Meet Methanobrevibacter smithii, the little bastards that have been causing me a ton of grief for the last several months.  This guy eats up hydrogen from other bacteria and then emits methane gas.  I finally got my actual breath test results back the other day and I’m emitting 0ppm H and 33ppm CH4 at baseline with a peak of 44ppm after about an hour which means that these guys, as well as some other bacteria, are living somewhere in my small intestine where they don’t belong.   This is a mild to moderate case of SIBO, I’d hate to see what a severe case of SIBO is like because  mild totally sucks.

My big issue right now is trying to my intestinal lining to settle down somewhat so I can start absorbing food a bit better.  At the moment I’m pumping in about 3000 calories a day and not doing any real exercise but still lose weight or remain more or less constantly low (hit 153 last week, down 30 lbs from Thanksgiving).   After meeting with both Dr. Hall and Dr. Siebecker last week I’m going try herbs to see if I can get the gut lining to be a bit more efficient and cut the inflammation.  This means lots of Vitamin A/D from cod liver oil added to my smoothie, l-glutamine/zinc from Klair Labs Endozin and some Tumeric from Gaia.   I’d even try some high CBD/low THC cannabis if I could get my hands on it, evidently it is good for intestinal inflammation, but I’m not severe enough for medical weed here in WA though I would qualify in CA or just go buy some in CO.

Just this question of how to repair the intestinal lining caused confusion – I was going to use some Intestinal Repair Complex that had these ingredients plus aloe, slippery elm and DGL licorice but evidently those three actually help feed the bacteria so now the plan is  basically getting the good ingredients and leaving the bad ones out.

This has been a huge problem for me lately – no one agrees on exactly what to do to treat SIBO.   And I do want this treated, not just controlled.  It can cause some nasty long-term health issues if left untreated and the more I learn the more I want these bacteria out of my SI and back where they belong in the colon.   Here are the confusing points I’ve run into just this past few weeks:

Diet – Can it cure or only control SIBO?   Some doctors say it can cure the problem and the bacteria will go back home where they belong if you don’t feed them.  Others say that no, diet will control the symptoms but won’t actually cure SIBO.   To cure you either need antibiotics, Rx or herbal, or a starvation period using an elemental diet or extreme fasting.  Even that appears to be a crap shoot, recurrence rates are high.

Which Diet – Regardless of cure or control, which diet do you use?  I thought that this low FODMAP SCD Paleo-ish diet I’m on was pretty much accepted as the way to go but no, there are other doctors that debunk parts of this diet and have their own diets.  I find food choice differences among these diets in every fruit and vegetable I try to eat.  In low FODMAP/SCD you can eat green beans.  In Fast Tract Digestion you can’t they have a high FP (Fermentation Potential).   Not sure about the Cedar-Sinai diet.   In SCD there are no grains, in FTD and Cedar-Sinai they allow white rice of some form – FTD allows Jasmine or sticky, short gain white rice while C-S uses long grain white rice.  Argh.   Honey is another contentious point – SCD and Paleo allow honey, FTD does not.   This has been the only sweetness I’ve had for 4 months and only less than 1T/day, I really don’t want to go to artificial Splenda (FTD) to make up for natural raw honey.    The only thing all of these agree upon is you can eat as much meat and fat as you want, after that maybe lettuce is allowed in all of them but not much else.  Very confusing.

Probiotics – Another tough one.  Lots of people recommend probiotics in the form of supplements for SIBO but others claim all they do is add to the bacterial load in the SI.  Who do you believe?   I’m afraid to take a probiotic at this point aside from my homemade almond milk yogurt, sauerkraut and kimchi.

At least a few things are clear – I need to be using Digestive Enzymes and taking some extra vitamins since SIBO can cause some serious deficiencies especially in B12.  I can eat all the meat I want, problem is I really don’t WANT to eat any meat but have been forced into it from SIBO.  I’ve gone totally to the dark side now, I had pork sausage for breakfast this morning – good pork sausage from Bill the Butcher.  I can eat all the fat I want, there are differences in which fats are allowed but at least coconut and olive oils are pretty consistently accepted.

I’m re-testing in the next week to see if the antibiotics did any good at all, or maybe they made things worse, who knows?  I have good days where I have almost no symptoms and quite a bit of energy and bad days where my gut is messed up, my head foggy and my energy levels next to nothing.  Sometimes I have both extremes in the same day and I can’t figure out what, if anything, causes the change.   I’ll start on the herbs this week to try and repair my gut lining some and hopefully start really gaining some weight for all the calories I’m pushing in.  The hope is that I can get a bit of health back and then I need to decide what to do – treat this with herbal antibiotics for a month or just continue down the diet only (which diet???) path longer.    Until then I’m reading more books, blogs and anything else I can find about SIBO to see what, if anything, has worked for people.   The only thing I know for sure is that I’m not going to try the Xifaxan/Neomycin combo again, that was too brutal and I’m just now starting to feel I’m receiving from it over two weeks later.