2019 in Review

Another year gone by already and what a year it was. I spent a lot of this year dealing with a relapse of SIBO and some other health issues but still managed to get outside every single day, got in a lot of hunting and fishing and had quite a few good trips locally, to the LA area and to British Columbia. So much, in fact, I couldn’t even really get it all in the picture grid.

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Atrantil, another round of treatment…

After failing to knock out the SIBO relapse with a month of herbals I decided to try something new – Atrantil.   Atrantil was designed by a GI doctor in Texas specifically for methane dominant SIBO.  It is a combination of three herbs that is reported to block the ability of methanogens to actually create methane thus give relief from symptoms.   Studies show it works about 80% of the time in tough to treat cases but it is unclear whether it just stops symptoms or actually kills off the bacteria.

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SIBO is back, with a vengeance

About a two months ago I started having some symptoms that reminded me of when I first started getting SIBO back in 2013 – a dull full feeling under my right rib-cage, bloating, burping, etc…  After a few weeks of it I decided to just start treating it in hopes of knocking it out quickly so did a month of AlliMed/Neem/Berberine.  I had my ups and downs over the month and settled into a strict Paleo diet and felt better thinking that maybe I had licked it.  I decide to test and see where I was actually at and was stunned at the results:

Worst test result I’ve had to date, high of 62 when my previous high had been in the 49 and that took nearly two years to clear out.    My baseline was off the charts high so it makes me think my system is simply full of m.smithii again.

Frustrating and depressing to say the least especially on top of this whole hormone mess I’m dealing with at the moment and I’m sure the two are somewhat related.  I’m not sure what direction to go with this.  I can:

  • Hit it hard with 2-3 months of herbal antibiotics again, maybe even increasing the dosage
  • Hit it with prokinetics at the same time
  • Try Atrantil
  • See if I can get into the SYN-010 clinical trial at Cedars

I’ll sync up with my ND in a week or so, summer vacations,  and try to come up with a plan of attack to see if I can get these numbers back down and not feel like crap again.   Until then I know I’m sticking to a lower FODMAP Paleo diet since I definitely feel better eating that way than the expanded gluten-free diet I had been on.

Can you be vegan with SIBO?

This is a question that has come up a LOT on the Facebook SIBO group and I thought I’d give my opinions on the matter having been a vegan and having suffered through SIBO.  I was on the spectrum from vegan to pescatarian most of my adult life, I think the last red meat or poultry I ate was at 18 years old until I got SIBO at 53.   This was a decision made for religious reasons as well as moral reasons to try and help save the planet and it wasn’t one made lightly.    Originally I was hard-core vegan living on rice and soy for the most part then switched to adding dairy and eggs to my diet with some occasional fish.  For many years we lived this way, eating fish often when traveling, otherwise maybe a few times a month.  Sometime a few years before I got SIBO I started having problems with dairy and went back to being vegan.

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2016, year of the dog

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2016 turned out to be a much better your than even 2015 was for me and really was shaped by our new family member – an Australian Labradoodle puppy we named Lira (river in Aboriginal Australian).   Catherine and I had been talking about getting a dog again and I wanted one that could hunt since I got back into hunting as well as be a good family dog.  We also wanted a non-shedding dog if possible.  This narrowed our options down to basically two breeds – a Pudelpointer or a Labradoodle.   We were on waiting lists for Pudelpointers when I found a breeder that had hunting doodles as well as Pudelpointers and after talking to her decided that the doodle would be a better dog for us.

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SIBO Symposium 2016

SIBO_headerAnother record breaking hot weekend in early June must mean it is time for the annual SIBO Symposium in Portland.   This year I decided not to attend the symposium live though and instead did some of the sessions from the comfort of my air-conditioned home where I could be at my stand up desk instead of stuck in a chair all day.  I didn’t attend too many sessions live and will watch the rest of them over the next few weeks as I have time. Instead I focused on some areas of interest and here are my notes.   For a good writeup of the top takeaways of the whole symposium see this great post by Riley Wimminger.

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A year without treating SIBO

A year ago I finally stopped taking antimicrobials for SIBO after a solid year of trying hard to eradicate it with first prescription antibiotics, then herbals and diet.   I never got a totally negative test last May but it was low enough that we all decided it was not worth trying to keep chasing down the last few points.  After the Symposium in June I decided that maybe I would never test negative due to large amounts of m.smithii in the colon so changed tactics to work on my colon flora and ignore the SIBO.

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Start a SIBO Support Group

support-groupsSIBO can be a very isolating illness.  Suddenly you can’t go out to eat with your friends since you are sensitive to everything.  You can’t really go out to a bar with your friends either, drinking is not recommended.   Often you just don’t feel like even leaving the couch when your gut is churning and you aren’t sure when you’ll next need to run to the bathroom.    Friends and family rarely can understand what is going on since until you experience SIBO you really don’t get it.  All of that can leave you feeling alone and a bit depressed, I know it did me.   I think the only person I saw outside of my immediate family for months was a string of doctors as I was trying to figure out what exactly was wrong and what to do about it.

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Can you breath your way out of SIBO?

Me with puffed out cheeks doing my breathing

Me with puffed out cheeks doing my breathing

SIBO may be happening in your small intestine but in many cases it is specifically a motility problem and thus tied to the enteric nervous system in the gut.   The most common cause  of SIBO is actually an auto-immune reaction where the body destroys a key protein that is part of this enteric nervous system and drives the migrating motor complex, the MMC.  The MMC fires the small intestine’s cleansing wave to flush any unwanted bacteria out.   If this protein, vinculin, is destroyed then the cleansing waves to do not fire as strongly and bacteria can back up in the small intestine causing the symptoms of SIBO.  The MMC can also be compromised if there is an issue in the vagus nerve, the main nerve bundle between the brain and the gut.   The vagus nerve and the enteric nervous system is so important that the gut is known as the ‘second brain’.  In fact, there are more neurotransmitters in the gut than in the brain itself, 95% of the serotonin in the body is produced in the gut and serotonin is a key transmitter in the MMC.

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