While I appreciate her forward thinking — it's a sad fact that many doctors across the country are not aware of the pioneering SIBO work — I decided not to follow her advice, no offense intended. I'm grateful to her for putting me on the path of a gut disorder as the cause of vitamin deficiencies that were giving me scary neuropathy and autoimmune joint flares — after eliminating conditions like diabetes, hypothyroid, and celiac — but she's running a busy family medical practice and doesn't have time to stay up to the minute on the very latest developments in this one not-so-common disorder. New information is arriving every day that wasn't known even six months before. That's why when you get diagnosed with SIBO, you have to become your own medical sleuth.
One of the unfortunate SIBO symptoms affecting me right now is insomnia. I say unfortunate, because research shows that disrupted sleep interrupts the cleansing mechanism of the gut, called the Migrating Motor Complex (MCM), and can in and of itself be the cause of SIBO.
I'd been a lifelong "good sleeper" and not getting good rest is almost the worst of my symptoms — coming in rough second only to the ugly autoimmune attacks on my finger joints. The one benefit of insomnia, if there can be said to be one, is that it gives me lots of additional time for quiet reading. As a result, I spend about three hours a night reading up on SIBO and other related gut issues, and this information has helped me tremendously as I direct the path to what will hopefully be my recovery.
It was only through reading and research that I learned the dismal failure rate of antibiotic treatment for SIBO-C (40-50% recurrence rate, according to many studies) and shared these studies with my primary care doc. Once I saw the failure rate for the Rifaximin and neomycin protocol to treat SIBO-C, I knew that wasn't the course for me. Even patients who are initially "cured" by the antibiotic duo usually relapse and most require rounds and rounds of more antibiotics, which for some can eventually lead to antibiotic resistance and even bigger problems such as C-dif. No thanks.
Almost immediately I was on a path to find a botanical antibiotic protocol instead. In many studies herbal antimicrobials are more effective than antibiotics.
In fact, I was just about to hit the "buy" button on Amazon Prime for a slew of herbal antibiotics, prebiotics and probiotics that bloggers at Animal Pharm/The Gut Institute and Hollywood Homestead had used to cure their SIBO when I learned that the bacterias that cause SIBO-D (diarrhea) and SIBO-C (constipation) are quite different and that there was a brand new botanical treatment available to treat SIBO-C called Atrantil that actually targeted the archaea bacteria that cause SIBO-C. I corrected my course accordingly.
MY PROTOCOL
Your SIBO treatment will likely not be exactly the same as mine. Every body is different and responds differently to treatment, based on existing conditions or infections, genetic expression, metabolic makeup and diet. But I'm writing this blog in the hopes that what I'm experiencing might help others like me.
Medicines
My herbal protocol is simple:- Atrantil, to create an unfriendly environment for the archaebacteria that's colonizing my small intestine, weaken their cell walls to eliminate them, and sop up the methane production that causes severe bloating
- Iberogast, a prokinetic proven to increase gut motility
- Natural Calm, a powder form of magnesium citrate, to bring water into my small intestine and encourage bowel movements (tastes better than the liquid magnesium citrate you can buy at any pharmacy for a few dollars, but works exactly the same way)
- Apple cider vinegar-spiked water drunk with every meal, to increase stomach acid and bile
Diet
If you've looked into diets for SIBO, you've likely come across the GAPs Diet, Specific Carbohydrate Diet, Paleo AIP Diet and FODMAPs diet. These diets have calmed symptoms for millions with gut problems, but when it comes to SIBO-C, they don't cure the source of the problem and may even over time make things worse. Practitioners like Chris Kresser have made the case that diet alone is not enough and that starving the gut of carbs and FODMAPs could have a deleterious effect on the large intestine biome. Additionally persuaded by evidence that very low carb diets can actually cause gastrointestinal disease by depleting the gut of Mucin-2, I decided to follow The Perfect Health Diet, and in fact I had already started the diet three months before I even got the actual SIBO-C diagnosis.You can read more about my diet and nutritional supplements here. In addition, I'm implementing other lifestyle changes that might help, like yoga and other forms of vagus nerve stimulation.
Resources
Sites I owe a debt of gratitude to:- The Perfect Health Diet: For setting me on the path to good nutrition and improved gut health and arming me with a vast amount of well-documented research to show my doctors.
- Chris Kresser: For breaking down very complex digestive issues into laymen's terms and for introducing readers to experts in the field, like SIBO pioneers Pimentel and Seibecker in addition to Dr. Kenneth Brown, the gastro who developed the botanical treatment Atrantil that I'm taking.
- Fix Your Gut: For clearly illustrating the difference between SIBO-C and SIBO-D.
- The Gut Institute: For sharing an herbal antibiotic protocol that has cured many SIBO patients — it is the protocol I would have tried if I hadn't come across the newly released Atrantil.
- Hollywood Homestead: For the lead on motility dysfunction and vagus nerve damage as possible causes of SIBO.
- Digestive Health Blog: For the lead on botanical medicine Atrantil to treat the archaea bacteria that cause the constipation version of SIBO that I have.
You said you used Atrantil, are you still taking it? Do you still have relief?
ReplyDeleteThanks,
Natalie
Hi Natalie, after taking 6 capsules (2 at every meal) for 30 days, I reduced it to 2 a day, then about a month later to 1 a day. I now take one only when I feel gas or bloating immediately after eating. I'm not "cured" so much as asymptomatic most of the time. I still have to be very careful to drink enough water, take daily magnesium, or constipation comes back, and with it bloating. I hope that helps!
ReplyDeletecan I ask what your symptoms were before?
ReplyDeleteI'm asking because constipation is my only symptom at this point which occurred after four rounds of antibiotics.
So when I see your protocol includes Atrantil, magnesium, and Iberogast I wonder if the magnesium and Iberogast are what is curbing your constipation rather than the Atrantil.
Do you still take the magnesium and Iberogast or were you able to drop those?
Thanks.
Charlotte
Have you been diagnosed with SIBO through a breath test? If you have, then you'll need to take the Atrantil, which has herbal antimicrobials that will eliminate some of the bacterial overgrowth.
DeleteIf you haven't been diagnosed, but are experiencing constipation after antibiotics, the magnesium alone might work. It depends on what's causing it. If it's lack of motility - like food just isn't working it's way down, then magnesium + Iberogast might work. Do you sleep regularly? Or experience insomnia?
Am not so sure that you can restore your microbiome by eating a pound of rice if(perfect health diet)
ReplyDeleteI do eat rice. I don't eat a pound a day. I eat a few servings of rice a week. To encourage autophagy, I eat only two meals a day. The first is a soup made of bone broth, followed by a snack of fruit, like an apple. Dinner may be meat, green vegetables, and root vegetables like plantains, yucca, potatoes or sweet potatoes or sometimes rice. Four nights a week I eat salmon with a side salad. Sometimes I have cheese or yogurt for dessert. What do you eat?
Delete"Once I saw the failure rate for the Rifaximin and neomycin protocol to treat SIBO-C, I knew that wasn't the course for me. "
ReplyDeleteWRONG. The study you posted was for rifaximin ONLY treatment and this has shown to be less effective against methane dominant SIBO.
You never tried rifaximin + neomycin so don't knock it so that others get discouraged, especially since you're claiming the wrong study data.
Luckily, I haven't had to resort to antibiotic treatment at all. What finally cured me was a 10-day water fast. I now eat whatever I want, practice intermittent fasting, and have watched all of my symptoms fade away.
Delete