In today's video I'm going to share a simple, five-step plan to navigating a SIBO diagnosis,
so stay tuned. If you're returning, 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. For weekly videos on how to find your personal diet and supplement plan for IBS and SIBO
please consider subscribing and be sure to hit the bell to be notified when I post a new video.
Today, I want to talk about the five basic steps to address SIBO infection because, frankly,
I see an awful lot of misinformation and also confusion from people who are navigating this
situation. I certainly know that it can feel really overwhelming when you suddenly have
found that you have this new condition or you think you might have it and your doctor doesn't
really know anything about it and you're not sure what to do. And as a SIBO and IBS gut health coach
who has also resolved her own personal case of IBS and SIBO and also helped many, many other clients
do so, I'm kind of an expert at how to navigate this space between, "Oh my gosh, I think I have
this thing," and, "What do I do about it?" So let me break this SIBO thing down for you
and hopefully make it a little less scary and just clarify the basic pathway through
to treatment and resolution. Let's go. First things first. What exactly is SIBO? Well,
SIBO stands for small intestinal bacterial overgrowth and we now know, thanks to Dr.
Pimentel, that SIBO is caused either by E. coli bacteria, Klebsiella bacteria, or
ancient pseudo-bacteria called Archaea which are methane producing. And this bacterial overgrowth
can cause abdominal symptoms like pain, bloating, diarrhea or constipation and even in some cases
reflux and heartburn. It can also cause some non-digestive symptoms like brain fog, joint pain,
and also some histamine type symptoms like itching and rashing and flushing and things like that.
To find out if you have SIBO you'll either run a lactulose or glucose-based breath test
and these tests are typically either done in the doctor's office or more commonly
using a test kit that's sent to your home and you complete the test at home after completing
the prep diet. I did make a whole video demoing how to use a SIBO test kit and I will leave a
link for that video right here. And I'll also leave a link for it below this video so you can
check it out when you're done here. Most test kits just test for either hydrogen or methane gas but
there's also a newer test called the trio-smart which also tests for a third type of gas, that
can also cause SIBO, which is hydrogen sulfide gas. Test results usually come back in about a
week and if your gas levels are above the cutoff levels, which is 10 parts per million for methane,
20 parts per million for hydrogen, or five parts per million for hydrogen sulfide gas, then you
have SIBO. So that's just the basic overview of SIBO and how to determine if you have it.
Okay, once you know that you have SIBO, now what? Well, a lot of people want to jump right to the
treatment part of the process, which I can totally understand, because you have a treatable condition
and you want to fix it but I'm going to give you a piece of advice which is going to save you a
little bit of heartache and trouble and actually enhance the effectiveness of your treatment.
The second thing you should do is work carefully over a few weeks to find out which foods are
likely triggering your symptoms and see if you can reduce the severity of those symptoms
before you move on to doing any treatment. A lot of SIBO symptoms are actually triggered
by particular foods and having clarity about what those are helps you reduce your symptoms,
and this helps your treatment work better. If you skip this step and don't figure out which
foods are triggering your symptoms, and you're still eating those foods, it's just throwing fuel
on an already inflamed fire and it's just going to make it that much harder to overcome things.
There's a lot of debate about what the right diet is for SIBO treatment but I can tell you clearly,
after working with hundreds of clients, that there is no one right diet for SIBO. What
there is is a diet that's right for you that minimizes your symptoms. That said,
the most common place that I direct people to start looking is either with the low FODMAP diet
or the low histamine diet. These are the two most common food mediators that I see for my clients.
And the way to decide which one is right for you to start with
is to make a list of the foods that you know, for sure, already aggravate your symptoms. It
might be a short list, it might be a long list, but write down those foods and then compare that
list of foods to the foods you should be avoiding in the histamine diet or the low
FODMAP diet and make a choice. Or you can just work on reducing the foods that you already know
cause problems. There's a lot of pieces to this diet puzzle and I honestly could talk for hours
about all the various things that are necessary to get the most traction out of this but to move your
treatment along you want to just focus on trying to minimize your symptoms as best you can and
move on. Don't dwell here overly long, or take a year to get through this part, and do keep in mind
that diet is not meant to cure SIBO. Again, it's really just intended to reduce the severity of
your symptoms while you're working on addressing and resolving the root causes of your problem.
I'm curious to hear from you, down in the comments, what foods you
have noticed really aggravate your symptoms, so you can leave a comment below this video.
Okay, now that you've got some clarity about your food triggers,
now it's time to think about treatment. There are basically three main SIBO treatment options,
herbal antibiotics, antibiotic drugs, or the elemental diet.
Herbal products usually include two separate herbal agents for 30 days. Antibiotics either
include rifaximin alone or rifaximin with neomycin, or metronidazole, for 14 to 21 days
and these antibiotics are drugs that do need to be prescribed by your doctor or naturopath. And
then the elemental diet is a treatment option used to treat very stubborn cases of SIBO by drinking a
medical-grade meal replacement shake for 14 to 21 days. This can be something like Dr. Dr. Ruscio's
Elemental Heal products. The elemental diet option is kind of an option of last resort
because it can be kind of challenging to just drink liquid meals for several weeks at a time.
Now, there are a lot of other potential add-on supplements that you may have heard about
during your research and some of these can be very useful but they really may or may not be
right for you. So these include things like digestive enzymes, probiotics, biofilm busters,
fiber supplements, or stomach acid support. These extras do require a little bit extra care and I
think personally some guidance from practitioners because there are a lot situations where they're
contraindicated and there's nuance to when they should or shouldn't be used. And it's important
that you have some idea of how to determine whether or not they're necessary for you. So
I highly recommend getting some help from someone before using any of these additional supplements
or at least doing some good research to understand when and where they're appropriate or not.
Okay, step number four is to retest and do reintroductions. After treatment, it's a really
good idea to retest your SIBO status. A lot of practitioners even somehow skip this step, and
I feel like it's really important. SIBO can take multiple rounds of treatment to resolve for some
people and retesting allows you to get a sense of whether the symptom changes that you're seeing
after treatment correlate with the gas levels that are actually happening in your gut. This also
helps you understand how effective the treatment you chose was for you or not. Did it work or
didn't it? And then, if you're feeling better, this is also an optimal time to carefully try
some food reintroductions of the foods that you had removed to see if your tolerance to them has
changed. A lot of people will find that when they successfully treat SIBO those food intolerances
or sensitivities that they had developed have resolved and improved. That was certainly the case
for me, as I can eat a lot of foods that I could not eat for many years while I was sick with SIBO.
Step number five on your SIBO journey is to prevent recurrence. Once your symptoms and
tests are where you'd like them to be you're going to work to reduce the likelihood of recurrence
because, with SIBO, recurrence is actually pretty common in the next six to 12 months
after treatment. So any practice or treatment that helps you poop regularly is going to
help prevent a recurrence of SIBO. So lifestyle options here include things like daily exercise,
good hydration, and keeping your stress levels under control.
Treatment wise, there are medications or supplements that can help and these are called
prokinetics. Essentially they are medications or supplements that help keep the speed of
things moving through your gut at a good clip so that bacterial overgrowth can't happen again.
Supplements that can help with this include MotilPro by Pure Encapsulations, or Iberogast,
also magnesium citrate or high dose vitamin C. Medications you can ask your doctor about
include Motegrity, also called prucalopride, or Linzess or low dose erythromycin. Getting
visceral manipulation or specialized belly massage from people like Clear Passage can also really
help prevent SIBO recurrence by addressing any adhesions may be affecting your gut motility.
These are likely to be the case for you if you have a history of abdominal surgeries or
car accidents or injuries from some other source. So, to recap, SIBO is a bacterial overgrowth in
your small intestine and it's diagnosed by breath test. You want to find a diet that minimizes your
symptoms, choose treatment, retest and do food reintroductions afterwards and take action to
prevent recurrence with prokinetic medications, supplements, or behaviors after treatment.
Now, if you have felt alone with your new SIBO diagnosis or you think you have SIBO or
you are feeling kind of overwhelmed with all the options, or you're not sure what to do about it,
I really want to encourage you to download my free guide called The Roadmap to Gut Recovery.
Inside this guide, I share the exact strategy that I teach my clients
inside my program to help them find their personalized plan for calm digestion.
You can grab your free copy of that roadmap by heading over to confluencenutrition.com/roadmap.
Here it is on the screen and I will also leave a link for that down below this video.
All right, take a deep breath and know that your SIBO is manageable and resolvable and I'm here
to help you along the way. If you like this video, please click like, and please consider subscribing
if you haven't already and maybe send this video on to somebody else who you think may need it.
Here's a couple more videos that can help you. And I look forward to seeing you next time.