My SIBO Story (part 3) - After The Elemental (Mental) Diet

Title SIBO STORY 3.jpg
_{Photo by ja ma on Unsplash}

After The Elemental (Mental) Diet

For those of you who don't know, I recently undertook a three week diet consuming nothing but medically formulated elemental liquid drinks and water! Pretty extreme, I know. Today is the final day and it has been challenging to say the least.

What is the elemental diet?

The elemental diet - this is a diet that consists of macronutrients broken down into their elemental state requiring little to no digestive functionality which allows time for the gut to rest and starves the bacteria. The nutritional make up of most elemental formulas are 14-18% of calories from protein (in the form of amino acids), 42-76% calories from carbohydrate (in the form of monosaccharaides), 6-43% of calories from fat (in the form of fatty acids) and a full spectrum of vitamins/minerals.

_{Quote from previous post - What is SIBO & How it has Effected Me}

Why have I undertaken this insanity? This treatment is meant to be 84% effective in eliminating small intestinal bacterial overgrowth (SIBO) with a three week course of treatment. I have suffered this debilitating condition for four years now, with no response to other treatments so I'm willing to go the extra mile.

So far, none of my symptoms have got better. If anything, they are worse. But I'm still hopeful. I've read on a forum that some people experienced a reduction in symptoms over the two weeks after the treatment. I have a hydrogen breath test scheduled for this Tuesday, 07th May. After this test I should have a better indication if the bacterial over growth (SIBO) has been eliminated. If this is the case the fact that my symptoms haven't reduced could be down to two factors.

If hydrogen gas levels have increase it means that, possibly, I've been misdiagnosed and I actually have an overgrowth of yeast (candida) or the bacteria has resisted the starving process. In this scenario I will start taking a course of herbal anti-microbial in a large dose while following the bi-phasic diet to try to kill the candida (and or bacterial overgrowth).
If the gas levels are considerably down then it is entirely possible that the overgrowth has been killed and the bloating, nausea, fatigue and brain-fog I'm experiencing is a reaction to the poisons that are released when the bacteria die-back (also known as the Jarisch-Herxheimer reaction).

To read more about SIBO and the elemental treatment I've just undertaken, please check out these two posts.

My SIBO Story (part 1) - What is SIBO & How it has Effected Me

My SIBO Story (part 2) - The Elemental (Mental) Diet - 3 Weeks Without Food

For anyone reading this article who has SIBO and is reading as a resource, I will briefly list how I felt during the treatment.

Day 1 - Day 9 was a real mixed bag. The first three or four days I had constipation which finally gave way to constant and persistent diarrhea throughout the rest of the treatment. My fatigue and levels of nausea were up and down during this period. Brain fog was moderate and I had a constant moderate headache which has persisted all through the treatment.
Day 10 - Day 14 was dieback time. Extreme nausea to the point where it disrupted my thought patterns. This felt like the point just before you are physically sick constantly, 24/7. Bloating increased. Stomach cramps to a moderate pain level, especially after consuming the elemental formula. Increase in diarrhea, 2/3 times daily. Severe fatigue and brain fog. During this time I was unable to do much other than walk to the kitchen or bathroom.
Day 14 - Day 21 slight easing of symptoms from dieback period. Diarrhea, once/day, usually after consuming elemental formula. Headaches, fatigue, brain fog and nausea back to pre-dieback period. Noticed extra bloating after consuming each round of the elemental formula.

TMI... yeah I know, sorry about all the grisly details that you would usually only tell your doctor. Unfortunately, many medical practitioners don't fully understand this condition and it is a common occurrence for many who suffer from SIBO to simply be ignored or diagnosed under the umbrella condition of IBS. This is why it is important to provide this level of detail so that we can learn from each other.

_{Image by congerdesign from Pixabay}

Plans for Natural Healing

Having identified two scenarios above, I have two different initial healing methodologies, dependent on what the hydrogen breath test shows. If the small intestinal bacterial overgrowth has actually been destroyed then further measures to starve and attack the bacterial overgrowth won't be needed and I can take a more holistic food based healing approach. If it hasn't, I will have to undertake a very strict diet with a mix of supplements aimed at killing both SIBO and potential candida. Lets take a quick look at the three most common underlying causes that need to be addressed to recover from SIBO.

Underlying Causes (triggers) of SIBO:

Low gut motility - this basically means how quickly food is passed through your digestive system by the cleansing waves or migrating motor complex (MMC). In some SIBO sufferers this is very low and manifests as severe constipation.

Low stomach acid or the wrong blend of acids and enzymes - when they are out of balance damaging bacteria can pass through to the small intestine where they create colonies and multiply exponentially. An example of this could be streptococcus. Some experts believe that an aggressive invasion of strep into the small intestine might be the culprit in a lot of cases of SIBO.

Malfunctioning ileocecal valve - this is the valve between the small intestine and the colon (large intestine) located in the area know as the ilium (please check Pic 1 above). When the ileocecal valve malfunctions it can remain open for a time allowing bacteria to wash back into the small intestine creating an imbalance of bacterial load in the small intestine.

_{Quote from previous post - What is SIBO & How it has Effected Me}

My methods of potential healing protocols attempt to take into account both the issue with low motility and low (or unbalanced) stomach acid. In regards to the ileocecal valve, I may possibly have to seek out a chiropractor who knows how to massage the valve to restore the healthy function of the large intestine. I did try to do this myself as per instructions on the linked website but the bloat in my stomach is so severe that I couldn't find the hardened spot that indicates the valve and ended up putting myself in further pain. Despite this healing process being quite complex, there are three things that will remain the same in how I try to heal in all scenarios.

Diet. During the first month, I will be consuming nothing but organic foods. For at least the first three weeks this will include only vegetables and clean sources of protein (in my case nuts and fish as I don't eat meat). I will not be eating any grains, including rice for at least the first three weeks, and may consider testing if I have a reaction to rice or quinoa in week four.
Motility. I will be using a combination of (gentle) yoga, exercise and and a natural prokinetic (homemade strong ginger and turmeric tea) to encourage the migrating motor complex (motility) in my digestive system.
Stomach acid. After the first week or two, once my system is acclimatized to food I will be adding two natural promoters of stomach acid regulation; celery juice and apple cider vinegar (and maybe HCL supplements if needed).

_{Image by DanaTentis from Pixabay}

Diet is Everything

To wrap up this post lets briefly look at the dietary protocols I plan to follow and a set of weekly food/activity diaries for the next few months.

For the first few weeks at least, I will follow the specific carbohydrate diet (SCD) with a view to adding (free range) eggs back into my diet to test my reaction to them once my digestive system has rebooted. The SCD is a diet that excludes the types of (complex) carbohydrates that the bacterial overgrowth in the small intestine feed on. The list of foods you can eat is restrictive and includes; various fruit/vegetables, clean protein in the form of nuts meat or fish, and eggs. No grains are allowed! I feel this is the safest option as I transition back on to food, to try and avoid undoing any of the benefits of the elemental diet.

After the first three weeks and following a successful reintroduction to eggs, I might switch it up to follow a modified version of the bi-phasic diet which is basically a slightly less restrictive version of the specific carbohydrate diet.

Dependent on how my body reacts to the food reintroduction, and if my symptoms decrease, I may start to trial each one of the four remaining trigger foods slowly each week.

Dairy
Gluten (& grains)
Soy
Corn (including corn syrup, corn starch etc)

If all goes well, the final stage is the repair stage where I will introduce specific probiotic supplements and possibly fermented products if tolerated. I read a medical study that suggested the best culture of probiotic to help restore the balance for SIBO is bifidobacterium infantis. I will most probably trial this supplement in the hopes that I hit on the magic formula.

Fermented foods such as cultured vegetables, sauerkraut, kimchi, as well as miso and yogurt are wonderful for the digestive tract as they contain high amounts of probiotics, or beneficial bacteria. This is helpful even in the case of SIBO but many people can react to the histamines in these foods. It is suggested to introduce them slowly towards the end of Phase 2.

_{Quote from The SIBO Bi-Phasic Diet PDF Handout}

The Healing Protocol as Planned

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Everything I am undertaking over the next few months will be subject to change based on reactions to the reintroduction of foods, how my body takes the various supplements and the general level of debilitation from my symptoms.

Sources of Research:

SIBO dieback - https://sibosurvivor.com/sibo-die-off/

Ileocecal Valve Massage - https://drjockers.com/benefits-ileocecal-valve-massage/

Vagus Nerve Info - https://www.arcvic.org.au/34-resources/402-vagus-nerve-exercises

HCL Balancing Stomach Acid - https://wellnessmama.com/36209/betaine-hcl-stomach-acid/

Specific Carb Diet - https://med.stanford.edu/content/dam/sm/gastroenterology/documents/IBD/CarbDiet%20PDF%20final.pdf

Full allowed foods list SCD - http://www.breakingtheviciouscycle.info/legal/listing/

Bi-phasic diet Research - http://www.naturalhealthresearch.org/wp-content/uploads/2017/04/SIBO-Food-Intolerance-and-the-Bi-phasic-Diet-Protocol-Jacobi-HANDOUT.pdf

https://sibotest.com/handouts/SIBO_Diet_FINAL.pdf

Bifidobacterium infantis Probiotic Study - https://www.ncbi.nlm.nih.gov/pubmed/29397491

All images are creative commons, linked to source below pics. If you have enjoyed this post, you can check out similar work on my homepage @raj808. Thank you.

My SIBO Story (part 3) - After The Elemental (Mental) Diet - Plans for Natural Healing

After The Elemental (Mental) Diet

Plans for Natural Healing

Diet is Everything

The Healing Protocol as Planned