Persistent Diarrhea. Reliable SIBO test?

[Needleandthread44]

My dad (72yrs) has been having persistent diarrhea ever since he was on a PPI (Omeprozole) whilst on steriods in 2019. Whilst he is no longer on the Proton Pump Inhibitor the diarrhea remains. It is daily.

I suspect it is potentially due to low stomach acid which has resulted in SIBO. (He has hypothyroidism and also has had low vitamin test results (b12 and B9). All I suspect linked in with low stomach acid/vitamin absorption.

Anyway, his GP was not very helpful, they did a few stool tests that came back clear and said there was nothing else they could do. I booked him into see a private gastroenterologist, who has recommended a endoscopy and colonoscopy but it is going to cost approx £2000.

Not sure there is any way around it, but have heard there is a SIBO breath test that can be done at home. Would like to try this if not too costly, before he goes for the procedures.

Any thoughts on the SIBO home tests? Has anyone any experience of these or could recommend where to get one?

Thanks

[Sunshineonmyshoulder]

I'm sorry I can't answer your question, but there's very active SIBO Facebook group (SIBO Discussion/Support Group) in which members have talked about at-home SIBO tests. Maybe you could join that and ask.

[grumpyold]

I just received my at home SIBO test from smartsibotest.com. There are a few at home testing companies you can order one from. Mine cost about £165. A LOT less than private endoscopy and colonoscopy you mention.

I haven't done the test yet.

If it turns out to be positive, the company has a couple of solutions to offer. Not cheap, but less than the £2000 you mention above and not intrusive.

They offer special antibiotics which kill the bacterial overgrowth in your gut and/or a very restrictive liquid diet which starves the bad bacteria so they have nothing to survive on.

If I were you, I would google SIBO tests and see which one might suit your dad, best. Some offer methane testing, they aren't all the same.

Good luck.

[Chitai]

Your dad’s bowel problems could also be as a result of taking the PPI, which is a risk factor for microscopic colitis (a form of IBD). To rule this out, his GP should refer him for colonoscopy with biopsies.

[Hidden]

It’s swings and roundabouts….ppi long term….forces the cells in the stomach to reduce acid which allows food to carry any germs into the lower bowel…it also reduces your ability to breakdown food and thus extract necessary vitamins especially b vitamins.Reducing acid this way never cures the problem…especially if you do not produce enough acid in the first place…people with low acid output also get reflux.

You can do a simple test…teaspoon sodium bicarbonate in half a tumbler of water…if you burp within three minutes…it is because it is reacting with acid…low acid will stop you burping.ACV would be a good choice just before meals….it closes the valve…and cleanses out the bacteria lower down.

Antibiotics just compound the problem….

Acid makes the valve at the top of the stomach close…melatonin does this too…but as we age we produce less melatonin and absorb less from our food…poor exposure to sunlight….blue light from devices…instead of infra red from incandescent all deplete melatonin.

Rebound reflux can occur when one stops ppi.

You can start to reverse this by correcting your diet…you really can.

Get away from sugar and yeast to begin with…introduce fermented foods….fiber and green bananas….probiotics…this builds back gut flora….you can do this while you stay on ppi….but the aim is to wean off ppi and eat foods that cleans the bowel….feed the gut…increase micro biome…

Think of it as unfertilised soil…put the right nutrients back….the flora returns…

Foods high in melatonin or supplement…we release most melatonin at night for a reason…one is rest and repair…and especially it’s ability to close that valve at the top of the stomach…it takes a few weeks to retain a weak valve…but it’s doable.Research gut micro biome…..it’s often overlooked.

[Needleandthread44 in reply to Hidden]

Thank you so much. Unfortunately this morning he has just tested positive for H Pylori which means they have prescribed 2 different antibodies + Omeprazole!! Any advice or suggestions of what I could say to his doctor?

[Hidden in reply to Needleandthread44]

Most doctors are chained to the pharmacy industry…so you need to deal with H.Pylori…with antibiotics…the low acid will allow h.pylori to flourish…so once he finishes the antibiotics…then deal with the low acid problem…the ppi will only mask the acid problem and make the low acid issue even worse…spoon of ACV in a tumbler once or twice aday before meals…start looking at probiotics and fermented foods after the h.pylori/antibiotics situation has passed.

[Ishallwearmidnight]

The antibiotics are necessary to get rid of the H. pylori. I wasn't sure why PPIs are given in parallel, but this article sheds some light on that - apparently the acid reduction by the PPI might make the antibiotics more effective: ncbi.nlm.nih.gov/pmc/articl....

My dietician has told me that after completing a course of antibiotics or having a bad bout of diarrhoea, it is always useful to start replenishing the gut flora by taking probiotics. So your Dad could complete the treatment for H. pylori and then start taking probiotics. I'm aware that not all probiotics are equally effective, and there are different formulations, so probably good to investigate a bit and shop around.