health

on SIBO: pitfalls and progress….?

In my post about the cost of having a digestive disorder, I shared that I had finally got an answer to what was causing me problems – SIBO (small intestinal bacterial overgrowth). That was in November 2017 and I’ve spent the whole of 2018 thus far, trying to get on an even kilter and improve things for my little gut bugs. I’d say overall, it’s not been smooth sailing but I definitely have made progress and feel better than I have done in the past, so I’m taking it as a partial success and I also keep reminding myself I have lived for years with a dodgy stomach and so expecting fixes in a few short weeks is asking too much of my poorly, damaged innards.

how i began 2018

The nutritionist I was seeing at the end of 2017 put together a herbal protocol for me to follow for a couple of months, which consisted of

  • A probiotic once a day
  • Saccharomyces boulardii with each meal
  • Apple cider vinegar before each meal (2 tsps)
  • Biocidin Broad Spectrum liquid antimicrobial (15 drops a day)
  • Vitamin D and B12
  • Magnesium Glycinate (3 tablets a day)

I saw results pretty much right away and felt lots better – I had more energy and the bloating/full feeling after eating disappeared. In March, I experimented and came off the herbals to assess the true state of my stomach which unfortunately did not go too well. At this point I hadn’t really changed my diet as we were taking the approach of feeding the critters so they were there to be killed by the antimicrobial. What I had done was started to have porridge for breakfast as the herbal protocol helped me to tolerate oats again and I wanted something healthier than the Rice Krispies I’d lived on for years. This, I believe, was part of my first pitfall – fibre, I have discovered, is ruinous for me. The accumulation issue I’ve experienced in the past worked it’s number on me again, where I won’t experience an issue with a problem food straightaway – instead, problems will accumulate quietly until they unleash their fury on me, a.k.a. stomach pains from hell.

So, after the flare up in mid-March, I went back on the herbals and went to see my nutritionist about moving forward with diet. I toyed with the idea of a few diets – Low FODMAP, SCD and the SIBO diet were all contenders. I have an issue with diets which I might work up into a bog post one day but the headline is following a diet to the letter is not always the answer. I have tried to follow diets for this SIBO journey with more negative results than positive which just goes to show everyone is different and what works for some does not work for everyone. 

Following a grain free diet is what led me to having the worst flare up I’ve ever had. Specifically, eating a grain-free granola for breakfast, using coconut oil to cook and nut flour to bake absolutely ruined me. I had such severe gastrointestinal symptoms I actually thought I had gallbladder disease or worse. The issues persisted for weeks and led me to going to my GP – something I never do after the issues with doctors I’ve seen in the past dismissing my symptoms. This doctor did suggest an ultrasound but said it’d take so long to get the appointment, that if I had private health insurance I may as well go down that route. Helpful.

more tests

I do have private health cover through my husband’s work and arranged to see a consultant gastroenterologist. He did stool and blood tests, an ultrasound and a repeat SIBO breath test. The good news that came back was on all fronts – no gallbladder/liver/pancreas issues, no h. pylori or serious, troublesome pathogens in my gut. Also, no SIBO! You heard that right. The breath test came back negative for SIBO but methane was still there in the large intestine so I got the diagnosis of large intestinal dysbiosis. I was really pleased that what I’d done had treated the SIBO so well and was encouraged – even though methane is so tricky to get rid of.

The doctor was postitive I can shift this – he said it’s just a functional gut issue and most probably has the contributing factor of slow motility meaning food is staying in my system longer than it needs to, providing fodder for the bacteria to feast on. He suggested as well as Rifaximin and a prokinetic, that I focus my diet towards more protein and vegetables, with an emphasis on low/no fibre or refined carbs.

Diet wise this sounded sensible and kind of confirmed what I’d been thinking already. I also cut out nut flour, large quantities of nuts in general and coconut oil, reintroduced Rice Krispies and white flour and saw my severe flare up disappear. Go figure. So much for healthy grain-free alternatives being the elixir we all need.

my experience with Rifaximin

I ended up with a months worth of Rifaximin as my pharmacy could not break a pack into two as I’d been prescribed two weeks’ worth. At the time, with the £420 price tag I really hesitated to buy it but I did and now I am glad to have another cycle there if I need it.

Overall, I think it worked for me. I took it alongside Iberogast (60 drops a day), a probiotic, saccharomyces boulardii and magnesium and definitely saw an improvement in my symptoms. I had a serious bloat for the whole time I took it but that disappeared as soon as I stopped taking it. It’s not been a miracle cure and I have had issues since coming off of the but again, I feel like I’m making progress in the right direction. I know it’s the methane being a stubborn arse that does not want to die.

It still frustrates me as I’m trying my level best to tackle these issues but yet they persist. It can be disheartening and feels like I’m never going to get there with solving it all but I need to keep being resilient and persevering. I have things in my arsenal that are helping and I need to keep at it and keep experimenting.

old habits

When I didn’t know what was wrong with me, one of the problems I had was insatiable hunger. Like, I’d eat something and 30 minutes later I was hungry again. I assumed I just had a fast metabolism but I suspect it was just the gut critters eating everything I put in me and leaving me with nothing. Hence, I’ve slipped into a cycle that has been years in the making of always eating when I’m hungry – of thinking I need to eat when my stomach rumbles. So I’ve really been sabotaging myself and not allowing my migrating motor complex time to do its job which has surely contributed to my problems.

I’m finding this really hard to undo. I no longer have that insatiable hunger so I know I’ve definitely helped to repair my gut to an extent but I still can’t quite get over the it’s OK to not be eating every hour cycle.I need to curb the snacking because I don’t need to eat all the time. I fully identify that this is part of a wider set of mental health issues I have surrounding my gut problems. I wouldn’t call it an eating disorder (maybe it is?) and I know what I need to do to an extent – stop eating all the time – it’s just hard to retrain the old grey matter.

What this has taught me though, is that as well as focusing on healing the gut, it’s also about (for me, at least) retraining the brain and my attitudes/habits surrounding food.

still not 100%

So here I am, 9 months into targeted treatment to help get my belly back on track and still not quite at the finish line is in sight stage. I’ve made progress but I’m still mystified at the complexities of the gut.

This much, however, I do know,

  • Fibre is no good for me. Neither is coconut oil and too many nuts.
  • I still have a problem with starchy vegetables, fructose, fructans and polyls.
  • Pretty convinced I have a sulfur intolerance.
  • There’s still something going on in there that isn’t right. Do I figure it out by myself or keep talking to specialists and having more tests?
  • Trying to find solutions and second guessing what’s going on in your stomach is the equivalent of falling down a rabbit hole every 10 minutes.

There we have it. The trials and tribulations of the first 9 months in trying to cure my stomach of its issues. Kind of a one step forwards, two steps back feel to it all but overall, I do feel better and feel like some progress has been made. I think the next bit will be the tricky part – nailing down any remaining issues and what I can do to solve those.

–NC

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