Living well with SIBO, a case study follow up

Not every case of SIBO can achieve normal lab values. Does this mean you are doomed to suffer with symptoms endlessly? Absolutely not! While everyone is different, I really wanted to share a follow up with Bob who is one of my SIBO patients. Even though his values are still positive he has achieved noteworthy improvement; gaining weight and being able to eat ‘off plan’ foods with no reaction are two of the most notable.

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

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Living well with SIBO, a cast study follow up

Dr. Michael Ruscio: Hey, this is Dr. Ruscio. I am here again with Bob, who is one of the SIBO cases that we’ve been chronicling.

You’ve been doing great. I don’t know if you can see this in the camera, but I think you are looking a lot better than you did several months ago. He was just commenting to me that some of his friends were even saying, ‘You look a lot better than you did several months ago.’

Bob: Correct.

DR: It’s always nice to look good, right?

Bob: When you’re 75, just being able to be looked at is good.

(laughter)

DR: Right. But the other thing that I really wanted to share with people: your SIBO is still…you are still positive for SIBO…let me move this. Sorry. It will sounds like a…

Bob: Are you going to edit this out I hope?

DR: We can do it. We can do it. We might even leave it; it’s kind of fun. But, one of the things I really wanted to share about Bob’s case is his SIBO values are better than they were before, but he’s still positive for methane and for hydrogen.

But, even in spite of that, through cleaning up his diet through treating it in a holistic fashion, I guess I would say, you were able to go on vacation recently to Italy, right?

Bob: France and Italy.

DR: France and Italy? And you were able to go on vacation and eat food, have some bad food, have some wine, and be OK. Would you mind sharing a little bit about that for people?

Bob: I think to back up, I was plugging along and getting marginally better but still having difficulty completing meals and still had affects of burping and belching and so forth. But less and less. I was sort of living with but getting a little bit better.

I was apprehensive about a 50th wedding anniversary trip to Paris and London. My wife was probably more uptight about me being uptight. Off we went, and I decided, ‘The hell with it. If I’m going to go down, I’m going down eating.’ Which I enjoy. So, as the doctor said, I just sort of put my noise down and had my glass, maybe two glasses of wine, and ate what I wanted to eat, and I wasn’t any more symptomatic with or without it . So I said, “Well, that’s good.”

It sort of gave me confidence to keep plugging along. And then we tweaked the treatment when I got back. I also, I think it’s important: I’ve been on pain medication for years and years and years because of chronic low back problems. Every doc I’ve been to, including Dr. Ruscio, knows that opioids are bad for your system…

DR: For SIBO.

Bob: For SIBO, in particular. So, I’ve worked at reducing those – I have been able to cut probably about in half.

DR: Just recently?

Bob: Just recently. Whether that is coincidental to feeling better with my SIBO, or which came first, I can’t sit here and tell you. But the combination – taking less pain medication, my energy level is better, and my weight is up, and I’m sort of at where I want to be. I’ve sort of leveled off at this point, and I’m pretty much eating what I want. The only restriction I have right now…specific foods – peppers, spicy foods sometimes gets me. I can’t eat a lot at any one meal. So, all is pretty good, relative to where I was.

DR: Yeah. And again, it’s great that Bob has seen these improvements, even though his SIBO labs are still positive – they are better, but they are still positive. Part of the reason why – I am so glad you mentioned this – is because he is on opioid pain killers, which can prevent SIBO from fully going away. But, I thought this was a really nice moment to capture where I think, sometimes, you get neurotic about trying to make the lab values clear, but in some cases you can have a partial-positive finding and still function and be quite comfortable and not too bad. And Bob is living proof of that.

Anything else you want to share?

Bob: I think a lot of it is accepting what life gives you a little bit, work with it, and don’t let it get you down emotionally, because it can do it.

DR: Sure. Exactly.  And Bob is one of the funniest patients that we have here. Every time he leaves, the whole staff laughing behind him.

Bob: But I always pay.

(laughter)

DR: All right, folks. We will keep you updated. Thanks so much. Thanks, Bob.

Bob: OK.

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!

4 thoughts on “Living well with SIBO, a case study follow up

  1. Hi dr. Ruscio,

    I was at your talk yesterday where you went through bobs protocol, I did not get the chance to ask you was what made you choose to give bob whey protein when he was presenting with a dairy intolerance? Would a pea protein not have been a better choice?

    1. Hi Katriona. Glad you made it out. Whey has been better studied for treating weight loss in aging populations. Also, I have found most patients can tolerate whey – perhaps because more of the ‘dairy allergies’ are caused by casein? Of course, and as one of our principles we discussed in the seminar, should he have had a reaction we would then consider another protein source such as pea (principle being we should constantly be evaluating our patients response to treatment and adjusting where needed). Hope this helps!

  2. Hi dr. Ruscio,

    I was at your talk yesterday where you went through bobs protocol, I did not get the chance to ask you was what made you choose to give bob whey protein when he was presenting with a dairy intolerance? Would a pea protein not have been a better choice?

    1. Hi Katriona. Glad you made it out. Whey has been better studied for treating weight loss in aging populations. Also, I have found most patients can tolerate whey – perhaps because more of the ‘dairy allergies’ are caused by casein? Of course, and as one of our principles we discussed in the seminar, should he have had a reaction we would then consider another protein source such as pea (principle being we should constantly be evaluating our patients response to treatment and adjusting where needed). Hope this helps!

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