portion of the two weeks on the Augmentin.

My doctor and I decided to wait a couple more weeks and go on a longer course but cut the dosage BY AT LEAST HALF. So this is next up for me in one week from today.

I called the Nestle folks to talk about Vivonex. I understand there are different levels of it. I am still concerned about weight loss as in two years I have gone down from 185 to 158 now. I hear you though, brownish, sometimes you have to eschew the weight loss temporarily to try and STARVE THE BACTERIA. So I am leading up to a two week course of it after this third round of a lesser dose of Augmentin.

As further evidence, my wife made pasta last night and I had one of my worst evenings ever. All I could picture was the CARBS TURNING INTO SUGAR AND THE BACTERIA FEASTING AND HAVING A BALL WITH MY SUGAR.


----------



## Brownish72 (Aug 26, 2012)

I recommend you UP the calorie intake. You are only taking 900 calories. I did 1800-2100. 900 isn't very much.

Unless of course you broke the fast? Did you eat pasta then?

I did not have a doctor to help me along, although when I went to see my doctor, I explained to her how I succeeded at lowering my Hydrogen Breath Levels. She was amazed, and open to the idea of trying it on others.


----------



## kenbkb (May 21, 2011)

Oh, I am trying to up the calories. Torn between being strict SCD and Pimentel. Pimentel as you know is much "softer" in his approach. I do the coconut oil teaspoon daily as you suggested and a local dietician here has recommended to keep adding olive oil to meats and such.

Of course I "experimented" with the spaghetti to see if I could handle it post-antibiotic and paid a dear price. 24 hours later and I am still suffering.

I know you lost weight, what did you do to boost calories?

Here is a guy on youtube, he makes this turkey sausage and eats it every day.






I for one am glad you are here and offer hope, particularly with the diet and Vivonex. Not too many come back to help and tell their story, brownish. So much obliged on behalf of all of us. That was a grind on the Vivonex. Not sure how you did it while working. More power to you. Don't you wonder how many people are successful with it off of that Pimentel protocol. I know he said 80% but I am not sure I have ever seen the formal test published.


----------



## frustrated21 (Jan 7, 2013)

Hi Brownish!

Thanks for the great post! I think you're responding to both kenbkb and my posts, and combined them.

I am still doing the Vivonex fast - no pasta for me...just finished day 5. I'm okay with the 900 calories...I usually only eat 1100-1200 daily. While the shake isn't too bad, it certainly isn't delicious and drinking 3 of them is enough work. I can't believe you did this while working. I would have guessed that would be impossible!

Based on your post, I cancelled my Sutton Bay order and will just use Crystal Light. I used 1 CL packet for 10 shakes so I'm not using too much and hopefully the Aspartame won't kill me 

I called Pimentel's GI Clinic today and talked to a nurse for a few minutes before she realized I wasn't a patient and cut me off. I asked her about the diarrhea and she said it is quite common for the first week. She said it is my body's reaction to the Vivonex and that it takes up to a week for one's body to adjust. The good news is that I just had it once today which is a huge improvement from days 2-4.

Ken, I have a gastro who tested me for SIBO. I did a course of rifaximin for 10 days but it didn't work. Based on my own research I decided to do Vivonex. My gastro wasn't actually a fan of it but I told her I was going to do it anyway.

Trying to figure out what to do post-Vivonex. Brownish, thanks for your thoughts. I don't like to hear that you used them and weren't successful. I personally like the idea of using a medicine that does something (like increasing the cleansing wave) instead of nothing much (reducing pain - antidepressants). In fact, due to my diet of no vege's and low fiber, I am usually constipated and think the idea of a prokinetic might be helpful for me. Although it worries me that you got the runs with it and need immodium to counteract it. Did you have problems with diarrhea before the vivonex and the prokinetic? Pimentel's clinic told me their protocol is to use a prokinetic after the Vivonex (and not to use an antidepressant). It sounds like you are having success with the prokinetic....any other side effects?

Thanks for the vitamin suggestion. That's great that it complies with the SCD diet (guessing it is probably in the book that is on its way to me). Random question...do you know how large the pills are? I'm not a huge fan of swallowing pills. I've been using a powder shake to get all my minerals and vitamins but I don't think it's good for my digestion.

I'm curious about this bone broth that many people talk about as being the best thing on the planet. Do you make it at home? I'm not a huge cook and can't imagine making something that needs to simmer on the stove for 12-24 hours! Did you feel better about your broth fast?

Thanks for the encouragement! I'm completely okay with just drinking these shakes (maybe cause I'm used to drinking a pretty gross one in the AM already!). These things are all psychological....the key is just to not focus on food at all. It's probably a lot easier for me since I don't have a significant other and live alone. I don't have to watch other people eating and I've decided to not have a social life for these 3 weeks...it's all good!

So, did you just decide to pack up one day and leave the States for Switzerland? Brave move! Glad you did it?


----------



## Brownish72 (Aug 26, 2012)

@KenBKB

I apologize, I had the impression you were on the Vivonex Fast, I mixed that one up.

I like the SCD over Pimentel's while one still has SIBO. Although Pimentel's diet suggests potatoes and white bread are okay, they still require digestion before absorption. The SCD diet on the other hand offers a way of nourishing oneself with carbohydrates that are "pre-digested", or in other words "Simple Carbs (hence the name of the diet), and there is less of a risk that the bacteria invading our intestines will have energy to ferment, grow, etc.. I feel the risk of Pimentel's diet is too much of a "risk" for those still with SIBO, simply because those of us with SIBO are soo sensitive. Even the SCD diet needs to be tailored to individual needs.

Where you got that video is from SCDlifestyle.com . I recommend you buy there E-Book and read it, and maybe start there 90 day diet? The two authors are great, smart, and they are available to answer personal questions (thats incredible considering the # of people that follow their site)

My way of gaining weight was fasting on Vivonex, getting rid of SIBO, and finally being able to absorb nutrients. I have noticed a 1000% turn around from pre to post fast. That is why I am out here promoting it, encouraging, and supporting those who want to try it 

I appreciate your last comments. I really want people with SIBO to avoid the suffering that I did. I was so sick, there were days I couldn't get out of bed, and diarrhea 10-20x a day isn't a joke, it hurts, physically and mentally. The SCD diet, and Vivonex changed my life. I may be down to only 1-2 BM's a day, well formed, no problems what so ever, but I am still battling like anyone else. I constantly pay attention to what I eat, I drink lots of liquids (I have found warm water, with a little lemon or tea through the day is also a big plus! )

"gluten free" diets are so ambiguous, for those of us with SIBO. Being gluten free truly is not enough, because corn, quinoa, soy, etc.. based products contains starch / carbs that only make our problem worse. Thats why I like the SCD diet so much.

Pimentel's study can be found on a website called PubMed. Unfortunately, unless you are a student @ a university, or a medical practitioner, you can't get access to the article :/ I however, have access to it. Basically, out of over a 100 patients, (I don't remember how many, but he had a "decent" number, it truly would carry more importance if you could get like 2000+, but as someone who does research, research costs a lot of $$$$, so I am thankful he was able to get the sample size that he did), 80% of people normalized there Hydrogen Breath Level tests after only 2 weeks, and of those that didn't pass, they continued for an additional week, and 85% total normalized their breath tests in the end. The article isn't of importance to read, it gives statistics, methods, etc.. but the result section, what I just wrote down, is the important part. *Clearly*, there was something that changed. The fast shows to be effective, and for someone who had extremely high levels of Hydrogen during my breath test, and severe SIBO, it worked for me.

Unfortunately it does NOT work for everyone, but statistically, and according to his research, it should work for 85% of the population. Those are good chances. Imagine those chances at a casino!!!


----------



## Brownish72 (Aug 26, 2012)

@Frustrated

Hope your feeling great! By now, your on day 6, and you got over the hardest part. Could you do me a favor, if you aren't doing it already, could you quickly type up a journal of how you feel each day, and if you haven't started, maybe just write key points of what you remember from day 1, day 2, etc.. Having read multiple journals of people on SIBO as well as my own, it helps to see common patterns amongst different people. And, if it wouldn't bother you, to either post it once you finish or send it to me via email?

Nice move on calling Pimentel's office. Way surprised they answered some of your questions! I feel doctors and their assistants are tough to get a hold of. I didn't even THINK of calling them. Good move









I think a prokinetic is KEY in keeping SIBO at bay. I know the one I am taking was giving me diarrhea, but I confirmed with a doctor that this is totally possible, and I simply lowered the dose, and yes, I do take 1-2 immodium a day to cut down on the water that I was getting in my stool. I was thinking this morning, of the last 3 weeks now that I am doing this combination, I have had 1 day where about 1/2 the day I had diarrhea, other than that, I'm 20 days strong, symptom free. In total, 32 days where I feel awesome. I personally feel the prokinetic is KEY, and I talked to a SIBO expert in Portland, Oregon, named doctor Allison Siebecker. Her website is www.siboinfo.com . She herself suffered from SIBO, she went to school, got a medical degree in Chinese AND Western medicine. She has a very open mind about how to treat SIBO. I only got to talk to her for only 18 MIN. (yes I counted because you pay by the minuite). but it was worth every penny. She's wonderful, and she has patients who have curbed SIBO, kept it at bay for several years thanks to their prokinetic as well as low carb diet, and they live a normal life. It is her, and Pimentels opinion, that some type of prokinetic is necessary to keep SIBO at bay for longer periods of time. Other than the soft stools right after fasting (which I dont have anymore) I have 0 side effects from my prokinetic.

I know my prokinetic gave me soft / water stools for the first week, but us with SIBO are very sensitive. The difference for me was to take 1/2 the dosage that was prescribed, and take some immodium to cut down on the water in my stool. I was taking up to 3 immodium a day, now I am down to 1-2 . My goal is to get off of it, but for now, I feel it is helping me, so I'm going to stay on it. Immodium, as far as we know, is safe, people have taken it for years without side effects. With that said, my goal is still to get off it.

Before Vivonex, I had only diarrhea. I strictly followed the SCD diet, got HUGE results, but still experience loose stools. although formed. The worst part was undigested food in my stool and frequently yellow stools. Although the SCD diet allowed me to live without pain, and I no longer had urgent diarrhea, but I was still getting it. Post vivonex, NONE of those are issues for me.

The freeda Vitamins are that big, and you could always break it in half if its a problem. The enzymes from giprohealth are not big at all, but Im not sure about the vitamins, I could let you know when I receive them (I hope soon!)

Bone broth: I recommend this above anything. It's like medicine. Here's a great article about bone broth: http://www.townsendletter.com/FebMarch2005/broth0205.htm

The Website above provides a recipe at the bottom

Basically: take 5-10 good beef marrow bones (easy to get, go to the butcher, even the store has them prepackaged) Put them in water, with a LARGE onion, cut in half (leave the skin on). 3-5 large carrots, peeled, spices (whatever you want: I use Thyme, salt, pepper, and a bay leaf) and I never measure the water, but 1 liter maybe, or more if you plan on canning and freezing it? Throw everything in the water, Boil at first, then reduce to simmering, cover, and let it sit for 3+ hours. Some people I have heard let it sit for 36 hours. I think thats a little extreme, I usually do between 2-3 hours. After, with Beef Marrow, you typically have to knock the marrow out with a mini spoon or something. Sounds complicated?? Its really really easy. I've only done it twice, where I "fast" for about 24 hours with marrow. It's easy, and I think it helps.

I DID pick up and move to Switzerland. Basically, I was bar tending / serving / working @ a coffee bar, plus 2 other jobs (manual labor stuff), saved up lots of money, sold almost all my stuff minus my 1970 VW bus and my tools







, and now I'm a masters student in a Biology / Ecology program in Fribourg Switzerland. I'm oooo so happy I did it, but the health problems abroad are the worst. They make me more homesick than ever. But this voyage has been one of the biggest mental challenges of my life in combination with my health, and so far, glad I'm coming out on top


----------



## kenbkb (May 21, 2011)

Brownish and frustrated, thanks for weighing in with comments and options.

Brownish, I almost feel like I am speaking to a disciple of Mark Pimentel. You once said that once people improve they leave the board so everyone here needs to thank you for staying with us and sharing your progress.

Most of what you said is such horse sense that any doctor would do well to read your words.

A couple of follow ups: Bone broth? Is this just part of the SCD? For what purpose is the bone broth? Or for all the reasons in that link?

And your prokinetic. Is it low dose ethromycin or Zelnorm? And are there others that you have tried?

Again, it appears after all is said and done, the prokinetic is the tie that binds everything together, or so it would appear. What is Pimentel's REAL REASON for prescribing it, the cleansing waves???


----------



## Brownish72 (Aug 26, 2012)

@Kenbkb

Bone broth is just awesome. The protein, collagen, is the same protein that the inside of our organs is made of. I think of it like a band-aide for the inside of the body. A ban-aide pack with vitamins, minerals, protein, calcium, sodium, etc.. The article that I posted sums it up pretty well. Bone broth is KEY to the SCD diet, but it's good for anyone. Make some, and the more you make it, the more you can change it for your taste. I've been making it for a year now (so not too long) yet I'm much better now, than I was 2 months ago at it, I'm always changing it a little bit. Tonight, for example, I made some and had my roommates girlfriend taste it. All she said was "wow". It's a taste we have lost because everything is pre-made, or in a can, but when you make it home made, all you can say is "wow' that's good.

I take erythromycin. 25MG @ night. Typically it's given at 50MG dosage, but that was a little too much for me. There is another prokinetic out, but it's available in Europe, the UK, and Canada, not in the US yet.

The sole reason for prescribing it is for the cleansing wave. That gets back to the fact that somehow, SIBO patients have a damaged Migrating Motor Complex, and a prokinetic can help "repair" this.


----------



## frustrated21 (Jan 7, 2013)

Brownish,

Just finished day 6 and all is well. I started taking notes - good idea. I really am just focused on number of bowel movements. Other than that, I feel totally fine. I did notice that I woke up earlier than normal this morning and just couldn't fall back to sleep. Not sure if that is related to the diet or not, but I'm really okay on it. It helps that I've pretty much secluded myself and am just hanging out watching TV, reading and relaxing.

It took me a week of leaving messages but finally a nurse did call me back from Pimentel's office. She was only nice until she realized I wasn't a patient, then she quickly "had to get off the phone". It was completely worth it though just to find out the diarrhea is normal for the first week as one's body acclimates to the vivonex.

32 days of feeling awesome is great news! You must be excited to be living life without symptoms. I can't begin to imagine diarrhea 10-20x's per day....so very tough on the body.

I like the idea of the prokinetic, especially to keep my constipation at bay. I'm a little scared though of the side-effects. It's an antibiotic - is it okay to be on it long-term? Or is the idea you are only on it for a short time? Wonder if it trains your system to do the cleansing wave more times so you can them come off of it? I looked at the wiki page for erythromycin and there are some serious side effects on there.

I am going to try the bone broth on day 1 after the vivonex. Thanks so much for your recipe. Do you drink this daily?

Stupid questions...

1) Should there be meat on the beef bones?

2) Do you strain the mixture before drinking it? You mentioned an onion with the skin on so I'm assuming you don't eat that!

3) After, with Beef Marrow, you typically have to knock the marrow out with a mini spoon or something....can you elaborate on this? Do you mean scrape the top (marrow) off the pan before drinking/freezing?

4) Do I just walk into a butcher and say, would you please hand over your beef marrow bones? Or will the guy look at me like I'm crazy? Do they charge you for these or are they going to throw them away?

Thanks your help with this...I am obviously not a cook of any sort. I spent some time today reading through recipes on SCD sites and I guess I'm going to have to start cooking to do this. I normally eat out which is just so much easier and more fun 

CONGRAT'S on selling almost everything and making such a huge move! I've moved a few times inside the US for college and grad school and jobs, and always found it exhilarating. Can't imagine how much fun it would be to try moving to another country! I'm thinking about taking 4 weeks this summer to do a Europe trip since I'm in my 30's and have never been. It looks beautiful and I'd love to experience it. Being sick while abroad is just no fun. I spent 5 weeks in India 3 years ago and was extremely sick with bronchitis while hiking around the very dry Himalayas. I remember thinking I just want to be curled up in my own bed and taking real medicine (instead of the crappy stuff I got in India). It sounds like the worst of your medical issues are over now so you can enjoy Switzerland!


----------



## Brownish72 (Aug 26, 2012)

@ Frustrated21

Hey,

I obviously cannot answer if the medication is OKAY for you, for legal reasons, but I will tell you what I do, and it may help answer your questions:I take 25-50 mg of Erythro @ night. The dosage is SOO weak, it's not even strong enough to act as an antibiotic. The risks associated with heart problems, antibiotic resistance, c-diff, etc.. are with those patients that take 500 MG tables (10-20x stronger than mine), and most likely several times a day. I was very clear with two doctors about this, and I have studied antibiotics in microbiology class, and it makes sense that the risk is extremely low, to non-existant.

For the broth:

I try and drink some everyday. But as good as it is, I get tired of the taste









The butcher will now right away, especially if you mention you just want to make some homemade stock, he / she will point you in the right direction. Here's what you are looking for:

http://www.google.ch/imgres?imgurl=http://www.mikesorganicdelivery.com/images/P/beef-marrow-bones.jpg&imgrefurl=http://www.mikesorganicdelivery.com/Marrow/&h=237&w=265&sz=25&tbnid=rNZqRqEKjWXr_M:&tbnh=99&tbnw=111&prev=/search%3Fq%3Dbeef%2Bmarrow%2Bbones%26tbm%3Disch%26tbo%3Du&zoom=1&q=beef+marrow+bones&usg=__8zxzlT8Oafq0ho3vWkHV1NgiVWI=&docid=n9xUrOfX1WP4xM&sa=X&ei=bYXuUIKzLKiF4ASHyYGgAQ&ved=0CFYQ9QEwBg&dur=62

ha, what a long link?!?! Anyways, you can see the marrow in the middle, its the off-white part. When you boil it for hours, it will either fall out on its own, or you simply need to push it out with a small spoon or something.

When I go to the butcher here and ask for them, sometimes they just give them to me for free because not many people want em'! ha. Even in Switzerland however, an absurdly overpriced country in some aspects, they cost $1-3 at the most for a bunch of them.

I think these guys go a little extreme with the broth, but here's an idea that could help you out:

http://scdlifestyle.com/2012/02/how-to-make-nourishing-beef-bone-broth-to-heal-your-gut/

Everything I boil with the bones, so the carrots, onions, whatever else, I throw away after. I sometimes put the carrots back in and purée them, but it depends on the taste I am looking for.

In the end, I mix what's left in the stock: so the marrow + liquid + spices + maybe carrots - and I use a mixer to blend it all together. This gives it a smooth consistency. Its not necessary, but I really like it.

You really just gotta try it, you'll make mistakes, o well, but you'll get the hang of it. The SCD diet is a big step to eating *real* food









Good luck!


----------



## frustrated21 (Jan 7, 2013)

Hi Brownish,

Good info on the low dose. Is your plan to stay on it permanently if you stay healthy or will you transition off of it? I'm going to call my gastro tomorrow to switch to it instead of the low dose anti-depressant.

Thanks for writing so much about the broth...I needed it written out like that  I'm really excited to try making it and drinking some every day. I received the two books today and glanced through the diet section of "Breaking the Cycle". She says that carrots should be avoided if one is suffering from diarrhea. I'm sure you know all this but just thought I'd pass it along in case.

I ordered the SCD multivitamin and a SCD calcium pill. The company said that I can just mash them up if the big pill is too scary  Thanks again for the site!

Guess it's about 9am there....enjoy your Friday!


----------



## kenbkb (May 21, 2011)

Brownish et al, good article you posted from the female doctor. Saw it effects fibro also so shared this with a friend suffering. So these overgrowth is seen as a culprit in other disorders/maladies/diseases? Very very interesting.

And also interesting is this cleansing action. The prokinetic. I may call Dr Allison just to talk about multiple rounds of antibiotics, prokinetics, bone broth, etc. Course I would want to keep it under 20 minutes with her due to the cost.

The prokinetic seems about as important as anything else in the whole dang process. And who turned you on to bone broth? Quite an addition to the diet, another important piece much like the prokinetic.


----------



## Brownish72 (Aug 26, 2012)

Hola,

I really recommend you talk to Dr. Alison Siebecker. Tell her the guy that called from Switzerland is still doing well  ha

Bone broth is a key part of SCD diet, and its just become a habit that I make and drink it all the time. Between the SCD deit, Dr Allison Siebecker, and my personal experience, I'm convinced bone broth is good stuff 

I haven't seen overgrowth can cause other diseases, except leaky gut, but people with Celiacs, Colitis, and Chrons have high rates of overgrowth as well. So its more the contrary, other maladies can cause overgrowth, as far as I have seen...


----------



## kenbkb (May 21, 2011)

Brownish et al,

I stumbled on this link whereby a sufferer, ala Brownish, has come back to share his experience. I thought it might be of interest:

http://curezone.com/forums/fm.asp?i=1707980

Also, brownish, I bought some soup bones. How many do you put in a pot and how much water in the pot? Thanks. PS...I just started the coconut oil as well.


----------



## Brownish72 (Aug 26, 2012)

Hello

I'm tossed up on Probiotics. I eat fermented foods, with probiotics naturally in them, and I do it in small amounts. As I have posted before, the one mistake I feel is done is that probiotics are taken in too large quantities. I particularly find relief in taking lactobacillus strains of probiotic, in small amounts, if possible with each meal. None of this 700 billion x 4 / @night (just an example!) The article you posted in the second I have come across where people notice symptoms come back when they take probiotics. On the other hand, there are many people where symptoms are relieved. I have been trying small amounts of Sourkraut with my meals. Maybe there is a "happy balance' between the two?

Awesome on the coconut oil. I think I over did it the other day. Felt a little sick. But, I small spoonful in my coffee in the morning seems to be the best idea. About its antibacterial properties, etc.. Who knows. I haven't found any scientific article that backs up that claim. On the other hand, the idea of intaking a Medium Chain Triglyceride is a well understood, great idea 

5 weeks, Feelin' good! Hope this keeps going. I replaced one of my immodiums a day with a calcium carbonate pill. I really flucuate with the immodiums, with 1-3 per day, instead of 3 everyday. I truly base it on how I feel, but I do feel my "dependance' going away, little by little.. Glad I found calcium carbonate in a capsule form, all other forms I've found are in tablets with sugar / artificial sweeteners which us, with SIBO, should try and limit. We'll see how this goes. Hope things keep up

I put 5-6 bones in a pot, and starting the whole process. .You can put more though. The more you put, logically, the more collagen, vitamins, etc.. in the mix  I don't measure the water, I've done it so many times I just kinda eye ball it, but 1-2 liters maybe?? Just type it in google, I'm sure you'll find great recipes to follow


----------



## kenbkb (May 21, 2011)

Brownish et al,

Started the bone broth. Not sure how often to drink it (once a day), but am going to give it a three week trial. Am due to start a very low dose trial of Augmentin again after being off it for two weeks. This would be my third cycle. The first one gave me 50%, but with the second I had the runs so often I could not tell if it was working or not. Although now I have been off it for two weeks I would say my symptoms are 30% improved. Course I have now added coconut oil and am doing a low carb diet. Not SCD, but low carb.

Anyone ever hear of Rifaximin and Guar Gum? Here is a medical article noting its efficacy in combination:

http://peer.ccsd.cnrs.fr/docs/00/56/70/44/PDF/PEER_stage2_10.1111%252Fj.1365-2036.2010.04436.x.pdf

Seventy-seven patients had SIBO. SIBO eradication rate was 62.1% in the rifaximin group (both

on per-protocol and intention-to-treat analyses), and 87.1% (per-protocol, p=0.017) and 85.0%

(intention-to-treat, p=0.036) in the rifaximin-plus-PHGG group. Clinical improvement was

observed in 86.9% and 91.1% of eradicated cases in rifaximin and rifaximin-plus-PHGG groups,

respectively (p=0.677).

Conclusion:

The association between rifaximin and PHGG seems to be more useful in eradicating SIBO

compared to rifaximin alone.


----------



## frustrated21 (Jan 7, 2013)

Brownish,

So glad to hear that you are feeling good after 5 weeks! All your hard work is paying off! After being miserable with symptoms, you must be so happy.

I'm on day 12 and all is going well. I'm going to do it for 18 days total and am now trying to plan for day 19. Ordered the vitamins and Artisana coconut oil (everyone online raves about it). Do you take 1 teaspoon of coconut oil per day?

Think I'm going to buy a crock pot so I can make bone broth without leaving my stove on during the night. From the research I've done, it sounds like the longer you simmer it, the more vitamins in the broth. Also, do you use white wine vinegar in your broth (that vinegar is okay to use on SCD, right?)? Supposedly this draws the vitamins out of the marrow. Ridiculous question...do you have to scoop the bone marrow out of the bones when it softens or does it stay in the bone? I remember you said to knock it out of the bone....so is the goal to have the marrow out of the bone and just floating in the broth?

Ken, here's a good page on broth I found since I know you are just starting this process: http://thenourishingcook.com/beef-stock-anyone/ How does your first batch taste?

I'm trying to get in touch with my gastro to have her prescribe erythromycin. Have you thought about switching to the liquid form of this so it is easier to take 25 mg (instead of breaking apart a 50 mg pill)? I wonder if there is any difference between the liquid form and pill form. Another ridiculous question...you take this at night before going to bed, right? Does the timing work out correctly that you have a bowel movement in the morning when you wake up? Or, does your stomach start rumbling and feeling uncomfortable before you go to sleep? Does it wake you up during the night?

When you make applesauce, do you take the skin off the apples before putting them in the pot?

Do you eat any nuts or are those off limits?

Have you ever tried these: http://www.soap.com/p/heathers-tummy-care-tummy-tamers-peppermint-oil-softgels-66491?site=CA&utm_source=Google&utm_medium=cpc_S&utm_term=AHE-001&utm_campaign=GoogleAW&CAWELAID=1323124834&utm_content=pla&adtype=pla&cagpspn=pla

I know you mentioned you eat fermented food. Do you know if kimche is okay? The bottle I buy says it has 2 grams of sugar which worries me...not sure what kind of sauce it is in. I'm sure you'll say for me to make it myself to be sure of the ingredients  I found a site which makes it look pretty easy. It does have kosher salt in it...is that okay? http://missymiller.wordpress.com/2011/04/05/maruchi-kimchi/

Is this SCD approved? http://www.peapod.com/itemDetailView.jhtml?productId=156931&NUM=1358273940670

Sorry for all the questions Brownish. I feel like my story mirrors yours a little and since you are feeling so good, I want to mimic what you are doing and not mess this up! After 18 days on vivonex I want to make sure I don't have to do this diet again! Since I'm used to eating out every night, this cooking my own food and trying to figure out what to eat is more difficult then it sounds. Thanks so much for all your help - I really appreciate it!


----------



## kenbkb (May 21, 2011)

frustrated, I would say my first pot was sort of non-descript, probably too watered down. Not bad though, not bad. I am flying blind on this so thanks for the link.

I put in 8 soup bones I bought over at Whole Foods, added about 10 carrots and 6 celery stalks, simmered for 5 hours and then drained everything off. Had to skim off alot of fat though. I wish I had made it more tasty. I have no idea what kind of nutrients I am getting out of it.

Brownish, does your bone broth have a strong flavor to it, or is it pretty diluted? If so, I can reduce the water and crank up the flavor, I suppose.


----------



## Brownish72 (Aug 26, 2012)

Hey Frustrated,

Congrats on the fast. I really wish the best for you, and hope it works. I'm keeping my fingers crossed. Do you feel better? Clear thinking, energy, etc..? Still getting any bowel movements?

I don't measure how much coconut oil I consume a day, but a decent spoonful in my coffee in the morning. Other than that, I cook with it. I was actually eating some mixed with nuts for example, but i've slowed it down. Really now I just consume it in my coffee and my cooked food.

Many times the marrow falls out of the bone, but sometimes you need to knock it out. Its simple, After boiling the bones for several hours, the marrow becomes very loose, and its easy to knock out with a spoon, etc.. You'll see once you try it. And white wine vinegar is fine. 

Careful with nuts. I DO eat them, but it's taken a long time to build up to it, and I chew them a ridiculous amount before swallowing. I try so hard to not over indulge in this. My opinion: be cautious. Try it a little bit, see what happens in the next few days, and add little by little.

I've heard about the liquid erythro. Being in Europe, I was happy a pharmacy was willing to work with me without a doctors prescription, and that they listened to my concerns about what they were going to mix the pills with. Its a good question for a doctor, but I would think that liquid or pill form, its the same...

I hear the pill start working, but it has never woken me up. Never had any side effects to be honest.

As for fermented foods: Kimche is okay. But, I gather that we shouldn't over do it. Some think probiotics for SIBO DONT work, some say they DO,. I do take them , little by little, through fermented foods. I make yogurt often, but maybe eat only a spoonful or two with a meal, never more. Look at the ingredients, if there is added sugar, I would stray away. There may be 2 grams of sugar listed, but those could simply be natural sugars in the cabbage, etc.. that is in the Kimiche itself, without adding additional sugar. You're right, making your own is always better  ha Even I don't make that! ha. But i'm sure its easy

Apple sauce, I do peel the apples. The peel has insoluble fiber which can be harsh on the intestines for those of us with SIBO. Remember, each person is unique, you may be fine, and little by little, I am noticing that I don't need to worry as much. But by taking the apple skins off, it makes it easier to digest.

I tried peppermint capsules before, not post SIBO though, Peppermint Tea is a nice way to calm the stomach down though, and I drink that several times through the week. I can't give peppermint capsules a plus or negative. It didn't work for me, but it appears to work for many. So, again, it's one you would have to try for yourself. I was quite sensitive to it. So I would be cautious with it, maybe even say stay away for a bit, but that is your choice. Your second link did not open up by the way.

Usually one bowel movement in the morning. It is now rare that I have more than one a day. And when I wake up, there is 0 urgency to go, its just usually in the middle of breakfast that I notice I need to go.

Are you going to be doing a follow of Breath Test or anything to see if the SIBO was successfully eradicated or not?


----------



## Brownish72 (Aug 26, 2012)

@kenbob

Interesting article about Rifaxamin + Guar Gum. Its great to see people are studying and researching SIBO. It shows its a complex issue, yet solutions are being sought after. Thanks again for posting that, I'm actually gonna save the article in my little archive of SIBO files that I think are worth saving.

Add some spices to your broth. If its bland, some more salt is easy to add. Paprika, thyme, basil, all good things to add to make it taste really good. Like i said, the more you make it, the better you get at it.

I drink a cup a day or so when I make it. Sometimes more if I replace a meal with it. But a cup a day seems to be fine for me 

Thanks for all the interest! Im glad my experience, as well as those of others like Moises, is able to help more people out! SIBO is a tough fight, but armed with the right knowledge, we can truly start overcoming it, little by little


----------



## kenbkb (May 21, 2011)

Brownish, to your "thorough chewing" comment. I once read that with each bite for people with digestive issues you should chew 30 times.

And as to the Guar Gum, I am going to do a bit more research on it, I have no idea what it even is. But if I find out more, I shall share that.

Today I start a reduced dosage of Augmentin. Perhaps like the ethryomycin, it won't even act like an antibiotic in reduced form, and I may get some cleansing wave action from it. Will report back on the Augmentin as well.


----------



## frustrated21 (Jan 7, 2013)

Hi Brownish,

I think it will be tough to say if the diet worked until I start eating but I'm hopeful it's all good. I don't really feel any different (except for no gas and no bloating, which is nice). I am still getting diarrhea once or twice a day...not fun. Looking forward to eating food again in 6 days to get rid of that problem! I don't think I'm going to get retested, mostly because I don't want to drink the sugary stuff. I will know pretty quickly once I eat some real food but I'm hoping that after 18 days on this liquid diet, that I'll be okay.

Thanks again for all the cooking advice  Today I bought a crock pot (for the bone broth and applesauce), food processor and 3 SCD cookbooks. I'm going hardcore on this.

Were you 100% SCD compliant after you did Vivonex the first time, yet the SIBO still came back? If so, that is very disheartening.

I'll let you know about the liquid stuff after I talk to my gastro.

I will stay away from the peppermint capsules. I do love peppemint tea so I'll stock up on some more.

Wow...one time a day....congrat's! What a huge improvement. So glad that you are feeling better.


----------



## frustrated21 (Jan 7, 2013)

Ken,

I haven't made the bone broth yet so I really don't know what I'm talking about. But I did read up a bunch on it and everyone says that the longer you simmer it, the better. Some people even say up to 72 hours (seems excessive!). So next time you might want to try longer than 5 hours and hopefully it will taste stronger.

Curious...you used 8 bones and how much water? Just enough to cover all the bones or more than that?


----------



## kenbkb (May 21, 2011)

frustrated, I probably used way too much water, probably a gallon. So I really diluted it. The bones were drowning I am sure. As to your comment...."Looking forward to eating food again in 6 days to get rid of that problem! I don't think I'm going to get retested, mostly because I don't want to drink the sugary stuff........"

I myself also got so sick from drinking the sugary stuff. The doc said to me let's just treat the symptoms and assume you have a form of SIBO. Again, my symptoms were the more I ate during the course of the day the worse I would feel. Mornings good....afternoon fair....evenings awful.


----------



## Brownish72 (Aug 26, 2012)

Just wanted to clarify, I feel my symptoms came back so quickly my first time because I did not adhere strictly to a low carb diet. I was drinking beer, ate pasta, etc.. So i was not strictly SCD, nor am I now. I eat SCD quite often, and probably 90% of my meals are SCD, but I may eat a small piece or dark chocolate in the morning, or add something that isn't SCD legal to a dish. Technically, if I don't have SIBO anymore, I should be okay, and this is my experience so far.

Just wanted to note, about every 10 days, I have one day maybe that my bowels just empty themselves for no apparent reason. Today was that day. Instead of one bowel movement, I had 4. First one was fine, 2nd and 3rd were loose, and 4th was basically liquid. No pain, no urgency, no gas, etc.. associated with it. It only lasts half a day, then I'm good again. Strange. I can't seem to think of an explanation for this.

I accept SIBO may come back, , it has an extremely high relapse rate. But Vivonex has truly been my only way of allowing me to truly feel normal again, even if it is for 2-3 months at a time (hoping this time is much longer). Its so much easier eating SCD when you know you are doing it because it's safe, but you have the liberty to add smal things to it. If I get SIBO again, vivonex will be my first stop, without a doubt. But, I am doing quite a bit of things for the moment to keep it at bay. Overal, still feeling really good! And I cannot wait to get my vitamins and enzymes I ordered from giprohealth.com I think those, in combination with all that I am doing will truly keep SIBO from coming back for quite some time. As of now, my results with the 2nd fast are much better than my results with the first fast, most likely due to my strict diet and positive attitude, and the prokinetic I take every night.


----------



## frustrated21 (Jan 7, 2013)

Wow...day 10 doesn't sound like fun! Today I had my first day with no bowel movement! I wonder if it has to do with the reduced water that I drank today? I normally drink 70 ounces per day but today only drank about 20 ounces.

Guess what? I talked to my gastro today and she refuses to prescribe erythromycin. She said she doesn't believe in the vivonex diet (she was not in flavor of me doing it) and she doesn't believe in taking erythromycin since she said it will likely cause c-diff. So...I guess I'm not taking it since she won't give it to me and she said no one else in her office will give it to me either. I'm bummed. Guess I'm just going to do the SCD diet after and hope for the best.

Does Vivonex cause the bacteria to die or just to go into hibernation since they aren't being fed?

Do you take any fish oil or flaxseed oil? I'd like to but seem to remember reading somewhere that bacteria like the fish oil.


----------



## Brownish72 (Aug 26, 2012)

Those days where are get that aren't that bad, they just happen.

Sorry about the erythro. I asked a lot of questions, to make sure the risk of C-Diff was low. In fact, according to sources I have read, and multiple doctors, its almost impossible, considering the dosage is soo small, the eryhtromycin doesn't even work as an antiobiotic. . There are other prokinetic agents that exist, even strains of lactobacillus have shown signs of activating the Migrating Motor Complex, but it has never been tested in a research study..

Vivonex does not kill the bacteria directly. The idea is it literally starves the bacteria, they go into remission, and then eventually will die due to the lack of energy to live. That it why it takes a minimum of 2 weeks...

Fish oil is a great source of omega-3, it has natural anti-inflammatory properties, and it does not feed the bacteria. However, other additives in the fish oil could be feeding the bacteria. It is just important to read the labels, and sometimes even call the companies that make them.

That's a real bummer about your doctor not believing in Vivonex. It's not just word of mouth saying that it works, but there's a decent study that backs up the evidence, and I myself have seen it work. I've had many doctors tell me that my SIBO would just one day go away, and to eat more fiber. What a joke. Really, what a joke!


----------



## frustrated21 (Jan 7, 2013)

Hi,

I agree...it's ridiculous! My primary doctor told me I was just fine since he sent me for a cat scan and ultra sound, which both were normal. Obviously I know something was wrong but it's frustrating when your own doc doesn't believe you! I did a ton of research on my symptoms and felt confident I had SIBO. Found a gastro who would send me for the hydrogen breath test which came back positive. I felt like waving it in front of my primary doc's face and saying...now do you believe that I wasn't making this up!

I feel much better on the vivonex. If the stuff tasted better, I could live on this! No gas, no bloating. A little rumbling but much better.

In addition to the coconut oil and the bone broth, I want to eat some yogurt daily. I think you said that you eat a little at every meal. Do you use this yogurt maker and this yogurt starter: http://www.scdkitchen.com/yogourmet.html

Stupid question but can you flavor your yogurt with something or do you eat it straight every time? I'm used to blueberry or strawberry and I'm worried about just eating it straight.

Thanks for the info again. I'll call the liquid fish oil company and see what else is in there. It does say natural lemon flavoring which might be bad but doesn't say anything about sugar.

Thanks!


----------



## kenbkb (May 21, 2011)

Brownish, you said...."

Just wanted to note, about every 10 days, I have one day maybe that my bowels just empty themselves for no apparent reason. Today was that day. Instead of one bowel movement, I had 4. First one was fine, 2nd and 3rd were loose, and 4th was basically liquid. No pain, no urgency, no gas, etc.. associated with it. It only lasts half a day, then I'm good again. Strange. I can't seem to think of an explanation for this. "

You know what my sense of this is? I think we probably had days like this when we were "normal" yet never gave it a second thought.

Secondly, I see that you are adding some vitamins, etc.? Is there a reason you are taking this extra step in light of the fact that you are doing so well? I am not trying to put a pin in your balloon, just wanted to get your thinking here. Is it that perhaps you can even be better still? Or you do not think the vitamins pose no harm? I would guess they can only help and not hurt. But would appreciate your insight.

Finally, I am going to post another SIBO treatment option here soon. This one done from studies with Chinese herbs. I mentioned the Guar Gum one the other day. And that one showed something like 90% efficacy. (I may even contact the doctors involved with that study). But it never hurts to have something "in your back pocket"....therefore the Chinese herb link which I will post here later.


----------



## Brownish72 (Aug 26, 2012)

I'm traveling in France, and it could be related to traveling, or who knows, but I had D this morning... I guess I could be angry, but that's not going to help. I'm just gonna hope that whatever this is, that it passes. It's tempting to take more immodium, but I feel that is a downhill path. Its very strange when I get this: Literally no gas, no pain, no headache,no bloating, no rumbling, no signs of stomach issues, just when I get, its not well formed, and its loose. Its not even physical suffering, its mental. Just gotta keep my head up in times when its not easy.

The yogurt make is what I use, they all do the same thing, and you can use greek yogurt as your starter, looking on the back to see what kinda bacteria they put in, or you can buy those little yogurt starter packs, and those work great as well. I typically eat a spoonful or two, plain, but you can add fruit after if you would like. If you make apple sauce, thats a great idea,..

I have added vitamins yet, they haven't arrived. The vitamins and enzymes I ordered, like vivonex, use products that do not react with people who have SIBO and I never have gotten symptoms from them in the past, they only made me feel better, and that's when I was really sick. So, i know i am going through an unfortunate flare up, but im gonna keep my head up, eat lightly today, go running, and remember that my last time after vivonex, I had flare ups as well. This one will go away, I just need to sit it out. The vitamins and enzymes, I feel, could help avoid this type of situation. The vitamins will help provide the nutrients for cellular regeneration, if I have damaged intestinal lining (even if I dont show signs of it) and they may give me more energy. The enzymes will help ensure proper digestion of carbs, they really helped in the past. So I will see, and will definitely let people on here know.

Thanks you two!


----------



## frustrated21 (Jan 7, 2013)

Oh no! Such a bummer of a post to read Brownish. D while traveling is not fun. On the other hand though, your traveling is probably while you have diarrhea in the first place and everything will return to being great when you go home. It's weird how sensitive our bodies are to traveling and eating/drinking new things. I know it's frustrating but don't panic and I'm sure you'll be fine in no time! Wishing good thoughts for you









I'm going to buy some enzymes right now...your post convinced me!


----------



## kenbkb (May 21, 2011)

Brownish, you have a super attitude. In fact, some of your previous musings about staying calm have positively affected me.

*****************************************************************************************************************************************

I wanted to post more of that PARTIALLY HYDROLYZED GUAR GUM and XIFAXIN study:

Gastroenterology Unit, Department of Internal Medicine, University of Genoa, Genoa, Italy.

Preliminary data were exhibited at UEGW/WCOG Gastro 2009, London.

Aims:

To assess whether the association between PHGG plus rifaximin is more effective than rifaximin

alone in the treatment of SIBO.

Methods:

50g-glucose breath test (GBT) was given to 500 consecutive patients. Patients with positive GBT

and predisposing conditions to SIBO entered into the study, and were randomized to receive

rifaximin 1200mg/die or rifaximin 1200mg/die plus PHGG 5g/die for 10 days. Patients

completed a symptom questionnaire and GBT both in basal condition and 1 month after

withdrawal of therapy.

Results:

Seventy-seven patients had SIBO. SIBO eradication rate was 62.1% in the rifaximin group (both

on per-protocol and intention-to-treat analyses), and 87.1% (per-protocol, p=0.017) and 85.0%

(intention-to-treat, p=0.036) in the rifaximin-plus-PHGG group. Clinical improvement was

observed in 86.9% and 91.1% of eradicated cases in rifaximin and rifaximin-plus-PHGG groups,

respectively (p=0.677).

Conclusion:

The association between rifaximin and PHGG seems to be more useful in eradicating SIBO

compared to rifaximin alone.

http://peer.ccsd.cnrs.fr/docs/00/56/70/44/PDF/PEER_stage2_10.1111%252Fj.1365-2036.2010.04436.x.pdf

The whole article is 24 pages long. You can also find it by googling GUAR GUM and XIFAXIN.

FWIW.


----------



## Brownish72 (Aug 26, 2012)

Thanks for posting that article. I have only browsed the pages, but that is promising research. As much as I support Vivonex, how much easier would a pill be that not eating for 2-3 weeks!! Unfortunately, when one says 86% clinical improvement, that is quite misleading. For example: if someone had diarrhea 20X a day, and now only 5x a day, well that's a drastic improvement, but the person is still having diarrhea. Nonetheless, it's a promising study, and its a great recommendation. Thanks for posting. I'm going to forward it to my doctor actually.

I didn't do anything special yesterday, other than stay happy and think to myself that my IBS does not control my life, but I control it instead. Happiness is so important I believe for those of us with SIBO, or any IBS related problems. Of course, thinking something will go away doesn't make it go away, but staying calm, and brief meditation of even one minute, can make a difference in the rest of the day. I make fun of myself when I think how "natural" I've become, from being a kid who worked on a farm in the West, eating / drinking whatever I wanted, to this wholelistic style of life, promoting healthy eating, meditation, and good thoughts. Ha, quite crazy? I'm gonna start a website soon, to start posting my experiences with SIBO, how I've managed to control it, and what is keeping me motivated. I'm really quite eager to start it. Today: Diarrhea is gone, and I'm feeling back on track.

@Frustrated,

you are rounding the corner to the last day on Vivonex. Congrats! Post-fast is the important part, and it's good to hear you are choosing a diet, such as the SCD diet. Remember, don't over do the yogurt  I think that is the biggest mistake people make. It has a lot of probiotic in it, and if you consume a cup for example, it can give you loose stools just because of all the bacteria you are consuming! I recommend starting out small, maybe a small spoonful with each meal, and working up from there. But, each individual is unique, and you may have no issues! As for the prokinetic: bummer. However, there are exercises that help stimulate the Migrating Motor Complex. Cardio, such as rowing, biking, and running are great. Squats, and exercises that involve ab workouts help too. Here's an article with a few tips (forget the image they put in the article: what a joke!)

http://www.livestrong.com/article/434866-peristalsis-exercises/

Some people would say Im obsessed with fitness, but its a completely the opposite: I'm obsessed with keeping SIBO @ bay!. If running everyday is what I gotta do, well at least that is motivation to go running! On top of the fact I do feel good after. I wish doctors would be more open to the obscure treatment options of SIBO, like vivonex, and prokinetics, but if that it was it takes, and since its safe, than that is was it takes! Nonetheless, I feel you are going down the right path by drastically changing your diet. I am keeping my fingers crossed that this works for you.


----------



## frustrated21 (Jan 7, 2013)

Hey Guys,

Just noticed that Guar Gum is on the illegal food list for SCD...

http://www.scdrecipe.com/legal-illegal-list/listing/


----------



## frustrated21 (Jan 7, 2013)

Well I'm just finishing Day 16 and I've decided that tomorrow will be my last day on vivonex. Tonight I starting making beef broth in my crockpot and no idea how it tastes but it smells delicious. Of course that could be because I haven't eaten anything for 16 days! Will one of you clarify something cause I'm still confused







I have 9 bones in the crockpot and after a few hours in there, I checked the bones. The marrow is soft but still inside the bones. Do I need to push it out of each bone and then return the bone to the crockpot? Why can't I just leave the marrow in the bone - aren't the minerals and collagen infusing the broth? Here's why I'm confused....a lot of websites say to pour the broth through a sifter at the end so you just have clear broth. Won't the marrow not go into the broth after you put it through a sifter? Is the idea to eat the marrow or not? Websites say you can reuse the bones to make broth again but I don't see how that is doable if you take the marrow out of the bone. Please help!!

Brownish, do you use ProZymes? Want to order enzymes but want to make sure I'm ordering the correct stuff.

I'm going to take a crazy amount of magnesium (900 mg) daily to ensure that I don't get constipated once I'm off vivonex and not eating any fiber. Hopefully that will help with the cleansing wave. Also going to put epsom salts in my bath once or twice a week to get even more magnesium! Thanks for the exercises...will do them. I box for an hour or two each day and I do think that cardio helps with gastro issues.

Are you still enjoying France or back home now? I've never been but hear it is beautiful.


----------



## frustrated21 (Jan 7, 2013)

Brownish,

Just bought a yogurt maker and was wondering which yogurt starter you use. I found two that look SCD legal:


http://www.giprohealth.com/giprostart.aspx
http://www.amazon.com/Yogourmet-Freeze-Yogurt-Starter-3-Count/dp/B001GVIS4M/ref=sr_1_2?ie=UTF8&qid=1358656684&sr=8-2&keywords=yogurt+starter

Also, what type of milk do you use?

Thanks!


----------



## kenbkb (May 21, 2011)

I just wanted to post some other treatments that have known results. I did try this Iberogast but I got the runs from it, much the same as I did with Magnesium Sulfate.

Combination Herbal Formulas

Multiple herbal preparations

such as Iberogast, Padma Lax,

and Tong Xie Yao Fang (TXYF)

have shown promising outcomes

for managing IBS.

Iberogast, a combination of

nine herbal extracts (Table 4),

was shown in several clinical

trials to improve symptoms of

functional dyspepsia at a dose

of 20 drops three times

daily.71-73 While symptoms of

functional dyspepsia are often

similar to IBS in terms of

gastrointestinal disturbances,

pain, and reduced quality of life,

only limited clinical data are

available regarding its effectiveness

for specific IBS symptoms.

The symptoms of functional

dyspepsia are often predominantly

related to food consumption,

with resulting gastric acid

secretion leading to gastrointestinal

symptoms without

detectable functional problems.

Iberogast has been shown to interact with several

receptors in the GI tract that play an important

role in regulation of motility and pain perception,

including serotonin, muscarine, and opioid

receptors. For example, the different extracts in

Iberogast bind to the 5-HT3 serotonin receptor as

agonists, while antagonizing the 5-HT4 and

muscarine M3 receptor in a similar manner to

current synthetic drugs. Overall, the pharmacological

effects of Iberogast are complex in nature,

affecting acid secretion, inflammation, oxidative

processes, as well as both hyper- and hypomotility

to varying degrees (Table 5).74

Although some case reports provide evidence for

effectiveness of Iberogast in alleviating abdominal

pain and normalizing gut motility,75 only one

clinical trial with a double-blind, placebo-controlled

design has been conducted in 208 patients with

IBS.76 In this study, patients were randomly

assigned to commercially available Iberogast (STW

5; n=51), a research preparation of some of the

herbs in Iberogast (bitter candytuft, chamomile

flower, peppermint leaves, caraway fruit, licorice

root, and lemon balm leaves referred to as STW

5-II; n=52), bitter candytuft alone (n=53), or

placebo (n=52) (20 drops three times daily for four

weeks). Both STW 5 and STW 5-II were found to be

effective in reducing abdominal pain severity

(evaluated via abdominal pain scale) and improving

overall symptoms (using the IBS symptom scale)

compared to placebo or bitter candytuft alone.


----------



## kenbkb (May 21, 2011)

Now here are the results for Chinese herbs:

Traditional Chinese medicine (TCM), in the form

of standardized combinations or formulas tailored

specifically to the individual symptom presentations,

improved common IBS symptoms compared

to placebo as evaluated in a double-blind, placebocontrolled,

randomized study.56 The study was

conducted on 116 patients who received placebo, astandard mixture of 33 herbs, or an individualized

mixture of herbs selected by a TCM specialist from

a list of 81 herbs. After 16 weeks, patients in the

active treatment groups showed significant

improvements in bowel symptom scores (as

evaluated by visual analog scales) and increased

QOL compared to placebo.

A specific TCM herbal mixture, Shugan Jianpi,

was found to reduce the number of serotoninpositive

cells compared to a placebo in patients

with IBS.80 The 24 patients received standard care

that included cognitive-behavioral therapy and a

whey protein (lactein). The placebo group did not

receive any additional medication, while the

Shugan Jianpi groups took 24 g of the herbal

mixture three times daily or 24 g of the herbal

mixture plus 15 g Smecta® (a high viscosity

muco-protective agent) three times daily for two

weeks prior to biopsy to measure number of

serotonin-positive cells. The authors did not

evaluate any subjective or other objective clinical

parameters.80

Tong Xie Yao Fang (TXYF), a Chinese herbal

preparation and a variation (TXYF-A) have the

potential to improve global symptoms in IBS-D.57,81

Although a systematic review of TXYF-A indicated

its potential effectiveness for reducing IBS symptoms,

more studies with rigorous designs are

warranted.82 The standard preparation of TXYF is

composed of four traditional herbs - Cang zhu

(Atractylodes chinensis), Bai shao (Paeonia lactiflora),

mandarin orange (Citrus reticulata), and Fang feng

(Saposhnikovia divaricata). Based on the individual

symptoms, additional herbs may be added to the

mixture, with the resultant formula referred to as

TXYF-A. The review evaluated 12 randomized

studies with 1,125 participants for the short- and

long-term effects of TXYF-A in reducing clinical

IBS symptoms. The heterogeneity of the study

design and duration of the studies complicated the

definition of end points. Overall, the preparations

improved various IBS symptoms, including

abdominal pain, distension, flatulence, and

diarrhea for as long as six months after the

intervention ended.

Leung and colleagues83 compared a preparation

of 11 herbal extracts (Table 7) comprising a

modification of the traditional TXYF formula

(n=60) with a placebo (n=59) in a controlled,

randomized, blinded design. They found that global

assessment scales and QOL did not differ between

the TCM herbal preparation and placebo after eight

weeks of treatment. Based on this study, TCM

herbal preparations may not be beneficial to all IBS

patients but may show promise for specific IBS

symptoms. More clinical data utilizing rigorous

clinical trial designs are required to further support

their use.

In summary, a number of single herbal remedies

or herbal combinations (Table 8) are reportedly

effective for relieving IBS symptoms. Further

studies investigating the potential mechanisms of

pharmacological action and symptom management.


----------



## kenbkb (May 21, 2011)

I can also provide links to these articles if you want to see the data in the TABLES.


----------



## frustrated21 (Jan 7, 2013)

Does anyone know if there is a difference in the clover pure honey you buy in the supermarket compared to this stuff?

https://www.digestivewellness.com/itempage-1002-24-18-1537.html

Honey is very high in sugar but for some reason it seems to be okay to eat while on SCD and a lot of recipes call for it.


----------



## Brownish72 (Aug 26, 2012)

Any cow milk is fine, I like whole milk, or even half and half, to get a thicker milk. It's trial and error, you'll have to see what you like. I pick a yogurt starter that doesn't have bifidus in it. Other than that, I don't concern myself too much with it. Again, trial and error, unfortunately you gotta pick what fits you best. This all sounds overwhelming, and in typing it, I realize the strides I've gone to for my health. At the same time, its just habit now, I don't even think about it. Once you get there, you'll see too, it just because a life changing habit, that is an amazing lifestyle change.

Careful with the magnesium, it can give you Diarrhea quite easily  unless of course, you are mainly constipated.

Honey; same thing. Clove honey at the store is great stuff, local raw honey (if you can find some) even better! Both are the same thing: Nature's sugar. Honey IS sugar, but it has a unique molecular structure allowing quite easy digestion. BUT, as with magnesium, honey can also act as a laxative. The biggest thing I want to stress about the SCD diet, even if it is SCD legal, that does not mean over indulge. Lots of things call for honey, but take it easy at first. Enjoy a hot cup of lemon honey tea for example, by adding a spoonful of honey in the tea with some freshly pressed lemon and hot water. There you got your vitamin C from the Lemon, electrolytes / carbs from Honey, and it's a warm drink that's easy to sip on. But, if you put a cup of honey in there, I guarantee you won't be feeling good! So, moderation is key in the SCD diet. Also, be careful with all the nuts that are available. Peanut butter is SCD legal: I can only eat small amounts. Also, after a handful of almonds, I gotta stop myself, or I may get diarrhea because almost are so high in fiber.

Good luck, if you kept a journal, I'd really like to read it if that wouldn't bother you, I could send you a message with my email so that way you wouldn't have to post it. If you didn't keep one, or you don't want to send it to me, that's okay as well.

Congrats on completing the Vivonex Fast. It's tough, and from my experience, worth every day to achieve that feeling of "yes"! once you finish. Now, the post fast part comes, which is equally, if not more, important. Good luck ~~


----------



## frustrated21 (Jan 7, 2013)

Hi Brownish,

Sure I'll post my notes tomorrow. The last few days have been the best with no diarrhea 

I have a sweet tooth and your caution about downing the honey jar is a good one. I'll take it easy on it. Good idea about the lemon/honey tea.

I wonder if the yogurt can be made with skim milk to cut back on the calories?

Yeah, you have definitely done a lot to help your health - it's impressive! Are you feeling back to normal now?

I have my beef broth brewing. Can you help me out with the marrow question? I'm just confused if you pull it out and drink it in the broth or if you strain the marrow out at the end?

Thanks Much!!


----------



## Moises (May 20, 2000)

frustrated21 said:


> Hi Brownish,
> 
> Sure I'll post my notes tomorrow. The last few days have been the best with no diarrhea
> 
> ...





frustrated21 said:


> Hi Brownish,
> 
> Sure I'll post my notes tomorrow. The last few days have been the best with no diarrhea
> 
> ...


You eat the marrow. Get it out of the center of the bone. I would take a knife and scrape it out. Or, put your mouth on one end of the bone and blow it out.

Listen to brownish. Just because honey is SCD-approved, you should be very careful. You just went through 17 days of deprivation. Try to consolidate your gains before getting too risky.


----------



## Brownish72 (Aug 26, 2012)

Exactly what moises said

Knock the marrow out with a knife, anything that will fit, sometimes it will just fall out. You will see, Sometimes the marrow is really hard, that stuff I leave alone, but if it falls out easy, I make sure I get it in the soup. The marrow is the whole reason we put the bones in the soup.

Hope that helps


----------



## kenbkb (May 21, 2011)

Here is one more clinical trial I found on a natural antibiotic Chinese herb. You can read the results of the trial here and I have the link to the entire article if anyone needs it:

Irritable bowel syndrome (IBS) is a functional bowel disorder and the etiology is not well understood. Currently there is no cure for IBS and no existing medication induces symptom relief in all patients. IBS-20 is a 20-herb Chinese medicinal formula that offers beneficial effects in patients with IBS; however, the underlying mechanisms are largely unknown. This study showed that IBS-20 potently inhibited LPS- or IFNΓ-stimulated expression of pro-inflammatory cytokines, as well as classically activated macrophage marker nitric oxide synthase 2. Similarly, IBS-20 or the component herb Coptis chinensis decreased LPS-stimulated pro-inflammatory cytokine secretion from JAWS II dendritic cells. IBS-20 or the component herbs also blocked or attenuated the IFNΓ-induced drop in transepithelial electric resistance, an index of permeability, in fully differentiated Caco-2 monolayer. Finally, the up-regulation of key inflammatory cytokines in inflamed colon from TNBS-treated mice was suppressed significantly by orally administrated IBS-20, including IFNΓ and IL-12p40. These data indicate that the anti-inflammatory activities of IBS-20 may contribute to the beneficial effects of the herbal extract in patients with IBS, providing a potential mechanism of action for IBS-20. In addition, IBS-20 may be a potential therapeutic agent against other Th1-dominant gut pathologies such as inflammatory bowel disease.

IBS is one of the most common gastrointestinal (GI) disorders affecting up to 20% of the adult population and is characterized by chronic abdominal pain and discomfort as well as alterations in bowel habits [<a>1</a>]. The lack of success of the current available therapies using serotonin as a primary therapeutic target in the management of the major symptoms may be related to heterogeneity of the etiology and symptoms of IBS [<a>2</a>]. There is no cure for IBS and no existing medication induces symptom relief in all patients. Therefore, it is believed that new strategies of developing effective treatments for IBS should be focused on agents that can simultaneously act on multiple sites/pathways.

Chinese herbal therapies have been used to treat GI symptoms for centuries and have provided effective relief of symptoms in IBS patients. Generally, traditional herbal formulae contain many different components that act on multiple sites/pathways with potential synergistic effects and chemical reactions among the component herbs that can maximize efficacy. IBS-20 is a Chinese medicinal formula containing 20 herbs that was developed from two traditional ancient Chinese herbal formulations known as *Tong Xie Yao Fang (Important Prescription for Abdominal Pain and Diarrhea) and Zhong Man Fen Xiao Wan (Separate and Reduce Fullness in the Middle).* IBS-20 offered a global symptom improvement in patients with IBS in a randomized, double-blinded, placebo-controlled clinical trial [<a>3</a>] and is currently on a phase II dose-escalation clinical trial for IBS patient. Like many other traditional Chinese medicinal regimes, the mechanisms for the beneficial effects of IBS-20 are unknown.

*There is mounting evidence indicating that previous GI infection is a key risk factor for a subgroup of IBS patients [<a>4</a>-<a>7</a>]. *More recent studies also showed that some degree of immune activation is present in nearly all IBS patients tested, regardless of previous history of infection or the type of disease (constipation, diarrhea, or alternating) [<a>4</a>, <a>5</a>, <a>8</a>]. Compounds that target the immune system are an important option in the treatment of a number of GI pathologies, including inflammatory bowel disease (IBD), but have not been evaluated fully in IBS. This study was designed, therefore, to investigate, (i) the effects of IBS-20 on the cytokine production from innate immune cells stimulated with inflammatory mediators, (ii) the ability of IBS-20 to block/attenuate the dysregulated barrier function in Caco-2 cell monolayer, and (iii) the anti-inflammatory activities of IBS-20 in the murine model of TNBS-induced colitis. The results of these studies indicate that IBS-20 has potent anti-inflammatory effects on innate immune cells in vitro as well as on murine model of colitis in vivo. In addition, IBS-20 blocks/attenuates the IFNγ-induced disruption of epithelial barrier function. Thus, the beneficial effects of IBS-20 in patients with IBS may be attributed to the strong anti-inflammatory activities of IBS-20 or the component herbs.

Collectively, this study demonstrates that IBS-20 possesses strong anti-inflammatory properties. The herbal extracts not only inhibit the pro-inflammatory cytokine production from the immune cells but also block the inflammatory mediator-induced epithelial cell barrier disruption. Moreover, IBS-20 is capable of suppressing the up-regulation of inflammatory cytokine in the inflamed colon in vivo. Thus, the beneficial effects of IBS-20 in patients with IBS may be attributed to its anti-inflammatory activities. *It should be noted that IBS patients are heterogeneous and inflammation may only occur in certain subtypes of patients particularly those with histories of previous infection*. These factors should be taken into account when applying anti-inflammatory therapies to IBS patients. Given the fact that there are similarities and clinical overlaps between IBS and other gut inflammatory diseases [<a>39</a>], IBS-20 may also be a potential therapeutic agent against other Th1-dominant gut pathologies such as IBD.


----------



## Brownish72 (Aug 26, 2012)

Thanks to all for being so active on this blog, I can't believe I have passed 4,000 viewers!

*For those curious about Vivonex Plus, page 3 has my day by day experience*, and I give periodic updates. There's a lot to read here, lots of it is a continuation of Vivonex post-diet, and how to keep SIBO away.

So far, its been 1 month, 2 weeks, and 2 days since Vivonex. I am still feeling quite up to speed. By this time, on my last fast, is when my symptoms were really starting to come back, and it was around 60 days that they were back in full: immodium, charcoal, nothing was working.

I have now lowered my dosage of immodium, from 3-4 a day to only 2 in the morning. Sometimes I take 250MG of calcium carbonate with lunch, but not every day. I just get a feeling to take it, and I do. Still looking forward to being off of immodium. I have less and less a "need" for it. Also; I have introduce gluten free grains such as rice, in small amounts. I mean 1/8 of a cup for example, well boiled, and I use sushi "sticky" rice, as Dr. Norm Robillard suggests in his book "Fast Track to Digestion", digests quite easy. I still pay extreme attention to what I eat, and hope this keeps up. It's annoying, but I haven't done this well in the last 3 years of my life.

I get symptoms on occasion, about every 10 days, although it seems less and less. Lets hope that improves once I start adding digestive enzymes to my diet. I just wanted to mention: I bought digestive enzymes with "Brush Border" enzymes included. The brush border refers to the microvilli in the small bowel that can get damage in patients with SIBO. Taking enzymes, like a probiotic, can help replenish these enzymes that have been wiped out due to an inflamed, damaged, intestinal lining. We'll see how that goes

So far, so good


----------



## Moises (May 20, 2000)

Glad to hear that you are coming along.

I am also glad you found something useful in the Robillard book.


----------



## kenbkb (May 21, 2011)

Brownish,

Several comments.

First, what is the link to your blog? Sorry if I missed it before.

Second, you ordered your Digestive Enzyme from GiPro, correct?

Third, I met with my doctor at Northwestern yesterday. She is technically a Digestive Behavioral Therapist, and works closely with all the Gastros at Northwestern. She is giving a talk in Milwaukee in April with Dr Pimentel. She is going to meet him, of course, and spend some time with him. i had told her about this last part of Pimentel's protocol and the pro-kinetis/motility/cleansing wave meds. She was completely unfamiliar and believe me, this woman is on top of most everthing. Anyway, I am going to give her some info on it (alot from one of your posts here a while back where you also talked about the microvilli). We have discussed this here before in detail as the "missing link", so to speak. Anyway, once I sent this to her, she was going to take the information to their motility docs, and from what she noted, Northwestern is "world-renowned" in this area.

I will share her input when I do get it back from her.


----------



## Brownish72 (Aug 26, 2012)

Hey there,

Great to hear you have found a doctor that is willing to listen and work so closely with you. It's a great feeling!

I haven't started a website / blog yet. This is the only thing I have as for now. I am planning on it however. I've seen Vivonex help other people besides me, and I would really like it to be more common info for those to help fight SIBO.

The enzymes I ordered were called Prozymes, from giprohealth.com I ordered them because they contain a broad spectrum of enzymes, but specifically: Brush Border Enzymes. In patients with SIBO, the gut can become inflammed, and microvilli can be "blunted", or damaged. On top of causing malabsorption and leaky gut, the enzymes called Brush Border Enzymes can be washed out because they reside in between the microvilli. Taking a supplement can help "replenish" the brush boarder, and also help with digestion of other carbs that those with SIBO, pre or post, may be struggling with, like Lactose for example. I pick this enzyme over others because it is made to go with the SCD diet, meaning it doesn't contain: sugar, lactose, soy, gluten, starch....the list is long. Long story short, its easy to take in. 

Your doctor may really benefit from calling Dr Allison Siebecker in Portland, Oregon. I have mentioned her site before, but just incase, it's www.siboinfo.com . She is the one that told me she has had patients keep sibo away for 2+ years because of a low carb diet, and a prokinetic drug, noting that the prokinetic was an extremely important factor. Pimentel also suggests this, and he has a study on it involving low dose erythromycin on PubMed which your doctor definitely has access too.

Best of luck, thanks for being so active in the fight with SIBO!


----------



## kenbkb (May 21, 2011)

Have started taking a DIGESTIVE ENZYME now after a short run of reduced dosage antibiotics. WAs only able to do about 8 days on the Augmentin on half a dose before it started giving me the runs.

Had some questions about Vivonex. Called Nestle to air some things out about it. The informed me that Vivonex per day has about 400G of carbs. The Cust Service guy said they were not all predigested either. I had to wonder about that.

I also asked him about baby food. Why not try that instead of the expensive Vivonex? He said, of course, that they are more formulated for babies than adults and would probably not give all the nutrition.

Any comments here anyone?

And, frustrated, how are you doing now having finished the Vivonex? Thanks.


----------



## frustrated21 (Jan 7, 2013)

Hi,

Today is day 9 post-vivonex. I've been waiting to post until I feel a little more stable. The short story is that my stomach was better but not near 100% once I started eating food. I noticed that garlic, onions and honey were all causing problems. It seems that there are 2 diets that people with stomach issues follow: 1) Specific Carb Diet and 2) Low FODMAP Diet. I did the SCD for the first week and my stomach was bloated and gassy. It wasn't near as bad as it was pre-vivonex but still uncomfortable. A few days ago I switched to Low FODMAP and am feeling better. I'm still trying to figure out how to not be constipated since I always am. I had diarrhea three, two or one time a day every day on Vivonex but never had it before that. Nestle said that D was not common, however, when I asked Pimentel's clinic a nurse told me that D was very common and should subside after the first week (I had it 14 out of 17 days on vivonex). Once I came off the Vivonex though, it stopped. The honey/bananas/raisins that I ate week 1 helped me stay regular but now that I'm FODMAP I can't eat honey (which is good since it blew my stomach up). I'm taking 1100 mg of magnesium and just started adding Citrucel tablets. I'll report back more in a few days when hopefully things have stabilized and hopefully I'm feeling 100%!

While the vivonex tastes crappy, it does give you all your minerals and vitamins. I would be wary of eating baby food and expecting the same kind of nutritional composition.

Brownish, just got my enzymes. Do you eat them with every meal or just ones with carbs? How are you feeling? Have you heard of low FODMAP? Quite similar to SCD but some differences that are helping me.


----------



## Brownish72 (Aug 26, 2012)

Hello to you both

I'm up to 73 Kilos: I was 67-68 pre/post fast. It sure takes time, but it feels good. Im gonna keep my head up that this continues

I don't remember where in this forum we spoke about it, but it seems like no matter which diet it is, it needs to be tailored to your individual needs. So I do promote SCD, but always caution that even SCD legal foods may cause individuals problems. I do eat certain low fodmap foods simply because I handle them better. Lately, I have upped the amount of meat I eat, but still make sure I eat enough veggies and fruit. I actually dislike how much meat is eaten on any of these diets, however if I'm so tired of being sick, if thats what I gotta do, I'll do it for awhile and see how I feel. So far, I'm still doing quite good! Still get those day(s) once every 10-14 days that I have a lot of BM's, starting out good and progressively going down, but the next morning I way up and its gone. But those days are less "extreme" than they used to be. When they first happened, it was somewhat painful, and I was unbelievable worried that SIBO was back, however it went away, and this seems to be the pattern, coming and going, always being less "worse" than the last (sorry about such the poor grammar there, but thats how I describe it!!)

If you are reacting to a food, put it down for awhile. Try again later. If your getting diarrhea, magnesium is a classic culprit!! Maybe try putting it down, or really lowering the dosage. About honey: a teaspoon full, maybe a little more, is a good way to start out in hot water, and I like to squeeze some lemon juice in it. It absorbs high in the GI, and its a great way to get electorlites/carbs in your diet, which are essential for normal body function. Even thinking requires a type of energy called ATP, and where does ATP come from?? Glucose, therefore, carbohyrdrates!! So if someone tells you that you dont need any carbs, its the biggest lie you could hear!. But that doesn't mean they dont need to be limited! Notice I said even a teaspoon full in hot water is enough to feel better sometimes. But if you're reacting, don't do it, seek a carb elsewhere. Or, maybe a vivonex packet a day in the morning, that way you know you've got an adequate amount of carbs for that day, and then eat other foods high in protein and fat throughout the day. A good idea: try an omelet with some smoked salmon and pesto sauce ( i skip the pine nuts: don't like em'). High in protein, high in great fats, and it just tastes AWESOME!!









It takes about 2 weeks for gut flora to repopulate the GI after a fast or antibiotics. It will be interesting, and hopefully good news, to hear how you feel after two weeks.

SCD yogurt, and any probiotic for that matter: try laying off of it for 3-4 days, see how you feel. Probiotics can give one stomach issues too. If you find low fodmap to be working, they suggest adding yogurt / fermented foods after a few weeks. Maybe worth trying in your case?

I got the enzymes last week, and I started off with two every meal. I'm gonna slow it down, skip them with breakfast, 2 @ lunch, 1 @ dinner. Then maybe reduce it even more, and keep them as a safety net for the days I know I will be eating a certain carbohydrate. I'm taking about 4 vitamins a day: they recommend 6. I started off with 6, it feels so crazy taking so many pills. But I would say I feel a difference between last week and this week. But ideally, I would like to get my nutrients from food, not supplements, and I plan on lowering my next week or so to just 2 in the morning, and calling it a day with the vitamins.

I've been in contact with another guy that fasted on Vivonex after reading all this. He's finally gaining weight again, and he's petitioning his insurance company to see if he can get it paid for because it's made such a big difference in his life. Just wanted to add this on here...

Post fasting is extremely important, and frustrated21, you are searching in the right places. I wish I could say eat this, not that, and then add this, etc.. but its so individual. Of course I can give you recommendations like I did above, but why you react to garlic and onions, but I don't, who knows. I find mandarines very easy to digest, and eat 2-3 a day. Not sure where they fit on the low fodmap diet.

Here's a helpful link: http://www.eat-real-food-paleodietitian.com/support-files/sibo-gut-healing-protocol.pdf

Forgot to add: White tea makes me feel good, a cup a day is nice if you like tea, and apparently it is "antibacterial, etc..." Not sure about those claims, but I do notice a positive difference.

Please keep us updated! Stay positive, anger really triggers symptoms for me, and lets keep wishing for the best


----------



## Brownish72 (Aug 26, 2012)

I wanted to add: this comes up a lot in my genetics courses, and in discussion in general about the research I'm about to start  :

A phenotype is influenced by both an individuals genotype as well as the surrounding environment.

A Phenotype is what is physical, what we can see. The genotype is the genetics, or DNA, of the individual, and the environment is the surroundings of the individual.

How could this apply to us? Think of it like this, our phenotype: SIBO, is influenced by biological factors (anything that gives and SIBO: this could be and IBD disease, celiacs, damaged Migrating Motor Complex, low stomach ph, etc..) and is influenced heavily by our environment: what we eat.

Phenotype is dependent on the environment. If you have a flower with the best genes in a population, it grows the tallest and produces the most seeds, etc.. well nothing will happen if you put that plant in the shade instead of the sun.

An extension to environment for us is not just what we physically eat and what surrounds us, but our emotional state as well. We can control SIBO by using logic against it, but that logic requires time and energy. Don't let that persuade you to give up! I try and write positive things, and I don't write about my negative experiences, but I too am still fighting this. I have days where I get angry, and it doesn't help. But then I think to myself: that would be letting SIBO win, and me getting worse mentally and physically. I may be really on top of it, but I know more now than I did 4 months ago, and I know more now than i did last week.

Keep up the good fight! Hope that made sense. It's just a basic scientific that is applied in all species around the world, and we are no exception


----------



## Moises (May 20, 2000)

Brownish,

You've supported me a lot here and I am most grateful. Not only that, you have done a lot to support many others here as well.

I think it is important to point out that carbohydrates are not necessary for human survival. This is a scientific fact. I once went seven month eating only meat.

Owsley Stanley ate no carbohydrates for more than 50 years. http://en.wikipedia.org/wiki/Owsley_Stanley

Read up on Vilhjamur Stefansson. (Here's a place to download one of his books for free [it is legal; the copyright expired] http://low-hi.com/literature/the-fat-of-the-land-not-by-bread-alone-vilhjalmur-stefansson-1958/ )

There is substantial archaeological evidence of societies that consume almost no carbohydrates.

If you want to read a truly amazing tale, check out this book:

http://www.amazon.com/gp/product/1585679569/ref=wms_ohs_product

This is not a book about diet. Just a story of a guy's life. He lived among people who would go months at a time eating only meat.

I am not saying that eating no carbohydrates is optimal for human health. I am just saying that it is not necessary.

Certain substances are necessary for human life. Scientists call these substances "essential." There are some amino acids that are essential. If we don't consume them we die. There are some fatty acids that are essential for human life.

We do need to have carbohydrates to survive but it is not essential that we consume them. The reason for this is that our bodies are fully capable of creating carbohydrates from ingested protein.

This can be demonstrated quite easily. Nowadays it is possible to purchase a blood sugar meter relatively inexpensively and without a prescription. Many times I have measured my blood sugar while fasting and then after eating a meal consisting solely of meat. Meat is composed of protein and fat. After eating such a meal my blood sugar rises. (Some people who have better blood sugar control than I do might not see much of a rise.)

The process by which amino acids (from protein) are converted into glucose is called gluconeogenesis. Wikipedia has a list of the amino acids that are "glucogenic":

http://en.wikipedia.org/wiki/Glucogenic_amino_acid

In summary, there have been stable human societies where people eat virtually no carbohydrates. This evidence is sufficient to establish the truth of the claim that consumption of carbohydrates is not required for human life. People can synthesize sufficient glucose to fuel the brain from the raw materials they get when consuming protein foods. The macronutrients essential for human life are in protein and fat.

It might be the case that for some or all human beings optimal health could be achieved through a more varied diet that included carbohydrates.


----------



## Brownish72 (Aug 26, 2012)

I stand corrected, although I may disagree with the high degree of meat, I also agree that animal protein is essential in helping those of us with SIBO.

Thanks for the input Moises!


----------



## kenbkb (May 21, 2011)

Brownish, good stuff on the environmental influences. I have incorporated the positive thinking process with your encouragement into my lifestyle when having a bad day. I think this can only help. I see the power in it.

Wanted to get your sense of these weight-gaining powders. There are so many in the local Whole Foods. I mean tens of them. How do you pick? Or would you even consider something like Vivonex as a SUPPLEMENT for maintaining/gaining weight? I am maintaining only right now, real difficult to gain a pound or two.

I am cycling now on the Digestive Enzymes, going to hold the Betaine HCL I just bought in my back pocket for the time being.


----------



## Brownish72 (Aug 26, 2012)

Not sure about weight gaining powders: look @ the back, if you find one with just protein, no sweeteners, I would think why not? However, I would lean towards amino acid drinks because of the fact they will absorb easier. However: Amino acids taste terrible, thats why vivonex is not pleasant, and they most likely all contain some type of carb, although some may contain sodium saachrine or aspartame. Some people do not react to those, thats a personal choice on your side.

Other than that, food. If you can't eat a lot, make the food you eat count. For example, in the morning, I eat:

3 egg omlette, smoked salmon, with homemade pesto sauce.

High in proteins and good fats, low carb count. I don't make that EVERY day, but I make it often.

Gaining weight is tough. I'm still working on it. I wish I could have vivonex as my supplement. I would be fine working out and drinking two vivonex shakes, but its $$$$, and I don't have anymore. When I come back to America, I may get it again. We'll see.

Good luck


----------



## kenbkb (May 21, 2011)

Appreciate any feedback, brownish or anyone...everyone here has been invaluable support. Not sure where we would all be without these forums.

Anyway, general question. Generally with a BM, most of society feels better or relieved. I don't, and I suspect many here do not either. When I am done with a BM I can have a general sense of nausea, or a feeling of being completely depleted. I wonder what that is? Is this, in a sense, the purging of the bacteria? Or is it the inflamed lining of the small intestine being "grated", so to speak? It happens to me almost without fail. My day can be quite good, until it comes time to have the BM.

For the feeling of nausea, or sour feeling in the stomach/intestines, I always think to reach for the antacid. But, through recent correspondonce here and on the INSPIRE.COM boards, I keep hearing the name of the supplement BETAINE HCL, which is a further means to digest food, so this is actuality putting MORE ACID back into the digestive reason. Must admit, has me a little flumoxed. Appreciate any insights as to the reasons for and measures to help with this awful feeling after a BM.....THX....


----------



## Brownish72 (Aug 26, 2012)

@KenBKB

Hey there. I have never heard of nausea associated with a BM, however it is very common that after a BM, those of us with IBS don't feel relieved, or many feel like they stil need to go, and a general feeling of discomfort is felt after a BM. I wouldn't think of it as "purging" bacteria, if anything; that happened during your 17 day fast. Although it appears that maybe you are still having quite a few bowel issues??

As far as your question above, it may be worth starting a new post / thread on this forum to see what other people think.

And the supplement Betaine HCL is for low stomach acid. Low stomach acid can actually cause acid reflux and burning in the stomach, because the sphincter muscle around the esophagus connected to the stomach can relax to the lower acidity in the stomach, and allow the stomach acid in the stomach to burn the esophagus, thus giving us that feeling of heart burn or stomach discomfort. (don't be confused with lower acidity when someone says higher PH levels. Low PH means very acidic, HIGH PH means not very acidic. Seems a little backwards eh..?) If you suspect low stomach acid, that may help. And by the way, low stomach acid is one of the reasons we can get overgrowth (believe it or not). It may be worth inquiring to your doctor and asking for a test.

On a side note: would you say have seen an improvement to vivonex or not?


----------



## Brownish72 (Aug 26, 2012)

Wanted to update people on my progress:

This week, I am rounding the corner of 60 days post vivonex.

I have gained 5-6 Kilos (11-13 lbs). Thats incredible! And really good!

I still take two Imodium in the morning, and about 25 MG / Erythromycin @ night before bed. For the last two weeks, I have been taking a multivitamin that is recommended for those on a low carb diet, and it is free of gluten, sugar, yeast, soy, etc. For the first week I was taking the full dosage, to try and boost vitamine levels a bit and more importantly, see if I felt a difference. I would say my energy is better, and I definitely drink less coffee. I was up to 3 double espresso shots a day to now only one in the morning, although today I didn't drink one. This may have nothing to do with the vitamins, I have been trying to ween off coffee, simply because it can push things through the GI quickly: although just wanted to note I have quit coffee before with seeing a noticeable difference before.. I also started taking Digestive Enzymes from the same company, and followed the same protocol. I took them full dosage, with each meal, at first, and now I plan on taking them with hefty meals, or meals that may contain a high carb count.

I do get flare ups. Can't pin point it. They don't appear to be anything I eat. It still is about once a week, to once every 2 weeks. Although they last for only half the day.

I have made it much better off this time fasting than from my last time. Diarrhea has stopped, cramping and gas are non-existent, and I'm gaining weight. I also pay quite a bit attention to my diet, and being in college, this sucks. But, to stay on the positive side: eating healthy, and feeling healthy is priceless compared to the price i'd pay drinking beer and pizza with friends the next days in the bathroom.

I hope in 30 more days my update is better than the last! I am thinking of starting L-Glutamin. I had leaky gut before, without a doubt. The headaches / brain-fog / undigested food in stool, etc.. was dead on with the definition of leaky gut, and it is highly associated people with SIBO. I confidently feel Vivonex fixed this for me. I used to literally not digest my food, it was becoming quite scary. I do not get that anymore, unless I eat a lot of nuts like almonds or peanuts, so I lay low on those for the time being. ANYWAYS, L-glutamine supplements seems to provide a helping hand in healing leaky gut, and I occasionally get headaches that I wonder if they are related to my bowels. It's safe, easy to get, I think I'm gonna try it.

Going to Zinal, Switzerland to get away this week! Check it out on google, I'm excited, it'll be nice to get away. Keeping my fingers crossed that my stomach doesn't act up!


----------



## kenbkb (May 21, 2011)

BROWNISH, that weight gain is remarkable. I think it is an obvious sign you have turned a major corner. At least in my uneducated opinion. This is great to hear and thanks for sharing. Again, is the primary reason for immodium simply because you are "moving" too fast? And do you attribute some of this movement to the prokinetic (ethromycin)?

You might be confusing me with FRUSTRATED. I never did do the Vivonex. My weight is 160, down from 185, and I just cannot take the risk. If I were to build myself up to 165-170, I would do it, but just cannot get there.

I think the feeling of not being relieved is what is called VISCERAL HYPERSENSITIVITY, or FECAL URGE, or HYPERDEFECATION. Yes, I know alot of us feel this. Horrible feeling actually. Again, my doc at Northwestern in Chicago, who also happens to be a researcher, states that there have been studies linking bacteria to this feeling.

Thanks for the description on the Betaine. I was thinking of it more simply to aid my digestive enzymes in processing the foods.

On another board at INSPIRE.COM, I am communicating with a woman who had this nausea also after a BM. She said she has improved radically on domoprine (sp?) and magnesium. So it appears another prokinetic is aiding someone.


----------



## Milly1 (Apr 6, 2011)

Hi Andy, How are you doing? I was most interested to read Moises comment about respiritory problems and the connection to SIBO, will be looking into that as have had a wierd virus that has taken nearly a year to clear...... Have made a definate connection to sugar - can't tolerate it in any shape or form now. Had a week totally off anything close to sugar and was fine - resisted today and had a hot chocolate, and its back this evening!


----------



## Brownish72 (Aug 26, 2012)

@Kenbkb

Yup, thats why I take Immodium + Erythro 

@ Milly

I'm doing pretty good, other than I've never been so stressed in my life for school / $$ / etc.. Welcome to the life of a student.

As you know, I fasted on Vivonex for a 2nd time, and this time, I'm doing many preventative measures to hopefully keep SIBO away for awhile. So far, so good, but all my hard work could go away if I change my habits. I'm working hard on a low carb, high protein / fat diet, making sure I stay calm when stress comes up, and I keep going from there. I finished my fast 60 days ago, and I've had about 45-50 of those days w/o diarrhea. I'm hoping I can keep these types of days up, and improve even more


----------



## kenbkb (May 21, 2011)

Brownish, I am particularly impressed with your weight gain. I know the diet you are on, a strict one, but not pure SCD. What food or foods account for most of your weight gain if you think you can identify them?


----------



## Brownish72 (Aug 26, 2012)

I apologize for the late response, I've been away from my computer for the last week.

I would attribute, first and formost, the most of it to the Vivonex fast, allowing me to finally absorb nutrients. I can't believe the hell I lived in pre-fast.

I adhere closely to the SCD, however I eat other things outside of the diet. I had chocolate tonight, but it was 100% chocolate, no sugar added, pretty bitter tasting, but somehow I still find pleasure in it  . Today, I made "java" almond butter which I'm pretty proud of: Almonds, Coffee Grounds, Coconut Oil, Salt, and a tad bit of honey all blended together till smooth. Its really good, and great on apples, bananas, or even plain! More or less, the gains I have had have taken these last two months, and I've gone to the gym quite a bit. I would think that much of my weight gain is the healthy diet and muscle gain from working out. I truly think the vitamins from giprohealth are making me feel better, and they are most likely contributing to intestinal healing and nutrient absorption.

I wouldn't think there is one particular thing contributing to the weight gain, other than close attention to diet, and things like adding coconut oil to my coffee in the morning.

MAN am I tired of dieting. Its tough staying motivated. Lets just hope one day we can all crawl outta this somehow.


----------



## kenbkb (May 21, 2011)

hi brownish,

Couple notes. First, how are you doing? Weight situation? Diet still the same?

Second, I know you spoke with Dr Siebecker via Skype. I see she says she cannot diagnose, so what is it you can get from her basically? Thanks......


----------



## Brownish72 (Aug 26, 2012)

Hey! I was about to do an update, I think I am going to start a new thread soon; there is soo much to read on here! All the better ! 

Today is day 81 post fast.

My weight fluctuates b/t 71-73 kilos. Although I would like to get up to 74-75, I'm not there yet. I started something new called "Bullet Proof Coffee" - Check it out on google; I'm definitely a fan..

Also, this last podcast from these guys at SCDLifestyle is pretty awesome too; Talks about animal fats, Coconut oil, etc..

http://scdlifestyle.com/2013/02/pam-killeen-on-the-hidden-addiction-epidemic-podcast-57/

With that said: I am no longer feeling 100% like I was immediately following Vivonex. I am 80-90%. My BM's are formed, but sometimes "loose", although they stayed formed in the water. Its frustrating, but I just listened to another podcast (I swear all I listen to is talk radio and NPR!! ha), and on of the talkers pointed out; think of what I consider a 'bad' bowel movement, would have been awesome when I was truly sick. Thinking on that, WOW have i come a long way!.

Remember I originally started with 4 immodiums a day, post fast, because my prokinetic was pushing things through tooo quickly. I'm not down to 0-1 a day. I really hate taking immodium (i know, I hear its safe, etc.. I hate taking it, I would rather have it for emergencies) SO I'm almost off of it, and maybe if I started taking it again,2-3 a day, I would get better stool; but so far, I dont feel I need it

Still no gas, no stomach rumbling, no aches and pains

I have been watching my diet quite closely, but I have relaxed rules such as: Sandwich meats that have traces amounts of sugar added to them. Also, about a month ago, I had a pastry. Other than that; I'm pretty good at it, simply because its a part of my life. However, I learn more about SCD / Paleo / Gaps / SIBO each week. I tweak it daily, and get better at all the time.

Overall: Writing it down makes me realize: I am well off compared to before. However, with symptoms like what I am getting, I do not want to exaggerate, but I am thinking about fasting again. Feeling as good as I am, and fasting now may make my chances of a third, post fast, to last even longer.

First fast; I made it 40-60 days (there was a period of just loose stool / Diarrhea thats why I said 40-60). I also was drinking beer, eating pasta sometimes, and NOT paying attention on how to keep SIBO away. This time, day 81, 70+ days symptom free, and still feeling overall, really great. I have flare ups, I deal with it, stay calm, and it passes.

Here's a fresh off the press article about SIBO from Dr. Siebecker:

http://ndnr.com/web-articles/gastrointestinal/small-intestine-bacterial-overgrowth-2/

I have scheduled a talk with her this Thursday. I am going to be asking some good questions that I hope to get a good response too; I will post it here after.

Cheers


----------



## kenbkb (May 21, 2011)

brownish, mostly good news, glad you are well above average for the most part. I cannot see how it would hurt you to do another Vivonex, other than the cost of course. Probably should give it a go. Wait another week or two to see if some of the bad days disappear, and then make your decision. But 80% is pretty good I'd say.

As to your consultation with Dr Siebecker, can you give an idea on a couple of questions you asked her in the past, and what you are going to ask now. Again, I see on her website that she cannot recommend or prescribe (or maybe she can "recommend"?), so I am not sure of the purpose in calling her? I know she knows alot but if she cannot share much....anyway, if you would be so kind....thanks again so much.....


----------



## Brownish72 (Aug 26, 2012)

Hey

Last time, I asked her questions like: would it be beneficial for me to fast longer than 2 weeks, what type of preventative measures can I take to assure it doesn't come back, etc..

She cannot diagnos, or proscribe medication for you; but she can give you advice on what meds you may want to try, or where she has seen success in her patients, and how it may work for you. Each individual is unique, she will listen to you, and do her best to help you find out where you should go next.

I found talking to her unbelievably helpful, and its great to talk to someone who really listens. She has a passion for it, and she shows that through her studies, her degrees, and how she talks to you as a person (not just another patient)

I am going to inquire this time about a fecal transplant (sounds gross right??) Here's why;

I study ecology, and I work the DNA of different species in my research. There is another researcher I met who pointed out an awesome example, and I linked it to my issues with SIBO:

Beavers are typically found living in and around Willow trees. In fact, the two species (the tree and beaver) actually share certain parts of identical sequences of DNA. When the tree expresses that DNA, the Beaver too will express that gene. Cutting the tree down doesn't just hinder the Beavers habitat, it is messing with it on a genetic level as well. Thats incredible to think how connected the world is!!

I took an antibiotic for quite some time, about 4-5 months, in 2009. At the end of the 5 months, thats when my SIBO really hit hard. Antibiotics do a number of wonderful things, but they can also turn on us. Bacteria replicate quite quickly, and antibiotics prevent bacteria from replicating, eventually causing them to die off because of their short life span.

When we take probiotics, the MAX amount I have ever seen is somewhere around 10-15 strains of "good" bacteria. However, in the yogurt we buy (or make) we are lucky to get 3-5 strains of bacteria., sometimes only 1 strain.

There are upwards of 300-500 species of bacteria / yeast living in our large intestine, many of them are unknown and never studied.

The antibiotics I took may have completely wiped me out of certain strains of microbes we need. Just as the Willow tree reacts with the Beaver on a molecular level, bacteria in our bodies do the same. I am taking a prokinetic agent to re-establish my migrating motor complex, yet there are some studies showing that Lactobacillus also activates the migrating motor complex. I had a stool test done, and I had 0 (thats right; Zero) growth of lactobacillus, not to mention MULTIPLE strains of lactobacillus exist.

I feel I could waste my time taking probiotics over and over again, however in a fecal transplant from a healthy individual, the goal is truly to reintroduce proper gut flora and yeasts, by introducing 100's of strains of bacteria into the gut, and overloading the current population of microbes, and re-establishing proper gut flora.

This treatment is typically done for C-Diff patients, and I do not have C-Diff. I dont know if its ever been done for SIBO patients, thats why I'm gonna ask, and if not; I'm more than happy to be the 1st candidate to do so. It would not make sense to do while someone has SIBO, but once SIBO is gone; it may be worth investigating.

Wow that was long; hope that makes sense


----------



## kenbkb (May 21, 2011)

brownish,

As to Siebecker....you noted...."Last time, I asked her questions like: would it be beneficial for me to fast longer than 2 weeks, what type of preventative measures can I take to assure it doesn't come back, etc.. She cannot diagnos, or proscribe medication for you; but she can give you advice on what meds you may want to try, or where she has seen success in her patients, and how it may work for you. Each individual is unique, she will listen to you, and do her best to help you find out where you should go next."

I presume you spent a good deal of time explaining your history/symptoms as well? I would think this is where you start and what consumes most of your time? Do you arrange HOW MUCH time in advance, or do you just go with the flow?

Interesting stuff you are broaching. I realize too that antibiotics are "napalming" the body. My goal was to do the napalming, so to speak, and then advance to the Vivonex, but I still need to gain 5 more pounds to do it. Neither of my docs want me losing more weight.

I am also adding a local Chinese woman for acupuncture and Chinese herbs. My Visceral Hypersensitivity is still what bothers me most.

As to your Fecal Transplant, there was some new news on it only recently I believe through Pub Med. A new article or new finding or something related to that. If you want me to dig it out, let me know.

Is your 80% hanging on or do you want more? We may all be in the category of this nature. A dentist friend of mine tells me that when people with horrible teeth come in for dentures, they want them to be PERFECT, because their teeth have looked so bad for so long. Now they want to look their absolute best. I wonder if that is where we are????


----------



## Brownish72 (Aug 26, 2012)

well, rounding day 90, post fast

I've digressed a lot. I am off immodium completely, but I am almost positive my SIBO is back, within the last 10 days or so. Formed stool; but undigested food in it. And the headaches; signs of Leaky Gut.

I will say I safely lived about 80 days symptom free post fast. Man it felt great!

I just got a new article, from The Townsend Letter magazine, Titled "Small Intestine Bacterial Overgrowth; Often-Ignored Cause of IBS" . This article, written by Dr. Allison Siebecker and her colleague Dr. Steven Sandberg-Lewis is absolutely amazing. The amount of research involved in this article is astonishing, and it gives a detailed plan of how they treat their SIBO patients, and how they manage to keep SIBO away, once its gone.

I could write a 10 pg article about this, and get quite into the details, however its not necessary. So; if your interested in the article; email me: [email protected] . I'll email it to you in PDF version. I recommend printing it, highlighting it, taking notes, asking questions, and trying it out.

I wish this had come out 90 days ago when I finished fasting. I'll be honest; I am not looking forward to doing this again. I cannot wait till the end. But, this type, I will be better equipped with knowledge I didn't have in the past, supplements I didn't know I should be taking, and a direction to take me to hopefully avoiding this for quite some time.

OVERALL: 2nd vivonex fast; much more successful than my first fast. I'm confident my 3rd time fasting will be even better. WIsh me luck and good feelings! I need it


----------



## Moises (May 20, 2000)

Brownish72,

Sorry to hear that you've relapsed.

The good news is that you have a clear diagnosis of what your problem is and you are continually improving.

Do you think you have a motility problem?


----------



## Brownish72 (Aug 26, 2012)

Just need to vent

I'm f*cking angry. Sorry, There are days its not easy; today is one of those. SIBO is like climbing mount everest, descending, and turning right around to do it again. I'm really gonna do all I can do this time to keep sibo away, wish I would of had this article 90 days ago, as for now; its my only glimmer of hope

thanks


----------



## salvationishere2 (Jul 1, 2009)

Hey do any of you know about the safety of taking Vivonex Plus long-term? Like on a permanent basis? Are there studies that verify the safety of it LT?


----------



## Brownish72 (Aug 26, 2012)

No idea; never heard of people on it for extended periods of time. People take vitamines, protein powders, etc.. all the time, for years on end (think muscle trainers, etc..) Vivonex is a similar product in an easier to digest form. BUT thats something a doctor may know.

If you got the time; Its worth setting up an appointment with dr Allison Siebecker via skype on her webpage siboinfo.com She would know the answer to that question and more.

Good luck


----------



## Brownish72 (Aug 26, 2012)

My quest continues;

Started Vivonex Today; for the 3rd time. Its gonna be long one; and like always, looking forward to the end. I'm putting all my chips on the table, and really hoping this last SIBO article is an answer at how we can keep SIBO away for good.

WIsh me luck


----------



## Brownish72 (Aug 26, 2012)

This thread has strayed a little from topic; please refer to my new blog that hopefully provides insight to those searching for an alternative method to SIBO if antibiotics are not working

http://www.ibsgroup....-fast-and-sibo/

its about my 3rd fast on Vivonex


----------

