Beating SIBO – A Patient Follow Up

Small Intestinal Bacterial Overgrowth, aka SIBO, is a common cause of digestive symptoms; gas, bloating, constipation/diarrhea, reflux and abdominal pain. It is also a common cause of IBS. This case reviews how you can become symptom free after treating SIBO. Also, and possibly more important, is that we do not always need to reach a “true negative” on the breath test to be symptom free and feeling great. 

If you need help with diagnosis or treatment of SIBO, click here

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Beating SIBO – A Patient Follow Up

Dr. Michael Ruscio: Hey, everyone. I am here with Christine, who has had some really good results with treating SIBO, and I asked her if she would take a moment to chit-chat with us, so, Christine, thank you for your willingness to do that.

The concept that I think was most noteworthy about your case was your SIBO levels have improved quite a bit from our initial testing, but you’re still not in the normal range, but we’ve seen… we got you down, down, down, down, down, and you kind of plateaued at this positive level, so you’re still positive, but that seems to be as low as we can get the values after trying numerous different treatments and numerous rounds of treatments. But you’re doing great!

Christine: Mm-hmm!

DR: Reinforcing this concept of, at least what I’m thinking, anyway, is not everyone may need to be in the normal range for SIBO in order to feel really good. So can you share a little bit about what you’ve noticed in your experience through the whole process?

C: Well, I noticed, you know, the dramatic change was really quick for me when I started treating SIBO, because I went from being almost bedridden at times to being absolutely fine within a month. I felt absolutely fine throughout the treatment. And that’s pretty dramatic to me, that it can happen so quickly.

DR: You improved very quickly. Not everyone is so lucky. You very quickly (got better).

Now, you also have lost quite a bit of weight, haven’t you? About 40 pounds over that time?

C: Yes.

DR: You’ve been able to tolerate FODMAP foods without much of a fuss.

C: Mm-hmm.

DR: I think your diet, in general, is quite a bit more broad than what it was before, correct?

C: Oh, yeah. I’m definitely going back up again as far as being able to reintroduce foods. I’m looking forward now to going back and introducing all the VIP foods that I’ve been off of now.

DR: You recently noticed that some starches really didn’t go well with you, so that’s one thing you noticed didn’t (make you feel very good).

C: Yeah, I don’t think starches are going to work for me! I’m pretty sure of that. Pretty bad reaction to starches.

DR: So you can do FODMAPs, but you can’t do starches.

C: Right.

DR: What are some of the most notable symptoms that I noticed improve as we got this kind of under wraps?

C: One of the things that was really affecting my life the most was my chemical sensitivity was being very severe, to the point where I couldn’t go to Hobby Lobby, I couldn’t be in large crowds of people, I couldn’t be around air freshener at someone’s house, so I was very limited. I couldn’t do a lot of social things that I could before.

DR: Right.

C: Because I would immediately get sick from chemicals, and that was gone after three weeks of treatment. That was absolutely gone, and that was really thrilling to me because I was suffering with that for years.

DR: Yeah, I can see that being very annoying.

C: Yeah. And I had just constant headaches. I mean, I always had a headache. It wasn’t a matter of did I have a headache; it was just how severe was the headache that day. And so many days, the headache was so severe I couldn’t leave the house. That was probably my worst symptom, was the neurological pain in my eyes and head that was very severe.

DR: And how were your digestive symptoms? Were they pretty bad before (your treatment)?

C: Yeah, they were pretty severe. I mean, I had a lot of bloating. That was the worst part of it. I mean, it would go from… in the morning I’d be fine, and by nighttime I felt like I was pregnant. I would be so swollen from the bloating, and that was really the worst part. Constipation was my whole problem my whole life, very constipated.

DR: So just the far-reaching impact of the gut, like we were talking about earlier.

C: Mm-hmm.

DR: So you responded really well to the initial treatment, and we did notice with you that you would fairly quickly kind of relapse.

C: Right.

DR: And so we’ve done some things and we’re doing some things that prevent the relapses. And again, the concept that I really want for people to take away is if our goal, if we’re defining success as getting your labs to normal, you would be failing right now.

C: Right.

DR: But I’m not necessarily defining success like that. I’m defining success as are we seeing, yes, objective lab improvements, but maybe more importantly, are we seeing the clinical picture, the person, the patient, feeling better, and I think overall you’re… I don’t think you really have much in the way of symptoms left, right?

C: No, I really feel very normal. Actually I feel better now than I did as a teenager. I honestly do.

DR: Ooo, that’s nice!

C: I have, like, never felt this good. I really feel this has been affecting my whole life, so to me it’s like a whole new life for me because I can really do things I wasn’t doing before ever!

DR: Right. That’s the whole point.

C: Yeah.

DR: And, yes, your labs are a little bit positive, but they’re better than before and you’re feeling great, so we’ll just monitor and keep doing what we’re doing, and I think we’ve got a good strategy here. So for people watching, maybe that’s something for people to take away because, again, if we had framed this differently, you may not be as happy. You may be feeling, “Oh, I have this chronic thing that I can’t get rid of.”

C: Right.

DR: I don’t necessarily think we have to do that. So in any case, thank you so much for sharing. Anything you want to leave people with before we close?

C: Well, I just think, don’t wait. If you feel that you have SIBO symptoms, don’t wait to get tested and treated because, my goodness… I mean it’s so dramatic and so amazing, what can happen with treatment if you have SIBO.

DR: As you were saying that, it reminded me that you had done a good program, but it was kind of like one of those online, do-it-yourself gut-repair programs.

C: Right.

DR: And that worked for you, but you weren’t able to maintain the results.

C: Exactly. I couldn’t stop the relapse myself. I didn’t know what to do to stop the relapse.

DR: Right. And so that’s where… if those sorts of do-it-yourself approaches don’t work, maybe it’s a good idea to bring in someone to help you with this, and once we’ve figured out what’s going on underneath the surface, we could prevent relapses and maybe have a plan going forward.

C: Yeah, the best move I made was starting up with you and really getting someone who knows how to stop the SIBO relapse from going on, and I’m so happy I did because I wouldn’t be here doing the things I’m doing now if it weren’t for that.

DR: And you were an easy one, so I was happy!

C: That’s good! I’m glad I was easy! That’s good!

DR: I mean, you made me work for it a little bit, but we got there, right?

C: Yes, very.

DR: Cool. Well, again, thank you so much. And for people listening, hopefully this helps you guys. OK, thanks.

C: Thanks.

What do you think? I would like to hear your thoughts or experience with this.

If you need help with diagnosis or treatment of SIBO, click here

Discussion

I care about answering your questions and sharing my knowledge with you. Leave a comment or connect with me on social media asking any health question you may have and I just might incorporate it into our next listener questions podcast episode just for you!

32 thoughts on “Beating SIBO – A Patient Follow Up

  1. Cool interview & i am happy for her 🙂 can u share clinical details of the case like labs & treatment s on a timeline? Thx

  2. Cool interview & i am happy for her 🙂 can u share clinical details of the case like labs & treatment s on a timeline? Thx

  3. I am also very curious what treatments are being used to deal with regulating the MMC, which seems to be at the heart of the relapse issues for many.

  4. I am also very curious what treatments are being used to deal with regulating the MMC, which seems to be at the heart of the relapse issues for many.

    1. As a GI research nurse..I’m curious why there isn’t more in detail info here..and just why more GI guys don’t get this simple tx…instead..they continue to shove Prevacid or the others for the continuous s/s of GERD that have nothing to do on most cases,with too much stomach acid…when the whole issue appears to be from lack of enough digestive enzymes AND/ OR the back up of methane like gases which is due to bloating in our intestinal track (Candida die off or addition) and inability to digest foods quickly due to motility issues.

      My next question is this…how do we fix slow motility. .l drugs for this were quickly yanked off the market years ago…so I’m assuming motility will improve once the colon is less bloated, …and able to pass these foods quicker due to more room and less edema in colon…….yes???

      Is it necessary to see a GI specialist or are more family practice Dr.s comfortable writing for this RX? What labs must be monitored while doing this please…..Once again….. it appears I need to educate my “Partner in Health “… WE NEED MORE FUNCTIONAL DR’S HERE IN IOWA!!!! Or more CME requirements on GI Health it appears! I begin to wonder niw why they aren’t pulling all the PPI’s etc off the shelf..I think the whole GI issues surrounds LACK OF DIGESTION ENZYMES. .not the over production of acid..that’s almost unheard of since Candida is one of the worst offenders of SIBO symptoms. Thanks for a speedy reply to my email…this nurse is tired of out guessing the practioner!! What’s the best bowel/liver cleanse to try. .or should I wait until after taking this antibiotic? Thank you for an expidited reply. .I’m miserable..and thanks to this article. .loaded with plenty of ammuniting to fire back. .thanks!

      1. Hi Mary,
        You ask great questions! Questions that are unfortunately beyond what I can answer here. Some of them have already been answered in other podcasts/articles/videos on my site. If you are after the clinical deep dive on this stuff I will be teaching one or two GI intensive workshops this year. If you are on my newsletter you will be notified of when/where. Hope this helps 🙂

    2. Yes..we are highly interested. .we want our health back..and without multiple Dr visits or added specialists who will make ss worse before they’re better!! They need to ban all the OTC AND RX antacid meds..they’re being recognized as kidney AND bone density killers yet they continue to prescribe them to unknowing and gullible patient’s who recieve bandaid only treatment from these meds!

  5. Thanks for posting this patient update!!! What is the connection between SIBO and chemical sensitivities? Why does clearing up SIBO clear up the chemical sensitivities?

    1. Glad it was helpful. I think its because of the gut-immune system connection. The highest concentration of immune cells, in your entire body, is in your small intestine. Remember, chemical sensitivities are, in part, immune mediated.

  6. Hi Dr. Ruscio,

    I just got diagnosed with SIBO. No methane producers, “just” the hydrogen bugs. I was given a tincture with goldenseal, myrrh and thyme to be taken 3x/day and Berberine 500mg 3x/day. I was told to eat normally the first week and then go on a SCD (Specific Carb Diet) on week 2 and for 6 weeks.
    I did some research on Berberine and am concerned because it kills the intestinal flora and it’s also a blood thinner. I have low BP (100/50ish). I voiced my concern regarding Berberine killing the good bacteria and was told that in order to kill the bad guys, some good guys will have to die too. The other option is antibiotics and I refuse to do that. I find this protocol rather light compared to the big guns you pull out when treating SIBO – heard you speak about treatment on a couple of summits.
    What’s your take on Berberine? Is that going to be enough with the tincture?
    What do you think about RS (Resistant Starch) and SIBO? Is it a no-no? What about fermented foods?
    Thanks very much for your insights.

    1. Hey Frankie,
      Glad you got the diagnosis. It’s really hard for me make any recommendations because context is huge. That being said, I don’t have any concerns with Berberine regarding impacting the microbiota. I would avoid RS – but I will be introducing a concept called ‘prebiotic responders in SIBO’ in one of my upcoming podcastas on Dr. Ruscio Radio. Fermented foods should be fine. Hope this helps! If you get stuck contact my office, we see tele patients.

  7. Can you post the link to the podcast that talks about maintenance treatment? I had SIBO and was treated, but I relapsed. I’d like to beat it and keep it managed for good this time.

  8. Thanks for posting this patient update!!! What is the connection between SIBO and chemical sensitivities? Why does clearing up SIBO clear up the chemical sensitivities?

    1. Glad it was helpful. I think its because of the gut-immune system connection. The highest concentration of immune cells, in your entire body, is in your small intestine. Remember, chemical sensitivities are, in part, immune mediated.

  9. Hi Dr. Ruscio,

    I just got diagnosed with SIBO. No methane producers, “just” the hydrogen bugs. I was given a tincture with goldenseal, myrrh and thyme to be taken 3x/day and Berberine 500mg 3x/day. I was told to eat normally the first week and then go on a SCD (Specific Carb Diet) on week 2 and for 6 weeks.
    I did some research on Berberine and am concerned because it kills the intestinal flora and it’s also a blood thinner. I have low BP (100/50ish). I voiced my concern regarding Berberine killing the good bacteria and was told that in order to kill the bad guys, some good guys will have to die too. The other option is antibiotics and I refuse to do that. I find this protocol rather light compared to the big guns you pull out when treating SIBO – heard you speak about treatment on a couple of summits.
    What’s your take on Berberine? Is that going to be enough with the tincture?
    What do you think about RS (Resistant Starch) and SIBO? Is it a no-no? What about fermented foods?
    Thanks very much for your insights.

    1. Hey Frankie,
      Glad you got the diagnosis. It’s really hard for me make any recommendations because context is huge. That being said, I don’t have any concerns with Berberine regarding impacting the microbiota. I would avoid RS – but I will be introducing a concept called ‘prebiotic responders in SIBO’ in one of my upcoming podcastas on Dr. Ruscio Radio. Fermented foods should be fine. Hope this helps! If you get stuck contact my office, we see tele patients.

    1. Yes..we are highly interested. .we want our health back..and without multiple Dr visits or added specialists who will make ss worse before they’re better!! They need to ban all the OTC AND RX antacid meds..they’re being recognized as kidney AND bone density killers yet they continue to prescribe them to unknowing and gullible patient’s who recieve bandaid only treatment from these meds!

    2. As a GI research nurse..I’m curious why there isn’t more in detail info here..and just why more GI guys don’t get this simple tx…instead..they continue to shove Prevacid or the others for the continuous s/s of GERD that have nothing to do on most cases,with too much stomach acid…when the whole issue appears to be from lack of enough digestive enzymes AND/ OR the back up of methane like gases which is due to bloating in our intestinal track (Candida die off or addition) and inability to digest foods quickly due to motility issues.

      My next question is this…how do we fix slow motility. .l drugs for this were quickly yanked off the market years ago…so I’m assuming motility will improve once the colon is less bloated, …and able to pass these foods quicker due to more room and less edema in colon…….yes???

      Is it necessary to see a GI specialist or are more family practice Dr.s comfortable writing for this RX? What labs must be monitored while doing this please…..Once again….. it appears I need to educate my “Partner in Health “… WE NEED MORE FUNCTIONAL DR’S HERE IN IOWA!!!! Or more CME requirements on GI Health it appears! I begin to wonder niw why they aren’t pulling all the PPI’s etc off the shelf..I think the whole GI issues surrounds LACK OF DIGESTION ENZYMES. .not the over production of acid..that’s almost unheard of since Candida is one of the worst offenders of SIBO symptoms. Thanks for a speedy reply to my email…this nurse is tired of out guessing the practioner!! What’s the best bowel/liver cleanse to try. .or should I wait until after taking this antibiotic? Thank you for an expidited reply. .I’m miserable..and thanks to this article. .loaded with plenty of ammuniting to fire back. .thanks!

      1. Hi Mary,
        You ask great questions! Questions that are unfortunately beyond what I can answer here. Some of them have already been answered in other podcasts/articles/videos on my site. If you are after the clinical deep dive on this stuff I will be teaching one or two GI intensive workshops this year. If you are on my newsletter you will be notified of when/where. Hope this helps 🙂

  10. Can you post the link to the podcast that talks about maintenance treatment? I had SIBO and was treated, but I relapsed. I’d like to beat it and keep it managed for good this time.

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