Category Archives: SIBO

Small Intestine Bacterial Ovegrworth, or SIBO, is a chronic bacterial infection of the small intestine that I have been dealing with since the fall of 2013.   These are not necessarily bad bacteria and are typically beneficial bacteria but they have moved up from the colon into the small intestine where they interfere with digestion and damage the lining of the intestine causing leaky gut syndrome and possibly auto-immune disorders.   In my case I quickly developed a severe gluten and casein intolerance, peripheral neuropathy in my feet and malnutrition/vitamin deficiencies that contributed to a sharp drop in weight.

Symptoms of SIBO include abdominal bloating and pain, constipation or diarrhea, and a feeling that one is basically allergic to food, especially carbohydrates.   Many other symptoms are also possible depending on the severity.  With leaky gut one can have fatigue, food sensitivities, headaches, and “brain fog”, I had all of these at the beginning.  With malabsorption syndrome one can have weight loss, I lost close to 35 pounds in a matter of a few months.   If left unchecked SIBO can lead to many auto-immune disorders or fibromyalgia.

SIBO is found with a lactulose breath test which measures the levels of hydrogen and methane in your breath.  These gases are not created by our human cells and can only be present if bacteria are producing them.  The test, spaced at 20-minute intervals over a 3 hour period can pinpoint where the bacteria are located in the small intestine.

SIBO is typically treated with one or more rounds of antibiotics, usually Rifaxamin and, if you have methane producing bacteria, Neomycin or Flagyl.   These antibiotics were too strong for me and I was in the unlucky 10% that experience severe side effects and I had to stop taking them before the full course was done.   Instead I had to use multiple rounds of herbal antibiotics – AlliMed and Neem Plus – to start to drop the bacterial levels.  I have also been using Metagenics CandiBactin-AR and -BR as well as FC-Cidal, Dysbiocide, ADP and Berberine HCL from Biotics Research.   Diet is also important in controlling SIBO and one must stick to a low FODMAP version of the Paleo or Specific Carbohydrate Diet.   The diet that worked best for me was developed by Dr. Allison Siebecker at the SIBO Center in Portland and it is SIBO Specific based on a low FODMAP version of SCD.

Some resources for those dealing  with SIBO that I have found helpful include:

Icon@2xSIBO App – I developed this iOS app in conjunction  with Dr. Allison Siebecker of the SIBO Center.  It includes an interactive version of her SIBO Specific Food Guide which can be searched, sorted and filtered.   Free on the AppStore.

The following blog posts cover my ongoing journey with SIBO from the beginning.

Finally, some UBiome results

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My gut bacteria

My gut bacteria ratios

It only took about 3 months but I finally got my first set of results back from my UBiome test back in November.  I’m doing a series of three tests each spaced 2 months apart to see if I’m making any progress with my gut repopulation.   I really don’t know what to make of a lot of these results but a few I do know what to make of.   I did a Genova test in August which had me in semi-bad shape, way low on the diversity index and in the red zone on butyrate and short chain fatty acids.   After that test I started heavily in on probiotics and fermented foods in hopes that this would improve.   Well, I have to say I think it worked!

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Getting fit again after SIBO

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NP9A2836-X3In one of my recent posts I talked a bit about exercise in relation to the Primary Foods concept and a bit about how I slowly got back in shape as I healed up from SIBO.  I thought this topic deserved a bit more discussion since it is an important part of my life and I know many people who are currently struggling with how to get back in shape after being ill for a year or longer.

Before SIBO I was in the best shape of my life.  I had come off a solid year with a  personal trainer, I had run several trail marathons and an ultra marathon and was pretty much doing  13+ mile trail run every Saturday.   When I got sick all that fitness went out the door. I lost a lot of weight, down a total of 35-40 lbs and with that weight went a lot of muscle mass.   With Epstein-Barr Virus (EBV)( coursing through my system I was exhausted and seriously unable to get up and do much of anything so all my cardio conditioning went out the door too.   After a year of this I went from being in great shape to being in the worst shape I’d probably been in for most of my adult life.

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Sleep, Rest and SIBO

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IMG_4366One of the things that I think was crucial to dealing with SIBO, or any chronic illness, is getting enough rest to give the body time to heal.   I had been thinking of writing this post last week and then I listened to this podcast with Meghan Telpner on the Ben Greenfield Fitness Podcast and decided that she said it all better than I could.   I’d recommend anyone dealing with a chronic illness listen to what Meghan has to say.

In my case I was used to living a pretty fast paced lifestyle.  If I wasn’t at work coding or managing a team at what was the world’s biggest and craziest software company I was out running, hiking, climbing, fishing, biking, etc… basically anything that would keep me in motion.  So getting SIBO was a huge shift for me and hard to accept that I had to slow down and get some real rest.   Dr. Bowen told me again and again, my new “job” was to relax and heal, not be be doing all the time.

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My stand-up desk experiment

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IMG_0105With the disc issues in my neck I began noticing that sitting was the worst thing I could do.  If I was on the move all day then my leg rarely started burning but if I sat down for more than about 45 minutes the burn would come on and once it came on it rarely went away for the rest of the day.  The most time I would spend sitting was at the computer which is where my worst bad habits of leaning forward and slouching come into play.  So I decided to change up my workstation a month ago and bought a stand-up desk unit.   With my old school 27″ iMac I was rather limited by weight as to what would work but the Ergotron Single HD unit would hold my system.   I opted for the one with the extra shelf so I’d have room for my collection of input devices since I’ve gotten oddly used to using a pen tablet, touch pad and mouse.

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New methane treatment coming in 2017?

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Dr. Pimentel has been at the lead of SIBO research over the last few years and has uncovered the underlying causes of the illness, notably the autoimmune reaction causing the destruction of the vinculin protein that helps drive the migrating motor complex of the small intestine.   For the last few years he has been focusing on methane patients quite a bit and trying to find a new solution to the illness since those with vinculin antibodies relapse frequently.  It looks like he is in Phase 2 Clinical Trials now on a new drug that stops methane production in m.smithii.  You can read all about it at the Synthetic Biologics site – the drug is currently known as SYN-010.  This “cure” seems to really just be stopping the archea from producing methane which causes the symptoms instead of killing off the m.smithii directly.  Not sure how I feel about this, it seems to be treating the symptoms instead of the root of the problem and those archea and bacteria will still be in the wrong place eating your food in the small intestine.   The drug is a variation on lovastatin and statin drugs also have side effects that are pretty undesirable to me at least, especially myopathy.

Dr. Ruscio is running a similar study using Red Rice Yeast instead of a drug since that is a natural statin.  Hopefully he gets good results w/o the side effect rate of SYN-010.   Stay tuned.

The non-treatment side of SIBO treatment

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primary-foodsIn my recent post I went over my actual treatment protocols that I used for SIBO and briefly mentioned the other things that probably helped my treatment.   I decided to do another post on just these aspects of dealing with SIBO since I think they are almost as important as the actual anti-microbial treatment.   In the classes I have done for Health Coach training at the Institute for Integrative Nutrition, IIN, these aspects are called Primary Foods in contrast to the actual foods that one puts in ones mouth.   The Primary Foods are – Relationships, Spirituality, Exercise and Career.  How do these apply to my SIBO healing?  Read on.

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My SIBO Treatment Re-Cap

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Sibo_small_intestine_bacterial_overgrowth-e1408896845282Lately I’ve been asked by several people about what treatment I did to get rid of SIBO so I decided it was a good  time to summarize so I have it in one place.  Now keep in mind, what worked for me may not work for you since it seems that everyone is different when it comes to SIBO.  I also had methane (CH4) dominant SIBO and didn’t show any hydrogen (H2) until my CH4 numbers were way down but having CH4 means you have H2 underneath since the m.smithii methanogens eat the hydrogen gas created by the other bacteria to create CH4.

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Going a bit outside Paleo

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Jasmine_1Ever since I started my serious attempt to gain weight I had added back in some white jasmine rice as a carb source to try and put on some pounds, especially as my running mileage is increasing.   I really hated the thought of eating white rice but jasmine has the lowest fermentation potential and gets absorbed quickly in the upper part of the small intestine.  Still, it never sat well with me since I always felt brown rice was much healthier option.   There are plusses and minuses on both sides of this and many Paleo followers won’t even go there at all just totally avoiding grains.    The argument for white jasmine rice is that it has no anti-nutrients at all since the bran has been stripped away but what you are left with is a pretty high glycemic carb source.    The best case for white rice in Paleo I’ve found is at Paleo Leap.  They argue for white jasmine rice and against brown rice since it does contain anti-nutrients.

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2015 was way better than 2014

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end_of_yearI was looking back on my 2014 year end summary and that was one rough year to say the least, 2015 turned out to be much better in every way.   The amazing thing is that my prediction in my #1 goal of “Get Healthy” actually was pretty accurate.  I expected to be over SIBO and healing my gut but didn’t expect to be feeling really good until 2016 but really I ended up feeling pretty good by mid-2015.  I stopped taking anti-microbials in May and declared myself cured of SIBO in June and since then have been getting better and better each month with no relapse in almost eight months now.   On top of eradicating my SIBO the last round of treatment I did got rid of my blastocystisis hominis too which was excellent news – SIBO and parasite free finally.  I also got good news that I do not have the auto-immune condition that is a major cause of SIBO which is why I think I’ve avoided relapse for so long.

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Weight gains continue

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IMG_9929Less than a month ago I finally topped the 160 mark and have been on a slow, steady rise since then.  This morning I came in at 162.2 and my body fat is now up at 16% from a low of around 12%.   It looks like the weight thing is really behind me and that I’m holding my own now in that department. I’m trying to make sure any new gain is in the muscle department so I’m trying to get in the gym and lift regularly during the winter.   The good news is that I’m still fast, I just had my second fastest 5-mile time this last week and overall my running is getting back to a more normal schedule though still lower miles than what I used to run but that is on purpose.   Zero SIBO symptoms the last month too which is great even eating a much more varied diet and it has now been over 7 months since I stopped actively treating!

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