How I’m Healing from SIBO
Before I was officially diagnosed with SIBO (small intestine bacteria overgrowth), I thoroughly researched all of the most recent information about how to treat it. Armed with this knowledge, I visited my naturopath, arrogantly thinking I knew the best way to eradicate my infection because I’d learned all the latest recommendations. Together, my very knowledgable doctor and I decided on a treatment plan based on the latest research, but as I strictly followed the “correct” course of action, my case of SIBO only got worse!
What is SIBO?
SIBO stands for small intestine bacteria overgrowth. It’s technically an infection in the small intestine, but not necessarily due to a pathogen. The small intestine and the large intestine are separated by a valve called the ileocecal valve. Normally, the small intestine contains only a small amount of bacteria, and the large intestine is teeming with bacteria. The ileocecal valve helps keep bacteria where they belong, in the large intestine. SIBO results when bacteria overgrow in the small intestine, which damages the intestinal lining and interferes with proper digestion, leading to malnutrition. Symptoms include excess gas, bloating, diarrhea and/or constipation, abdominal pain, cramping, fatigue, muscle and/or joint pain, headaches, etc.
What Causes SIBO?
There are many potential causes of SIBO, and usually a combination of factors leads to its development. A few major causes include: stress, a history of gastroenteritis (food poisoning), antibiotics, acid reflux medications, previous surgery causing scar tissue and intestinal adhesions, celiac disease, Crohn’s disease, diabetes, moderate to heavy alcohol use, etc.
How I (Probably) Developed SIBO
I’ve never had optimal digestion to begin with. On and off, all my life, I’ve had IBS-like symptoms. I believe this, combined with having a stressful career (I’m an operating room nurse) set me up for a vicious cycle of worsening digestive problems. When I was 27, I experienced a severe food poisoning-like event that left me bed-ridden and without an appetite for several days. I lost eight pounds, which my already small frame couldn’t afford to lose. It took me about a year to feel somewhat “normal” again, but a couple of years later I began experiencing severe acid reflux after my stress level increased when I started working in trauma surgery. My doctor at the time prescribed Prilosec, a very strong medication for treating acid reflux, and it definitely helped me feel better, but I lost weight again. I also started having diarrhea on and off until I decided to try probiotics, which were somewhat helpful. A few years later I adopted a paleo diet and felt better than ever, although I began realizing I had a few food intolerances. A combination of multiple stressful events a year or so later left me with a scary bout of diarrhea that wouldn’t go away. I’d heard about an elimination diet called the autoimmune paleo diet (AIP) and was already interested in trying it, so I figured this was a good opportunity to jump right in and get started. Thankfully, the diet helped manage my symptoms right away, but my attempts to reintroduce foods after elimination weren’t very successful. I learned that often times an infection is at the root of the development of multiple food intolerances, AKA “leaky gut,” so I visited my naturopath for some testing and found out I had a pathogen in my gut called Yersinia enterocolitica. This pathogen was likely the cause of the food poisoning-like event many years earlier. With my doctor’s help, we successfully eradicated the infection, but I didn’t feel better. The diarrhea came back, and I started developing more food intolerances, specifically to certain carbohydrates called FODMAPs and to starches. Consuming bone broth and taking probiotics, which normally help heal a “leaky gut” only made me feel worse, and I started getting bloated, which I’d never experienced before. So, I went back to my naturopath, and after more testing we discovered I had SIBO.
What are some current recommendations about how to treat SIBO?
The current recommendations for treating SIBO include adopting a low-FODMAP diet to starve the bacteria in the small intestine; taking at least one round of antibiotics (usually rifaximin or herbal antibiotics) to kill the bacteria; then avoiding probiotics to prevent the regrowth of bacteria in the small intestine; using a prokinetic medication to help stimulate the migrating motor complex (MMC), a cleansing wave through the small intestine that helps keep bacteria moving forward into the large intestine; and stress management techniques.
How I Attempted to Treat SIBO and What Went Wrong
To manage my symptoms before I was officially diagnosed with SIBO, I adopted a low-FODMAP diet in addition to the autoimmune paleo diet I was already on. This helped a lot initially, but it wasn’t until I went on an even more restrictive diet outlined in The Loving Diet that my symptoms got under control. For antibiotic treatment, I tried one round of four weeks of herbal antibiotics in the form of emulsified oregano oil and allicin (garlic). I felt pretty exhausted while on this treatment, but it did seem to improve my digestion somewhat, so I felt hopeful. When treatment was complete I tested to see if SIBO was gone, but my test came back showing that my case of SIBO actually got worse! So, I did another round of herbal antibiotics, this time using the Biotics protocol from this study. I felt even more exhausted during this treatment, and my digestion started declining even more. Eventually I couldn’t tolerate raw foods or cruciferious vegetables. I tried reintroducing probiotic capsules, but they caused uncomfortable bloating and cramping, and I developed a histamine intolerance.
In order to give my poor gut a bit of a break, I quit the probiotics and started on the Digestive Health with Real Food (DHwRF) elimination diet when my second round of antibiotics was complete. I was at a loss for what to do next, but I was certain that taking more antibiotics was not the answer for me. It was at this very low point I met a woman in the DHwRF Facebook group who offered me some excellent advice based on what had worked for her, and I finally started to see a light at the end of the sad, dark, lonely SIBO tunnel.
What’s Finally Working for Me
***I’m not affiliated with any of the products I mention below. I just want to share some specific things that are working for me in case they might help you or someone you know, too.***
I was on the DHwRF diet for six weeks, and it indeed helped calm my digestive system, which I think allowed it to start healing, but I knew that I desperately needed probiotics, which is why I had tried the probiotic capsules previously. Thankfully, my DHwRF friend had some excellent advice for me. She, too, could not tolerate any probiotic capsules, but her body readily accepted properly fermented foods, meaning that the food is fermented in a completely anaerobic environment. I purchased a couple of fermentation jars and started by consuming fermented carrots, which have a short fermentation period. Amazingly, my body happily accepted this fermented food, my digestion improved rapidly, and I was ready to transition off of the DHwRF diet. For the past three months I’ve been successfully reintroducing foods, as I’m regularly consuming a variety of properly fermented foods. I’m tolerating raw veggies, cruciferous veggies, FODMAPs, starches, and even non-AIP foods with minimal bloating and no pain. While it might seem like fermented foods were my miracle cure, that is not the case. There are many other very important factors that have contributed to my healing.
Another major piece of helpful advice my DHwRF friend offered me was to try performing breathing exercises regularly and working on achieving proper body alignment. She is absolutely certain this is what finally cured SIBO for her, so I decided I must try this, as well! I downloaded the app “Breathing Zone” onto my iPhone and started with slow, deep breathing for at least ten minutes a day, but usually more. I love using this app on the bus on my way home for work, and I find it often makes me fall asleep! As far as addressing body alignment is concerned, I’ve actually been interested in this for a long time, so I already knew of some great resources to get me started, including books, videos, and blog posts by my most favorite biomechanist, Katy Bowman. Through Katy I also learned about a yoga program called Yoga Tune Up, created by Jill Miller. I ordered Jill’s at-home DVD program, some Yoga Tune Up balls, and her book “The Roll Model.” After about two months of faithfully following her program, I’m no longer feeling chronic upper back and shoulder pain I’d had since working in trauma surgery, and I am already feeling much more flexible and strong.
Deep breathing and yoga are both wonderful stress relievers, and that’s so important for me, as my instances of digestive distress have all been intimately tied to stress. In addition to these therapies, I also meditate regularly, using an app called Headspace, and I start each day with prayer and devotion using an iPhone app version of the Magnificat.
Stress reduction techniques stimulate a very important nerve in the body called the vagus nerve, which helps manage digestion. The vagus nerve plays a central role in helping the body relax into a “rest and digest” state as opposed to the “fight or flight” stress response. Digestion can not occur properly in a stressed body. Even if you were to eat a perfect diet, stress will cause incomplete digestion of the “perfect” food, and incompletely digested food particles actually harm your body. I’ve found eating while sitting down and without distraction (no cell phone, no TV, no books, etc.) is non-negotiable for my digestive health. Sometimes I also find it helpful to lie down and relax my psoas muscles after eating. Relaxing the psoas muscles is a wonderful way to help counter stress.
The vagus nerve also plays an important role in managing the migrating motor complex (MMC), which, as I mentioned above, is a cleansing wave through the small intestine that helps keep bacteria moving forward into the large intestine. A properly functioning MMC is vital for keeping SIBO at bay. Cleansing waves only happen outside of eating, and they occur about once every 90 to 120 minutes, so spacing meals at least four hours apart (no grazing) allows a good amount of time for the MMC to do its job effectively. Vagus nerve stimulation helps to strengthen the MMC. There are many ways to stimulate the vagus nerve. Some ways I’ve found that work for me are performing breathing exercises, yoga, meditation, prayer, singing, laughing (my husband and I recently started going to local improv comedy shows), getting massages regularly, splashing cold water on my face in the morning, and stimulating my gag reflex by using a tongue depressor a couple times a day!
Tips for Healing from SIBO (A Summary Based on My Personal Experience)
***Just because these tips are working for me to resolve SIBO does not necessarily mean they will work for you; everyone’s SIBO is unique, as there are many different root causes that must be investigated in order to eradicate SIBO for good. This information is meant to provide you with a variety of ideas of things to try on your healing journey.***
- Consume properly fermented foods.
- Perform breathing exercises (I like this app).
- Work on achieving proper body alignment (Good resources here and here).
- Meditate regularly (I meditate using Headspace).
- Make time for prayer and devotion (I use the app version of the Magnificat).
- Eat while sitting down and without distraction (no cell phone, no TV, no books, etc.).
- Lie down and relax your psoas muscles after eating and any time you feel like resting.
- Space your meals at least four hours apart (no grazing).
- Stimulate your vagus nerve (ideas include: slow deep breathing, yoga, meditation, prayer, singing, laughing, massage, cold water exposure, gag reflex).
- Wear clothing that does not constrict your core (or restrict your body’s ability to move in general).
- Don’t suck in your gut! Relax your core.
- Become aware of where you hold stress and tension in your body. I find using Yoga Tune Up balls helpful for achieving this awareness and also for releasing that tension.
- Dig deep and address the mind-body connection. This book helped me a lot!
More Interesting Information
The following are some articles I’ve found very helpful as I’ve researched treating SIBO:
SIBO Has Transformed Me and I’m Grateful for It
While dealing with SIBO has been one of the most frustrating experiences of my life, I realized that some of my personality traits, like perfectionism, probably made me a bit more susceptible to having SIBO. Therefore, I’ve had to change some things about myself (for the better!) in order to heal. In this way SIBO has transformed me and has been a blessing. I’m learning little by little how to let go of perfectionism and, very importantly, how to manage stress. I’m understanding that a lot more than just diet contributes to being healthy. I’m letting the fact that it’s not possible to have perfect health sink in, and it’s quite freeing. I hope sharing my personal experience will help others who are also struggling, and if it does, that will be one of the most rewarding aspects of having experienced SIBO!