SIBO Ain’t Gone Yet


I began this current journey of reducing the SIBO symptoms and thereby reducing my gasses, methane and hydrogen, in January 2020. I didn’t have high hopes of any kind of resolution. After all, I’ve been at this SIBO eradication since 2015. In February, after working through Dr Pompa’s month one of his SIBO protocol, I started to see a naturopath through telemedicine. She encouraged me to keep at it and to retest to see if I still had SIBO. Surprise! My methane-dominant SIBO (recently being termed IMO, intestinal methane overgrowth) was drastically reduced and now the real numbers of hydrogen-producing bacteria were revealed. I was now diagnosed as SIBO — small intestinal bacterial overgrowth — meaning methane gasses were low and within range, leaving just hydrogen gasses present.

Since March 2020, I’ve been using SIBO killers and biofilm busters on two-week rotations. I’ve also done one 5-day water-only fast — next best thing to a 2-week elemental diet for starving the bugs. In May 2020, it was decided we needed to see how the bugs were doing in my colon, where many of them are supposed to live. Enter GI360 Microbiome 3-day stool test from Doctor’s Data. Results came back this week.

GI 360 Microbiome Test

Well, you might be asking what is this test and what will you find out. Once I got over the cost, I decided to dig in and figure out what could be learned from such a test. The main goal is to find out what my colon’s bug diversity truly is after all the killing that I’ve been doing with herbal antibiotics for the last 5-6 months. Additionally, this test looks at GI pathogens, parasites, other microbes and stool chemistries. It also lets me know which antibiotics, herbal and/or pharmaceutical, will work best to get rid of the remaining overgrowths.

The diversity of your microbiome can tell you so much.

Results — My dysbiosis index, a calculation based on the overall bacterial abundance and profile compared to a reference population, was 3. Although it was above the reference range of 2, it isn’t too bad. Basically, the bacterial abundance were okay. There were/are a few strains that will require bolstering once we finish with the killing phases. But on a happier note, I had no pathogenic guys like parasites, bad bacteria, protozoa, worms — tape or round, flukes (not even sure what these are, but ow), or other not healthy markers. Yeah! So, apart from low secretory IgA. I have to dig in and learn about this immunoglobulin, as it has been low over the last decade. I had two healthy bacteria that will need some help. One is low likely due to the low FODMAP diet and the other apparently needs some cruciferous veggies to make it happy. Subsequently, I will need to figure out how to put these additions successfully into a ketogenic lifestyle for me.

Next Steps For Me

Since my SIBO symptoms are improving and my colon bacterial diversity it okay, I will complete at least 2 more 2-week rounds of SIBO killing treatments. At the end of these rounds, I will need to decide whether I want to another lactulose breath test or use lack of symptoms as my guide. Undecided as to which way to go yet. I should be done the killing stuff by the end of July. Wahoo!

After the killing phases comes the rebalance phase, which is to repopulate and build up the good guys to take up the gut real estate and keep the bad guys from doing so. This rebalancing usually involves using a prokinetic. A prokinetic is a supplement that supports healthy motility of your digestive tract. Basically, it helps to move broken down food from the stomach through your intestines. This is where the Goldilocks scenario is true — you want your motility to be just right, not too fast so no nutritional absorption can take place nor too slow where fermentation by the bugs (good and bad) thrive and possibly overgrow.

Prokinetics should be rotated at least monthly. And you will need to take them for at least six months after treatment (think rebalance phase start).

Personally, I have used a number of prokinetics suggested by SIBO health practitioners. The hardest part has been accessing products in Canada. Here is a list of prokinetics I am aware of

  • Prokinetic foods made into teas that might work for some people: ginger (as in grated ginger root or tea bag), dandelion tea, or fennel tea – drink after a meal/food and/or before bed
  • Iberogast – I usually find this at the local Rexall Drugs. Dosage: 60 drops once at bedtime OR 20 drops 3x/day between meals
  • Prokine by VitaAid – a natural formula (available through my online dispenser; call for details)
  • Triphlax-750 by AOR -supports digestion and regularity (AKA motility) (available through my online dispenser; call for details)
  • Low-dose naltrexone – must have a prescription from a GI specialist, so this one is very hard to access
  • Prucalopride (Resolor in Canada) – again must have a prescription from GI specialist

Usually also introduced during the rebalance phase, if they weren’t previously during remove phase, is probiotics. Like prokinetics, probiotics should be rotated/changed monthly. I will reinvestigate probiotics in a future blog post.

To find out more about prokinetics, check out the link below from a previous blog post.

Previous SIBO Blog Posts

If you are wanting to know more about SIBO and my journey check out the following posts:

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