Hi Guys, I have a hell of a ride this year, and have had starting off erosive gstritus that morphed into a hosipotal stay with a bleeding stomach ulcer despite PPI's. The upsetting thing was i had to force my consultant to have another look when he claimed there is no way it could be another ulcer given treatment already. Then tested positive (hydrogen) for SIBO, and given the old acorn from the Drs Oh you have IBS as well. I have had the various tests to rule out stomach cancer (hopefully) as 2 weeks in the oncology ward was scary, given they could and still cant tell me what caused the ulcer. But I have constant pain, in my stomach and even now if i push anywhere from the belly button down it is tender, likes its inflammed yet not showing in blood markers. To top things off my LFTS were spiked and discovered I have Fatty Liver disease, thankfully the Liver does not appear to be damaged, but its a lot to take in. I know the treatment for SIBO is another bloody cocktail of antibiotics but I dont want to go down that line as i believed that drugs caused this whole in balance anyway. So can anyone answer any of these. Can I have SIBO Hydrogen dominant but be constipated rather than have diarrhea. As all the literature says Hydrogen dominant causes the runs rather than blockage. Are the SIBO tests really reliable? or just another throw away diagnosis? Does anyone have any experience of IBS related to medications like SSRI's, they gave me those to treat IBS but im not convinced they made it worse. Im not a health anxiety person just trying to understand whats going on. Have a clean diet, fit etc apart from insomnia not due to pain at night but maybe anxiety over all this mess. Sorry for the length of the post.
SIBO real or not: Hi Guys, I have a hell of a... - IBS Network
SIBO real or not
Unfortunately the SIBO tests aren't accurate, true SIBO cases are rare, but there are certain things that can cause SIBO. Unless you have any of these causes, it's unlikely you'll have it. You could discuss the list of causes with your medical team, so they can check these things out for you. If you truly have SIBO and don't treat the cause, it will keep coming back. I understand the drug (antibiotic) that treats it (Rifaximin) isn't licensed in the UK for SIBO. I believe it's mode of action is limited to the small intestine (but you'd need confirmation of this from a medical professional). You can protect yourself against the effects of antibiotics by taking saccharomyces boulardii (a beneficial yeast) at the same time and for a while after.
I was presented with this handout which shows the root causes of SIBO:
clinicaleducation.org/docum...
On the right hand side you will see the box containing the heading "Aetiology" which actually means 'a set of causes'. I went through this list with my gastroenterologist and I have added comments from my own health perspective.
He said that these areas would be covered by the Small Bowel MRI scan that I had:
• Stasis: dysmotility – not apparent
• Surgery (loops, vagotomy, bariatric) – not apparent
• Short Bowel Syndrome - not apparent
• I also added ileocecal valve (which sits between the small and large intestine) to this list, which my therapist kept going on about. She said that my ileocecal valve was stuck open allowing bacteria from my large intestine to wash back into my small bowel and I'd need to visit an osteopath who practices visceral (organ) manipulation to get them to close it for me (or you can do it yourself via a youtube video). I had to go to another city 1.5 hours away to visit such an osteopath who eventually said he didn't manipulate the ileocecal valve (although a phone call indicated he might), but I had a couple of sessions of him manipulating my intestines because they were stiff. My small bowel MRI showed there was nothing at all wrong with my ileocecal valve - it was closed and showed no inflammation or any abnormality that would cause SIBO.
And now for the rest:
• Achlorhydria – no stomach acid – he said this was highly unlikely and also considering I can experience acid reflux
. I also would have thought a fecal elastase test would show if you aren't breaking down proteins correctly (which require stomach acid for digestion) and mine came back OK.
• Hypochlohydria – low stomach acid – same answer as above – the only real test is a PH test directly into your stomach, but he said they didn't do this any more and home testing is inaccurate
• PPIs – my therapist said that I hadn't been on PPIs long enough to make a difference
• Malnutrition – no
• Collagen vascular disease – immune system inflammation e.g. arthritis – not in my case
• Immune deficiency - unlikely
• Advancing Age – no
• Chronic Pancreatitis – this causes constant abdominal pain/fatty stools - no
. It is interesting that another IBS Network member had responded to Rifaxamin but was also diagnosed with a compromised pancreas.
• Chronic ABX use – no
• IgA Deficiency – my tests show this is normal range
• Coeliac Disease – I had blood tests with the GP and these came back fine
• Crohn’s Disease – I had blood tests with the GP and these came back fine
and colonoscopy was OK
• NASH – non alcoholic fatty liver disease –looked at my records for this and this is normal
• Cirrhosis - no
• Fibromyalgia – widespread pain - no
• Rosacea – no
I don't know whether this list helps at all, but might be worth working through from your perspective. As mentioned, if you do have SIBO and the root cause isn't tackled, it will only keep coming back. Good luck.
Hi Ruggerhead. Sorry that you are having a tough time. I'm not an expert, but I can tell you what I know.
It is more common for Hydrogen dominant SIBO to coincide with Diarrhoea, but it can be coincide with constipation as well. That being said, while SIBO is medically recognised the tests for it can vary in reliability. I suppose it depends on where you got tested?
Rifaximin is the usual antibiotics that is used to treat Hydrogen dominant SIBO which is normally well tolerated, although if you got your diagnosis through the NHS they will most likely provide different medication as Rifaxamin is not available on the NHS.
If you don't want to try antibiotics, there is some evidence that taking probiotics can help with SIBO, although I would talk to your doctor first.
Some good information on SIBO can be found here: monashfodmap.com/blog/whats...
Good luck!
Hi Ruggerhead..Sorry to hear you are on the merry -go-round of SIBO.Which you probably know is made more complicated if you are on long term PPI 's and or antibiotics.
Most doctors have not got the time or inclination to pinpoint exact cause and effect.
You however do.....Go back to the first sign of trouble...did you start with reflux or stomach pain?Reflux often occurs when you dont produce enough acid and the LES does not close.Gastritis occurs through damge to the muscosal lining....which left untreated can become an ulcer.
Did anyone ever explain how you ended up with an ulcer?
Was it H .Pylori?Were you given long term antibiotics?Did you take nsaids aspirin ibruprophen long term?Did you have teeth issues?
If the ulcers healed then you seem to be stuck in the inflamed gastritis type situation.You need to do some detective work.And start to address the ongoing inflammation....lessen it to allow good bacteria to win.
How you might fix this...finish whatever antibiotics you are taking.
Start the healing...by eating the RIGHT foods...did you know prebiotics/probiotics will replace the missing gut bacteria (good germs)that long term ppi/ antibiotics destroy?
Leafy greens will help the stomach cells to regenerate Hcl production and rebalance/replace the stomach acid levels which is why bad bacteria thrives in the first place....and why SIBO increases.Betaine HCL will retrain stomach to replace hydrochloric acid levels, thus deal with sibo.
Thin mucosa (mucus lining)"allow" the h.pylori that most of us have to invade the cell wall of the stomach duodenum and bowel.This makes the situation hard to treat....if you repair your linings...you will not get ulcers...or inflamation,..period.
Heres a simple test to see if you are not making enough acid...swallow some bicarb of soda and see if you produce air...if not it is likely you are not making enough stomach acid to break down food and destroy bad bacteria
Raw garlic or allicin tablets will kill most of the bad bacteria and even heal ulcers in some people...two cloves a day
Things that heal inflamed gut due to thining mucosal lining....porridge...bananas...glutamine...dgl liquorice...marshmallow root...slippery elm bark...these provide quick relief and allow healing to begin.
Things that inflame it...alcohol...nsaids....smoking...coffee...stress ...dairy...gluten...processed carbs....bad bacteria.
Apologies for the long winded blunt answer...but thats the only way i can cover what i did to address mine...it helped me..good luck.
Was it H .Pylori?Were you given long term antibiotics?Did you take nsaids aspirin ibruprophen long term?Did you have teeth issues?
Re the above, may I ask what made you mention teeth issues. Is this in relation to h pylori or SIBO or something else. I have SIBO severe constipation and the first symptom I noticed was gum infections and gum recession and tooth loss. Thank you
Chicken or egg?Gum infections usually due to tartare buildup holding bad bacteria in the calcified bit that joins the gum line...and lodge between teeth.Regular cleaning and removal of plaque may address this...so will oil pulling which softens tartare enough to remove it bu brushing alone (sesame or coconut with oil of clove) (youtube covers this topic)and stopping consumption of sugary things.Funny thing is people who up their magnesium and or K2 find they never get plaque build up anymore.The problem with sibo stems from low stomach acid (ppl usage long term)which inturn allows bad bacteria to thrive which becomes systemic.
Your immune system then runs on fumes and cannot even deal with any infections so well thus the protracted long drawn out issues.
I feel for you. SIBO is a minefield. I had a private breath test and it came back hydrogen high and methane. Different people interpret the methane level differently as it was about max 8 in mine.
The NHS knows little about SIBO and from what I’ve seen has little interest in it. IBS and food poisoning is also being given as a cause in more recent findings. I am in a similar position to you and you can get rifaxamin prescribed in the UK through a private gastro but I haven’t taken it as I have severe constipation too. For constipation SIBO Rifaxamin plus neomycin is supposed to work but neomycin is a strong antibiotic with and FDA black box warning. Scary stuff. All my symptoms became 100x worse after a course of metronidazole. Wish I’d never touched the stuff.
There is a huge amount of info on SIBO online. I know some people who are trying herbals but have no experience of this myself. Had your weight been affected by any of this- loss or gain?
I am trying to find out which are the safest laxatives with SIBO. It’s a minefield as you can’t just eat high fibre foods as they increase my bloating like crazy. My liver enzymes are raised too which is worrying me but the gastro isn’t worried as scam showed liver ok but for how long?
Hi flower, unfortunately my symptoms are with me constantly, stomach pain, anxiety, constipation, gas it has been a night mare. I was tested a while ago and it showed hydrogen above 20 over the time period to show SIBO, but its hard to get anyone to believe thats what it is, as somer say yes, others say that the testing is just a scam, ie that everyone has those readings. The liver thing is a bit different, as not sure SIBO or IBS should cause this, my suggestion is to get a Fibrascan, Why? Because i had an MRI with contrast, 2 actually, an abdominal ultrasound, and a CT in the hospital and dismissed as Liver is fine, then i tracked my liver bloods for 3 months as they were raised had a fibrascan and then Fatty Liver Disease. A Bit of a shock as my diet is good and I am not overweight and fit, so something is up. So i suggest that maybe look at those tests in a bit more depth..
Was the fibrascan done on the nhs? Doubt my gastro will agree to it.
No, Why? Because they believe they know everything, well they don't. Im sure like me you have researched things and know more about what is going on. They (some Dr's) play God with your health when you should be placed first, all my problems started when a professional put me on a drug reserved for young cystic acne patients, told me nothing about it and perscribed it, it has ripped my system apart. anyway. If your liver enzymes are raised above your normal levels, what i mean is try and track as to what they should be, Drs often look at them and say Oh normal range, but whats normal for you is the question. Then say Ok ALT, AST, Alk Phos, GGT etc all raised, so what am i doing different. Could the meds you are on being doing that? could the SIBO be doing that? If they stay elevated for a period you have a right to question Why? As I siad I was told by a few Drs Oh your just above normal dont worry about it, but if my normal for say ALT was usually 20 and Im now at 60 for 3 months, thats actually 3 X my normal. Ok if it was 25 or something but 3X. So I was referred to a liver consultant who sent me straight away for a Fibrascan ( you can get them done privately) and suddenly I have stage 2 Fatty Liver disease. Not picked up by all the other scans, go figure. So I have tried to change diet, exercise etc etc and reverse it as best I can, or at least keep the numbers steady and not allow the Liver to become any more fibrous. The scan measures how much damage ie stiffness and also how much fat cover, I was high on the fat cover ie CAP over 300, but not too bad on stiffness, still bad enough but not high high. I know from some stages of NASH its about just holding steady, so in a way Im glad I found out when I did. As i say when i look at all the scans from the hospital they all say, liver fine, but then it wasn't. I think the scan should cost about 150 pound, but money well worth spending, maybe track your bloods a bit longer.
NAFLD ...Fatty liver is most certainly due to consumption of high corn fructose...American children are developing this in huge numbers ever since Macdonalds increased the sizes of soft drinks.The liver has not evolved in how to process this stuff.High Corn Fructose came on the scene in 1966 thanks to the Japanese who were trying to find a cheaper way to sweeten food.Now its in everything most booze beer, cider , soft drinks, cakes biscuits, bread.....sauces gravy granules the list keeps growing.
When it enters the liver it gets stored THERE because the liver knows its bad for the body, so instead of sending out it tries to protect the other organs, probably hoping a shaft of light will enter the brain and reveal the folly it is heading for, and the only thing known to remove the fatty deposits is CHOLINE,milk thistle and dandilion root, arkichoke...will help regenerate new cells.Fisetin will remove dead or damaged cells.
Thankfully you can buy a product designed for this purpose.Its called LIVERCARE and i reversed my fatty liver in 18 months using this stuff.Amazon or Ebay sell it.
I realise you are atributing the cause to medication used.Liver has the ability to repair providing it still has 30 % functionality...with milkthistle and dandelion root...it a known fact
My liver enzymes when back to normal in 3 months......my wake up call came after a gall bladder scan.best wishes.
Hi Jomico thanks for your great advice, the only thing is I live in Ireland so Im not sure the whole corn syrup applies as much here as over there. But hopefully like you I can resolve my liver, I have already brought my LFTS down like you in a few months so at least no ongoing or continued damage (fingers crossed) now with a better diet, no alcohol, exercise I am keen to get my fat deposits down to a healthy level. I want to think that at some stage I am back to normal. I am taking choline as a supplement along with milk thistle, and dijestive enzymes each day. I hope to have another Fibrascan done at the 6mth mark just to see if I have put a dent in it. Thanks again, really appreciate your wisdom. At least that will be another thing off the list, just the stomach pain next..
Thats great to hear, wish you all success, and of course better health.
My dominant symptom was intestinal pain - this would occur mainly at night time. I used to be IBS-D, but controlled that with a low fodmap diet. The pain started getting worse even when I was eating foods that I could normally tolerate. The pain mainly occurred during the night in the early hours from 2am or 5am onwards. I have since been diagnosed with visceral hypersensitivity (functional abdominal pain) and IBS-C, though I wouldn't have said that I had bad constipation prior to all the SIBO treatments. I think they messed up my microbiome which made me constipated, although I have been diagnosed with a redundant (long loopy) colon which could make me more prone to 'C'. Due to the SIBO treatment, which I didn't need, I am now having to consume a huge amount of fibre to get the same BM results that I used to get pre-treatment. Linaclotide and Alflorex probiotic have reduced the pain considerably, which suggests that a gut bacterial imbalance was also contributing to the pain.
So sorry to hear that. I had my IBS-D under okay control until I took symprove in Oct 2018 and that messed me up. Think it started my SIBO. But everything became so much worse after a dose of antibiotics.
Agree tests are hit and miss so a good nutritionist should look at symptoms and stool test too. My hydrogen numbers are high in 80’s. How did you treat SIBO- with herbals, which ones did you use? I agree these can be too strong and cause more issues. It’s an absolute minefield. I don’t know what to do with my SIBO or severe constipation. Fibre just makes me bloat.
Personally I can't recommend nutritional therapists, since they were the ones who messed me up. They diagnosed me with SIBO when I didn't have it and put me through hell with their treatments. I lost over a stone when I am slim anyway. I took antibiotics and herbals, but since I didn't have SIBO all it did was mess up my microbiome. If I did have SIBO I now wouldn't do anything unless it was under the guidance of a medical professional, but that is just based on my personal experience.
I have pm'd you.
Hi have you been tested for h pylori ? That causes ulcers x
Yes i wish it was that, in my mind a drug called Accutane, meant to be an anti acne drug for young people, has done a right job on my system.
It has inflamed the whole of your digestive system that’s bad x
Not what you're looking for?
You may also like...
SIBO
IBS or SIBO
Has anyone been treated for SIBO?
Sibo or not
IBS-C & Sibo
Related Posts
IBS and testing for SIBO - symptoms 
SIBO 
IBS/SIBO and bloating/painful Sex (dyspareunia)
Possible sibo?Moderation team
