What Is SIBO?
SIBO stands for small intestinal bacterial overgrowth. It is, “is a chronic bacterial infection of the small intestine. The infection is of bacteria that normally live in the gastrointestinal tract but have abnormally overgrown in a location not meant for so many bacteria.” - source
In layman’s terms, SIBO is when a lot of bad bacteria grows in your small intestines. The bad bacteria consumes the foods that we eat. This prevents the body from absorbing the nutrients it needs from foods.
This causes problems like nutrient deficiency, IBS symptoms and even food sensitivities.
Signs and Symptoms
When I was began seeing my functional medicine doctor she suspected that I had SIBO.
I have bad IBS symptoms and the bloating was - and still is - unbearable.
When I wake up in the morning (that made me want to break out in the K$sha song) I am a little bloated. On a scale of 1-10 I would say I’m somewhere around a 3 or 4.
By the time I go to bed in the evening I am a 10+. My clothes don’t fit and I feel like I’m six months pregnant. While I can be a dramatic person, I assure you I am not exaggerating about this.
I experience this every. single. day. - no matter what I eat or don’t eat.
How I Developed SIBO
I’ve asked myself over and over, “how did I get SIBO?”
The short answer? I’m not sure.
It could be from the chronic stress of overtraining.
Or it could be from the antibiotics I took every day from my early teens through my 20’s for acne.
Or it could be all the above.
Or something else.
I think all has contributed to my having SIBO.
Treatment for SIBO
This was just one of the many things my functional medicine doctor treated me for. From September 2013 to March 2015 I was on herbal supplements. I completely changed how I ate, believing that food can be medicine.
By March 2015 I was feeling wonderful. I had lost about nine pounds of bloat and it was pretty much gone! I could fit in my clothes again! And I no longer had IBS symptoms. Life was grand!
In my research I learned that SIBO recurrence was common and by late May I relapsed. It came back like a vengeance. Unfortunately by then, my functional medicine doctor closed her practice and moved on.
I had invested thousands of dollars in working with her. I was hesitant to start over with someone new.
Then I came across The Ancestral RD’s podcast. They talk a lot about the things I was experiencing - gut issues, Adrenal Fatigue and SIBO (to name just a few). I loved what they talked about. When I read that they worked for Chris Kresser I scheduled a consultation with Kelsey Marksteiner.
At about the same time I was starting the I Quit Sugar 8-week program. The program recommends participants to get some basic before and after blood work done.
My blood work came back with abnormalities so my primary doctor referred me to a gastroenterologist. I decided to work with him and Kelsey to treat my symptoms.
One of the abnormalities of my blood work was abnormal liver results. I was showing early signs of cirrhosis. I had ultrasounds and an MRI (which by the way are super expensive even with insurance!) that confirmed this. I do not drink alcohol so this was concerning.
At first my GI doctor told me I had to clean up my diet and start exercising. I laughed because he had no idea of my background. But Kelsey told me that an abnormal liver panel was common in people with SIBO. She urged me to ask my doctor to test me for it. I did and he obliged.
Getting Tested For SIBO
My GI doctor ordered a lactulose breathing test which is one way to test for SIBO.
You cannot take any probiotics (at the time I was taking Align, I now take VSL #3) for two weeks before the test. So by the time my test date rolled around I was so bloated and it was painful.
You have to fast for 12 hours before the test. So you want to have it done first thing in the morning, otherwise you'll be famished by the end of it. I was dumb and did not do this.
The practitioner administering the test gave me a cup of lactulose to drink. It’s kind of a syrupy drink that gave me an upset stomach. This is what it was supposed to do because it has to activate all the bad bacteria in my gut.
Then I breathed into a tube. That tube was then placed on a machine that reads the levels of hydrogen and methane in my breath.
The first reading was my baseline. Thereafter they took another breath reading every 20 minutes for three hours. The results were sent to another doctor for analysis. Being the Type A person that I am, I recorded my readings in my own notebook. Then I consulted Dr. Google about my results. Dr. Google told me that I had SIBO.
So when I got the call that I had tested positive for it I was not surprised.
At first my doctor prescribed Flagyl. It's an antibiotic also called metronidazole. I recognized the name because it is what my vet prescribes for my dog when she has GI issues.. Through my own research I knew that Rifixamin was the antibiotic that had the best results for treating SIBO so I asked him to prescribe that instead. He was hesitant because most insurance companies do not cover it. But I assured him that mine would and it did.
I took Rifixamin for 10 days and near the end of the treatment I started to feel better, less bloated. But shortly after the 10 days I was back to being bloated and having IBS symptoms again.
The doc had me wait 2-3 weeks before taking anything else. After two weeks I didn’t feel better and asked for another test.
The results of the second test were worse than the first. So then he prescribed Flagyl. I took it and it did not help at all.
Kelsey sent me several studies showing that Rifixamin taken with Neomycene was the most effective treatment for SIBO. I sent those same studies to my GI doctor and he eventually ordered a prescription of both for me.
And that my friends is where I’m at right now.
I’m not feeling any better and the prescriptions run out this weekend. I am hopeful that it may take a while to take effect.
If it doesn’t work I’m not sure what I’ll do next. I might try herbal antimicrobials. Those have proven to be effective but it improvements don't appear as quickly as antibiotics. But since antibiotics haven't worked so far, I really wouldn't have anything to lose.
Living with SIBO is no fun. Besides having IBS symptoms and living in a constant state of bloat I am very limited in what I can eat.
In My Next Post…
In my next post I’ll discuss about how and what I’m eating while having SIBO. And I'll talk about why and how it doesn’t fall into any set “diet” plan.
I'll also talk about how this has affected my social life and how I've navigated through the holidays.
According to the practitioner who administered my tests, SIBO tests are being conducted more and more often every day.
Have you experienced any of these symptoms? If you have, I'd love to hear from you!
HI I'M NAOMI!
I’m a Certified Holistic Health Coach who helps people who suffer from fatigue and digestive distress learn how to eat real food and adopt clean living practices for better health energy, and endurance. Why feel tired when you can feel fired up and ready to go every single day?
I love running outdoors, connecting with like-minded people, and exploring the San Francisco Bay Area with my pup, Coco Pop.