In today's video, I'll be sharing a review and key takeaways of Dr. Pimentel and Dr.
Rezaie's new book, The Microbiome Connection: Your Guide to IBS SIBO,
and Low-Fermentation Eating. So let's get started. If you're a returning viewer, welcome back,
and if you're new here, welcome. My name's Amanda Malachesky, I'm a certified Functional
Nutrition Health Coach and a Digestive and Allergy Detective. And I'm also the host of the online
program, The Calm Digestion Method. For weekly videos on how to find your personalized diet and
supplement plan for IBS and SIBO, please consider subscribing and make sure to hit the bell to be
notified when I post a new video every week. Well, I was super excited to order and read
the book, The Microbiome Connection, when it came out in March of this year in 2022,
and so I thought this week I would do a review of the book so that you could assess whether or not
it would be a good thing for you to add to your personal library of books and also to give you a
quick summary of some of the key takeaways that I found most interesting and useful
for SIBO and IBS patients. So let's get started. First, let me share what this book is and isn't,
it fulfills two basic functions. Number one, it's a comprehensive summary of IBS,
how SIBO fits into IBS, and exactly what SIBO is and how it happens and how to treat it,
as well as the most up-to-date research that Dr. Pimentel and his team have been working on
at Cedars-Sinai over the last decade or so. The second main focus is to share the low-fermentation
diet, which Dr. Pimentel and his team use in his clinic to treat patients with IBS and SIBO.
So now that we've got a sense of exactly what the book is and isn't, now I'd like to talk
about some of the pros and cons of this book. One of the biggest positives right off the bat,
which is a huge plus for me, is the way that Dr. Pimentel and Dr. Rezaie
speak directly to the experience that IBS patients often have, which is that they
feel unseen by their doctors and that they feel discouraged by the search for a cure
and really bummed out about how difficult it's been for them to treat their condition.
As someone who really values client-centered work, and really thinking about who you're
talking to and who you're trying to help, I just find this really endearing and I love that.
Ultimately, the author's goal is to provide IBS and SIBO patients with some hope that there is
a better future in store for them, and I find this really heartwarming and personally lovely.
The next pro is that the book gives you a really clear and thorough discussion and understanding
of the causes of IBS and SIBO and how to treat them. And there are some new
gems inside of this discussion that I think you would find very interesting.
Now, if you've been listening to Dr. Pimentel and podcasts and interviews over the last couple
of years, there aren't likely to be too many new pearls in here, but I do find it's really
valuable to have all of it all in one place in written form so that's also really helpful.
A third pro is that the low-fermentation diet approach to eating for IBS and SIBO patients
actually does have some interesting new tidbits about how to approach diet for IBS and SIBO.
And to say that I was surprised by some of these details is saying something because
I have extensively studied a lot of different diets and dietary theories. So there you go.
And an even better pro is that the book contains a whole chapter dedicated to people who have been
struggling with their IBS and SIBO and aren't getting anywhere. So if you've already tried
first-line therapies and have failed those, there is a whole chapter dedicated to what you might be
able to do or how you might be able to approach your situation better to get better results.
I love this so much because I meet a lot of you who are really struggling with this piece of
the puzzle and you've already tried a lot of the basic things and you're still not getting anywhere
so I really appreciate this extra clinical guidance for people who are in those shoes.
Now let's talk about the cons. The way I see it, there are three main cons to this book.
Number one is that the low-fermentation diet advice is very general and you're likely to
have a lot more questions and need for support in the implementation of that diet than just
reading this book. In their defense, they're trying to bring the clearest principles to the
forefront in the book so that you are working on a diet that's not going to make you crazy.
But on the other hand, I still think people are going to need some support
actually putting this diet into practice. Con number two is that, likewise, the SIBO
treatment advice that doctors Pimentel and Rezaie give inside the book is also
really general and will probably require a doctor or other kind of health professional
to help you navigate. So if you're hoping that this book is going to give you a comprehensive,
everything-you-need-to-know protocol to apply to your SIBO situation, it's not going to do that,
it's more of an inventory of all of the available options and a discussion about when and where you
might use them, but you're still going to need a professional to help give you
guidance about when and where to use those things. And the third con is that some of the information
in this book may feel kind of jargony and technical to you. I've been learning about
this as well, how a lot of you don't necessarily respond well to super nerdy, technical language,
and so there is a little of that in this book and there's discussion about medications and different
kinds of medical diagnoses that may be involved in SIBO and IBS. So if you're not afraid of that,
don't worry about it. If that's hard for you, this book may not be for you
There you have it, a quick overview of the pros and cons of The Microbiome Connection: Your Guide
to IBS, SIBO, and Low-Fermentation Eating by Dr. Mark Pimentel and Dr. Ali Rezaie. I hope
I'm saying his name correctly. In case you want to grab a copy of the book, I'm going to leave a link
to Amazon to purchase that book down below this video so go ahead and grab that if that works for
you. And now I'm going to continue on talking about a few of the key takeaways of the book.
Okay. Now I want to discuss the top five takeaways from the book as far as I see them.
Number one takeaway is that SIBO is caused by a breakdown of these natural
cleaning waves that help move material and food and bacteria through your small intestine. And
when those cleaning waves break down and don't function properly, this is what allows the
bacterial overgrowth of SIBO to happen and this leads to IBS symptoms and SIBO symptoms. This is
also what allows fermentation to happen, which can lead to the bloating, distension, diarrhea,
or sometimes even constipation of IBS and SIBO. The second big takeaway is that a common and
significant cause of this breakdown of the cleaning waves is a case of food poisoning,
which can lead to antibodies that attack the nerves that control the cleaning waves. This
was a significant discovery that Dr. Pimentel and his team have discovered during their research,
which is that food poisoning can be an actual cause of what's known as post-infectious IBS.
The third big takeaway that I want to share is that the authors share a basic three-step protocol
and approach for dealing with SIBO and IBS. Number one, this is to identify the modifiable
causes of SIBO, such as inflammation, adhesions, obstructions, low enzymes, other GI diagnoses like
celiac disease or Crohn's disease, narcotic use, and diabetes was a really surprising one for me.
The second step is to treat SIBO itself with antibiotics or antimicrobial herbs.
And the third main step is to maintain control and prevent recurrence
by reducing fermentation and promoting the natural cleaning waves of the small intestine using diet,
medications, lifestyle factors, and so on. I really like this basic breakdown because
it really just simplifies all of the complex information, you just have to kind of focus
on those three steps and apply them to your situation to move through this in a good way.
The fourth key takeaway of the book is that there are really just two main rules
for eating a low-fermentation diet. Number one is to restrict foods that are high in carbohydrates
or undigestible materials, and this primarily falls into the category of fibers, certain FODMAPs
and things like sugar alcohols like xylitol because these are foods that are going to lead to
fermentation and therefore symptoms in your gut. And the second rule about low-fermentation eating
is to space your snacks or meals a minimum of four to five hours apart
because this gives those cleaning waves a chance to actually happen and do their job. You have to
be fasting for a minimum number of hours between your meals for those cleaning waves to happen.
This is a really important piece of information and I hope that you will all take note of this.
The fifth big takeaway that the authors mentioned was something that was a little
bit of a surprise to me, and this was to say that Dr. Pimentel really doesn't believe that
probiotics are useful for SIBO treatment. He had an extensive discussion of the research and what
it says about probiotics, and he claims that his review of the research hasn't really shown him
that there's any benefit to be had for IBS and SIBO other than minor symptomatic management.
Now, this contradicts a meta-analysis, which was a conglomeration of multiple probiotic studies,
which showed that people who had SIBO who used probiotics felt better in general. But
Dr. Pimentel's reasoning is that because the primary issue with SIBO is a motility issue,
it's this breakdown of the natural cleaning waves in the small intestine,
and that probiotics are unlikely to help with that action, that they really don't have a place
in SIBO treatment. And he typically takes his patients off of probiotics if they're already
on them and he generally doesn't recommend them. On the other hand, some of you may find that you
do feel better with probiotics. And so this is a case where I apply my usual thinking to this
situation, which is that there's a theory here and it sort of checks out, but for some of you,
probiotics still may be useful. So if you are wanting to give that a try and assess
how that works for you, there's nothing wrong with that, but you want to be responsive to
how your body's responding to those probiotics and avoid them if they're not helping.
So I hope this video gave you a great overview of Dr. Pimentel and Dr. Rezaie's book and gave
you an idea of whether or not the book would be useful to add to your personal library or not.
Now, if you're someone who's feeling lost and confused about how to proceed with your SIBO
treatment or your IBS treatment or your management of that using diet and lifestyle factors,
I do want to let you know that this is exactly what I help my clients with
inside my Calm Digestion Method program, and if that's something that you feel confident that you
need help with right now and you'd like to talk with me more about that, I'd love to invite you to
schedule a free discovery call with me to learn more about the program and how I can help you.
You can schedule that call by going to confluencenutrition.com/contact.
And I'll leave a link for that below this video in the description box.
And please, if you found this video helpful or you liked it, please click like or leave
a comment below this video, it really helps me out. And next, you might want
to watch this video about four strategies for IBS and SIBO. I'll see you next time.