SIBO

[Cakebake]

Does anyone have any experience of resolving SIBO? What did you do and what were the improvements? I think this may be why I don't absorb B12 as well as I could so am keen to try to correct it.

[Nackapan]

Once you have a diagnosis a low fodmap diet may help. Pribiotics. Or and antibiotics I've not had it .

My daughter took this approach with good results. Ongoing .

Hope tih have had an endoscopy and seen a gastroenterologist.

[Cakebake]

Thank you Nackapan I am hoping to get a referral to a Gastroenterologist

[Cherylclaire Forum Support]

A fasting hydrogen breath test will hopefully be able to determine if you have SIBO or not. I was sent for one by a haematologist after my MMA was found to be raised, just to eliminate SIBO as the cause. The bacteria rob you of B12, among other vitamins, which can cause MMA to build up in your bloodstream. I think the other vitamins affected are fat-soluble ones.

If after the results of the test are logged and interpreted, SIBO is thought to be the cause, it normally would fall to your GP to decide on appropriate treatment - usually antibiotics. SIBO is not always easy to get rid of - sometimes more than one course of antibiotics is needed, and the type of antibiotic changed to stand the best chance.

The breath test is carried out once every 1/2 hr over the course of 3-4 hrs to get a clear picture by plotting points on a graph. My results showed either SIBO or IBS - not clear which - so since I was sent for the purpose of eliminating SIBO, my GP decided to treat me with antibiotics in case. Nothing happened- beyond having a bad reaction to the antibiotics.

My raised MMA eventually dropped down to within range, but took 3 years (and six tests) to do so. This would usually happen very quickly once B12 injections are started- certainly by the time the loading injections are completed. Renal problems need to be eliminated as a cause for raised MMA too, but that just requires a simple blood test. Functional B12 is another possibility; the one diagnosed by my GP.

All these tests are available via the NHS.

[Bonjourtristesse]

I take probiotics, read the ‘fast tract diet Ibs’ by Norman Robillard, it recommends limiting carbs and fermentable sugars, fibre and sugar alcohols. I wonder if my issues were partly owing to eating disorder (binge eating) so if eating disorders are relevant it is good to address these also.

[fbirder in reply to Bonjourtristesse]

FODMAPs (Fermentable Oligo, Di, Monosaccharides And Polyols) can cause symptoms of SIBO, IBS, coeliacs, etc. Indeed, many people that believe themselves to be non-coeliac gluten sensitive actually have no problem with gluten, but with FODMAPs. newscientist.com/article/21...

I have a big problem with fructose and fructans.

[Slothlike]

I have IBS. I never got diagnosed though, mainly because my diagnosis of ME/CFS slammed the door on any symptom help from the GP. I had to help myself in the end. Sorry for tmi on the next bit ...kind of need to elaborate.

I had alternating daily runs and constipation and constant severe heartburn with no clear link with what I was eating or the amount. I have managed to successfully reduce heartburn from having to take a couple of sheets of gaviscon double action a day (severe symptoms that wake you up at night.cause nausea and sometimes vomiting), to maybe a couple of tablets once per year. The runs ..still present but this has gone from daily to every couple of weeks ...normally when I’ve overdone it.

What I did. I put myself on a very low carbohydrate diet for 8-10 weeks (very strict around 50-60g per day). I used a calorie and nutrition tracking app on my phone. After 8-10 weeks I very slowly increased carbs starting with 100g for another 4 weeks then under 150g for another 6 months. After that I relaxed a bit keeping it below 220 for another 6 months. After that I could eat normally.I very rarely go over 300g per day nowadays. I have not had to revisit the low carb diet since and my symptoms have been “stable” for over 2 years now. This has made quality of life so much better. I didn’t restrict the type of carbs ..although cutting out potatoes and bread for me was the easiest way of bringing it down quickly.

I’m not saying this will work for you but it might be worth starting with something simple like this at first to see if you can simply reset your gut flora before stepping in to anything more complicated. The internet is awash with rather dodgy pseudoscience on this subject. I follow gut microbiome research quite closely and so far most of the research is very top line and very speculative. It’s easy to fall down a rabbit hole on this subject.

For instance we don’t actually know what a healthy gut flora looks like in enough detail (strain or species level studies are few and far between and there is very little at all on viruses). It’s a branch of science that’s in its infancy and it’s very complex. That doesn’t stop people on the internet selling services, books or supplements to claim otherwise of course. Dietary probiotic health claims for Yakult or similar were banned in the EU in 2011 based on this lack of scientific proof for example. A tip I use to filter out nonsense from fact is to dismiss any source that describes bacteria as being ‘good’ or ‘bad’. This is fundamentally incorrect and so over simplistic as to be misleading. It’s a safe bet anything with this description in it means the author will have not a clue about their subject matter so their assertions are also likely to be suspect.

Good luck in managing your symptoms I hope it’s something simple.

[was918]

I would suggest you ask to do the breath test. I just finished mine and am awaiting results, but I believe it will be positive because the glucose solution you are supposed to drink gave me terrible diarrhea and I read that is pretty much a slam dunk positive. As I understand it SIBO isn't about "bad" or "good" bacteria exactly, but rather about an overgrowth of bacteria where it shouldn't be...the small intestine. Apparently your large intestine is overflowing with all types of bacteria, but the small intestine not so much. Anyway, I've included an article I thought was helpful. But I'll preface it by saying that I've read other places that if you are going to try antibiotics (property prescribed for this condition of course) then you shouldn't be on the FODMAP diet while taking the antibiotics. The idea being that if you are trying to kill the bacteria you want them active and not dormant. I don't know if that is legit, but it's one philosophy. Anyway, if you find a miracle cure please post it on here. I'd like to know how to get rid of SIBO too! restartmed.com/sibo/

[Slothlike in reply to was918]

Worth noting that antibiotics won’t kill all of your gut flora but can easily put it off balance. yeast could overgrow etc etc so could be counterproductive and make the situation worse. As mentioned nobody knows what a healthy gut looks like to the right specificity, so tests that measure things or supposed “treatments” (antibiotics or otherwise) are useless when there is no reference to help interpret the results.

I had a scan of some of the studies mentioned. There are a few studies cited worth reading here, but as mentioned earlier, research is generally of low quality in this area so the level of certainty promoted on the site is overstating things. He also quotes the use of herbs and probiotics and cites studies that are misleading IMO and some have no relevance to the point he is making. I would say that most of what he conjectures doesn’t stand up to scientific scrutiny.

The web link has a shop and quite a bit of marketing directing you to buy so draw your own conclusions there. The pattern to the marketing copy is also quite formulaic and recognisable (I am an expert because the other experts don’t know what they are doing...disrupter expert positioning) shame he has no evidence for his approach/treatments other than anecdotal.

Sorry if that’s a bit harsh ...this sort of misleading marketing gets my goat so I may have gone on a bit.

Roll on regulation of advertising standards on the internet and for more quality science in this area.

[Cakebake in reply to Slothlike]

Slothlike I had thought that

antibiotics could make things worse

[was918 in reply to Slothlike]

This particular doctor's recommendations are in line with both the Mayo Clinic and Johns Hopkins. And Johns Hopkins also mentions herbs as a potential treatment. So...

hopkinsmedicine.org/gastroe...

[Slothlike in reply to was918]

Ok let me clarify my comment on herbal medicine/remedies...it’s worth bearing in mind that herbal medicine is not generally accepted practiced in the U.K. so things may be very different in terms of practice/regulation vs the USA and readers may interpret things differently depending upon where they live. I gather the NHS did dabble in the past but the policy now is to follow an evidence base so herbal medicine is not practiced. This goes back to my comment about scientific proof for these so called treatments.

That isn’t to say that the U.K. or other places in Europe don’t offer this privately using loose and suspect rationales to sell the treatment or that the NHS or other places are perfect in other regards.

It’s also worth noting that herbal supplements are only very loosely regulated in terms of supply ...the supply chain here is not subject to the same rigours of testing and traceability as the food industry for example. So there is also a higher risk of doing harm through looser standards being applied (contaminants etc) if you buy them online to self treat.

[Cakebake in reply to was918]

Thank you that link is very interesting and fits a lot of what I have experienced