After failing to knock out the SIBO relapse with a month of herbals I decided to try something new – Atrantil. Atrantil was designed by a GI doctor in Texas specifically for methane dominant SIBO. It is a combination of three herbs that is reported to block the ability of methanogens to actually create methane thus give relief from symptoms. Studies show it works about 80% of the time in tough to treat cases but it is unclear whether it just stops symptoms or actually kills off the bacteria.
Tag Archives: SIBO
Wait, methane may not be SIBO?????
Well if there is one thing that is for certain it is that the SIBO world in changing at rapid speed these days and Dr. Mark Pimentel of Cedars-Sinai dropped a few bombshells at the recent SIBO Symposium. I didn’t attend this year’s Symposium but I got a good summary from Shari so I’m just going to paste her notes here and then comment:
A year without treating SIBO
A year ago I finally stopped taking antimicrobials for SIBO after a solid year of trying hard to eradicate it with first prescription antibiotics, then herbals and diet. I never got a totally negative test last May but it was low enough that we all decided it was not worth trying to keep chasing down the last few points. After the Symposium in June I decided that maybe I would never test negative due to large amounts of m.smithii in the colon so changed tactics to work on my colon flora and ignore the SIBO.
Start a SIBO Support Group
SIBO can be a very isolating illness. Suddenly you can’t go out to eat with your friends since you are sensitive to everything. You can’t really go out to a bar with your friends either, drinking is not recommended. Often you just don’t feel like even leaving the couch when your gut is churning and you aren’t sure when you’ll next need to run to the bathroom. Friends and family rarely can understand what is going on since until you experience SIBO you really don’t get it. All of that can leave you feeling alone and a bit depressed, I know it did me. I think the only person I saw outside of my immediate family for months was a string of doctors as I was trying to figure out what exactly was wrong and what to do about it.
Can you breath your way out of SIBO?
Me with puffed out cheeks doing my breathing
SIBO may be happening in your small intestine but in many cases it is specifically a motility problem and thus tied to the enteric nervous system in the gut. The most common cause of SIBO is actually an auto-immune reaction where the body destroys a key protein that is part of this enteric nervous system and drives the migrating motor complex, the MMC. The MMC fires the small intestine’s cleansing wave to flush any unwanted bacteria out. If this protein, vinculin, is destroyed then the cleansing waves to do not fire as strongly and bacteria can back up in the small intestine causing the symptoms of SIBO. The MMC can also be compromised if there is an issue in the vagus nerve, the main nerve bundle between the brain and the gut. The vagus nerve and the enteric nervous system is so important that the gut is known as the ‘second brain’. In fact, there are more neurotransmitters in the gut than in the brain itself, 95% of the serotonin in the body is produced in the gut and serotonin is a key transmitter in the MMC.
Finally, some UBiome results
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!
Getting fit again after SIBO
In 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.
Sleep, Rest and SIBO
One 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.
My stand-up desk experiment
With 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.
New methane treatment coming in 2017?
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.