SIBO diaries, pt. one | an introduction

Back in January, I shared my experience of struggling with severe abdominal bloating and starting the low FODMAP diet. Long story short, I visited multiple doctors and underwent a handful of tests, none of which gave me a diagnosis or a cure. By chance, I heard about the low FODMAP diet, a nutrition protocol that avoids foods high in FODMAPs (fermentable oligo-di-monosaccharides and polyols), which are not digested or absorbed well, and subsequently can be fermented upon by bacteria in the intestinal tract. Here’s how I’ve been doing since then. (Fair warning: this is a long post.)

The low FODMAP diet was a great initial stepping stone towards relieving my symptoms, but in the end, it was just that–a temporary relief, but not a lasting remedy at the root of the cause. Since beginning the low FODMAP diet in January, I saw and felt my bloating somewhat decrease, by following the protocol to the best of my ability: eating gluten-free, avoiding garlic and onion, and staying away from other fruits and veggies on the do-not-eat list, and so on. But after a couple of months, I still wasn’t seeing the results that I wanted, and still experiencing intermittent bloating, fatigue, and other IBS symptoms. Plus, I’ll admit, it was difficult to follow the diet to a tee without proper guidance or understanding how dieting and nutrition works with each individual body.

During that time, I had joined a couple of FODMAP community groups on Facebook, where people in similar situations share experiences, ask questions, offer words of encouragement, and exchange low FODMAP recipes. Seeking advice and solidarity, I posted my story on the page, which promptly received a comment suggesting that I ask my doctor about SIBO.

SIBO? Another foreign acronym that left me feeling even more puzzled and exasperated in my journey to figuring out what the heck was wrong with me. (And I’m sure many of you can understand how mentally and emotionally draining it is to go down the rabbit hole that is the Internet to find an answer to a medical problem.) Figuratively dragging my feet, I opened up a new tab to Google and typed the four letters into the search bar.

SIBO stands for Small Intestine Bacteria Overgrowth, and it’s when bacteria that would normally live in the lower, large intestine somehow end up in its smaller counterpart. The small intestine isn’t designed to house these unwanted bacteria that emit hydrogen and methane gasses when digesting food. This manifests in a myriad of symptoms, including bloating, cramps, constipation, diarrhea, acid reflux (heartburn), nausea, food sensitivities, joint pain, headaches, mood symptoms, eczema, iron deficiency, abdominal pain, vitamin B12 deficiency–the list is long, varied, and unique to each affected person. But to put it simply, SIBO has a major and detrimental effect on the overall quality and joy of life.

After I pored through countless forums and websites on the subject, I was pretty convinced that SIBO could be the culprit. In late July, I decided to seek a nutritionist, and especially one that knew about SIBO. (I would later realize that many GIs and doctors, like the ones I’d seen previously, either do not know about this new field or do not acknowledge the legitimacy of the syndrome.) Some hours of research later, I contacted a nutritionist, explained my story and how I had already been on the FODMAP diet, and asked if he knew what SIBO was. He replied confidently that he was very familiar with this digestive condition. Trusting his word, I scheduled my initial consultation.

My nutritionist believed that all of my symptoms pointed to SIBO, especially because I had been on the low FODMAP diet, yet was still experiencing symptoms. He decided to put me on a combo diet of low FODMAP and Paleo; and the next step was to take a Lactulose Breath Test, one of the few (yet often inaccurate) tests for SIBO. The at-home test required me to eat a special, exciting diet of strictly jasmine rice and plain protein for two full days and fast for 12 hours prior to the test. On the morning of the test, I took a lactulose solution (a manmade sugar that is not digestible by humans, but on which SIBO bacteria thrive), and breathed into a six different tubes at 30-minute intervals. The idea is to see how the bacteria functions. SIBO Center puts it best:

When bacteria digest food, they produce gas. These gasses go through your intestinal walls into your bloodstream, end up in the lungs, and you breathe them out. The breath samples that are collected get tested for the levels of Hydrogen and Methane being exhaled. These levels tell your doctor where bacteria are fermenting in your intestinal system, and how much gas they are creating. This will enable your healthcare professionals to help you get rid of your bacteria and the symptoms they cause.

So, I took the test, packed up the tubes, and shipped them off to the lab. For the next few weeks, I stuck to my assigned diet, which my nutritionist had to restrict even more due to the extremely sensitive nature of my stomach. From an already narrow gluten-free, dairy-free, sugar-free, and seemingly-everything-free diet, I cut out insoluble fibers like bell peppers, and raw leafy vegetables. The hardest was going cold-turkey on coffee, my lifeline, and missing out on family wine nights or happy hour. Through trial and error, I later realized I had fructose malabsorption, which meant that even fruits I was allowed to eat were causing me symptoms. Since July, I’ve kept a food log of nearly every single food and liquid my body has consumed. Needless to say, my life now revolves around what I can and can’t eat, and this handicap-of-sorts has dragged me through bouts of mild depression and countless emotional breakdowns.

Speaking of breakdowns: remember the breath test? Two weeks later and still with no results, my nutritionist contacted the lab, and–just my luck. They had never received my test, and even if it somehow arrived late, the test tubes were now ineffective. Feeling disheartened was an understatement. However, contrary to my own, my nutritionist’s morale was unmoved; he was 95% certain that I had SIBO, and asked if I’d like to proceed with the herbal antimicrobial protocol to treat and rid of the bacteria. Tired of being in gastrointestinal limbo, I agreed. But I still cried my eyes out on the drive home–disappointed, discouraged, defeated.

If the vicissitudes of this journey has taught me anything, it’s that sometimes, I have no control over the circumstances in my life. And it’s okay. In my next update, I’ll share the details of the herbal treatment I’ve been taking for the past month or so, my progress, and how learning to meditate (physically and spiritually) has helped me in the process of coming to terms with (and hopefully soon overcoming) my situation.


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