I’ve started 2018 feeling better than I have in years after finally diagnosing and treating an underlying bacterial infection that was causing all sorts of problems.
I’ve had a sensitive digestive system ever since I was a kid. I grew up in a household with a lot of healthy whole foods and not a ton of processed stuff, but still wound up with a lot of seemingly random stomach aches and problems. These were annoying, but never too life altering. But starting at the end of college things went from annoying, to agonizing. A few months before graduation, I started getting pains in my side like you get from running, these aching stitches in my upper ribs, accompanied with heartburn, nausea that often lead to vomiting, among other fun things. Nothing I ate seemed to sit right. After going to the hospital, doctors thought it was my gallbladder, but the ultrasound revealed nothing. They they chalked it up to advanced acid reflux, aka GERD and sent me home with a GERD specific diet, and told me to limit drinking alcohol, eating tomatoes, and spicy things.
Flash forward 3 years. I’d been taking daily over the counter acid reflux medicine off and on, and things would calm and resurface, calm and resurface. I didn’t want to take these meds on an ongoing basis because they can have long term effects on your bone health, especially in women. Then around Thanksgiving of 2016, I started feeling the sharp pains again, accompanied by a new symptom – a constant lump in my throat that felt like undigested food was stuck there. I was mostly following a GERD diet, but I was often feeling sick and vomiting. I went in to the doctor, and again they checked my gallbladder and sent me home with a print out on GERD, and instructions on an even more restrictive and low acid diet, which included cutting alcohol altogether. This may sound like no biggie – but it was right before Christmas, pretty much food and alcohol central. You really see how much boozing and food is involved in social situations when you can’t have any of it. After the holidays I was chatting with some friends about what had been going on, and how frustrated I was. One of them who works in healthcare recommended I go see a naturopathic doctor that she had great things to say about. Always interested in a holistic approach, I sought out Alena Guggenheim ND.
My first appointment with Alena left me feeling more listened to and cared for than I had by a doctor in years. She took my entire medical history, felt and listened to every part of my stomach, and started mapping things out on a whiteboard. Every minute detail. She was acting like a true detective. At the end of the almost hour long appointment she looked at me and said, I don’t want to get your hopes up, but I really think you have something called SIBO – and it’s treatable. She sent me home with tons of information, and recommended I get the breath test for SIBO.
With the help of my family, I decided to finally get the test done (it was a pretty penny and it takes 3 hours). SIBO stands for small intestinal bacterial overgrowth. This occurs when bacteria gets into your small intestine (where you’re not supposed to have much bacteria at all) and things get out of whack. The bacteria feeds on certain foods, and the gas byproduct of their digesting and flatulence causes symptoms like bloating, heartburn, stomach pain, nausea, constipation and or the alternate, weight fluctuation, anxiety, and general malaise and fatigue. So yeah… pretty lovely effects, and my symptoms definitely fit the bill. I then started to picture my stomach filled with these SIBO bacteria as the cartoon from the Mucinex commercials – gross, alive, and up to no good.
To test for SIBO you have to spend 3 days eating only plain cooked chicken or fish, white rice, or plain eggs. For the last 12 hours you eat nothing. The SIBO bacteria does not feed on these foods, so this ensures there’s nothing left over in your system that would produce the gases they test. Then, you are given a lactulose (sugar) solution. After throwing this back, you breathe into a tube every 30 minutes for 3 hours. The doctor tracks the levels of these gases over time. Just 20 minutes after drinking the solution, my stomach was completely roiling, and I was belching like crazy. I wasn’t sure if this indicated something or not, but it was definitely strange since I hadn’t eaten anything in 12 hours. The test itself was nothing terrible, just long. The next day I got a call from my doctors office saying that they needed to see me as soon as possible. I asked for my results, but she said that my doctor needed to speak to me in person. This was pretty mysterious. It was the first time in my life I had wanted to test positive for something, hoping to finally have some answers.
I got in to see my doctor as quickly as I could and she immediately said “Well I’ve got good news!” My graphs from the breath test showed extremely high levels for both hydrogen and methane production, some of the highest numbers she’d seen in her years of treating the overgrowth. Usually people with SIBO are either methane or hydrogen dominant, not both. So yeah… I tested positive, really positive. Next I was given two treatment options. You can either take a very heavy (and expensive) antibiotic, or go an herbal route for around 8 weeks. I’ve done a lot of research on SIBO since my initially diagnosis, and repeated rounds of these two options seem to be standard protocol. So here’s the thing – I always seek out and prefer a natural method, but when antibiotics are really called for, I have no qualms using them. The studies on the treatments showed that option 1 had a higher success rate with more studies done vs. option 2, so that’s what we moved forward with. You gotta just do your research! The plan was to take the 2 week course that would essentially “kill” a lot of the bacteria, and then I would begin a diet that would “starve” the rest.
Initially my insurance was not going to cover this medication, which out of pocket is $1,600, but with a lot of back and forth and proof of everything else I had tried, I was able to get it covered. This was a huge blessing. The medication itself is *strong* and it left me feeling dizzy and sick. It’s also so strong that any alcohol, even alcohol found in your mouthwash, would have an adverse reaction. The one benefit is that you can eat whatever you want during this period, as you want the bacteria to come out from hiding. Having a diet with zero restrictions was something I hadn’t been able to do in a very long time. So it was a blissful two weeks of dizziness, nausea, burritos, and pizza. Following the meds, I moved to the diet. Now, I have had some restrictive diets in my digestive journey, but low FODMAP has got to be the most interesting.
The whole diet centers around fructose levels, so high FODMAP foods contain higher levels of fructose. The low FODMAP diet is used for a number of digestive issues like IBS, Crohn’s, and ulcerative colitis. It centers around avoiding foods with high fructose levels (high FODMAP). While these foods may be troublesome for many digestive issues, they are pretty common, and often part of a healthy diet. The biggies are: gluten, dried fruits, apples, blackberries, agave and honey (which are in what feels like everything), legumes (beans), garlic, onion, avocado, sweet potatoes, broccoli and a bunch of other random seeming things. Cutting these foods out was extremely difficult and frustrating. Eating out, or eating pre-packaged foods like granola bars, was pretty much out of the question.
I’m not going to lie, it was difficult. As someone who loves to cook and dine, I got really upset as weeks, and then months, went by wondering if I’d have to eat like this forever. I tried to keep a smile on, but at times I’d lose hope, and luckily my friends, family, and amazing boyfriend Yost were there to cheer me on. Luckily, I did feel the diet was helping my symptoms, and I was feeling so much better. However, the diet is not a long term plan. After about 4 months total of the diet, my doctor deemed that I was ready to start the re-introduction phase. This would be another 8-10 weeks of low FODMAP, while introducing a set amount of specific high FODMAP food each week. I’d have to track my symptoms in a log every day to figure out what was affecting me after the treatment. If you had an adverse reaction to a certain food group, you’d have to wait a week to “wash out” your system before trying the next one.
The re-intro phase was time consuming as I did have some reactions, but also illuminating. I was somewhat down because not every phase went with flying colors, and I was worried I’d have to do the last 6 months all over again. After finishing all the sections (sorbitol, mannitol, lactose, gluten, oligosaccharides, fructose) it was back to the doctor to talk next steps. I shared my results with her, and she was actually encouraged, which I was surprised by, but happy to hear. Basically, she was confident that the next phase for me was honing in even more on what I could and couldn’t eat, and to start reintroducing more foods, versus more restriction. While it left me feeling really good, low FODMAP is not a long term option. Your diet needs variation to keep you from building even stronger food intolerances.
So, where am I today?
I would say I’m feeling 70-90% most days – which is incredible! I’ve added in a ton more foods, but have also learned what certain foods to do my body in certain quantities, and what to avoid altogether. Gluten legit wrecks me and makes me so sleepy, but sometimes a girl’s gotta have a donut. Like anyone, balance is key. I’ve created a pretty good little routine between my diet and supplements, and learned so many swaps from all the months of low FODMAP, that I feel far less restricted than I did at first. If you’re struggling with SIBO, you can see my more in depth routine and treatment here. Everyone is so different and will need different treatment, so it’s not a one size fits all, but it’s what’s working for me now. Additionally, there’s a lot of buzz about your mental health playing into your digestive health, with the gut rendering your emotions, and I fully believe that. So, during the last year I also took a look at my life, and things that were making me unhappy and stressed figured out a plan to change them. I think this had an added effect on my recovery.
I’m living my life more freely and happily now. There is a high chance SIBO will return after initial success, but I have learned so much about digestion, natural soothers, and nutrition through this whole thing, and feel equipped should I relapse. It was always something I was interested in, but now I have hopes of one day helping people with their issues through nutrition and diet. I feel so thankful for my family, friends, and the incredible Yost, who were there for me throughout this. SIBO had a lot of physical effects, but emotional effects such as anxiety and hopelessness are a huge part of it too, so support is key. To my friends who genuinely cared, and wanted to know about this strange bacterial thing I was dealing with. To my parents who supported me mentally and financially through this (SIBO treatment is expensive!!), and made me separate meals at family gatherings and holidays. To my brother Daniel who talked with my constantly on GChat from another city to let me vent about all the gritty details. And to Yost, for hugging me and letting me cry sometimes, and for finding a low FODMAP enchilada sauce that he made so many times to cheer me up.
rebeccamigibson.wordpress.com 