This is a guest post written by Amy Nett, MD.
The normal small bowel, which connects the stomach to the large bowel, is approximately 20 feet long. Gut microbiome bacteria are normally present throughout the entire gastrointestinal tract, but in varied amounts. Relatively few bacteria normally live in the small bowel (less than 10,000 bacteria per milliliter of fluid) when compared with the large bowel, or colon (at least 1,000,000,000 bacteria per milliliter of fluid). And, the types of bacteria normally present in the small bowel are different from those in the colon.
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Why You Should Thank Your Small Bowel and the Beneficial Bacteria That Live There
The small bowel plays an important role in digesting food and absorbing nutrients. It is also an important part of the immune system, containing an impressive network of lymphoid cells (cells of the immune system that help fight infections and regulate the immune system).
Are you at risk for small intestinal bacterial overgrowth? Find out what the most common risk factors and symptoms are.#SIBO #SIBOsymptomps
The normal (beneficial) bacteria that are an essential part of the healthy small bowel also perform important functions. These beneficial microorganisms help protect against bad (i.e. pathogenic) bacteria and yeast that are ingested. They help the body absorb nutrients, and also produce several nutrients (such as short chain fatty acids) and vitamins like folate and vitamin K. These bacteria help maintain the normal muscular activity of the small bowel, which creates waves that move the contents of the intestine, like food, through the gut.
What Is SIBO?
SIBO, small intestinal bacterial overgrowth, is defined as an increase in the number of bacteria, and/or changes in the types of bacteria present in the small bowel. In most patients, SIBO is not caused by a single type of bacteria, but is an overgrowth of the various types of bacteria that should normally be found in the colon (1). Less commonly, SIBO results from an increase in the otherwise normal bacteria of the small bowel.
SIBO has been shown to negatively affect both the structure and function of the small bowel. It may significantly interfere with digestion of food and absorption of nutrients, primarily by damaging the cells lining the small bowel (the mucosa). Additionally, this damage to the small bowel mucosa can lead to leaky gut (when the intestinal barrier becomes permeable, allowing large protein molecules to escape into the bloodstream), which is known to have a number of potential complications including immune reactions that cause food allergies or sensitivities, generalized inflammation, and autoimmune diseases (2).
These pathogenic bacteria, whether too many or the wrong types, can lead to nutritional deficiencies on top of those due to poor digestion or malabsorption. In particular, the bacteria will take up certain B vitamins, such as vitamin B12, before our own cells have a chance to absorb these important nutrients. They may also consume some of the amino acids, or protein, that we’ve ingested, which can lead to both mild protein deficiency and an increase in ammonia production by certain bacteria. (We normally produce some ammonia daily from normal metabolism, but ammonia requires detoxification, so this may add to an already burdened detoxification system.) The bacteria may also decrease fat absorption through their effect on bile acids, leading to deficiencies in fat soluble vitamins like A and D.
What Causes SIBO?
The body has several different ways of preventing SIBO. These include gastric acid secretion (maintaining an acidic environment), waves of bowel wall muscular activity, immunoglobulins in the intestinal fluid, and a valve that normally allows the flow of contents into the large bowel but prevents them from refluxing back into the small bowel. (This is called the ileocecal valve because it’s located between the ileum, or terminal end of the small intestine, and the cecum, a pouch forming the first part of the large bowel.)
The cause of SIBO is usually complex, and likely affects more than one of the protective mechanisms listed above. A number of risk factors for SIBO have been identified, with some of the more common risk factors listed below. For a more complete discussion of associated diseases and risk factors check out this study and this study.
Risk Factors for SIBO
- Low stomach acid
- Irritable bowel syndrome
- Celiac disease (long-standing)
- Crohn’s disease
- Prior bowel surgery
- Diabetes mellitus (type I and type II)
- Multiple courses of antibiotics
- Organ system dysfunction, such as liver cirrhosis, chronic pancreatitis, or renal failure
Moderate Alcohol Consumption and Oral Contraceptive Pills (OCPs) Also Increase the Risk for SIBO
Heavy alcohol use has long been recognized in association with SIBO (3). This study also found an association between SIBO and moderate alcohol consumption, defined as up to one drink per day for women and two drinks per day for men. Alcohol appears to have effects on several of the normal protective mechanisms, including causing injury to the small bowel mucosal cells, contributing to leaky gut, and decreasing the muscular contractions. Additionally, alcohol may “feed” a few specific types of bacteria contributing to overgrowth (4).
Overall there appears to be a moderate association between OCPs and inflammatory bowel disease (IBD) such as Crohn’s disease (5). Though no studies to date specifically correlate the use of OCPs with SIBO, given the known relationship between IBD and SIBO, it is likely that this association holds true for SIBO as well. However, once patients stop taking OCPs, this risk appears to reverse.
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How Do You Know If You Have SIBO?
The number of people with SIBO in the general population remains unknown. Some studies suggest that between 6 to 15% of healthy, asymptomatic people have SIBO, while up to 80% of people with irritable bowel syndrome (IBS) have SIBO (6).
Complicating this, the most commonly used tests (breath tests measuring levels of hydrogen and methane gas) still have fairly high rates of false negatives (meaning the test results come back as negative but you actually do have the disease) (7).
The most common symptoms of SIBO include:
- Abdominal pain/discomfort
- Bloating and abdominal distention
- Diarrhea
- Constipation (generally associated with methanogens as Chris discussed in his recent podcast)
- Gas and belching
- In more severe cases, there may be weight loss and symptoms related to vitamin deficiencies.
Is SIBO Contagious?
Unlike many other bacterial infections of the gastrointestinal tract, SIBO is not contagious, and there is no evidence that exposure to any single microorganism increases the risk for developing SIBO. SIBO occurs due to a complex interplay of many different factors and is not passed on between individuals. However, some evidence suggests that there is an association between Helicobacter pylori and methane production, suggesting that H. pylori plays a role in gut dysbiosis. (8)
Why SIBO Can Be Difficult to Treat
Antibiotics are often used to treat SIBO. However, studies show that despite treatment with antibiotics, recurrence develops in almost half of all patients within one year. One study comparing treatment with rifaximin (the most commonly used antibiotic for SIBO) and botanical antimicrobials showed slightly better outcomes with the botanical protocol, but still with successful treatment in close to only half of all patients after one course of treatment.
These finding suggests that treatment of the overgrowth alone is not enough for most people. An additional piece of successful treatment must include addressing the underlying cause, or predisposing factor.
Though there are many identified associations between SIBO and other diseases as described above, abnormalities in gut motility are recognized as one of the most common associations. One study published this month demonstrated that patients with SIBO do have significant delays in small bowel transit time (the amount of time it takes something to move through the small bowel). This finding suggests that patients with SIBO, who do not recover after a standard course of antibiotics, or botanical antimicrobial protocol (which we prefer), may benefit from the addition of a prokinetic agent, which increases the muscular contractions of the small bowel. Octreotide and low dose naltrexone are two such options that are being investigated, and may help treat some cases of SIBO that don’t respond to antimicrobials alone. Other options may include prucalopride and low-dose erythromycin, as well as lubiprostone. (9)
As research into SIBO continues, we are increasingly understanding the complexity of this disease, and how treatment must be tailored to each individual to maximize success.
If you need support in dealing with SIBO, consider working with the California Center for Functional Medicine. CCFM offers a membership-based health transformation service that excels at helping people with chronic conditions make the changes necessary to reclaim their health. Find out more about what CCFM has to offer.
About Amy: Amy Nett, MD, graduated from Georgetown University School of Medicine in 2007. She subsequently completed a year of internal medicine training at Santa Barbara Cottage Hospital, followed by five years of specialty training in radiology at Stanford University Hospital, with additional subspecialty training in pediatric radiology.
Along the course of her medical training and working through her own personal health issues, she found her passion for Functional Medicine. She works with patients through a Functional Medicine approach, working to identify and treat the root causes of illness. She uses nutritional therapy, herbal medicine, supplements, stress management, detoxification and lifestyle changes to restore proper function and improve health.
Better supplementation. Fewer supplements.
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July 8th I was a very healthy energetic human being. July 9th I had a colonoscopy and my nightmare began. Was it the prep kit, or that they did a colonoscopy when I wasn’t fully cleaned out (as I told them). Since that day my upper stomach has been blown up and felt like I ate 3 Thanksgiving dinners, as well as my bowels were not eliminating on their own any more. All my test come back as if I am fine, but I am not. I brought up SIBO to my doctor, and because she is probably sick of hearing from me everyother day she threw at me 500mg of Neomycin 2 times a day for 14 days. She never even set up a test for me. I notice when I take the Neomycin I feel really weak. How does a nightmare like this happen when I was perfectly healthy.
Christine,
There is help. The sooner you set up an appointment with someone who can get you properly diagnosed and knows what to do, the faster you will recover.
There are several or more doctors around the country who specialize in SIBO. I haven’t utilized Allison Siebecker, Naturalpathic Doctor, but she is an expert in SIBO and has helped a lot of people. She is doing Skype appointments and her colleague is also doing Skype and possibly in office appointments (I think). They are located in Portland, Oregon. Best to call and find out what is what about appointments, also you can ask if there is anyone near you that knows what to do – they keep a list. http://www.siboinfo.com/
Good article that she wrote that gives details on what to do: http://www.townsendletter.com/FebMarch2013/ibs0213.html
This is a good video with question/answers. https://www.youtube.com/watch?v=piHbr1dhymM
Christine,
What it sounds like is a new GI is needed, a doctor should never just throw meds at you and if you feel like your doctor did this to you it is your right to find a new one and fast. I would look at Jean’s post from September 12 she recommends good resource.
my mom has been sick with stomach over 2 years, we just got results saying she bad bacteria, and is depleted in good bacteria. The doctor put on antibiotic for 6 days and proboiotic for the next 2 monthes. My question is what type of diet should I have do, what foods are best???? Help?
Annette,
This is too vague she may not even have SIBO. It maybe someone else bacteria related, “bad bacteria” doesn’t help. The best plan is to ask the doctor about her diet, a GI should have outlined that for her.
I have had two positive readings for sibo after having breath tests. I have major bloating, pain, constipation etc. I was diagnosed with IBS years ago and after the first positive breath test I was given six weeks of rifaxamin. The breath test was repeated after the six week course of antibiotics was done and again the test was positive with even higher numbers. I have multiple stomach issues but after reading this article I don’t know if SIBO is indeed causing the most problem. It’s so frustrating to constantly feel like this with no relief.
I was in extreme pain for almost 4 months before they figured out it was SIBO. Mostly had attacks at night. I am currently finished with the antibiotic treatment which was originally suppose to be only 2 weeks and ended up being 5 weeks to 6 weeks at 3 times a day. Also I am on specific probiotic and a specialty compounded drug that is blended at a specialty pharmacy (i.e. you cannot get at a Walgreen, CVS, Walmart etc.) to maintain the balance. I have had 2 “relapse” for a lack of better wording, and had to go back on the antibiotics for 2 weeks min. each time, and be off my other maintenance drugs while I took it.
I no longer eat white refine flours (typically very little in carbs/gluten) if I do want those I eat complex cards. Also I workout regularly which helps. No more high fructose corn-syrup in ANYTHING. (ketchup is a big one). It took about 4 months after being treated to starting feeling 100% and it is not always perfect, I feel bloated today, but I can live my life normal again which I wasn’t even able to work at one point because the pain was too bad. If you want additional details please feel free to email me.
Tiffany what is your email address? I’d like to contact you.
Im experiencing the same symptoms Tiffany . I have been on Xifaxan for 2 weeks and prior to that I started then stopped and started again . I am not having any luck with the Gastroenteroligist and cant take the pain, weakness, tiredness. and always feeling sick.
Michelle,
Xifaxan will work to kill the extra bacteria built-up but what is your GI doing for the maintenance of the bacteria? How is he/she preventing it from building back up? I am on a specialty compound it has to go through a specialty pharmacy and diet. I find that High Fructose Corn syrup is no good as well. Where do you live, like what big city are you around? Maybe myself or someone else on the feed could recommend someone else.
What are they compounding for you? And where is this compounding pharmacy?
Only thing Ive been doing is xifaxin, I will be starting a second dose as soon as insurance approves,,, low fodmap diet and probiotoc daily, but still having issues, my GI isnt very helpful. Also on Amitiza for a sluggish bowel, since this all started
Good info, but would be better if the CURE cases could be on a different post, as now many people just repost their problems or questions for a doctor near them
Hello,
I was told I have IBS about 2 years ago and have had stomach issues (abdominal pain/cramping, constipation, extreme bloating all the time) and am now concerned it’s SIBO.
I am curious whether the course of antibiotics is a necessary treatment as I was on strong antibiotics last year (2 courses back to back) and am hesitant to put my body through that again and further mess up my intestinal flora.
I have read an article by Dr. Dinsmore a naturopath practicing in Vancouver, BC and he talks about the use of herbs and probiotics that help. I am wondering what your experience has been with that and if there are some herbs you can recommend that I try.
Thanks!
I’m testing for SIBO this week, I’m positive I have it, and have for 5 years. I looked like I’m 6 months pregnant. I have leaky gut, get stiff joints from eating almost everything except meat, and have a bacterial infection that my doctor wants me to do twice a week Clindamycin IV treatments to clear it up. My question is, should I wait until my gut has healed some to do the 5 weeks of antibiotic treatment? I know antibiotics are bad for the gut, so should I wait until mine is intact and the SIBO is under control? Or should I work on everything at the same time?
Clindamycin IV treatments is what gave me C-diff from surgery that I know have SIBO and have suffered since January 2015. I see a naturopathic doctor who got rid of the c-diff and now needs to treat this. Be very careful with the Clindamycin
I was diagnosed with SIBO from a hydrogen only breath test (no methane) and tried xifacin 2 weeks. GI does not consider motility or prokinetic. I may switch to functional dr or nd. Anyome very good dr recommendations in Boston or ri? Anyone heard of treatments with Biocidin and oliverex? Pt iven my nd but don’t we as a suggested treatment.
Meant to say my nd gave me these, but I don’t see them used for SIBO.
After a year and 2 months the Dr has finally figured out that I have SIBO! I have never been so happy to have something wrong with me! My symptoms have been nausea.. extreme sometimes. It got better when I stopped my Byetta which is a diabetic med I had been on for 7 years but then it started again! I got my LapBand deflated thinking that may be causing it, although I have had the band for 7 years too, that didn’t help either. So, my Gastro Asst ordered the breathing test for SIBO and it came back positive and I started the antibiotic this week. I still am feeling sick to my stomach, even worse so I’m thinking it’s the antibiotic but I’m still taking it 3x a day and am following the diet the l
Low Fermentation. Diet . Stay tuned!?
Atrantil is the best remedy I have found.
Delight,
How long did it take you to see improvements? Did you go off the low fodmap while you were taking it like dr. Pimentel suggests during antibiotic treatment? Do you think your sibo is cured? I just started taking atrantil about a week ago and I’m still experiencing symptoms. I tested positive for sibo and I think I’ve had it for a long time, so I’m hoping the atrantil will start working soon. I so appreciate any feedback 🙂
Thanks!
At first I followed the directions on the bottle, but this is what worked for me: I got rid of any competing probiotics and started taking one capsule of Atrantil about every 2 or 3 hours each day (for continuous coverage). I also took Oxy-Powder (a safe, natural laxative) right before bed to help with the constipation while waiting for the SIBO to die off.
I was avoiding all GMO’s, grain, gluten, starch, dairy, high FODMAPs, fruit, probiotics, prebiotics (including FOS, inulin, lecithin, guar gum, xanthan gum, psyllium), nightshades, fibrous veggies. Sweeteners I used were Lakonto and stevia.
It took about 30 days total for the SIBO symptoms to all disappear. (I think it would have been quicker if I had not been taking probiotics in the beginning, which were interfering with the process.) My days of constipation are gone, and my belly does not blow up anymore. Oh, and the extra 5 pounds that I had gained… those are gone too.
Note: I am still taking one capsule of Atrantil before each meal for maintenance, as I am still working on getting my Crohn’s, leaky gut, hiatal hernia, and ileocecal valve problems under control. These issues make us prone to developing or redeveloping SIBO, and I do not want it to come back!
I’m so happy you are doing so well. Do you know what the ingredients are in the Atrantil product? Are they listed on the bottle? The website just says proprietary.
Atrantil ingredients: the company’s label uses latin names for herbs that have more common names. Sneaky and underhanded. So here’s a translation:
The three ingredients are Horse Chestnut, peppermint, and a high-tannin herb called Quebracho. If you want to substitute a less expensive high-tannin herb, simply buy white oak bark in capsules (for example, at swansons vitamins or on amazon).
The makers of Atrantil even say that the reason for the Quebracho is the tannins. Therefore, substituting a more available, less expensive herb high in tannins would perform similarly.
And the other two herbs, peppermint and horse chestnut, are widely available for low prices.
One of the SIBO sufferers talks about her triumph over battling this disease that she thought she would die from………
Are you saying your SIBO is healed through taking Plexus product? Beside gluten free what other diet did you follow? Thank you, Sandy
Please!!!!!
How can I get in contact with this lady (Sandra)?
I am in dire need at this moment with many of the same symptoms and feel exactly as her. I know that she can help me.
Sheila Morda email: smorda@ comcast. net 717-440-5776
Praying some response
This is all so overwhelming. I got a breath test today at the Open Medicine Institute. Within an 1.5 hours, I was at 121ppm. The nurse stopped testing once I reached that point, and said my high score indicated that I most likely had SIBO. The thing is – I have no gastrointestinal problems. No issues at all, except for minor, occasional constipation. What I do have is increasingly severe CFS and Fibromyalgia. It’s almost unbearable. I eat pretty well already, and can’t imagine limiting my food options so drastically in order to adhere to the FODMAP diet or even a basic SIBO diet. Food is the one thing that I can still appreciate. On the other hand, I’m nearly bed-bound. Has anyone improved their CFS symptoms by diet and antibiotics?
Personally, I believe CFS and Fibromyalgia are caused by mineral deficiencies and the need to detox. I have friends who have reversed their symptoms that way. Minerals help you detox and are so very important for us. With our soils being so depleted, I believe that’s the reason behind many ailments. Even Dr. Linus Pauling was quoted as saying “You can trace every sickness, every disease, and every ailment back to a mineral deficiency.” Most likely your constipation issue could be as simply as drinking more water. So many people are walking around dehydrated. We should be drinking half our body weight in ounces of water at a minimum!
I have CFS as well, and have been treating it with modest success using Dr. Myhill’s modified Stone Age diet.
When I started the diet, I was having severe memory issues, exhausted all the time, and crashing hard after meals. I had to take two naps to get through the day. I would stay awake and stare at the ceiling because I was literally too tired to listen to music or watch sitcoms. The boredom was almost unbearable. I was heading downhill fast.
Within two weeks of eating basically vegetables and meat, my symptoms were retreating. The brain-fog lifted. My energy stabilized. It’s been six months, and I feel WAY better. I’m awake all day, I am on top of basic chores, I’ve even be working on some music with a band.
I still have a long way to go, though. I have no physical stamina whatsoever and have to take it really easy all the time. I think there are two main reasons for this: first off, my body is damaged on a cellular level. It can take months to years to repair that kind of damage. Second, I still haven’t found a way to kill the Sulphate-Reducing Bacteria* (the presumed culprits in my case) because they thrive on vegetable fiber and I can’t find any info about how to fix that. I also can’t find a doctor who isn’t an idiot about CFS.
I can’t work in my condition and am barely able to survive on social assistance. Plus the conservatives slashed funding to the healthcare system so that I can’t see a dietitian. Without Dr. Myhill’s website, I probably would either be bed-ridden or have committed suicide by now.
What it comes down to is this: Do you want to get better? Or do you want to eat cheesecake? Those are your options. After a few weeks on the diet, the cravings went away. It’s hard to watch other people eat my favourite foods, but on a daily basis I’m happy making the foods that I can have.
Seriously, try the diet for one month and see how it feels. Then decided if you want to continue.
Oh, and FYI, I had no real GI symptoms except for farts that stank like sulphur.
And I probably got the overgrowth by eating too much soy. (I was mostly vegan for a while.) Occasionally consuming dairy despite my lactose intolerance could also have been a factor.
– A
*SRBs produce hydrogen sulphide in your body, which, in the quantities produced when you have an overgrowth, is sufficient to poison your mitochondria and shut you down.
Antibiotics didn’t help my SIBO. Only garlic. Crush a clove and let it soak in a few ounces of water for 15 minutes. Then chug it. Not very appetizing but VERY effective. Within 10 minutes you will feel the effects. Bloating goes right down. Garlic is a natural antibiotic, antifungal, antiparasitic. Stay away from all carbs and sugars. That’s what the bacteria feed on.
I would consider doing this, but would I end up offending everyone around me for the rest of the day due to bad breath?
Dawn
Seriously — garlic? Can you please share a bit more information with me. Suffering for long time with SIBO. How long did you do the garlic treatment for? Are you still SIBO free? Do you consume all foods that you did before you got the SIBO? Million thanks!!!
Kim, it might be a good idea to get tested for Lyme disease. Many people with Lyme are misdiagnosed with CFS and Fibromyalgia. Lots of people with Lyme don’t remember a tick bite and many don’t get a bullseye rash. You need to see a Lyme literate doctor for reliable testing and diagnosis. Contact ILADS.org or LymeDisease.org to help find a doctor in your area.
I also didn’t have the intestinal issues but I was tested for fibromyagia, MS and other things. Once I started on the antibiotics I noticed an improvement very quickly. I went through some detox issues but once that cleared I started to feel like myself again. There is a mouth swab test that can be used which is more accurate for results.
you’re so lucky you responded to antibiotics! i hope they help to heal you. i responded poorly. Darn it.
Hi,
I’ve never heard of the mouth swab test for SIBO. It sounds a lot easier. Can you say more about where, how, who can provide the mouth swab test?
Thank you.
Gut bacterial imbalance caused me to suffer greatly from CFS and fibromyalgia… I was never tested for SIBO because this was years ago. I discovered a systemic overgrowth of candida among other things, and by sticking to a strict diet of ONLY meat and vegetables: no sauces, no sugars, no grains, no dairy, no fruit, no mushrooms…. but all of the meat and veggies that I could consume… with lemon juice and s&p for spices… along with homeopathics to kill the candida albicans and specific herbs to clear the dead debris from my colon as the bacteria died, I lost 20 pounds and felt great after 2 months. I realized that if I cheated on the diet my chemistry would go back to what it was and the excruciating pain would return, so I stuck to the diet… and just kept myself satiated… and I ate like a horse! If you believe the diets are too rigid then I would suggest that you need to do more research, because even though each case is totally unique, we ARE what we eat! I’ve been CFS- and Fibromyalgia-free for 24 years!
Congratulations for being CFS and Fibro free! That is encouraging to here. Do you still eat only cooked meat and vegetables, or have you introduced new food (i.e. fruit) into your diet? Again, I have no gastro issues, and suspect my CFS was caused by mercury poisoning. Do you think that one with no GI problems can still strongly benefit from eating only meat and cooked vegetables? Thanks, and I’m truly happy you’re feeling well. You deserve it!
(I apologize if this post shows up more than once…having trouble with it)
I tested positive for SIBO with the hydrogen breath test and was given antibiotics. They didn’t help at all. I haven’t gone for my follow-up visit yet but my doctor doesn’t have the best bedside manner unfortunately. Not sure what to do next, maybe try the natural remedies and see a nutritionist?? I’ll see what my doctor says as well but I’d rather not take another round of heavy antibiotics unless it’s going to actually help. So frustrated with the pain, bloating, gas, weight gain and feeling hungry constantly…which is not normal for me at all.
Where do you live. I can recommend a very reputable Gastro with amazing bedside manner
Thank you but I live in Los Angeles and found a great SIBO doc here that I didn’t know about.
Nicole King- I love outside of Los Angeles. Can I ask for the name of your SIBO doctor? Thanks so much!
I haven’t seen this doctor yet but heard great things about him…and he’s the director of gastro dept at Cedar Sinai med center in LA. One of his main focus’ is SIBO. Dr. Mark Pimentel.
Hi Nicole,
My daughter is a student in LA and I need a good SIBO doctor for her. Would you mind telling me the name of your doctor? thanks!
You may want to see Dr. Enrique Slodownik at Cedars Sinai MC in LA in their GI department.
Bests,
Jeff Harris
I haven’t gone to see this doctor yet because I have to get a referral from my current doc for insurance to pay more but I read a lot about him and he’s the director of gastroenterology at Cedar Sinai in LA…Dr. Mark Pimentel. He appears to be very knowledgable about SIBO and has a specific protocol on how to successfully treat it. I have also been hearing about the natural remedy, called Atrantil, developed by a doctor in Texas. I’m thinking of giving this a try as well.
Hello! I am a Kinesiologist and help people with their health issue holistically. I work in Laguna Beach. I carry Biotics supplements. They have a natural remedy protocol for SIBO that has been tested at Johns Hopkins with great success! If you would like to know more, please email and I will send you the details. [email protected]
Hi,
I live in St. Louis and would love a recommendation for a great GI doctor. I was just diagnosed with SIBO, but have not been happy with my current doctor. Any recommendations would be appreciated.
Thanks!
Ruthann, live in Philadelphia pa.
Ruthann, I also live in Philly, and have a SIBO diagnosis. I noticed you wrote a little while back about an association made with a mouth sore you got, then Burning Mouth Syndrome. My BMS started the same way 16 years ago. However, I didn’t get the SIBO diagnosis until this past Fall! I’d like to talk to you privately about it. May I give you my email address?
Yes
Sherry I too went to temple, saw Henry Parkman. I tried to address sibo on all levels. I knew my motility was an issue. I had the smart pill, it said my digestion was slow. Unfortunately he did nothing for me. At the same time I took the herbal antibiotics, they worked. Also did the scd diet. Two months later it came back. I would up with inflammatory ulsers. Had it removed and biopsyed . I now have burning tongue and many mouth sores. I would love to talk to you. You can reach me at2678474496.
I live in Philly too, and also got not help from Dr Parkman. I have IBS and Sibo, also leaky gut and burning tongue. Have you thought of FMTs? That’s what I hope to get, now I’m just getting by, My phone number is 215-247-1419. I have yours because you wrote it down when you posted on 9/1,
Hi Linda I will call you if you don’t mind
I would love to talk to you
Check out a product developed to treat SIBO by a GI dr in Texas called Atrantil. I’m trying it – just started – because I didn’t want to go straight to the antibiotics. Maybe it can help you.
Susie, I would love to know your results from the Atrantil. It sounds like a great option, thanks!
Atrantil does not list its ingredients on its website, an irresponsible decision making it impossible for people with allergies or sensitivities to buy the product without being stuck with it once they see the package to see what it contains. Big thumbs down.
Atrantil ingredients:
Proprietary blend 550 mg
Quebracho extract, powder
Conker Tree extract, powder
M. balsamea Wild extract, powder (leaf)
Other ingredients: Microcrystalline Cellulose, Gelatin, Magnesium Stearate, Silicon Dioxide, Titanium Dioxide.
Atrantil website: http://www.atrantil.com/#_l_62
Atrantil ingredients: the company’s label uses latin names for herbs that have more common names. Sneaky and underhanded. So here’s a translation:
The three ingredients are Horse Chestnut, peppermint, and a high-tannin herb called Quebracho. If you want to substitute a less expensive high-tannin herb, simply buy white oak bark in capsules (for example, at swansons vitamins or on amazon).
The makers of Atrantil even say that the reason for the Quebracho is the tannins. Therefore, substituting a more available, less expensive herb high in tannins would perform similarly.
And the other two herbs, peppermint and horse chestnut, are widely available for low prices.
This man can help you. His name is Myron Hardesty. His office number is 502-456-9453. He is an Intergrative Medicine Specialist in Louisville, Ky. I have suffered with SIBO for 6 weeks before getting to him.
Having no clue as to where you live, I would contact him ([email protected]) and tell him what is going on with you, perhaps he can direct you to someone in your area like himself.
Bet of luck beating this thing, its scary as heck.
John,
Please contact me at [email protected]. I believe I have sibo and would like to speak with you, if possible.
Thank you,
Jon
I tested positive for SIBO with the hydrogen breath test and was given a round of antibiotics. It didn’t help me at all. Not sure what to do next but I’m so tired of the bloating, pain and gas. Nothing seems to help…not exercise, eating healthy or those meds. I have yet to see my doctor again because I was out of town. I’m thinking I should see a nutritionist and try the natural remedy for SIBO??? Obviously I need to talk to my doctor but he doesn’t have the best bedside manner.
I have actually been gaining weight and feel unusually hungry all the time as well. Both of these things are not the norm for me. So frustrating!
I too was not helped by antibiotics. But was helped a bit by a FODMAP diet which cuts out sugars and carbs. However since I take codeine for back and stomach pain I imagine it is preventing the motility I need to get better even though i am using eurythomycin. Any thoughts on alternatives to opiods besides pot which isn’t helping ?
Lisa Dettmer
I am new to sending replies from this site but your comments caught my eye.. I am preparing a response with great detail as a response to your online comment. Before I complete this information I would like to share with your others on this site, it would benefit me if you can receive my proposed information.. As such, please respond to me thru this site. Thank your, Jeff Harris
Lisa,
Please find an earlier response to your salient post. If you see my post please acknowledge and I will later give you details of my experience that may be germane to a similar experience I have and now proceeding with.
Jeff Harris- Newport Beach, CA 7.27.15
8.7.15
Lisa Dettmer Lisa Dettmer’s Post of 7.24.2015
I am new to this blog site and want to share my experience as it may help others and provide some beneficial feedback for me regarding IBS and central stomach pain.
Over the past three years I have been tested with just about all the test known to mankind- all normal. The most recent was an endoscopy ultrasound (ESU) proving normal. And there is a pending camera endoscopy. I live in Newport Beach, CA and fortunate have local access to Cedars Sinai MC in Beverly Hills near Los Angeles. You can Goggle their GI and GI Motility through their Website: http://www.cedars-sinai.edu/ . My latest consultation last month at Cedars Sinai MC was with a renowned GI Motility specialist where he prescribed MOVANTIK (NALOXEGOL) and suggested I continue on Norco for two-months seeing him afterwards. This drug therapy was to determine if I had a narcotic bowel/stomach and motility issues.
Shortly later I consulted with two pain specialist who would not prescribe any opioids but one did prescribed a procedure called a Celiac Plexus Nerve Block. My Norco use has been within the parameters not to exceed four 10/325 daily and I have used this at such a level for 7 years initially due to oosteoarthritis through a total hip replacement and later from the stomach pain.
Truly through this saga of opioid use without abuse may or may not be the reason for my stomach pain. Because doctors cannot determine the etiology of my pain, the only thing they can suspect in opioid induced pain in my gut as generally defined as NARCOTIC BOWEL/STOMACH. I had no problem with withdrawal symptoms abstaining from Norco for six weeks prior to a breath test but only pain continuing in my stomach that I had to deal with.
It was suggested, from an initial consultation with a GI doctor at Cedars Sinai last April that I have Narcotic bowel syndrome and later after a breath test proved normal, there was an additional consultation with a doctor at Cedars Sinai specializing in GI motility who thought I had as previously diagnosed, a narcotic stomach. He said stay on the Norco or other opioids and Naloxegol (MOVANTIK) for two-months and to see him in two-months. I later emailed him a question I did not present in the above consultation and through their patient portal: “That because of no improvement in pain or bowel movement quality resulted from my 3.5 months of a LO-FODMAPS DIET, may I resume a “normal” diet?” And he suggested I try and reintroduce slowly certain food groups previously restricted in a LO-FODMAPS DIET to find if I am affected.
While I have adhered to a LO-FODMAP diet now for over four-months losing weight from 165 to 149 pound, I have not experienced any relief of stomach pain. My stomach pain is dull and constant only in my stomach while I experience belching starting early in the morning around 4AM and pain in my stomach. The belching stops in a couple of hours upon rising. The stomach pain wains around 3PM after taking 4 Norco pills between waking and 3PM. The specialist at Cedars Sinai, whose expertise is GI motility, thinks this pain and belching is the result of lack of “cleaning” of my stomach in my GI tract which occurs in the early morning while sleeping. This may be interpreted as motility issue. Naloxegol (MOVANTIK) is essentially a laxative I have to take daily along while taking Norco to further diagnose a narcotic bowel/stomach syndrome and suspect to evaluate GI motility issues as a source of centrally located stomach pain.
Since seeing two pain specialists, none wants to prescribe narcotics and the last pain specialist said he will only approve a Celiac Plexus Nerve Block. While I see a nerve block may be similar to acupuncture, having a nerve block may null the diagnostic efforts using Naloxegol (MOVANTIK) and Norco concomitant. I will investigate that a nerve block and the diagnostic test of continuing Norco and Naloxegol (MOVANTIK) with Norco is advisable as together the drug therapy test may be masked by a nerve block not recognizing whether is beneficial in pain relief. I recognize that drug therapy as described with Naloxegol (MOVANTIK) is both to relieve pain suspect from a motility issue and relief of pain so would also be a result of a Celiac Plexus Nerve Block. So while I wish pain relief and use of Naloxegol and Norco concurrently with Celiac Plexus Nerve Block may give me pain relief how would be Naloxegol be diagnostic as one of the purposes of Naloxegol is to determine pain relief while I may experience concurrent therapy with a Celiac Plexus Nerve Block?? My local GI doctor in Newport Beach, CA does not understand my logic and replied: “Are you not seeking pain relief?” Is my logic flawed?
There are two other GI tests suggested being a capsule endoscopy and a ERCP (short for endoscopic retrograde cholangiopancreatography) that my local GI doctor in Newport Beach suggested while ECRP has been ruled out from the normal EUS results. The capsule endoscopy is mutually recommend already from the motility specialist at Cedars Sinai and my local GI doctor while I believe the previous tests performed and a psychological evaluation met with negative findings except that the neurologist suggested stopping all my meds.
Test Performed – All Normal:
Colonoscopy
Abdominal US – EUS
Endoscopy US.
US surface abdominal
CT two with contrast, Abdomen & Pelvis
Stomach Gastric Emptying Testing with Radio Isotope
Blood tests
Fecal tests and bacteria
Bacteria Breath Test
Hydrogen Breath Test – only lactulose (not lactose)
Neurologist Evaluation- Said stop all meds.
Maintaining a strict LO-FODMAD diet without apparent pain relief
Esophageal Manometry
pH 24 Hour Study with a probe into my stomach
EDG: An esophagogastroduodenoscopy (EGD)
Lipase Test: One of the causes of severe abdominal pain is inflammation of the pancreas.
GASTRIN TEST: Gastrin is the main hormone that controls the release of acid in your stomach.
Tests or Future Therapy Pending:
Celiac Plexus Nerve Block
Capsule (pill) Endoscopy
Acupuncture (have to petition my advantage Medicare provider)
Laxatives:
Stool softeners – sometimes up to 5 pills
Ducolax – rarely
Saline enema – not very often – few times per year
Magnesium Citrate not very often – 3 times a year perhaps
Suppositories – not very often – maybe a few times per year
Other fiber supplements – tried but no significant results- stopped
Other drugs previously taken without benefit:
Linzess 290mcg
Ondansetron
Various Probiotics including Align and VSL#3
Xifaxan 200mg
Erythromycin 50mg
Amitriptyline 50mg
Omeprazole 20mg
Drugs currently taking:
Naloxegol (MOVANTIK)
Norco
Probiotic Digestive Care (Rite-Aid) 4 strains bacteria
All the tests and drugs have not helped me or revealed any reason for my stomach pain or belching over the past few years while not any test so far preformed offers any clue to my stomach pain.
It may be clear that I do not have SIBO; the therapeutic effectiveness of antibiotics may not help others with levels of therapy less than 550mg XIFAXAN for SIBO. I was prescribed 200mg XIFAXAN without relief prior to a hydrogen breath test with lactouse. To get a better breath test diagnosis of SIBO, it was recommended that I abstain from opioids and antibiotics for a period of time prior to my breath test. My breath test was normal and antibiotics were ruled out. I found http://www.iffgd.org
helpful.
Functional dyspepsia, the enteric nervous system known as the enteric nervous system, nerves in the wall of the intestines control how the gut reacts to an ingested meal, and they regulate the processes of digestion, nutrient absorption, and waste elimination.
http://www.giresearch.org/site/iffgd-research-awards/2013/gary-mawe
His research interests include the understanding of signaling by the neurotransmitter serotonin in the digestive tract; changes in the gut (enteric) nervous system in response to and following inflammation; and the mechanism by which smooth muscle function is disrupted in gallstone disease. (I may have this problem).
IBS, SIBO and motility problems as we know can be difficult to diagnose and treat while I hope my story here may give some ideas for treatments and diagnosis for those whom experience digestive disorders. I encourage any feedback.
Sincerely,
Jeff Harris – Costa Mesa, CA
In very short. I’ve also dealt with what the gentleman above is dealing with for over a year…I’ve had a Colonoscopy, Endoscopy, and several other tests done. I was tested for SIBO and it came out Positive. Went to go see my Dr. who practices holistic medicine with the help of MetaGenic Supplements. He’s prescribed a quite Difficult Regiment for me, and although I’m quite confused, I do know it will help me some…Everything came out ok with my Colonoscopy & Endoscopy nothing too alarming aside from some Internal Hemmarroids, sorry don’t mean to be graphic…But other than that, everything is ok…I was very scared for a while of the unthinkable…But Since my SIBO came back positive the GI wanted me on an Antibiotic called Xifaxin….Which would cost me $500-$900 depending how much my insurance would cover, if they covered anything at all…I said Forget about it, because not only did I know now I was dealing with SIBO I also knew I’ve been dealing with Candida for more than several years, and Yeast overgrowth….So when I went to go see my PCM who practices holistic medicine…He recommended a Protocol that would Eliminate Dairy, Gluten,Soy,Corn and ALL Sugar from my diet including Fruits! Along with the protocol I would need to drink Bio-Active Silver Hydrasol three times a day 2tbsp for 8weeks! Along with that I would also need to take Candida Forte & Ultra Flora Spectrum which is a combo of really high count Probiotics. But since the prescription Silver was going to cost me $96 a bottle from his office I ventured out to my local health food stores and found a comparable product called Soveirgn Silver it was 10ppm versus the Argentyn 23ppm. I came back with my doctor with that info, and he said I had to be on Argentyn because its a prescribed strength…I grabbed a pamphlet from Argentyn, and another from Soveirgn Silver and they both said the absolute same things…I looked at the back and noticed they were both made by the same company so I called…I spoke with a Dr. they had on call and he initially said that even though Argentyn is stronger…That Soveirgn Silver would and could potentially also do the job! So that’s where I’m at, at the moment! I will be starting my Protocol today! And hopefully it works, and I will update after the 8-weeks! To see if my test comes positive or negative.
On the Diet…I’ve been extremely confused….There’s a Diet for Candida, for Yeast, for Leaky Gut, for SIBO, there’s diets like Whole 30, FODMAP, Nigthshades….As you can see it can get a bit overwhelming, especially if you’re dealing with a number of things….In my case SIBO,Candida, and Yeast. Some of the ok’s in Candida aren’t ok with SIBO and or Yeast, vise versa…So how do you know what to eat? Because by the time you cross reference what you’re left with, it’s basically Protein, some Veggies, and salt! lol I have a dedicated Nutritionist that is helping me and gave me a handout/list of a Candida yes/no’s but obviously some of those I can not have because of the SIBO as well…And although she’s been a lot of help, I feel like she lacks knowledge in the SIBO dept, along with the other two…So it’s been a work in progress…I know that I will try my best and if I fail in some areas, or eat the wrong things it will be unintentionally, but for the most part I have a general understanding of what is ok to eat and what isn’t. Another thing I should add, is that I’ve started a Myers Cocktail IV Therapy. The DR. put me on it for twice a week for 4 weeks then once a week for 8 weeks…Please let me know if there’s any other feed back…I certainly hope that my knowledge helps some! Best Wishes, and God Bless!
Look into Median Arcuate Ligament Syndrome.
I saw Dr. Patrick Nemechek in Arizona. He tests for autonomic disfunction which explains a lot about the always feeling hungry. He has me on very high DHA fish oil, 2-4 Tbs of US extra virgin olive oil, tad of flax meal (I use oil) and SCD or Fodmap diet. I saw improvement in stools and energy within a couple weeks. Still not 100%, but it was nice to have some energy. I took a backslide after two recent surgeries. Oy.
Is the probiotic SacB safe to take with SIBO? I am slowing re-introducing probiotics into my system and want to ensure I steer clear of candida overgrowth but I heard that it aggravates SIBO. would love any clarity or insights on the best probiotics to leverage as a strategy to repopulate with good gut flora.
Holly, to me that sounds more like candida. Whatever the case, I highly urge you to seek help from a qualified practitioner.
I’ve talked to GI and my regular doctor, nobody’s helpful.
I’m not sure if I have this, I know I have diarrhea and I’m overweight with eating anything sweet whether be fruit or anything so for the past two/three days I’ve changed my diet to SIBO diet, on the fodmap diet I still had diarrhea, after eating bread, pasta I feel yucky, bad taste of sugar after eating bread, and like a high and low of eating sugary food, I have celiac, I have a toe fungus toe, hopefully not tmi. Here’s the sites I found. I’ve been on this diet for 3-days and I’m hungry, I want and crave a potato. I’ve taken a lot of antibiotics in my love, which doesn’t help! I lived on a sugary diet and almost all sugary!
http://www.siboinfo.com/uploads/5/4/8/4/5484269/sibo_specific_diet_food_guide_sept_2014.pdf
Let me know
Holly, that sounds typical of yeast overgrowth in the intestinal tract. Have you heard of candidiasis? I would do some research on that if you haven’t.
My symptoms of whatever digestive disorder begun differently than others that I have read here but I’m hoping I can find someone with a similar story so perhaps together we can figure out how to stop these frustrating and painful symptoms.
I have been ‘unwell’ since January 1 although having many months to put some of the pieces of the puzzle together, I reckon this has been progressing over the past few years.
I had a full GI work up-colonoscopy, EGD, esophageal manometry, pH monitoring, upper abdominal ultrasound, HIDA scan, barium esophagram over the recent months. All tests have been negative.
I was diagnosed with Hashimoto’s thyroiditis in 1995. I take no meds for this.
My symptoms started with severe retrosternal and inter scapular pain. One dr. called it nutcracker esophagus. Soon to follow was dysphagia. I couldn’t eat anything besides liquids and pureed foods. Dropped 10 lbs in two weeks which I couldn’t afford to lose.
Symptoms evolved to forceful belching, bloating, chest pain. I have had chronic constipation as long as I can remember.
Found a functional MD who ordered a Nutraeval blood test and she diagnosed me with dysbiosis and leaky gut. I’m off gluten and dairy and alcohol. Not much improvement. Have tried taking Microb-x but felt so ill on it that I couldn’t work. She also put me on a bunch of other supplements so it might be the combination.
Acupuncture is the only way I have pain relief. I go twice a week.
trying to work up the courage to try Microb-x again because I cannot function anymore. Can’t socialize or work because of the belching. Obviously like so many here, this is ruining my life.
Next plan to have breath test for proper and formal diagnosis. I do not want to go the antibiotic route since I’ve read that the chance of relapse is high.
Good luck to you all and I will keep you posted if I learn anything new.
Hi, i am belching so much throughbout the day too! Its constant foe over a year, can someone tell me what this might be caused by?
I empathize with your unexplained belching. Unfortunately “Gas” is used in writing herein that does not define whether it is flatulence or belching GAS. Gas would be better defined as from whatever orifice it emits.
So, I have belching that starts when I wake while in bed along with pain centrally located in my stomach. I had a hydrogen lactose breath test that suggests that I do not SIBO or need antibiotics.
I am preparing a very comprehensive letter to be placed on this site describing years of past testing, future testing, therapies, results, etc. You may want to review this letter in a couple of weeks after I submit. However, I noticed you suffer from belching as I do and thought I would refer you to a Website of a hospital in Beverly Hills, CA. This is a huge world renowned hospital that deals with GI issues and if you dig extensively into this hospital’s Website you will benefit hugely wherever you seek medical attention.
After my breath test there, I was referred to a GI Motility doctor there because of my stomach pain and belching especially awakening in bed early in the morning and continuing a for short time upon rising. My stomach continues until late afternoon long after the belching desists.
Again, I am attempting the completion of a letter to be placed on this site that may explain what I have had done over years in terms of testing, diet, drug therapy, pending testing and therapies. I remain to suffer greatly with stomach pain while belching does not cause pain. But, until then, may I suggest Googling this hospital to learn what may cause GI distress as well as testing and therapies.
Hospital is Cedars Sinai Medical Center – http://www.cedars-sinai.edu/
Hope this may get you and others using Chris Kresser’s site to better understanding IBS in general and motility issues.
Kindly,
Jeff Harris
Costa Mesa, CA
Hydrogen Breath Tests: Found unreliable by government tests as this article points out==also excerpts below about alternative tests that can be used to confirm a positive test
Info pasted below is from
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1856094/
-also the wonderful site http://www.siboinfo.com (which appears to be a truly helpful, non-rip off site)
Hydrogen breath tests are simple and safe, providing us with an easy tool to unravel the pathophysiological alterations behind symptoms difficult to explain. However, these tests have a number of limitations. The importance of SIBO and bacteria in other parts of the gut for functional gastrointestinal symptoms remains to be determined, and breath tests used wisely can be important together with other techniques in future studies. Today, regular use of the lactulose breath test in clinical practice in the evaluation of symptoms in patients with suspected functional gastrointestinal disorders cannot be recommended. The relevance of maldigestion of specific carbohydrates, such as lactose and fructose, in functional gastrointestinal disorders is probably overestimated. However, in some patients with a large intake of products containing these sugars, a hydrogen breath test, followed by dietary restriction of the sugar in case of a positive test, may be advised. Hopefully, the occasional abuse of hydrogen breath tests seen today can be turned into proper clinical and scientific use in the future.
There is no general agreement as to which breath test is preferable.25,88,89,104 In some investigations the 1 g 14C‐D‐xylose breath test has shown excellent results but this has not been confirmed in more recent studies.23,25,104 However, as stated above, the hydrogen breath test with lactulose was found to have both lower specificity and sensitivity than other breath tests.16,89 Although sensitivity in general is acceptable, because of the low specificity for diagnosing SIBO compared with jejunal cultures, it has even been questioned if breath tests are useful at all for diagnosing SIBO.16,20,23,24,81,90,104,108
Glucose is readily absorbed in the proximal small bowel, and in the absence of severe transit abnormalities it rarely reaches the colon,26,105 making it an attractive substrate to detect at least proximal SIBO. The glucose hydrogen breath test is considered positive if there is a clearly recognisable hydrogen peak, exceeding 10–20 ppm (fig 3
3
).12,13,89 High fasting concentrations may be due to SIBO but this is a very unspecific finding which may also be due to slow intestinal transit leaving a residue of poorly absorbable carbohydrates remaining in the colon.16 Mostly, however, high fasting concentrations occur when the instruction to follow a low fibre diet before the test not has been followed.
****************
What are the alternatives to hydrogen breath testing?
For diagnosing lactose intolerance, an alternative procedure to breath testing requires blood samples to be taken after the ingestion of lactose. If the digestion and absorption of lactose is normal, the levels of glucose in the blood should rise. The elevation of blood glucose occurs because the lactose is broken down into its two component sugars, galactose and glucose, as it is absorbed into the blood. A second alternative is to give a dose of lactose (or other dietary sugar) and observe an individual for symptoms. If the individual is intolerant, bloating, distention, pain, flatulence, and diarrhea are likely to occur. A third alternative is a trial of a diet in which the potentially-offending sugar is strictly eliminated. All of these alternatives, however, have limitations and problems.
Bacterial overgrowth can be diagnosed by culturing (growing) the bacteria from a sample of fluid from the small intestine and counting the numbers of colonic bacteria that are present. This procedure requires a tube to be passed through the nose, throat, esophagus and stomach under X-ray guidance so that fluid can be obtained from the small intestine. It is an uncomfortable and expensive procedure, and most laboratories are not able to accurately culture the samples. Hence, this test is not performed routinely. Continue Reading
A pattern of hydrogen production that is typical for bacterial overgrowth does not necessarily mean that an individual’s symptoms are caused by the overgrowth. For example, there may be anatomic abnormalities of the small intestine such as narrowing or functional abnormalities in the way the muscle of the small intestine works. These abnormalities can cause symptoms of bloating, distention, pain, and diarrhea themselves, but they also can lead to bacterial overgrowth with its similar symptoms. Therefore, it may be an underlying abnormality that is responsible for the symptoms and not the bacterial overgrowth. The only way to differentiate between the two causes of symptoms-an underlying problem or bacterial overgrowth – is to treat and eradicate the bacteria. If the symptoms disappear, then it is more likely that it is the overgrowth rather than the underlying abnormality that is responsible for the symptoms.
Any condition that results in the delivery of undigested or unabsorbed food to the colon may result in abnormal breath tests when dietary sugars are used for testing. Both pancreatic insufficiency and the condition called celiac sprue can cause abnormal breath tests, in the former instance because pancreatic enzymes that are necessary for the digestion of carbohydrates are missing, and in the latter instance because the lining of the small intestine is destroyed, and digested food cannot be absorbed. It may be necessary to exclude these causes of abnormal breath tests by additional tests-pancreatic function tests and small intestinal biopsy. Continue Reading
Other corroborating tests
Blood tests may be ordered looking for different causes of anemia, electrolyte imbalance, and vitamin deficiencies.
Breath tests may be considered to measure the byproducts of digestion, especially those that are dependent upon bacteria in the intestine. These include tests for hydrogen breath test, bile acid and D-xylose. Interpreting the test results may help make the diagnosis of SIBO without having to perform an endoscopy or biopsy.
Upper GI endoscopy allows a gastroenterologist to look at the inside of the upper part of the small intestine and take biopsies or small bits of tissue that can be examined under the microscope. Samples of the fluid from the duodenum and jejunum can be analyzed looking for abnormalities that are associated with SIBO.
Because the hydrogen breath tests are considered unreliable,
I am now reconsidering whether to take anti-biotics for the SIBO they found from mine because that treatment is not very effective either and has many risks, by the way—-I suggest also that you google side effects of any mediicine you are about to take, and also the effectiveness of medicine at all to treat the kind of condition you think you have.
amanda in austin
July 10, 2015 at 3:38 pm – your blog
8.6.15
Hi Amanda,
Your blog is erudite and beneficial to readers. It gives areas for investigation, insight and hope.
I am preparing narrative on my many years suffering from IBS. Within the general definition of IBS is SIBO. While I wish I could submit this in-progress narrative it takes some updates and editing. As such, I would like to contribute a little to your blog submittal of 7.10.15 in hopes you can add some sage advice and others may comment and benefit.
At this stage of investigation into my severe stomach pain and belching upon rising from bed, I have gone through most all the classical testing and therapies and most lately was prescribed a drug called MOVVANTIK (NALOXEGOL) from a GI MOTILITY doctor at Cedars Sinai M.C. in L.A. after a hydrogen breath test found normal and no antibiotics were recommended.
Next is a CAPSULE ENDOSCOPY approved but not scheduled at Hoag Presbyterian in Newport Beach, CA. Two-weeks ago I had a ULTRASOUND ENDOSCOPY proving normal.
Lately, I have been to two PAIN SPECIALISTS, the first would not treat me due to no etiology of pain while the second doctor felt similarly he suggested a Celiac Plexus Nerve Block which is being approved by my IPA. My local GI doctor in Newport Beach, CA referred me for ACUPUNTURE and was denied by my IPA, while I have alterative to contest this with my Medicare Advantage insurance carrier.
My GI above mentioned that an ERCP (short for endoscopic retrograde cholangiopancreatography) may be indicated if the EUS proved necessary. Apparently normal results from this recent ULTRASOUND ENDOSCOPY did not warrant an ERCP.
Now I am confronted with a pending CAMERA (PILL) ENDOSCOPY and a Celiac Plexus Nerve Block.
All in all, having prescribed MOVVANTIK (NALOXEGOL) to continue for another six-weeks, it seems to me that having a Celiac Plexus Nerve Block concurrently while on MOVVANTIK would be contraindicated because MOVVANTIK is to increase Gut Motility and secondary to determine my continuing use of Norco is a result of Narcotic Stomach. It was explained to me that MOVVANTIK was a diagnostic therapy to see if I may have a GUT MOTILITY issue as well a NARCOTIC STOMACH or BOWEL SYNDROME.
Years of testing and therapies to date have not helped me in my stomach pain. There is a Website sent to me by a friend that describes among other GI issues, further advanced testing I never heard of! http://www.cpmc.org/services/gi/services/uppergut.html
Another recommended Website and hospital I visit for my GI problems not able to be tested or addressed in my area is:
http://www.cedars-sinai.edu/
It is my hope that my contribution herein will benefit others and I encourage members to offer advice.
Kindy yours,
Jeff Harris
I read on another website that GERD can also be caused, or at least influenced by SIBO? Is that possible? And why could it be that when I tried taking probiotics my gerd flared up?
Hi Grati,
Yes, GERD can be caused by SIBO. When the aberrant bacteria in the small intestine produce gas, this can cause pressure that forces stomach acid into the oesophagus. Probiotics can exacerbate symptoms in some by further increasing the bacterial load in the small intestine, increasing the amount of gas produced, resulting in a worsening of symptoms.
I am a RN and have been struggling with SIBO for the last year after being Dx with Blastocystis H. parasite, which was easy to treat and rid. I have the same story as most of the commentaries. Recently I have stumbled on an excellent resource and possible excellent treatment to a healthy body again. Dr Datis Kharrazian, he has a youtube video that explains so much AND gives a path to helping and possible curing yourself.
“The Gut Brain Axis: Overlooked &Undertreated, 57 min long and worth every second!!!
Tobi, Thanks for posting Dr. Kharrazian’s youtube. I listened to the whole thing, too. And took notes. It makes a lot of sense. I’m going to do the simple things he suggests and look for the botanicals and substances that are over the counter. Jean
Jean,
I would be interested in what you have decided to do after listening to Dr Kharrazian, and any results you have noticed. I have only been doing the coffee enemas with nice results. We shall see……
Hi Tobi,
I haven’t had a look at your link yet but willdo. Interested to know…I also diagnosed with Blastocystis parasite and have now had it in my system for 3 years. Had two courses or antibiotics but can’t seem to rid it. Then was diagnosed with fructose malabsorption so I started a low fodmap diet. Still was having problems and got tested for SIBO which came back positive. I have had the antibiotics for that too and no positive results yet…only been 1 week since finishing but have been worse since antibiotics have finished. Just wondering what you did to get rid of parasite? Cheers, Michelle
Hi Michelle,
Sorry to hear…….. The Blastocystis was easy to rid with 3 days of Alinia antibiotic, per the CDC reccomendations ( seeing how I am a nurse, 3 days seemed way too short, but with follow up stool specimens the parasite was gone). I did have a terrible, terrible “die off” for 3- 4 days, couldn’t do anything. But after that it was like a miracle in the change of my energy and brain fog, every little ache and pain in my body went away! Wasn’t sure how long I had had it (anywhere from 3-10 years) but it showed it’s ugly face after I picked up swimming as a new sport and quickly had no energy for it. Then athletes told me about GU and Procarb which help with energy in endurance sports (they are raw carbs) AND FEED PARASITES and SIBO. SO after the Blastocystis was gone, SIBO came back positive and been working with that for the past year. I am a methane producer, which are harder to rid the body, 3 rounds of Rifaximin and my gas numbers were 20…….. so I began eating a bit more carbs, and my numbers quickly were back up to 50 (my peak results were3 150). So back on a strict low carb diet with intermittent bloating. Decided a year was long enough to try what I was, with little results ( my expectations are to feel my “normal self” as I was 3 years ago- a gourmet cook and eating healthy without limitations). July 4th ran into someone who introduced me to the mind of Dr Datis Kharrazian. He only takes very ill patients, so stumbled upon someone (an accupunturist )who has gone to a lot of his Apex seminars. He is guiding me in a different direction, which goes along with the you tube video of Dr Kharrazian’s. There is a “brain gut connection” through the vagus nerve, which appears to get disrupted, from many causes. This connection is imperative for a healthy gut!!!!!! This is my path right now and seems to be having results. I am no longer bloated even with testing myself with “bad” foods (carbs). My stools are regular and easier. I have mostly been doing coffee enemas that seem to be making these changes. I did them every day for a week to get great results. But deciding how and what I want to do with them as they seem to give me a caffeine effect and keep me up at night (I do the enemas early in the morning). If I skip a day of the enemas, I sleep normal. There is a great Wikipedia article on coffee enemas. I am a believer!
Good Luck everyone out there!!!!!!!!
Hello Michelle,
I had IBS and with further investigation found out I had blastocystis h. and dientamoeba fragilis. Parasites are a common cause of IBS. I had a 2 year journey to recovery with a very strict diet but the thing that I think rid me of the blasto was following a course of very strong herbal remedies from a place in Australia where blasto is a problem in their town. It is called Mullum Herbals: http://mullumherbals.com.au/ They don’t have info on the site, you have to contact them personally about blasto. One of the guys there is researching blasto all the time and they originally told me to take the course for 3 weeks and then upped it to 6 weeks as a result of his research. There are a few different tinctures to take, one of which is very strong, but I found this a much preferable path to antibiotics. I also took ADP Oregano Oil and ground Nigellla Sativa seeds while I was doing the course from Mullum Herbals. When I finished I followed up with a course of florastor. Hope this is helpful. Good luck.