xifaxan/SIBO

[lcar28]

Just completed my first whole30 and it was a total bust, so my doc is prescribing what will be my third round of this drug, and I'm going to start another whole30 with low fodmaps. Anyone have experience with something similar?

[Carlaccini]

I have no experience with the drug - but if you want to learn more about SIBO / low FODMAP etc - look up Chris Kresser.  He's had some excellent podcasts with regards  to SIBO a little bit ago.  He talks about treatment as well.

[SugarcubeOD]

Just completed my first whole30 and it was a total bust, so my doc is prescribing what will be my third round of this drug, and I'm going to start another whole30 with low fodmaps. Anyone have experience with something similar?

Sorry, can you give a few more details on 'it was a total bust'?  

 

I'm not familiar with the particular affliction but eating whole foods in proper quantities (leaving out things that exacerbate your particular medical condition of course) is never going to be a bust... 

 

Maybe if you could list what you were eating (quantities, timing) we could try and help you?  If you want help that is...

[lcar28]

Sensing a kind of hostile tone, not for the first time, and I will say part of the bust has been I haven't really found the forums as welcoming as I was expecting. That said, it was a fellow poster who suggested fodmps, and for that I am grateful. What I mean is, as stated in my other posts where I've also painstakingly detailed my template-following eating, the first whole30 didn't alleviate my hypoglycemia, cravings and fatigue and actually worsened some of my already-unpleasant GI symptoms.

[SugarcubeOD]

Sensing a kind of hostile tone, not for the first time, and I will say part of the bust has been I haven't really found the forums as welcoming as I was expecting. That said, it was a fellow poster who suggested fodmps, and for that I am grateful. What I mean is, as stated in my other posts where I've also painstakingly detailed my template-following eating, the first whole30 didn't alleviate my hypoglycemia, cravings and fatigue and actually worsened some of my already-unpleasant GI symptoms

Hi Lcar - 

 

There was nothing hostile about the response.  I was simply asking if you wanted to detail your food to see if we could help and I wasn't aware that you had already done that on a different thread. 

 

I will say that unfortunately, some conditions take longer than 30 days to see relief with, which can be frustrating.  Hopefully your low fodmap Whole30 helps you.

[Brewer5]

I went back through every topic you've posted, and I must say that you have received some excellent, detailed advice.  People here have spent quite a bit of time trying to help you with a situation that is actually quite complex.  

 

I have no idea what "hostile tone" you are referring to.  Possibly consider that since you are not feeling well, and you are frustrated and stressed -- you could be reading a tone that is not really there.  It happens.  

 

So, to recap:  You are a breastfeeding mother of a 10-month-old, working a full-time job, working out 5-6 days per week, dealing with PCOS and SIBO, trying to do a Whole 30 -- and saying you are not particularly stressed.  Each one of these things is stressful in its own way, and it all adds up.  I say, it is really hard to see the impact of the stress when it is your norm -- but that makes it no less stressful on your body.

 

To answer your question:  A low-FODMAP approach would probably do you a world of good.  

 

I also think you need more FAT.  Which I know others have already told you, but I don't know if you've really taken it to heart.

 

I also highly recommend Dr. Perlmutter's book:  Brain Maker.  It is all about our gut microbiome and the gut/brain connection.

[lcar28]

Point taken. I'm really not that stressed, I promise. I guess I didn't take kindly to the "if you want help" part, but ellipses can be easily misinterpreted, so I apologize for reading into it. Of course I want help, and I'm feeling at a loss. I try to eat as much as you can, but with my stomach issues, on a budget and especially with the low fodmap approach, it's a real struggle. Thanks all for the input.

[Growing123]

With sibo try to remember certain foods are going to feed the bacteria and therefore help them grow. This is why in conjunction with the strong meds the low fodmap helps because it works to starve the pests. I suspect your hypoglycemic reactions are also do to potentially creating a feeding frenzy with certain foods and also a kill off too. All of which makes the healing process a challenge and can be quite a struggle.

It may be while trying to kill off the sibo and heal your gut that whole30 will be too difficult to follow and taking a break might give your body what it needs to kill off these bugs. Something to think about?

If you are dealing with the hypoglycemia with the pcos do you use a blood glucose monitor to track your body's reaction to foods? With both the sibo and pcos has your physician tested your vitamin levels for d and b? Both get impacted with sibo and pcos which makes testing helpful as deficiencies with these tend to be common. Even while eating the whole 30-- especially with the damage caused by sibo it can be tough to get the absorption rates up as the body heals.

Hang in there! I've been there and it is awfully frustrating but you can get through it. I followed a sibo fodmap plan outlined by my naturopath and gastro doc which helped to alleviate the sibo issues and make it better for my insides. Give it time and be gentle on yourself because so much is going inside while your dealing with the sibo bugs combined with the endocrine issues of pcos.

[tiva]

I have SIBO too, and I've found the following to be very helpful:

a. Kill the bacteria, with antibiotics and a low FODMAP diet (many people also need to stick to a low starch diet, so potatoes are out. Pumpkin is a good substitute. For a while there, all I could eat was chicken broth with poached chicken or fish, pureed carrots, more carrots, a little squash, and the occasional green bean. Now I'm back to a much wider range of choices)

 

B. After you've dealt with the bacteria, you then need to address the root causes, which are typically one or more of the following:

1. reduced motility: treat this with ginger, ginseng, Iberogast, or prescription antibiotics (neomycin in very low doses). Yoga poses help too.

2. reduced gall bladder function and bile salts: treat with digestive enzymes, Swedish bitters, or Iberogast, or lots of beet kvass, carrots, ginger, lemon, artichokes

3. hypochloridia (ie, low stomach acid): treat with HCl

 

C. Then you need to heal the gut: bone broth, turmeric, fish oils, and eventually returning FODMAPs back to your diet, since they do contain a lot of nutrients that help liver, gall bladder, and gut function. 

 

It's best to work on all this with a functional medicine specialist, not on your own, if you can find one. 

 

Good luck! I also take a combination of ginger, ginseng, and sichuan pepper to calm the bloating--there's lots of research supporting this particular combination  (look for daikenchuto in pubmed--that's the Japanese term for the combination, and that's  how it's known in the medical research community). THe combo it helps me quite a bit.

 

Without digestive enzymes, I could never eat all the veggies that are part of Whole30. If your SIBO is really bugging you and you can't digest fats (which often happens), then digestive enzymes with ox bile can help. And you can also take coconut oil instead of other fats, since that's digested in the stomach instead of the small intestine, giving your small intestine a break.

 

There's a very active facebook group for SIBO, where you can find a lot of support and feedback 

[lcar28]

Thank you last 2 posters. This is a lot to ponder. Unfortunately the GI specialist I had been seeing retired, so part of the problem for me has been to find a medical professional who is helpful, knowledgeable and supportive. I appreciate everyone's input and will take it to heart.

[tiva]

Lcar, there are a fair number of SIBO specialists who will do online coaching. They can't write prescriptions without seeing you once (in most states), but that shouldn't be a concern for you since you already have your rx for the antibiotics.

 

Dr Alison Siebecker is one of the world's great SIBO specialists, and she does Skype consultations for a very, very reasonable rate. She books out months in advance, but she often has cancellations. Her website, siboinfo, has a lot of solid, scientifically verified, information as well.

[lcar28]

Thanks tiva! I'll check that out as well.