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SIBO the Diagnosis
I’ll begin with my personal story and struggle. I have been battling nonspecific fatigue, severe constipation, IBS diagnosis, migraines, occasional bloating, food allergies and intolerances, intermittent joint pain and swelling, brain fog and weight gain. Many times over the years I have gone to my primary care doctor in search of answers. I’ve had a battery of blood tests, CT’s, swallow studies and colonoscopies. The tests have included testing my thyroid and for arthritis. All coming up essentially empty. The last two years my liver enzymes while still normal are creeping up showing signs of stress. While taking a nutritional therapy certification program I have learned about the power house that is the liver and really it’s the master detox organ in the body. Chronic constipation and bacterial overgrowth can certainly place stress on the liver amongst many other things.
Knowing what I know, and knowing that I don’t know it all, I did some research and decided to see a functional medical doctor to see if we could sort out and identify the cause of my symptoms. I have truly believed that all my symptoms are connected and likely the origination has been in my gut. I had my gallbladder removed in my mid 20’s after the birth of my third child, so clearly I have had gut issues since before that day.
I completed a lengthy health assessment in prep for my appointment. At my appointment Dr Teresa combed through my assessment asked many questions, did an exam and ordered many tests. Many tests were blood work done in the office the other 2 were take home tests. One was a saliva hormone test completed over the course of 24 hours and the one that revealed the diagnosis was a breath test. The SIBO or small intestinal bacterial overgrowth test had a 2 day prep (1 day for non constipated folks). The prep consisted of only consuming chicken, white rice and eggs. The only seasonings were salt and pepper. No oils, fats or other herbs and spices were allowed. The test sampled your breath every 20 minutes for 3 hours the day following the prep diet. You needed to be fasting from the night before and only consume water the morning of the test until completion, with the exception of a 1 time drink of a provided small cup of lactulose.
The Results
2 weeks after completing all the tests I went back to the doctor for the results. I was SIBO positive! In fact so positive that I am apparently case study worthy. I’m not sure that it’s ever a good thing to be case study worthy, LOL. Dr. Teresa did say, (which was almost tear producing), “No wonder you feel so bad!” The blood work also confirmed that I am not really absorbing my fats. I am sure this is partly due to the lack of gallbladder and the SIBO combine.
SIBO
What is SIBO? It is the over accumulation of bacteria in the small intestines. The small intestines usually have only a small number of bacteria present and when this alteration of bacteria occurs in types, numbers and/or location, all kinds of symptoms can emerge. It has largely been unrecognized in the medical community; however that position is starting to change. It is estimated that approximately 60% of people with Irritable Bowel Syndrome are suffering with SIBO.
| Symptoms of SIBO | Causes of SIBO |
| Bloating Diarrhea Cramping Constipation Chronic digestive complaints Nausea Belching Flatulence Fatigue Bad Breath Brain Fog Headaches Heartburn Joint pain Nausea Sinus Congestion Rosacea, Eczema Acne Restless Leg Syndrome Food sensitivities Chronic nutrient deficiencies (esp. Iron, Magnesium and B12) Muscle twitching (Magnesium def.) Mood symptoms (depression, anxiety) | Intestinal motility disorders (Slow stomach Emptying, constipation, Scleroderma, Muscular Dystrophy, Cystic Fibrosis, etc) Celiac Disease Low stomach acid; PPI usage Food poisoning Chronic NSAID/Opioid/Antibiotic use Alcohol abuse Hx of C-sections, appendectomy or other abdominal surgeries which may cause adhesions or damage to interstitial cells of Cajal (ICC) Ileocecal valve dysfunction Food Poisoning Gastroenteritis Gastrointestinal infection Fungus overgrowth Hypothyroid Stress Diabetes Initial poor colonization of gut bacteria at birth and infancy |
Sources of table siboinfo.com, sibotest.com and stillwaternatural.com
Why get rid of SIBO?
SIBO damages the microvilli of the small intestines and this damage leads to malabsorption. There are several different types of bacteria that tend to colonize the small intestines. One type metabolizes bile salt that leads to compounds that cause fat malabsorption and lead to symptoms like bile acid diarrhea. Another type of bacteria metabolizes carbohydrate to short- chain fatty acids and contributes to symptoms such as gas and bloating. This means the bacteria are using the carbohydrates and fibers you eat for their own metabolism and leaving you depleted. The digestion of the foods you eat by the bacteria leads to fermentation in the gut and releases methane and hydrogen gases while increasing damage; this continued damage also potentially leads to leaky gut syndrome. This process can trigger the immune system and inflammation. The whole interaction of the fermentable fiber foods such as starch, fructose, grains, gluten, fruits and vegetables and the bacteria can cause symptoms of bloating, gas, fatigue, and hormonal imbalances just to name a few. Additionally this interaction can paralyze the villi and microvilli and slow down the movement of food through the small intestines increasing the contact time and increasing the fermentation process. This will also put a significant strain on the bodies detox pathways as well as on the lymphatic and immune systems.
Repair
The goal is to rid the SIBO and restore gut health. This is accomplished by “starving” the bacterial overgrowth and likely fungal overgrowth. Dietary modifications for this will last anywhere from 2-6 month. Along with dietary restrictions herbs, supplements, possibly antibiotics designed to stay and act locally inside the intestines will be required. Sometimes a special diet called an Elemental diet can be used for a short time to rid the intestines of the bacterial overgrowth. During this restriction the addition of pro and prebiotics will be added and aim to replace and strengthen the good/normal bacterial. After a confirmatory negative post SIBO treatment breath test is completed the goal is to grow the diet back to a regular diet without symptoms or return of SIBO.
The phase 1(early phase) of the reduce and kill plan has been tough for me. It is very restrictive and rather lacking variety. For this reason it is mentally and physically taxing. It requires planning and support. I have worked really hard to follow the plan but have slipped a few times. We have had some family celebrations that included restaurants which were very difficult to eat at with such restrictions.
I am a horrible pill swallower and there are multiple required supplements, herbs, antibiotics, and probiotics taken several times a day. So for me the goal was to find as many liquid herbs and supplements as available. Because of this I am on the restricted diet for several weeks and then will transition to the elemental diet for another 2 weeks. Hopefully after that I will be able to transition through the recovery phase and progress to normal diet. I am both not looking forward to and looking forward to the Elemental diet. I am not looking forward to it because it is a specially prepared amino acid rich meal replacement drink that is the ONLY thing you can consume other than the water for the entire 2 weeks and its expensive (I’ve heard). But I am looking forward to it because it requires far less planning and research. I have also read that the Elemental diet has about an 80-85% rate of effectiveness. I am hoping that with the restricted diet, herbs and Elemental diet I will have complete healing. There are other diets one could follow to try to clear the bacteria including the FODMOPS, AIP, GAPS, and SCD none of these diets are perfect but all can be helpful in decreasing the bacterial overgrowth and hopefully ferreting out which foods bother you and allow you to heal. For more info about the SIBO adapted diet which is a combo of FODMAPS and SCD (which is what I am following) visit www.siboinfo.com or www.theSIBOdoctor.com.
The Die Off
As the bacteria starve and start to die, there will likely be symptoms experienced. I currently feel unsure of how to assess what symptoms I am experiencing. Are they from die off or something else? I occasionally get overcome by brain fog or feel heart burn or stomach burn like. I don’t usually experience heartburn but I also don’t eat such a restricted diet. Sometimes I wonder if what I am eating is not agreeing with me. The symptoms for me are vague and occasional. The dead and dying bacteria are releasing toxins and they themselves can increase body inflammation and irritation. These reactions are also known as the Herxheimer effect. Sometimes you can feel like you are coming down with something or feeling run down. I was told if my die off reaction becomes too strong I can go back to the doctor for IV hydration and/or vitamin infusion to help support the immune system and decrease the symptoms. So far I have been ok.
For now I will continue to plug along and hope the restriction and herbs are working. I generally am not a recipe creator but with this diet I have created a few meals and will post them in my recipe section.
In Health and Healing.
References:
Coomes, Rebecca 2017, SIBO Summer Cookbook, VIC, Australia
Pumpkin Time of Year
Now that we have officially dipped into October, we are well on our way to the lovely colors of fall and the cool crisp air that precedes the cold winter months (depending where you live). I know that for many people this is their favorite time of year. But with this comes everything pumpkin! Pumpkin bars, cakes, pie, and who can forget every drink pumpkin! This year I decided to do pumpkin a healthier way, and so I made my own pumpkin puree to freeze and use in my cooking, baking, smoothies and beverages 🙂
Pumpkin is a member of the winter squash family. Pumpkin is actually a fruit as it has seeds, but its nutritional profile is similar to a vegetable.
- pumpkin is full of antioxidants such as beta-carotene and alpha-carotene which help fight free radicals in our body
- pumpkins are full of vitamins ( this is only a small sample of what each of these vitamin helps with), such as:
- Vitamin A (supports eye sight, improves immune system, improves bone health)
- Vitamin C (repair of all body tissues, bone, teeth, and connective tissue health, immune boosting, collagen production)
- Vitamin B2 (Riboflavin) (helps body’s energy supply by converting carbohydrates to ATP which is needed for energy creation)
- Vitamin E (protects cells from free radicals and damage, converts food to energy, boost immune system and widen blood vessels)
- aside from all other functions, vitamins help boost our immune system which helps fight infections and prevent us from getting sick. This time of year we need to keep our immune system stoked because the crud (as I call it) is everywhere.
Be sure to check out my pumpkin recipes 🙂
Tidbits Tuesday
As I am sitting here learning about blogging and trying to put my thoughts and understanding of this process together, I took a pause and what did I do? Turn to social media because, lets be real, that’s how we roll now. Well anyways I ran across a meme by Dr Frank Lipman MD (A well known and highly knowledgeable Functional Medical Doctor) and it says:
We need to start thinking of the body as an integrated whole, and not as a machine with separate parts treated independently
This got me thinking of things I have said many times before, we in the medical world have sliced and diced the body to such an extreme that each specialty thinks of only their specialty, meaning that if you see a GI (gastrointestinal) doctor they will only look at symptoms and issues related to the gut, ENT doctor (ears nose and throat) only things related to the ears, nose and throat, or Cardiologist (heart and it’s vessels) looks at whats going on with the cardiovascular system. We do not have systems or body parts in isolation, they all work as a moving team, very intricately I might add. When one system is out of balance so likely are many others, this can include our emotional and mental states. I once heard a physician tell a family (they asked a question about a certain set of symptoms) I only do ears, noses and throats, I do not know about anything else going on with the body system. ( Really??)
While I am sooo thankful for specialties, they have saved many a life, I wish the governing body of medicine would not have compartmentalized medical specialties to this extreme because there is sooo much more at play inside our bodies that better healing could occur when treating the whole person! When the spirit is broken so it the body. Even if there could be a better integration of specialties and communication we may actually heal more people instead of just band-aid on symptoms. I think the idea was for the family practice or internist to manage the whole patient, monitor and create the plan while having communication with all the specialties. In theory this is plasuable but in reality with increasing numbers of patients, increased demands on physicians to comply with regulation agencies and metric compliance it is very difficult to spend any quality time with patients.
This is also why I have just begun the process of seeing functional medical doctors and also naturopaths, they know we are a sum of ALL parts and want to look at the body as a whole to address the root causes of ill feelings and symptoms and heal from the inside out, this includes nutritional status! Check them out in your area ifm.org or naturopathic.org. You can also google your city + functional medicine.
Tidbit Tuesday
I work hard to be positive and have thought inspiring posts… but this time I am having a hard time with sounding negative, so please forgive me for that. But hopefully this post will be thought inspiring none the less.
I am concerned with how we are treating each other . This is not the first time I am writing about this. I feel called to point out the examples that I see or have experienced in person, on social media, or hear in my family and friends stories. I write these as points for you to reflect on and think about later…. I think writing about is also helps me frame these situations in my head for a what I would do or have done….. My hope is that this will help you for later, As in, if I come across this type of situation in the future what will I do, what will my roll be? Walk away, offer kind words, help, shame or command the “audience”? This sort of pre-thinking helps me to reflect and also prepare for the future. I hope it will help you.
Ok, now for the situation….
Think busy mall on a busy Saturday afternoon, my brother is up on the 3rd floor, waiting for his girlfriend to finish shopping in a store and so he is in the open walkway looking over the railing down at the busy first floor. A woman with a service dog catches his eye, she appears to be hurrying, suddenly the dog begins to poop on the floor, this happens to be near a large sitting area and food court. He can see the woman is stressed and panicking a bit. No one will help her and people begin to yell at her, yelling “gross” and “what’s wrong with you” “get that dog and poop out of here”, throughout the entire time people are yelling and making rude comments to her, loud enough to be heard on the 3rd floor! She has her hands full and is desperately looking for something or someone to help her. Eventually someone walking by throws a bag at her, she bends down and is trying to wipe the dog poop and its smearing; people continue yelling and then she spills her soda all over the floor. NOT one person helped this woman out! My brother said there had to be at least 6 strollers nearby. ( not one of them had wet wipes for a child emergency??) Eventually she had done what she could and just gave up. She begins looking around frantically for a trash can, someone does point in the direction of one, at that point she took what she could to that trash can and then just left. My brother was crushed. He could not get down to the 1st floor from the 3rd floor easily or in what he felt was a timely matter. This was at the Mall of America, if any of you have been there its huge and the escalators are not always convenient to get to. He was upset enough to talk about it for most of family brunch on Sunday.
This brings me to my concerns, where has our empathy gone? our compassion? When have people moved from jeering and saying rude things from the safety behind their screens to real life (I do not think this is acceptable either way)? How is it we have moved the needle so far that no one is willing to help someone in need? I can’t imagine how that woman felt! Aside from any other reasons to help someone in need, she clearly had something going on that she had a service dog with her, which makes the situation even more deplorable in my eyes.
Just some food for thought. When coming on or visualizing a situation where someone appears in need. First the situation must be assessed, can your life or your families life be in danger if you help? Is the scene safe for you to help, you don’t want to become a second victim. If the answer is yes to either of those or even if you are feeling uneasy or fearful of helping, then it IS your responsibility to call for help for that person… police, security, emergency services, and if able yell to them that help is on the way. In her situation if you are near and can’t help, notify a local business to call for housekeeping or maintenance to clean the mess. hopefully if you have any items to help you will help or if something like napkins from the food court are near by grab some. Also if it safe take a stand with her and don’t let bullies yell and belittle her.
Luckily, I know that there are still good hearted people out there fighting for those in need and those that don’t have a voice of their own. So, for those of you who are saying “Me” I would have helped or gone above and beyond for this woman or any other person in I commend you and we need more of you!
In our complex and ever isolating world, we have a responsibility to being involved in our community… be the village, be the voice… for those in need, for each other, for our children, for our future…. Our existence depends on it.
When you are in a good space take time to reflect on what you would do, what’s most important here and talk to your kids. We teach our kids and others by example. Be the Shining light, Be the Star
Sending all my Grace and Love
Put Your Heart in Your Mouth-Book Review
Put Your Heart in Your Mouth
By Dr. Natasha Campbell-McBride M.D.
A Book Review
The big idea of this book is the importance of essential fatty acid balance. We have been brain washed for decades to believe that we must stay away from fats and cholesterol. We have been led to believe that fats and cholesterol are the cause of heart disease. This book explains what causes high cholesterol and why fats are actually so important in our diet. This book also discusses the consequences of our obsession with lowering fat intake and cholesterol levels. This book brings us to the foundations of our health and wellness and clearly supports the fact that we cannot achieve health without including appropriate balance of good fats in our diet.
This book has taught me or further explained why we would have different cholesterol levels at different times of the year and throughout our lives. Post surgery, when ill, or after dental work your cholesterol will be elevated due to inflammatory processes in the body and in the winter cholesterol levels will be higher than in the summer. When a physician sees elevated cholesterol level they are quick to put you on a Statin. They are forgetting to look at why there is an elevated cholesterol level in the first place. By doing this they are simply placing a band-aid which may actually be causing more harm than good. This book also covered the consequences of using personal care products that are full of chemicals. It’s easy to take for granted what a big organ the skin is and its ability to readily absorb what it comes into contact with. It really hit home to me that every time we use chemical laden products on our skin they cause endothelial damage. This impacts the liver making it work harder and when it is overwhelmed is unable to detox these chemicals which then enter and damage the blood vessels, ultimately leading to cardiovascular disease. This book really broke things down and took a dove deeper while keeping reading easy and understandable. The discussion of how elevated blood sugar damages the blood vessels by attaching to proteins and making sticky AGE’s is very scary. The book makes quite an impact on just how all our lifestyles and food choices really do impact our health at the cellular level.
I really loved this book. I found it easy to read and understand. I felt that it really supported the foundations of health and explained how to work towards being healthy and supporting our cardiovascular system. I also loved that they ended the book with recipes and explanations of why they are important. Even though I still am having a hard time considering consuming organ meat, I am learning to appreciate its place and importance in our diet. I recommend this book to anyone who is trying to decrease their risk for heart disease, improve their quality of life if they have heart disease or are considering Statin drugs.