Today I'm going to answer a few frequently asked questions about SIBO so stay tuned. If you're new
here, welcome. My name's Amanda Malachesky. I'm a certified functional nutrition health
coach and digestive and allergy detective and I help people with IBS and SIBO symptoms find
their personalized plan for calm digestion. For weekly videos on how to find your personalized
diet and supplement plan for SIBO or IBS, please consider subscribing and make sure to hit the
bell to be notified when I post a new video. There are so many important questions about SIBO
and I want to make sure that you are equipped with the best answers to these very common questions so
that you can find your best course of action to help you get your SIBO or IBS symptoms resolved.
So this week I decided I wanted to speak to all of these common questions in one single sort of FAQ
video, so that you had all of these answers in one common place. So that you can rely on it as
a resource as you work through healing your gut. Now, if I didn't answer your question here by the
end of the video, please make sure to leave me a comment down below the video with your questions
so that I can make sure to answer them in a future video. With that said, let's get started. Okay.
So the number one question that I want to answer of course is what is SIBO and what isn't SIBO?
SIBO stands for small intestinal bacterial overgrowth, and as its name implies, it means
that there's an overgrowth of unwanted bacteria in your small intestine where there really shouldn't
be a whole lot of bacteria to begin with. New research tells us that the bacteria that are
primarily responsible for SIBO are klebsiella bacteria and E. coli bacteria in the case of
hydrogen SIBO and something called archaea, which are kind of ancient bacteria like organisms in
methane SIBO. The specific organisms that cause hydrogen sulfide SIBO are as yet undetermined.
These different types of bacteria either produce hydrogen gas, methane gas or hydrogen sulfide gas.
Now what isn't SIBO? Sometimes I see a little bit of confusion from people asking questions
about this. SIBO is not candida. It's not a parasite and it's also not in the
large intestine. The microbiome in the large intestine is entirely different than that in
the small intestine. Dr. Pimentel's research definitively showed this. So even though you
may test positive for something like klebsiella bacteria on a stool test, this does not mean
that you have SIBO. So just make sure that you're clear that SIBO means that you have
an overgrowth of bacteria in your small intestine. Question number two is what causes SIBO? Normally
when you fast in between meals or overnight, your nervous system initiates what are called
these natural cleaning waves in your small intestine. These help move things along and
clear out anything that shouldn't be there, including bacteria. When the normal cleaning
waves in your small intestine don't work properly, you then can develop an overgrowth of bacteria and
this is what leads to SIBO. Most often the thing that gets in the way of these natural cleaning
waves is a previous case of food poisoning. The toxins from the food poisoning bacteria damages
the nerves of the small intestine and prevents those natural cleaning waves from happening.
Or those food poisoning bacteria can lead to antibodies to those nerve cells and damage
them that way. You can also impact your natural cleaning waves by snacking too much in between
meals or not having a long enough overnight fast. Other potential causes include structural issues
from your gut caused by either previous injuries or surgeries, things like C-sections, tummy tucks,
or even just other kinds of abdominal surgeries. Question number three is how can you tell if you
have SIBO? The most common symptoms that people with SIBO experience are things like bloating,
abdominal pain, stomach cramps, constipation or diarrhea, or both constipation and diarrhea.
Then some non digestive signs and symptoms of SIBO include things like reflux and heartburn,
brain fog and fatigue. So if you have these signs and symptoms and other causes have been ruled out,
or you really clearly remember having a case of food poisoning, or you have a history of
injuries or surgeries, you can run a SIBO test. In many cases you can order test kits directly
from labs, even if you're just an ordinary citizen. I did make an earlier video about
how to do this. Or you can use something called the FoodMarble device to do home
testing for yourself. In general, I prefer the Trio Smart SIBO test because it tests for all
three SIBO gases in one test and I feel like this is the best information you can get. If
you want to find out more about how to access SIBO testing, you can check out my earlier video called
how to access SIBO testing without a doctor. Question number four is what is the treatment
for SIBO? Well, conventional treatment is to use a specialized antibiotic that's been designed
specifically to address just the small intestine and SIBO, and it's called Rifaximin. Its trade
name is called Xifaxin and that's primarily for hydrogen SIBO. If you also have methane SIBO,
Rifaximin is combined with either metronidazole or neomycin. If you have hydrogen sulfide SIBO, the
Rifaximin is paired with bismuth. Usually these courses of antibiotics are for 14 or 21 days, or
you can also use herbs and those include allicin, which is a garlic extract. Neem, berberine,
and oregano oil and some combination of these herbs is used usually for 30 days as one course.
You can also use something called an elemental diet, which is a complete meal replacement that is
a diet free of all residue that is fermentable. So this basically starves out the bacteria and this
is usually done for 14 to 21 days straight. Sometimes you can also use additional tools
like atrantil to help with bloating. Then after treatment, you use something called a prokinetic,
which is a drug that helps improve or enhance those natural cleaning waves. Some of the
medications available for this are things like prucalopride or low dose erythromycin
or the supplements motil pro or iberogast. This is obviously a super brief overview of
treatment, but I do have some other videos about this and you can also check out Dr.
Allison Siebecker's website, SIBOinfo.com to get specifics about these SIBO protocols.
All right. Question number five is what should you eat if you have SIBO? Now this is a super huge
topic so I'm going to be as brief as possible, but try and give as complete of an answer as I
can here. So bear with me. Certainly if you want to know more about this topic,
let me know down in the comments and I can make a much broader and bigger video about this topic.
The simple answer is that there's no single answer to this question that will suit everyone's needs.
Here's how I think about it. You should eat a diet that minimizes your symptoms to the best
of your abilities. This means taking the time to understand exactly what your specific food
triggers are. In most cases, these food triggers are things like FODMAP foods,
high histamine foods, sometimes they're high oxalate foods. I've seen other
causes as well. It really just depends on you. Now it will certainly take some experimentation
to figure this out specifically for yourself. This is why I devote a lot of time and effort and
space to this inside of my calm digestion method program, because this is something that a lot of
you are really struggling with. But know that there is a way to triangulate on the specifics
and figure out what exactly is triggering your symptoms, even if this is something that you've
really struggled to figure out before. It can be done with the right strategy and process
that helps you tease out the details here. Question number six is should you eat a "normal
diet" during your SIBO treatment or should you stick with the diet that you're already on? I
know that this is common advice. I hear from people all the time. I heard I'm supposed to
eat a normal diet. What I was eating before I had SIBO to draw the bacteria out so that I can
treat them appropriately and then I'm going to go back to a SIBO diet after treatment. I
do not agree with this advice at all. The logic is that if you feed the bacteria,
the treatment will better be able to address the bacteria. But for most of you, you're probably
already eating a narrower than normal diet and you already are at the point where if you eat off
of that plan, you're flaring your symptoms. If you eat foods that you know are going to
trigger your symptoms, this is just going to trigger a flare and make you feel even
ickier while you're already maybe feeling a little uncomfortable from your treatment.
Encouraging more symptoms is just going to make you more miserable and make you less likely to
complete the treatment. I just don't believe that making big changes with your diet at the
same time that you're also doing treatment is the right idea. I'm a huge advocate for
only changing one thing at a time so that you can get a clear picture of exactly what
the impact of that thing that you're doing is. So this means that I suggest sticking with the
diet that you know minimizes your food symptoms during treatment. Then after you finish treatment
and maybe confirmed that you're SIBO free, then you can worry about reintroducing some
foods that you missed to see if your tolerances have changed as a result of your SIBO treatment.
Question number seven is, should you use probiotics while you're doing SIBO treatment?
Again, this is a really common question and again, the answer is basically it depends.
The short answer is that you should use them if you find that they improve your symptoms. If you
find that they make things worse and they flare you, then you shouldn't. If you're not yet sure
whether they help you or flare you, then you can carefully trial them to see how you do on them.
Dr. Pimentel, who's the primary SIBO researcher in the US, does not recommend using probiotics
for his SIBO patients because he often finds that they flare them. On the other hand, Dr. Ruscio,
who's a well known gut expert does use them for most of his patients or at least trials all of his
patients on them and he's seen some pretty good results. So what accounts for the difference?
Basically everyone's different and we have to be willing to experiment carefully and evaluate for
ourselves whether or not something is true for us. Question number eight is, should you supplement
stomach acid if you have SIBO?So the previous advice was yes, you should use stomach acid
because the idea was that the bacteria that were infecting the small intestine were likely
coming in through the mouth. This is one of the roles that stomach acid plays for us is
that it protects us from incoming infections via the mouth. However, Dr. Pimentel, again,
did some research that found that his patients who were using stomach acid support often felt
worse and that his patients who were using proton pump inhibitors, which are
acid lowering medications, actually generally felt better than those who were not using them.
So the thinking now is that acid supplementation actually helps feed the hydrogen bacteria and you
should probably avoid using acid supplementation while you have SIBO. Once you've cleared your
SIBO and you're SIBO negative, that might be a good time to introduce hydrochloric acid and see
if it improves your digestion and if you feel better. If not, ignore it. If so, keep going.
So there's some answers to some frequently asked SIBO questions for you. But if there's a question
that I didn't answer that you really would like to know the answer to please leave them down below
in the comments so that I can answer them in a future FAQ video. I really hope that this video
helped distill down and provide some really key information about SIBO all in one place. These
are exactly the kinds of questions I support my clients with every single day inside the calm
digestion method program. Everyone going through this journey has a lot of questions like this
and they often need a trusted expert to help them make the right choices, make the right decisions
and figure out where to go and what to do. So if you've been feeling confused or in the
dark about how to address your suspected or confirmed case of SIBO, I want to encourage
you to download my free guide called The Roadmap To Gut Recovery. It's a free guide that shares
the exact strategy that I share with my program clients that helps them find their personalized
plan for calm digestion, regardless of what kinds of IBS or SIBO symptoms they're starting with.
You can download a free copy of that by going to confluencenutrition.com/roadmap
and I have that link here on the screen and I'll also leave it below this video for you
in the description. Let me know if you liked this kind of video and if it would be helpful
for me to do more by clicking like or leaving me a comment or again, another SIBO question.
Next you might want to check out my video about how to access SIBO testing without a doctor if
you think you have SIBO and you need help with that. So that said, I'll see you all next time.