Until recently, there was NO way to know for certain if a person had IBS (Irritable Bowel Syndrome).
And even if your doctor ruled out other diagnoses and landed on IBS, you had no way to know WHAT caused the IBS.
It felt like IBS was a medical mystery!
That’s why I have been so excited to share the new ibs-smart test with the SIBO SOS® Community. The ibs-smart test is a simple blood test that can definitively diagnose diarrhea-dominant and mixed IBS.
Here’s how it works:
ibs-smart tests for two antibodies (anti-CdtB and anti-vinculin) known to be elevated in patients with IBS-D and IBS-M. These antibodies are known to be triggered by gastroenteritis (AKA food poisoning), which is a key insight to help IBS, because further infections can significantly worsen your symptoms. (I’ve written about it before in this blog post.)
Find out for sure if you have IBS – and if food poisoning is to blame – with the ibs-smart test!
And even MORE good new – now you can order the test kit with an online prescription and get answers right away!
Outside the United States? Go here to get the test: https://www.ibssmart.com/international
Questions? Learn more about the science behind ibs-smart in THIS blog post and by watching the interview below!
Today I’m excited to share with you an all-new FREE webinar with my friend, colleague and founder of Microbiome Labs, microbiologist Kiran Krishnan!
Kiran is a fan-favorite here at SIBO SOS® and he is back by popular demand to talk about a “controversial topic” – stool tests!
If you’ve been confused or overwhelmed by stool tests, you don’t want to miss this Q&A. We’ll cover:
What stool tests can and can’t diagnose (SIBO, parasites, gut imbalances and more)
The problem with many stool tests
A new approach to stool testing (available directly to patients)
This is the very first time Kiran has spoken publicly about Microbiome Labs’ new stool test- and for the first time, it’s available directly to the SIBO SOS® community!
Watch now:
You can view sample test results by clicking HERE.
Want to order your BiomeFX test?
Normally, you would need to order this test through a practitioner.
But Kiran has agreed to make the test available directly to the SIBO SOS® Community! That means you can order it yourself, and get the results delivered straight to you. (I do recommend working with a practitioner to help interpret the results.)
First, register as a patient with patient direct code “SIBOSOS” HERE: https://sibosos.com/microbiome-labs (This is the first step and it is essential to be able to order.)
Then, watch the below video to learn how to order and what to do once you place your order to successfully complete your test. (Having trouble? Please contact Microbiome Labs directly for help with ordering: https://microbiomelabs.com/contact/ or call 904-940-2208). (My customer service team cannot assist you with ordering!)
Since I was diagnosed with SIBO in 2015, I have been blessed to meet many talented practitioners to answer my questions, including Dr. Steven Sandberg-Lewis. I like to call him the teacher’s teacher. He has taught so many incredible practitioners and is a gifted clinician himself.
Dr. Sandberg-Lewis (or Dr. SSL as he is affectionately called by many of his patients and colleagues!) is an expert in functional gastroenterology – he quite literally wrote the book on this topic! This means that he looks at digestive issues like SIBO, acid reflux, and IBS as part of the whole body (not just isolated issues). He has been instrumental in my own healing and that of thousands of other people.
Last month, Dr. Sandberg-Lewis graciously agreed to take time out of his busy practice, Hive Mind Medicine, in Portland, OR to answer some of our community questions. The SIBO SOS® community has been blessed with his teachings in every single summit we have done! He always provides incredible insight and advice.
In this Q&A (and trasncripts as our gift to you) he covered:
adrenal and thyroid health
acid reflux causes and solutions
prostate inflammation
heavy metal poisoning
breath test interpretation
and much more!
There is so much information packed into this Q&A – don’t miss it!
Over the past few months, I’ve sat down with several digestion experts and asked them questions I had myself and questions submitted by YOU! I’ve rounded them all up here for you to watch.
But that’s not all… I’ve also included all the SIBO SOS™ exclusive discounts we have!
Enjoy the Q&A with each digestion expert!
Want to try products you learned about in this Q&A?
Microbiome Labs: use patient direct code “sibosos” when you register and code “digestionsos” for 15% off your first purchase
Some links included in this post are affiliate links. When you purchase using an affiliate link, SIBO SOS® earns a small commission (at no additional cost to you). This helps support our work. Thank you!
IBS & SIBO SOS™ Summit Vlog
Today I want to share something I’m really excited about with you: our very first IBS and SIBO SOS® video blog (AKA a vlog!)
This is an excerpt from Dr. Ken Brown, MD’s presentation for the next IBS & SIBO SOS® Summit in 2020! Dr. Brown is the creator of Atrantil, the supplement that has helped so many people deal with constipation and bloating.
It’s been 4 years since I was diagnosed with Small Intestine Bacterial Overgrowth.
Back then, I was bloated, confused, and overwhelmed.
I felt like SIBO had taken over my life… and I just wanted to get the answers I needed to get better so I could get my life back…
It wasn’t easy, but I sought out all the experts. I examined every angle – and I tried everything (yes, including the elemental diet!)
Today, I want to share 3 things I wish I had known when I was first diagnosed with SIBO.
If I had only known then what I know now…
I can’t, but you can!
#1 SIBO Is Chronic – But It’s OK
When I was first diagnosed, I thought having SIBO was like getting the flu. I thought it was going to suck for a few days, I’d take the right medicine, get some rest, get better, and move on with my life.
Nope… not exactly.
I learned SIBO is actually a chronic condition for most people. Why? Because SIBO is the result of another underlying cause (in that way, it’s more like a symptom of your underlying cause).
Some people have underlying causes for their SIBO that can be treated and resolved. But most of us have underlying causes that will be with us forever:
Post-infectious IBS (aka autoimmune IBS caused by food poisoning)
Lyme disease or other underlying infections like Epstein-Barr
Ehlers-Danlos Syndrome
MCAS (Mast Cell Activation Syndrome) or other histamine issues
Structural problems or past abdominal surgeries that have altered the gut (anyone out there missing their ileocecal valve?!?)
And many more!
When I first learned this, I was devastated. I just wanted to get rid of SIBO and move on with my life.
But after some reflection, it actually brought me a lot of peace and relief.
I learned that every time I had a setback or a day with bad symptoms, it wasn’t a personal failing on my part. It was just part of the condition.
Started to thinking of it the way I’d think about an old foot injury I had. Years later, sometimes that foot pain STILL flares up. I can’t do certain things or it will hurt.
But I also know what to do if my foot DOES start hurting again. I’ve been through it before. Knowing it will get better in a couple of days if I rest it.
When I realized it was the same thing with SIBO… it was like fireworks going off in my brain.
I wish they told EVERYONE this when they got diagnosed. It would have saved me so much frustration and disappointment.
#2 You’re Not Alone – There are MILLIONS Of Us
I used to have a lot of shame and embarrassment around my digestive problems and I didn’t want to talk about them – even with my husband or my closest girlfriends.
I was even embarrassed of the name Small Intestine Bacterial Overgrowth. So not sexy! Bacteria – yuck.
But the deeper I got into researching this condition (and IBS, too) the more I realized – there is nothing to be ashamed about.
Our culture teaches us that:
Bathroom stuff is private (don’t talk about it!)
Sickness is something to be ashamed about (so fake that smile!)
Once I got rid of my own shame and was open about my health, I found out pretty much everybody has some sort of digestive issue.
It’s just part of life – and the more open we are about it, the less people have to suffer.
Once I got comfortable with talking about my own problems, walls came down, I connected more deeply with the people around me, and I found an amazing community online of people going through the same thing as me.
I think I have been able to get healthier (physically and mentally) because I’ve worked through the shame and embarrassment and found a community of other people in the same situation.
We are all #SIBOSuperheroes!
#3 Nothing Lasts Forever (Including a Negative Breath Test)
I worked really hard to treat SIBO when I was first diagnosed, and I was ecstatic when I re-tested and finally had a negative breath test result!
But – as we know – SIBO has a bad habit of coming back. Because I have post-infectious IBS and adhesions, I’m even more prone to relapses. I was recently treated for a relapse of SIBO.
What causes SIBO to relapse? It really depends on your underlying cause. Because one of my underlying causes is post-infectious IBS, I have to use a prokinetic to prevent relapses. If I loosen up on my prokinetic use, I’ll have a SIBO flare.
But it’s not just that SIBO can come back – what works (and doesn’t work) can also change over time.
For example – lots of people get immediate relief from switching to a low-FODMAP diet. But over time, it usually stops working as well. And (for most people), long-term low-FODMAP diets wind up doing more harm than good.
Your body can develop tolerances to herbs used long-term and prokinetics, too. What worked the first time might not work the 2nd time.
Every time I’ve re-treated my SIBO, it has been a little different than the past times – that’s why continuing education is so important for SIBO patients.
The IBS & SIBO Journey
The day I was diagnosed with SIBO was a happy day. I was so relieved to finally know “what was wrong.”
Days and weeks after, though, were so frustrating. I felt confused, hopeless, and overwhelmed.
I don’t want anyone else to have to feel that way!
Today…
Instead of confused, Iunderstand exactly what’s going on in my body
Rather than hopeless, I have a plan to treat my SIBO (and prevent relapses)
Instead of overwhelmed, I feel empowered
Now, I know what to do to get better.
Learn With Me
Newly diagnosed with SIBO or IBS (or even just suspect that’s what you’re dealing with)? I’ve been where you are – and I made it to the other side.
I want to guide you to the other side too – it is my calling in life to help other people with SIBO get relief.
To be honest – I wish I had named this the “SIBO Solutions Series” – because that’s what the 10 SIBO experts teaching are doing: sharing solutions for relief from SIBO.
There are someone to cover every topic I have found to be vital to healing from SIBO – parasites, hormones, root causes, probiotics, candida, the brain-gut connection, and more. It’s not just “theory” – it’s real information you can put to use right now.
It took me 4+ years to learn all of this – but you’re getting it all in just 10 months. (That’s the benefit of having someone who has been through it all as your guide.)
There Is Hope For IBS & SIBO
I’ve been where you are right now – and I want to help you get the answers you need to get relief, and GET YOUR LIFE BACK FROM SIBO!!
Won’t you join us? This is your chance to join before the next event.
P.S. Sick of SIBO being the focus of your life?? Read this inspiring note we got from Beverly:
“First, thanks for being SIBO rock stars and bringing us this info. I hesitated to sign up because I am so tired of SIBO and other conditions being the focus of my life. But when you came out with the payment plan (and didn’t charge extra for this option –thank you) I really couldn’t resist. Just watched the lecture on parasites, and wow, I made the right choice.” – Sally
Dr. Sandberg-Lewis really explained to me HOW exactly the gut can impact our hormones (and it was information I’d never heard before). If you want to get access to the Workshop, go here.
Hormones are much more than estrogen and testosterone – there are about 50 different hormones in the body, and each has a really important function. They control everything from mood to weight – and they can cause SIBO and other gut issues to get worse (or develop). But having SIBO or other gut issues can also lead to hormone imbalances. It’s a “chicken and the egg” scenario.
Hormone imbalance and gut issues – which came first? It’s a chicken and the egg scenario!
Here’s what’s clear: whether you’re a man or a woman, and no matter your age, you NEED to be thinking about your hormone health. And especially if you have SIBO, IBS, or ANY gut issues.
(And especially if you’ve had your gallbladder removed or have had gallbladder issues in the past.)
Ahead of the Workshop with Dr. Sandberg-Lewis, I wanted to share a few interview snippets from past discussions I’ve had with experts about hormones.
My goal is to get you thinking and open your idea to new perspectives about hormones and SIBO.
Shivan Sarna: “You do treat a lot of people with SIBO, and also, with fertility issues. Tell us how you have observed a relationship between those two if you would.”
Dr. Stefani Hayes: “I think the relationship came about over several years of practice, especially with a lot of my patients who had unexplained infertility, or fertility struggles from PCOS or endometriosis. A lot of them didn’t have GI issues, but some of them did.
Because a lot of my colleagues are experts in SIBO, we started trying SIBO tests on a lot of my patients, and surprisingly, many of them came up highly positive usually with a methane-type SIBO overgrowth, which was really surprising for us.
And a lot of them didn’t have the constipation pattern that a lot of methane-type SIBO does. But they often had had constipation as young adults or young kids, but had learned over the years how to manage it. And sometimes literally never really struggled with much GI stuff beside some occasional bloating.
But when we addressed the SIBO, it seemed to make a significant effect on pelvic bowl health and their women’s health.
The connection between SIBO & Fertility.
Some got pregnant on their own, naturally, and were able to hold their pregnancies and have sweet, little kiddos.
Others tolerated IVF a lot better, and were able to start ovulating on their own with PCOS, if they hadn’t before, or were able to, with endometriosis, there’s often times—endometriosis is really tricky, and so patients who had had multiple surgeries, and then it re-grew, I definitely saw sometimes after we balanced out the SIBO that the endometriosis would re-grow slower, or not at all.
We would just get a little bit longer window between those surgeries, so that those patients could have more options for trying to get pregnant.”
Shivan Sarna: “Why do you think that is?”
Dr. Stefani Hayes: “Because the small intestine does really overlay, not just the uterus, but over the top of the ovaries, and when I think about methane-type bacteria, it’s a pretty noxious gas.
And if I think about what that might be like, I imagine it would seep into the surrounding region. And for me, I like to have visuals of things that seems to me like a fog or a smog, if you will, that’s in that whole pelvic bowl.
And so again, it’s coming back to that smog—if the neighborhood is not very happy, the some other neighboring structures can really get affected too, in my perspective.”
Cortisol & SIBO – Dr. Mona Morstein, ND
Dr. Mona Morstein: “Cortisol is kind of like Goldie Locks with the bears. Cortisol needs the middle chair and the middle bowl of oatmeal.
If there’s not enough cortisol there is development of gut inflammation. And that’s a problem because from gut inflammation we can lose our protective mucus lining, we can start changing our microbiome, we can start breaking away the IGG immunity there and start reacting to what would necessarily shouldn’t react to and so forth.
But if you have too much cortisol for over time it’s also inflammatory to the lining of the intestine as well.
There are so many ways to work with people along that level of cortisol. Whether it’s getting counseling, addressing their sleep, their stress and relaxation – do they do journaling or gratitude, do they exercise, are they creative? Do they take time, you know to relax, do they get into nature?
Broad-based look at ways that people are feeling bad. We can also of course use homeopathy. I do that quite a lot with people.
Of course supplements such as nutrients that support adrenal hormone functioning, there are botanicals that support and help balance what we call adapter genes. If the cortisol is low it can raise it up, if it’s high it can lower it down.
And of course diet, right? What you eat and drink can be very supportive to adrenal healing or very problematic to adrenal healing.
We can also get into methyltetrahydrofolic law because the adrenal gland needs a lot of mentholated enzyme reactions to have it function well, so it’s a broad-based look at both, since we do know that there is inflammation with SIBO.
Whatever else may be happening in their life, if we’re trying to heal that intestinal lining, heal the lining, heal the leaky gut, heal the nerves having a proinflammatory state is going to work against us in that regard through the cortisol.”
SIBO, Your Hormones, & Weight – Dr. Steven Sandberg-Lewis, ND
Dr. Steven Sandberg-Lewis: “Another really important thing is the “thyro-adrenal,” which is something I made up. Both the thyroid gland and the adrenal glands are so important in normalizing blood sugar, maintaining bone mass, helping with mood and energy and blood sugar, very, very important, and blood pressure as well.
Those glands are so important for the maintenance of normal function. And so often, in standard medicine, the only time you really look at the adrenals is when there’s 90% of their function gone. That’s called Addison’s disease. It’s very rare. It’s an autoimmune disease.
Or when a person has Cushing’s disease, which is when their stress hormone, cortisol levels are so high that everything goes haywire, and we can actually die from it. Very serious condition, which is a little more common than Addison’s.
But in naturopathic medicine and other forms of natural medicine, we like to look at the adrenals before they’re 90% gone because many people have a lot of dysfunction there, and you can’t really—in my book, you can’t really separate thyroid from adrenal. They work so closely together.
So that’s my suggestion is balance your adrenal and thyroid function, so that your blood sugar can normalize, so that you can lose the weight around your waist because that’s one of the better ways that we have of measuring abdominal fat or that apple fat.
The waist circumference for women, over 35-inches is too much. For men, over 40-inches is too much.
And so it’s easy enough to say, “Oh, lose that waist circumference. Bring it down. Just get to it.”
Well, that can be almost impossible. If your insulin levels are very high, and your DHEA levels are very low, and your cortisol is very high, that’s the worst group of hormonal levels that can lead to a waistline that just gets bigger and bigger.
You could lose weight all over your body. Your face might look amazing, but you can’t lose the weight around your waist. And that’s the weight that’s controlling the whole blood sugar issue, which causes GERD and causes SIBO and other digestive problems.
So the thyro-adrenal, if you would, gland is really important there. It’s just my way of letting my student doctors and my patients know that—it’s my way of thinking. It’s a little superficial to be treating somebody’s thyroid and ignoring their adrenal or vice versa. You have to look at both.”
SIBO & Hormone Balance
This blog isn’t meant to be comprehensive – there are plenty more ways SIBO and IBS interact with the hormones that I didn’t get a chance to cover in this post.
The Workshop includes a 1-hour class on the link between the gut (and specifically the gallbladder) and your hormones. Then there will be 2 hours of live Q&A with Dr. Steven Sandberg-Lewis. We’re also adding new community discussion before and after the class to help you take your learning even deeper. (You don’t have to attend live, either – we always offer the full recording and transcript. You can even pre-submit your question.)
You can also access this Workshop with the SIBO SOS™ Speaker Series. When you join the Speaker Series, you get access to 10 brand new Workshops and 7 exclusive bonuses for one low price. It’s like buying SIBO knowledge in bulk to save money! You can access the Speaker Series here.
P.S. In the past, we’ve done expert Masterclasses – but starting now, Masterclasses are going to be Workshops. Why workshops? We want to highlight how interactive and action-oriented these events are. It’s not just listening or reading – it’s like being in a classroom with other people! We’ve added some new features to the Workshops, too – learn more here.
P.P.S. Our Workshops are taking what you already love and making them EVEN better, more hands-on, and more useful. I can’t wait. If the Workshop sounds like what you need, please join in here.
Don’t give up! Here are the wise words that gave me hope in my own journey to heal SIBO.
Have you ever felt 100% hopeless about your gut health?
Especially when you’ve seen multiple doctors and specialists…
Tried this diet and that…
Tested positive, then negative, then positive again…
I get it! At one point I felt a real sense of hopelessness around my own SIBO and IBS.
What changed?
First, I took responsibility for my own health. I stopped looking for a doctor to fix me and started trying to figure out how i could heal myself.
Second – I immersed myself in as much information as I could! Everything I learned was like a little nugget of hope. Some things I applied right away (and had BIG results). Other things I filed away for later on.
I don’t feel hopeless anymore – I feel empowered.
I want that for you too. So today, I’m sharing some of my favorite nuggets of hope with you!
I hope these inspire you to keep learning and never, ever give up!
Dr. Mona Morstein, ND: People Get Better
Dr. Mona Morstein: “There’s been a lotta people very poorly treated with SIBO. It’s not necessarily that SIBO is this totally impossible disease to treat. It just means it’s one of, by far, the more complicated ones, which is why, you need to do it in a very step-by-step fashion, addressing all of the components that need to heal in the gut; but when it’s done that way. I know, people get better! For sure! Absolutely! The majority get better.”
Riley Wimminger, MScN: It’s A Marathon
Riley Wimminger: “I think my biggest thing that I always tell people is that it’s a marathon, it’s not a sprint. And to have this concept in your mind that you’re just going to take an antibiotic, and then you’re going to take a prokinetic, and everything is going to be healed, maybe – maybe, you’ll have great results happen. But that’s just not what I’ve seen in most people.
So, don’t feel discouraged when that stuff doesn’t work for you. Just take it at the pace you can and start uncovering what else is going on and be patient with your body. And there will be ups and downs. But ultimately, I really see that, a lot of people, they have this upward trend. It maybe looks like this, but it goes up eventually as long as you stick with it and be patient with yourself.”
Dr. Stefani Hayes, ND: Look At The Bigger Picture
Dr. Stefani Hayes: “We think about SIBO as a chronic illness, like diabetes or something like that, that it has to be managed for potentially a lifetime. There’s every once in a while sometimes the miracle cure, one treatment and they’re better forever. But most individuals, it’s a lifetime’s worth of management, whatever that means, if it’s a modified diet or every few years, getting a re-treatment or just being conscious of the decisions and choices they make, know about some area of weakness for them, and could potentially be an area of weakness for their children.
And so just watching that and working on long-term management, I think, is where we often go.
And I think then it’s a little more empowering rather than disempowering because if the self-expectations and the negative self-talk that can come in when—cheats on the diet, it’s about finding that sweet spot where you live your life, and you enjoy your life, and you don’t struggle with the symptoms whether they be the typical IBS-type symptoms or if they show up differently like my patients have with pelvic pain or menstrual irregularities or fertility struggles.”
Dr. Michael Ruscio, DC: Reframe How You Think About Chronic Conditions
Dr. Michael Ruscio: “And we were talking specifically about how IBS is a chronic condition that has a propensity towards relapse – which is true. But what the public will go to with that understanding is “Oh, my God! This is a chronic condition. I’m never going to be able to get rid of them my entire life.” That’s not really the case.
What more so is the reality is that you can go from having IBS and from having SIBO and feeling awful—being bloated, having constipation or diarrhea and some of these associated symptoms that go along with that like insomnia or fatigue or brain fog – and then you can start feeling way better. You may have occasional times when you flare a little bit. But the example I used with Dr. Siebecker when we were talking on the phone the other day was if you had a bad knee injury in college, every once in a while, your knee may start to ache, you’ve got to do some stretches, you’ve got to do some exercises. It’s not a huge deal.
The same thing with your gut. You may have a flare every once in a while. Not a huge deal! We’re all human. There’s therapies we can use to quell that flare. It doesn’t mean anything is wrong or broken or you’re in a dire situation.”
Trudy Scott, CN: Be An Archaeologist
Trudy Scott: “There’s no magic solution. There’s no “You’ve got SIBO. This is the protocol that you need to do.” You need to try this. And if it works, great. If it doesn’t, you try this. Or you try various different permutations.
I mentioned my diet is not exactly the same as someone else’s diet who has SIBO. You may need to try LDN. It may not work for you. You may try tryptophan, and it may work for you. People will often have this fear of starting something or having to be almost a human guinea pig.
I remember you talking about being like an archaeologist, digging and trying to find solutions.”
Don’t Give Up!
Dr. Allison Siebecker, ND told me that it usually takes about four years for her patients to really figure out how to manage SIBO and IBS, so that they’re not having their lives run by their SIBO.
Learning that was a relief in some ways and a real bummer in other ways. Of course, SIBO and IBS are really obnoxious conditions. We want to get better right away! But once I developed a “long-term” perspective, it gave me peace.
It is so helpful to say, “Yes, this is a chronic condition. This is something that I need to manage.” Once I tried that on as a concept, it made me less anxious because I realized that it was just a new way of being. It wasn’t my preferred way of being, but it was a new way of being that if I at least embraced it, and took the pressure off.
That’s why my company is actually called Chronic Condition Rescue because we are dealing with these chronic conditions (and you really do need to be rescued, or you need to rescue yourself).
The Way Forward For SIBO & IBS
I’ve been where you are right now – and I made it to the other side. Sure – SIBO and IBS are conditions I’ll live with forever, but I’m not hopeless. I’m empowered.
I want to guide you to the other side too – it is my calling in life to help other people with SIBO & IBS get relief.
To be honest – I wish I had named this the “SIBO Solutions Series” – because that’s what the 10 SIBO experts teaching are doing: sharing solutions for relief from SIBO.
We have someone to cover every topic I have found to be vital to healing from SIBO – parasites, hormones, root causes, probiotics, candida, the brain-gut connection, and more. It’s not just “theory” – it’s real information you can put to use right now.
Every month we have a new expert speaker who teaches the Masterclass and then answers YOUR questions at a live Q&A.
Because SIBO and IBS are chronic conditions, you need continuos information.
It took me 4+ years to learn all of this – but you’re getting it all in just 10 months. (That’s the benefit of having someone who has been through it all as your guide.)
We’ve already had 3 of the speakers present (if you join the series now, you can immediately access those so you can watch whenever you want) and 7 more to come. Not to mention TONS of bonus classes, Q&As and other resources.
(Plus we are adding more bonuses all the time – it’s our way of telling you we appreciate you!)
This is your last chance to join the Speaker Series at this price and with the easy payment plan.
I’ve been where you are right now – and I want to help you get the answers you need to get relief, and GET YOUR LIFE BACK FROM SIBO!!
Won’t you join us? This is LAST CHANCE to join with the payment plan.
It starts innocently enough: you decide to try an elimination or other specific diet for Small Intestine Bacterial Overgrowth like:
Low-FODMAP
Low-Fermentation
SIBO Specific SCD
GAPS or AIP
At first, taking certain foods out of your diet really helps!
But then there is a fork in the road for almost everyone:
You either get better and are able to reintroduce foods…
Or, your symptoms don’t resolve, and you continue eliminating more and more foods.
It can get to a point where you’re only eating a handful of “safe” foods – and you’re feeling worse and worse every day. You’re scared to eat more foods – but also scared to continue on the path you’re on.
What do you do then?
In this post, I’m talking about the good – and the bad – of using elimination diets for SIBO with Dr. Michael Ruscio, DC.
Dr. Ruscio is often my “voice of reason.” He has a very straightforward, commonsense approach to treating SIBO and IBS – even the very tough cases.
I hope this information is helpful to you!
How Elimination Diets Can Be Useful
Dr. Ruscio uses elimination diets like Low-FODMAP as part of his treatment for patients. He also is an expert of the Elemental Diet, which is probably the most restrictive diet of them all!
Here’s how he describes his treatment approach:
“I start with diet and lifestyle. Step #2 would essentially be things like probiotics and enzymes. They’re inexpensive. They’re generally helpful. You don’t need lab testing to apply those.
And then, Step #3 would be considering some kind of antimicrobial therapy—antifungal, antibacterial, anti-biofilm, antiprotozoal.
And then, one of the final things within the realm of the microbial step, we’ll be potentially considering the Elemental Diet as a different method of antimicrobial. It does more than just antimicrobial, but that’s kind of where I classify it.
And after that, we broaden the diet and try to support the gut with things like fiber and some probiotics—if they’re tolerated.”
The Importance of Reintroduction
Dr. Ruscio views restricted diets as a temporary intervention, not a long-term approach to staying healthy:
“We don’t want to have anyone on a restrictive diet longer than they have to be. This is a general principle. We should be working to use these diets to gain awareness, figure out what foods work, and what foods don’t work, and then, ultimately, be trying to broaden to the widest diet possible. That’s very important.
And for some people, the main thing that’s making them feel sick is the fact that they haven’t tried to push to a broader diet, and they keep going more narrow, more narrow, more narrow. And they haven’t pushed back outwards. Sometimes, that simple change of just trying to loosen up your grip or your rules on the diet can actually be very healing and helpful for people.”
Don’t Let Fear Be Your Motivator
Dr. Ruscio says that those who are MOST successful with elimination or restricted diets are those who approach it with a mindset of curiosity rather than fear.
“We want to motivate patients to buy books or undergo programs or watch documentaries—which is good on the one hand. But we don’t want to “fear factor” them into being compliant or motivated to get them there. I think [fear is] a short-term motivator. I don’t think people are motivated in the long-term.
And that’s why when people say to me, “But we need these labs to motivate patients,” my experience has been if someone is not motivated, and you tell them, “If you eat this food, you’re going to cause all these inflammation for months on end, blah-blah-blah,” they’ll follow that advice for a little while. But very quickly, they’re going to go back to what they feel to be how they want to live their life.
And so, what I would rather do, rather than extrinsically motivating someone with fear, is coach them through, “Okay, let’s tighten up your diet for a little while to see how good you feel. And then, because you’re going to probably want to do this anyway, let’s have you re-introduce… and you’ll probably notice a lot of these foods are okay. Even a lot of these foods the Internet says are bad are okay. But there’s a couple, ‘Ugh, I really didn’t feel well when I eat those.’
And then, they’re going to be intrinsically motivated to avoid those foods. And they’re going to be intrinsically motivated to avoid these foods to the degree to which they have a reaction.”
Remember This If You’re On A Restricted Diet…
When you’re stuck eating a small number of foods, you can feel hopeless – uncertain what to try next or how to progress. Dr. Ruscio has some words of wisdom for you:
“Realize that there is a whole world of therapeutic options. I was just talking with a friend’s girlfriend and she was telling me how she’s had IBS for three years. And she’s tried everything.
“I’ve tried everything!”
I said, “Oh, so the low-FODMAP diet didn’t work?”
“What’s that?”
Now, you probably have heard of the low-FODMAP. But the point I’m trying to articulate is there’s a lot of options out there for you.
So if you’re feeling defeated, don’t go to despair too quickly because there’s a wide array of therapeutic options available to you. And if you can utilize those in the right way, then there’s a very high probability that you’ll be able to feel a lot better.”
A New Treatment for Tough Cases?
If you’re “stuck” in SIBO limbo and not making any progress toward healing – especially if you’ve tried a LOT of different treatment – I have something to share with you.
Intestinal Repair Formula is a blend of immunoglobulins that help restore a healthy immune system. (We get so many questions about immunoglobulin treatments and why I was so excited to learn about this new supplement!)
Here’s a video Dr. Ruscio shared that explains the science behind this therapy.
If you’ve already tried other treatments like changing your diet and probiotics, but you’re not seeing complete resolution of symptoms – watch this video NOW!
“IRF has been shown to help patients who did not respond to treatments like diet, probiotics, antimicrobials and soothing agents. IRF binds to irritants like bacteria and toxins. IRF allows healing to begin. Due to its healing effect, Intestinal Repair Formula may even improve nutrient absorption.”
I’m so excited about the possibility with this treatment!
(And if you decide to buy, use code SIBO-SOS for $5 off!)
P.S. Do you have any questions about this product or for Dr. Ruscio? Leave them in the comments below!
P.P.S. I want you to know that I take making recommendations very seriously! For this particular product, I was impressed with the amount of time and research that Dr. Ruscio put into to – and with some of the preliminary results. I’ve worked with Dr. Ruscio extensively on past Masterclasses and Summits, and I trust him and find him to be very genuine. While I obviously can’t guarantee that this product will or won’t work for anyone, I can tell you that I think it’s worth considering. My goal is simply to share the information and let you make the decision. And – you should know, I don’t make any profit of the sale of this product.
Being sick is bad enough…
But being sick without knowing WHY or WHAT is causing your symptoms is truly torturous.
And for millions of people with gut health problems, it has been their reality.
You’re guessing at the right treatment (and getting it wrong more often than not)
Feeling isolated and alone
Struggling to explain what’s going on to your family and friends
You fear that it could be something really bad – like cancer or an autoimmune disease
This was my story, too: since I was five years old I have struggled with gut problems. I bounced from doctor to doctor and tried every treatment you can imagine (with varying success) before finally being diagnosed with Irritable Bowel Syndrome in 2013 and with Small Intestine Bacterial Overgrowth in 2015.
I know firsthand the pain of undiagnosed gut problems! That’s why I am really excited about a new development in the testing and treatment of gastrointestinal disease that could potentially change this reality for so many people!
The Problem with Diagnosing Irritable Bowel Syndrome
Until recently Irritable Bowel Syndrome (IBS) was a “diagnosis of exclusion.”
That meant that if you had IBS symptoms like:
Constipation
Diarrhea
Bloating
Gas
Incomplete or painful bowel movements
Mucus in the stool
Your doctor couldn’t diagnose you with IBS until they had ruled out other causes like:
Inflammatory Bowel Disease (Crohn’s, Ulcerative Colitis, and Celiac Disease)
Food allergies or intolerances
Bowel obstruction
Gastroesophageal Reflux Disease (GERD)
And more…
The process of testing for these other diseases could be costly, risky, and time consuming, including:
Elimination diets
Allergy testing
Colonoscopy
Endoscopy
CT scans
Blood testing
When all those other causes were ruled out, your doctor could finally tell you that you (most likely – not conclusively) had IBS.
My symptoms were so bad I actually ASKED for a colonoscopy! I was in so much pain, I knew there had to be *something* going on. I was devastated when my doctor told me the results of my colonoscopy were totally normal. It gave me the strangest feeling: why am I frustrated that I had a good result on my colonoscopy? (Eventually I was relieved the results were normal, of course.) But at the time all I wanted was a DIAGNOSIS! I wanted a name for what I was experiencing.
Why Has IBS Been A Diagnosis of Exclusion?
Until now, IBS has been a “diagnosis of exclusion” because doctors didn’t know what caused IBS in the first place.
Without identifying the root cause of IBS, they couldn’t test for it – so it had to be diagnosed by exclusion.
That’s how I wound up diagnosed with IBS in 2013: the doctors couldn’t find any other root cause for my bloating, food intolerances, and digestive pain.
But all that has changed thanks to groundbreaking research completed in part by Dr. Mark Pimentel and Dr. Kapil Gupta of Cedars-Sinai Medical Center. They discovered that in a significant number of cases diagnosed as IBS, the root case was food poisoning. (And about 1 in 9 people who get food poisoning then develop IBS!) It’s called post-infectious IBS. (And they’ve created a way to test for it!)
It has to do with a toxin called Cytolethal Distending Toxin B, or CdtB for short. It turns out that every one of the most common bacteria that cause food poisoning releases CdtB.
When a toxin like CdtB enters your body, your immune system fights back with an antibody – in this case, anti-CdtB.
Anti-CdtB can confuse your body into developing another antibody called anti-vinculin. This harms a naturally occurring protein in your body called vinculin that helps cells migrate and connect to each other.
This is an autoimmune response and leads to gut nerve damage and improper functioning of the Interstitial Cells of Cajal (ICC) and Migrating Motor Complexes (MMC), which regulate the contractions of your gut.
This can ultimately result in Diarrhea-Predominant and Mixed-Type (Diarrhea with Constipation) Irritable Bowel Syndrome, sometimes many years after the initial infection.
That means anyone who has ever eaten a questionable salad or sandwich that sat out too long is at risk of developing IBS! (Even if you haven’t had food poisoning in years.)
Understanding the root cause of IBS allowed these brilliant doctors to create a test for it…
Does This Test Work for SIBO Too?
I knew you’d ask that!
The answer is a bit complicated.
There is so much overlap between Small Intestine Bacterial Overgrowth and IBS. Dr. Steven Sandberg-Lewis says 75% of people with IBS have SIBO. And we know food poisoning is a major root cause of SIBO too.
That means you could have post-infectious IBS and SIBO. (I did!) I was tested and sure enough – I was positive for post-infectious IBS.
Bottom line: whether you’ve been diagnosed with SIBO or IBS – or neither one yet! – I think this test is incredibly valuable. It can change your entire path of healing.
The Blood Test for Irritable Bowel Syndrome
It’s a simple blood test your doctor orders for you – and it can definitively tell you if you have post-infectious IBS.
It works by measuring levels of the anti-Cdtb and anti-vinculin antibodies in your blood. High levels of these antibodies is a sign you have post-infectious IBS.
Knowing you root cause can save you years of uncertainty, potentially risky medical procedures, medications you don’t need, and a lot of heartache.
Personally, once I knew *for sure* that I had post-infectious IBS, it was like things clicked in my brain. I knew the post-infectious IBS was causing issues with my motility -so I finally started using a prokinetic religiously. BINGO – a huge reduction in symptoms for me.
Knowledge is power!
Get The Test (At A Discount with Online Prescription)
And even MORE good new – now you can order the test kit with an online prescription and get answers right away!
Outside the United States? Go here to get the test: https://www.ibssmart.com/international
Then pop in to the comments and tell me what you think. Do you have (or suspect) post-infectious IBS?
P.S. There has been so much buzz about this test in the SIBO SOS™ community and on Facebook, so I wanted to get accurate info about this test out and set the record straight. I hope this was helpful to you!
Shivan Sarna interviews guest expert, Dr. Gary Weiner on the topic of IBS, IBD, and SIBO
If you’re having digestive problems, you have enough to deal with without having to keep a bunch of acronyms straight.
But if you go visit your doctor – or do some research on your own – you’ll find a LOT of acronyms – and three of them more than any others: IBS, IBD, and SIBO.
Today, I want to teach you not just what each of these important acronyms means, but what the difference between each is – and, most importantly, how they are all related.
Understanding the link between Irritable Bowel Syndrome, Inflammatory Bowel Disease, and Small Intestine Bacterial Overgrowth can help you get the right treatment the first time.
If your doctor has told you or someone you love that you have any of these conditions (or even if you just suspect it), keep reading.
In Western medicine, “syndrome” is a way of classifying a group of symptoms. Think Chronic Fatigue Syndrome or Restless Leg Syndrome.
In almost any syndrome, doctors use what is called a diagnosis of exclusion. A diagnosis of exclusion just means that there is no other physical explanation for a person’s symptoms.
Imagine you go visit your doctor with stomach pain and diarrhea. They might refer you to a gastroenterologist who performs tests to check for pathological issues, something like Celiac Disease or an ulcer. But if all those tests come back negative – yet you still have symptoms – you might be told you IBS.
The most common symptom patterns in IBS are abdominal pain, bowel motility disruption like spasms or gastroparesis, diarrhea, constipation (or alternating between both) and pain, bloating and discomfort.
Doctors use something called the Rome Criteria to define what type of IBS a person has:
Predominantly diarrhea
Predominantly constipation
Mixed constipation and diarrhea
Post-infectious
(Just FYI – there is some controversy about the Rome Criteria. Not all doctors think it is useful.)
Depending on what type of IBS you have, your doctor might suggest medications or other treatments that can make the symptoms go away or be less severe.
That means that there is a pathology – AKA a cause – for the symptoms that doctors can find.
It gets confusing because IBS and IBD can cause the same symptoms: abdominal pain, constipation and diarrhea, and bloating (to name a few!). But IBS and IBD are different.
Imagine you’re back at your doctor with symptoms. They refer you to a gastroenterologist who performs more tests. But this time, not all the tests come back negative: instead, tests show you have an Inflammatory Bowel Disease.
There are two inflammatory bowel diseases: ulcerative colitis and Crohn’s Disease.
Ulcerative colitis (UC) causes inflammation on the mucosa of the colon. This can cause severe diarrhea, blood in the stool, and lots of pain.
Crohn’s Disease causes inflammation throughout the entire digestive system – anywhere from your mouth to your anus – but the inflammation goes deeper than it does in ulcerative colitis. This is called intramural inflammation.
Treatments for IBD include both medications to manage symptoms (sometimes the same ones used for IBS) and to treat the inflammation in the digestive system.
Why IBS & IBD Aren’t Totally Same OR Different
You might be thinking that it sounds like IBS and IBD are totally different. You either have IBS or you have IBD.
But that actually isn’t all true.
In fact, according to naturopathic physician Dr. Gary Weiner, IBS and IBD are more likely two different ends of the same continuum.
Both IBS and IBD have overlapping features. And even more importantly: the same person can have both IBS and IBD.
This can be confusing for both people with IBS and IBD and for their doctors. They might wonder why treatments don’t seem to be working or why some symptoms went away and others didn’t.
While IBS and IBD can cause similar symptoms, the treatment needed for each can be totally different in some cases – that’s why figuring out which symptoms are part of IBD and which are caused by IBS is a crucial step in the healing process.
Does That Mean IBS Causes IBD?
Right now, doctors can’t say for certain that IBS and IBD exist on a continuum or that one could cause the other.
But there is evidence to support the idea.
IBS and IBD can have overlapping features like causing:
Production of inflammatory cytokines
Alterations in the microbiome
Inflammation at levels not detectable by colonoscopies or or other standard tests
This evidence has led some experts – like Dr. Weiner – to question if IBS is a precursor to IBD.
After all, many people who are diagnosed with IBD have struggled for years with IBS symptoms – or even have a formal IBS diagnosis. Their tummy troubles seem to have “escalated” into either UC or Crohn’s.
And, just because someone has IBD doesn’t mean they can’t also have IBS. Sometimes people with IBD have an increase of symptoms like diarrhea, pain, gas and bloating. But when they are tested for elevated levels of fecal calprotectin or fecal lactoferrin (two signs of inflammation), results come back normal. This means their IBD isn’t active or “flaring” – they are just having IBS symptoms.
Of course, not everyone who has IBS develops IBD – and not everyone with IBD had IBS symptoms first. But there’s another thing IBS and IBD have in common, too.
What Does SIBO Have To Do With IBS and IBD?
You just learned that IBS and IBD can overlap. Now, imagine 2 circles drawn so they overlap – a Venn diagram. One is labeled IBS, and the other is labeled IBD. Right in the middle where the overlap occurs, that’s SIBO.
SIBO stands for Small Intestine Bacterial Overgrowth, and it can be both a cause and an outcome of IBS and IBD.
SIBO researcher Dr. Mark Pimentel has demonstrated that SIBO is often a root cause of IBS.
And SIBO is also often present in people who have an IBD.
So what’s the difference?
While SIBO is a known cause of Irritable Bowel Syndrome, with Inflammatory Bowel Disease, it’s the other way around: Inflammatory Bowel Disease can cause SIBO.
Let me repeat that because it can be confusing:
SIBO can cause Irritable Bowel Syndrome.
Inflammatory Bowel Disease can cause SIBO.
Is SIBO the Chicken Or the Egg?
Just like the question of the chicken and the egg can be very confusing if you think about it too much, so can the relationship between IBS, IBD, and SIBO.
SIBO is often the cause of Irritable Bowel Syndrome. While there are many other potential causes for IBS, and not everyone with IBS has SIBO, it is estimated that as much as 84% of people who have IBS have SIBO, too.
But there actually isn’t any evidence that SIBO causes Inflammatory Bowel Disease. In fact, it seems to be the other way around: having an IBD can cause SIBO to develop.
The inflammation caused by IBD can create an opportunity for SIBO to develop when normal motility is disrupted.
In basic terms, this just means that when inflammation brought on by UC or Crohn’s causes the digestive system to either slow down (constipation) or speed up (diarrhea), bacteria has a chance to overgrow in the small intestine.
IBD can also interfere with the function of the migrating motor complex (MMC). The MMC is responsible for moving food through the digestive system – some people think of it like a broom sweeping food down the digestive system. When the MMC is interrupted, SIBO can occur.
Why The IBS-IBD-SIBO Link Is So Important
I know that everything we’ve covered so far has been complex and sometimes confusing – but it is really important to understand how Irritable Bowel Syndrome, Inflammatory Bowel Disease, and Small Intestine Bacterial Overgrowth are all related if you want to get healthy again.
If you have SIBO, you (or your doctor) might be confusing it with Inflammatory Bowel Disease. If you IBS, your doctor may not realize it is being caused by SIBO. And if you have Inflammatory Bowel Disease, you might also develop SIBO.
Knowing this is so important for getting effective treatment.
Treating the SIBO within Inflammatory Bowel Disease can help you get better faster and go into remission from IBD. For some people, treating SIBO can cause all IBS symptoms to disappear. And if IBS does often to lead to BID later on, getting IBS under control is even more important.
If you have symptoms of IBS, IBD, or SIBO it’s very important to find out which condition is causing what symptoms. If you treat the SIBO as IBS or the IBD as IBS, you wind up very frustrated and not healing.
Take Ownership & Find The Right Treatment For You
Whether you have Irritable Bowel Syndrome, Inflammatory Bowel Disease, SIBO, or a combination of all three, there is hope for healing and remission.
But, healing starts with become educated and empowered about what is happening to your body! Just like I did, you need to take ownership of your health. That means asking questions, researching, and staying informed.
After all, if you won’t advocate for yourself, who will?
That doesn’t mean you have to become the expert on SIBO, IBS, or IBD. Fortunately, there are many other people who already ARE experts on these complex topics – and they’re willing to share their knowledge with us so we can finally get better.
