15 thoughts on “The SIBO Saga: Part 4

  1. Gundega

    Dear Angie,
    I also have SIBO, and I'm also on the AIP + Low FODMAP diet like you. I have a little question. I've improved a lot but something is holding me back, and I'm wondering if it could be the bone broth & gelatin that I use. Every day I take either one or the other (meaning gelatin powder on the days when I don't take broth). Is gelatin also fermentable by the bacteria? If yes, then maybe I should stop taking it. Thank you for addressing these issues!

    Reply
    1. Angie Alt

      Post author

      Gundega, it really is possible it is the the broth & gelatin. You could try meat or marrow based broths for awhile & see if it helps.

      Reply
      1. Gundega

        I'll try & let you know. Also you mentioned probiotics for the people with SIBO, that (though usually helpful) they might also aggravate the problem since there's an overgrowth of harmful and beneficial bacteria. I've been wondering to myself if I should stop taking my probiotics while I'm taking Herbal Antibiotics. Also you mentioned oregano oil that you had a rough time with it. So you haven't been able to take any of that?

        Reply
        1. Angie Alt

          Post author

          I don't tend to use Oregano, no. I did not tolerate it well. I think probiotics can & should be taken, but work w/ your doctor on timing & type so you help the "good guys" not the "bad guys."

          Reply
          1. Gundega

            May I ask what were the effects when you tried the Oregano oil and how much did you try? I might risk and try it since I hear it's so potent. Maybe it might help me with my SIBO.

          2. Gundega

            Dear Angie,
            I still decided to risk it and have been taking 2 drops of Oregano oil for about 6 days. Now I see what you mean - it is crazy-powerful. I feel dizzy and kind of strange when I take it. I've never felt like that before. I also have been getting lots of new acne on my chin, so I'm wondering if the Oregano oil is actually killing off my SIBO and acne is due to the "die-off". I wonder if I should continue or better not...

    2. Nadira

      Gundega, gelatin causes a MASSIVE flare in symptoms for me, and broths do as well. I stopped making broth the "easy way" and now make broth with either meat alone (ie the broth from stew meat), or I literally pick and cut all the cartilage off the bones of my chx beef pork etc., before putting it in the pot to boil. The other stuff, the cartilage, joint tissues, I boil as well to use for broth for the rest of my family. It's a huge pain, but it is great bc I can drink broth without symptoms anymore whereas before i never knew if it would bother me or not. And since my diet is so limited, I'm glad I can at least drink broth still.

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      1. Dawn

        Same thing for me. I think a lot of people aren't aware of the connection between FODMAPS and cartiledge/gelatin. I did an experiment to see if it was the chicken foot broth- I drank some on an empty stomach and within 2 minutes my stomach was in an uproar! The FODMAPS peopel need to publish something on this!

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  2. Britt

    Hey Angie,

    Thanks for all the posts about SIBO. I've been struggling with it for years, at first trying to treat it with diet alone. Now that I'm (fingers crossed!) hopefully on the road to getting rid of my SIBO under control, I'm curious about maintaining that state.

    I wonder about a standard paleo diet or AIP diet alone? Is there any evidence or discussion on whether a standard paleo or AIP diet can be maintained successfully after SIBO is not active? Or does it seem like SCD, low FODMAPs or Cedar-Sinai modifications to paleo are necessary to keep the SIBO from coming back? And what about "cheat" meals?...I think the emotional challenge of it would be greatly lessened if I felt I could eat a strict diet 95/5, instead of an absolute strict adherence 100% of the time. Many paleo experts advocate an 80/20 approach (like Chris Kresser). I've always felt unable to do that with active SIBO, but I wonder if it's possible once I'm more maintenance level. I appreciate your thoughts!

    Reply
    1. Angie Alt

      Post author

      Hi Britt! Thanks for reading! The diets have not been well studied in terms of SIBO itself & this is actually something that all of the docs at the Symposium seemed to want to see happen. Paleo & AIP have no evidence, but my personal experience is that AIP + Low FODMAP worked well. It seems like this has to be done for awhile, following treatment, but you should at some point be able to transition, provided any underlying reasons for the overgrowth have been addressed. Personally, I am dealing w/ multiple autoimmunes & former SIBO issues, so strict adherence is the only way for me, but I understand how emotionally hard that is . . . I think each person needs to discover what is right for them & if a less strict approach is doable, they should go for it. I don't think anyone should be more food restricted than necessary.

      Reply
      1. I can't figure out what you are possibly eating when doing AIP and low-FODMAP. At least for me - my one big problem with AIP is that I can't seem to digest much fat or broth or any of the digestive supports recommended. This leaves me lower fat (at least for now) with little to eat. I tried to stick low-FODMAP on top of my already miniscule diet and after 2 weeks my boyfriend insisted my sudden depression was diet related and to please eat a sweet potato. Depression gone in 2 hours. I was merely hungry! THAT is not helpful.

        My diet is chicken, fish, some leaner beef, and, all cooked: greens, carrots, summer squashes, sweet potato, apple and I'm now experimenting with beets. Are you just eating a lot more fat? How are you not hungry. Cutting out the FODMAPs leaves me maybe eating 1000 calories a day and as mentioned above, that is not good for me.

        I've had some weird success with AIP. I went on it to help chronic indigestion, GERD, and to hopefully support my skin which has been effected by some sort of 'immune response' from medication (which I'm no longer on). With no dairy, grains, etc. my lifetime of allergies and asthma seem to have vanished. My GERD is also essentially gone (as long as I don't eat GERD triggers and don't lay down for 3 hours). This is huge! So I'm loath to give it up. That said, my indigestion soldiers on with only millimeters of improvement, it remains really easy to piss off, and my food list is extremely small. Everything's cooked; anything raw or even 'not cooked enough' gives me immediate GERD and/or indigestion.

        I'm also curious about the recommendation of SCD for SIBO since SCD is FODMAP heavy. The first foods you add back are butternut, acorn and apple. These are all high-FODMAP foods. Are the doctors doing the same SCD the rest of us have tried or do they just want us to eat cooked foods? It's confusing.

        Anyway, I for one am feeling both better and SO frustrated and SO hungry on AIP Paleo, even with the FODMAPs I'm eating. I'm about 2 months in and want to kill someone. If I weren't having these other improvements I would be eating rice right now and other bland, filling foods. Maybe other folks can digest fat but for those of us who can't, this is a bit of a nightmare of a diet. My doctor is on board with the elimination part but is not happy I'm hungry. There's no way to win with this. I'm damned if I eat off the diet (so I read) and damned if I do (starving). If you can share what you eat when low-FODMAP and AIP, I'd really appreciate it. Thanks.

        Reply
        1. Angie Alt

          Post author

          Hi Alexandra-
          I can understand your frustration. AIP+Low FODMAP is very, very challenging. A few things: 1) I would recommend you only add the Low-FODMAP component if you have confirmed SIBO through testing. "Test don't guess" is the mantra. As you are pointing out, it is extremely challenging & I think emotionally taxing if you don't have a proven reason to do it. 2) If you are doing AIP, I don't think there is a reason to switch to SCD just for SIBO treatment. AIP + Low FODMAP will work fine. 3) Diet alone is not going to work for SIBO. You also need to combine it w/ a conventional or herbal antibiotic course, which will also shorten the time you need to layer on the Low FODMAP componnent to AIP. 4) If you are having trouble w/ fat digestion, that may indicate a gall bladder or stomach acid issue. I would talk w/ you doctors about ways of dealing w/ that, perhaps w/ digestive aids or treating an underlying problem. 5) A great book for dealing w/ the "what" of eating AIP + Low FODMAP is here: http://www.acleanplate.com/my-books/28-days-of-low-fodmap-aip/ Best of luck!!

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  3. Susan

    Hi Angie! Thank you so much for all of this helpful information. I have SIBO and Type 1 diabetes. I am already AIP and low fodmap, and I'm going to try following SCD once I get antibiotics and begin treating my SIBO. I understand that we want to avoid complex carbs so the sugar will be digested before it gets to the bacteria and feeds it. Well, what about excess glucose in the bloodstream? Do you know if that would have an effect? If I have high blood sugar, would that feed the bacteria?

    Thanks!
    Susan

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  4. Jana

    I'm starting the Berberine/Neem/Allisyn natural antibiotic treatment and am trying to follow low-FODMAP/SCD diet. Two questions: 1) I want to confirm that the garlic in the Allisyn supplement should be a problem even if I am sensitive to garlic?
    2) I lost weight a year ago when I started dealing with digestive issues and trying dietary approaches. I haven't had my period in 10 months and my OB/GYN wants me to gain weight to see if that helps. Any suggestions for how to gain some weight while also following the low-FODMAP/SCD diet? I don't know how to find the right balance of avoiding carbs and still be able to gain weight (I already add lots of coconut and olive oil to my diet.) Thank you!!

    Reply
    1. Angie Alt

      Post author

      Hi Jana-
      1) To my knowledge the Allicin is still fine. 2) More fat & just more food in general is the first step, but these two priorities may be competing. There are some SCD "weight gain" shake recipes out there. I don't know how they fit in terms of low-FODMAP, but they may be worth a try. Thanks for reading!

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