Saturday, 31 May 2014

SIBO Update

It’s been about a month since I finished my SIBO meds - to recap I was taking a Rifaximin + Metronidazole combo three times a day for two weeks. In the lead up to the meds I adopted low FODMAPS on top of the strict paleo I have been doing. Before and during treatment I was eating autoimmune paleo protocol but as I mentioned in my last blog post, I did have a few cheats during treatment (I have provided plenty of links throughout my blog on these particular ways of eating and dietary modifications if you require more info).

After I finished my round of meds I realised that starches don’t agree with me, sweet potato and parsnip had to go (bloated and fatigued soon after eating). I’m still ok with carrots and pumpkin thankfully! I figured these things out doing an eliminate and challenge process as outlined in my favourite book by Aglaee Jacobs, Digestive Health with Real Food. Chris Kresser also touches on it in his book, Personal Paleo Code (there are other sources but these are my favourite two). So I've kinda ended up at the specific carbohydrate diet by default, which turned me towards SCD Lifestyle eBook which provided some more information and insight as to why I wasn’t tolerating many foods well and gave me more knowledge on how/when to introduce foods.

Food

Currently this is what my safe food zone looks like (the guys over at SCD Lifestyle explain what this is in their book in more detail). Keep in mind it’s very different for everyone.

Safe foods, as far as I can tell, I can tolerate:
Meat - chicken, fish, beef, lamb, turkey (pork is not listed as I simply don’t like it)
Oils - Coconut, Olive, Infused Olive, Macadamia nut (in small doses) and occasionally red palm oil
Vegetables - Carrot, pumpkin, zucchini, spinach, silverbeet, summer squash
Fruit - Coconut water, kiwifruit, oranges, lemons, lime
Misc - Coconut cream (1/3 of a tin), gelatine, herbs (fresh and dried), salt

Pretty much what you read is what I eat. In the coming weeks I will be trialling: broccoli, green beans, butternut squash, bok choy, blueberries, eggs and ghee; trying one food at a time for three days and introducing the next food if I have no symptoms. If I do have symptoms, waiting till they ease before trying another food.

Supplements

I’m currently taking:
Digestive Support: Digestzymes by Designs for Health, Prescript Assist probiotic, L-Glutamine
MTHFR: My Doctor had special day and night multi made up for me with vitamins and minerals to support detoxification as well as types of folate and B12 my body could utilise.
Bowel Function: Magnesium Glycinate by Designs for Health, low dose compounded erythromycin (a follow up from the SIBO meds to prevent reinfection).
I've introduced these one at a time. In the coming weeks I want to try lauricidin (derived from coconut oil and helps busts biofilm in the gut), will add in saccharomyces boulardii (a probiotic yeast) and I will also add probiotic foods such as homemade coconut yogurt and sauerkraut. 

Symptoms

Fatigue, bloating, constipation and gut pains are gone (probably a lot to do with the strict diet as well), I still get nausea but it’s less frequent and not as random as it was. Cravings have decreased, the first week was the hardest. I get tired still but not the deep fatigue I used to get. I still struggle with acne and depression and am trying to pinpoint triggers for these (stress and chocolate being two of them, lack of sleep being another, not enough time outside also contributes). Unfortunately I did have a major flare in my skin after the meds, which upset me as I had read that after treating SIBO roughly 92% of people notice better skin. I've read a few stories of people having a hard time with symptoms after a course of  Metronidazole, as it's known to be particularly potent at killing good bacteria as well (and the cheats I had probably didn't help). 

My muscle and joint pain has decreased and while I still have brain fog its nowhere near as frustrating as it was. I still have a hard lump in the right side of my tummy that I believe is due to the blastocystis that I’m still working on eradicating (more info on that in previous posts and more coming up).

Take home points:
  • Have a strict protocol when coming off antibiotics (medical or herbal) to prevent reinfection
  • Don’t expect all your symptoms to go away straight away
  • Address dysbosis and leaky gut
  • Add in lifestyle factors like sleep, fresh air, social time and joy
  • Hot baths, meditation and journal writing help a lot
  • Keep a food diary/symptom tracker
  • Be patient, it took you awhile to get sick so it will take awhile to get well
  • Reach out to others who are going through the journey, forums and Facebook groups can be a good tool
  • Move, gently, daily
  • Prepare for set backs
  • And when you start feeling better, you might want to re-read this to prevent sabotaging yourself: The Glass Wall Mistake

Saturday, 17 May 2014

Treating SIBO

AKA Bugs be gone!

I won’t go too much into what SIBO (small intestinal bacteria overgrowth) is in this post as I’ve covered it a few times before, main one being HEREI’ve also shared THIS LINK from the guys at SCD Lifestyle which has a great video and audio to explain it further. If you want the brief overview, Aglaee Jacob has a great blog post HERE.

Choosing which way to go

As I alluded to in my last post on SIBO, I’d had a visit with my GP where we discussed possible medication options for treatment of SIBO. I’d tried once before with a basic broad spectrum antibiotic but my symptoms remained: constipation, bloating, constant reactions to food, acne, brain fog, fatigue and nausea. 

I was initially put off due to the cost (one of the two drugs is not covered by the government medical system), as well as the fact I’d spent a decent amount of money on unsuccessful drugs for blastocystis last year - so I was hesitant. But when I started working with my health coach, Angie Alt, she advised me that due to the nature of my symptoms and the duration of my stomach issues, that the meds were the best way to go. Herbal antibiotics are also an option but they take longer, aren’t anymore cost effective, aren’t always more gentle and they effectiveness is slightly less. Also, with constipation predominant SIBO, it can be more stubborn to treat.

I still believe a large part of the reason my endeavours in eradicating blastocystis were ineffective largely because of the bacterial overgrowth in my gut holding up the works! So I was ready to tackle it head on.

Meds and Diet

With Angie’s help I got my prescription for Rifaximin (the usual first line medication for SIBO) and Metronidazole to make the whole process more effective. Neomyocin is also used but Angie and I decided on a Rifaximin + Metronidazole combo and my GP was happy with that option too.

If you’ve read any of my posts on diet you know that I’m a fan of JERFINGI’ve tinkered in the PALEO AUTOIMMUNE PROTOCOL and I’m a big fan of Aglaee Jacobs GUT HEALING PROTOCOL and had a pretty good idea of WHAT FOODS WORK FOR MEAlong with this I’d also recently reduced FODMAPS in my diet to help relieve pain and bloating. 

I had a few cheats during my treatment as I’ve read that it’s beneficial to have some fermentation in the gut when you’re trying to treat SIBO. So I had a few extra serves of sweet potato, some dark chocolate and a few fruit/nut bars (things I usually avoid) during my 2 weeks or treatment. I found on these days the side affects were actually lessened… Maybe because the meds had something to work on? I don’t really know. 

After treatment I realised that starches don’t really agree with me and due to fatigue I thought it would be a good idea to drop coffee and chocolate for awhile… So I’ve found myself doing a low FODMAPS, no dairy, no nuts, low fruit version of the specific carbohydrate diet. The book I’ve found most helpful for this is the eBook by the SCD Lifestyle guys OVER HEREElaine Gottschall’s book Breaking the Vicious Cycle is the original book on the subject and still full of great info. I like this approach as you start with an intro diet and then very, very slowly add foods in one at a time to create your own customised diet. Aglaee Jacob has a similar approach in her book, Digestive Health with Real Food.

Results

The first week of taking the meds I had more energy than I had in ages, I was delighted! But as the drugs built up in my system I started to feel pretty unwell, nothing I was unfamiliar with but intense and I was unable to shift it - so I just rode it out and my health coach assured me I’d feel ok again once I’d completed my course of meds. 

It took a few days for the brain fog and heaviness to clear, and it’s still early days, but I’m feeling better. I’m not in as much pain, I have more energy, I have less nausea, bathroom visits are more predictable and I don’t rely on strong laxatives, enemas or colonics to relive symptoms anymore. My diet is still restricted and I’m taking a few things for gut healing including: multivitamins specific to my MTHFR mutation, l-gluatmine, probiotics (prescript assist), digestive enzymes and magnesium. I’m also taking a low dose antibiotic, erythromycin, nightly to prevent reinfection.

I think this is the main step many people miss, strict diet, gut healing and ensuring bowel function to prevent a relapse - which is usually and unfortunately quite common!

Angie’s help was pivotal during this whole process. I’d done way too much research and had almost paralysed myself with too many options. She was there to guide me through my bad days (she had been down this road twice already) and was there for encouragement on my good days. The journey can be tough, and lonely! And with so many doctors and professionals out of the loop on gut issues it’s really important to find someone you trust and can relate to, to ensure your success. 

Below are some of Angie’s blog posts on SIBO, personal experience and an overview of a recent SIBO symposium. All good stuff so dive in!








From here I’ll continue with my gut healing protocol and strict diet for 3 months, slowly doing some food reintroductions as my gut begins to heal and I can tolerate more things. I’m still struggling with some skin issues but I’m hoping as I build up the good bacteria in my tummy and continue to fight inflammation they’ll soon be a thing of the past too. I’m still struggling with some adrenal fatigue which shows up in shakes, nausea and spaciness when I don’t make sleep a priority. So still a ways to go but I feel a lot more in control of my symptoms and now feel like I’m playing an active role in the process - not just being a passive passenger on a ride my body was taking me on.

So there you go, my adventures in SIBO!
K xx