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SEVERE SIBO ATTACK
Hello dr, I’m writing to you because I was diagnosed with SIBO 3 months ago and I followed a high antibiotic protocol for 14 days (rifaximin+flagyl) along with digestive enzymes, Berberine. And after protocol NAC+selenium.
I tried to keep dairy and gluten out after my protocol but I eat sourdough bread and sometimes dairy..
The past week I started to feel pain in my upper stomach and it kept on building up daily until yesterday I got a bad attack of pain similar to stabbing pain in my upper stomach.
I don’t know what to do -
11 Replies
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This is the test that shows I have SIBO
[226990-SARA EL SOKHNI.pdf] -
Hey @Sara,
With SIBO often a low fodmap diet is recommended. Below I attached a handout from the BBetter library so you won’t need to search it!
I would, however, recommend stopping sourdough and all gluten-containing grains. Breakdown products of gluten will elevate zonulin and zonulin will cause the gut to be more leaky by opening the tight junctions (basically doors between cells) in the gut lining.
SIBO
To prevent SIBO from reoccurring you should also spend some time in finding what causes it. Here are some factors that can lead to SIBO:
• Low Stomach acid. Stomach acid is our first line of defence against foreign invaders. When stomach acid is low (for example to chronic stress, a slow thyroid or simply bad eating hygiene) the wrong microbes can populate the microbiome.
• Snacking. The migrating motor complex (MMC) is a pattern of electrical activity observed in the gastrointestinal tract causing intestinal peristalsis. Eating stops the MMC. If you find yourself snacking all day, you might want to change this habit, since it can cause bacteria from the large intestine to migrate to the small intestine causing SIBO.
• Antibiotics kill bacteria. In order to prevent yeast and fungi from growing I often recommend my clients take a good broad-spectrum probiotic supplement. Ther-biotic from Klair Lab has a wide range of probiotics and I often recommend this one myself. It can take a really long time after a course of antibiotics to repopulate the gut microbiome. I would advise you to at least take probiotics for half a year.
• Make sure you aren’t constipated. This video offers great solutions if you are in need of them.
• Are you using Berberine as an anti-microbial? Berberine is a great option. With SIBO I often use a mix of antimicrobials containing wild oregano, thyme, cat’s claw, pau d’arco, peppermint, garlic, cinnamon and olive oil extract. Great multi-herbal supplements that are anti-microbial are Metagenics CandiBactin-AR + CandiBactin-BR.
• The immune system plays a critical role in ‘allowing’ which microbes can live in the gut. I often recommend my clients check their vitamin D levels. I personally aim for around 50 ng/ml. Zinc and vitamin A are also important nutrients for the immune system.
• Digestive enzyme support in your case could help you as well. Bile for example is antimicrobial to a degree and creates a good environment for an optimal microbiome.Pain in the upper stomach
There are a few reasons why you could experience pain in the upper stomach.
• Indigestion.
• Abdominal muscle strains from exercising for example can also cause abdominal pain.
• Hiatal Hernia, which happens when the stomach pushes through the diaphragm.
• Gallstones are formed by cholesterol crystals and can cause pain in this region. Make sure you aren’t hydrated. D-lemonene in this case can help resolve the cholesterol crystals.
• Peptic ulcers can also cause pain in this region
• Inflammation in the liver can also cause some pain in this areaThe type of pain is hard to assess for me. If you feel worried, you should talk to your doctor since he will be able to judge the situation better and faster.
If you did talk to your doctor, you can share his findings. We could provide you with much more targeted advice!
I hope you feel well soon!
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did you recall ingesting either glucose or lactulose, waiting some time, and then doing a breath test? That’s typically how SIBO is diagnosed. The stool test you attached only suggests the possibility of SIBO and says “consider SIBO testing” because of a higher IAD (Inflammation-Associated Dysbiosis) and Methane score.
Now keep in mind that SIBO is not a root cause. It is also a symptom. Here’s a post I did about that to give you better insights.
If you are sure it is SIBO however, then I suggest you have a listen to this live recording (skip to the 18min20sec mark) where I discuss causes & solutions for SIBO with other members, along with the areas to focus on (the 3 major players: stomach, gallbladder, pancreas which I discuss in the Gut Health Masterclass). Have you had a chance to watch those videos yet?
In addition to Daniel’s recommendations, make sure stress is addressed if that’s a factor in your life, especially around meals; eating hygiene is simple but powerful. Also check your thyroid status and rule out H Pylori overgrowth in the stomach. Low thyroid function can compromise and slow down overall digestion.
Regarding your severe pains, did you seek help from your doctor? Please do let us know if you did and what they suggest it could be.
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Thank you so much for replying B
No I did not do a SIBO test it was just the stool test I attached and my doctor had put me on the antibiotics sibo protocol based on this test only.I watched most of the videos yesterday trying to find answers, I know for a fact that stress is a big trigger for me as I have lots of pressure and responsibilities.
I never eat on the go but I believe even when I eat I still have my stress factors..
I never checked my gallbladder or pancreas function( please suggest what kind of tests do I need for that I will do them)
I have a blood test today for my doctor but please advise which tests are the most relevant for the diagnosis.Thank you
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since you’re going in to get tested, see if your doctor will order the following tests for you:
To check immune health:
• CBC with differentials
• Vitamin D
• RBC zinc (or serum zinc & copper if RBC is not available)
• Vitamin ATo check if stomach acid is low due to:
• H Pylori breath test
• Full thyroid panel (click here for full list on the last page)To check liver/gallbladder function:
• CMP panel (see the same handout for full list) but if your doctor refuses since they are many, then simply ask for these as a minimum: ALT, AST, GGT, Total Bilirubin, Direct BilirubinTo check pancreatic function, they usually measure Elastase-1 marker in stool.
It’s often difficult to get doctors to order this many tests without clinical reason unless they are trained in functional medicine. Dr Makk at Zia Medical Center will run these tests (and more) but it’s all pay and claim back.
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Hello again, my blood work just came out please let me know your thoughts
[SARA ABDEL AZIZ EL SOKHNI – 73885.pdf] -
Hey ,
Your vitamin D appears to be borderline low. I usually recommend my clients have their serum levels around 50 ng/ml. Also folic acid (or vitamin B9) I usually recommend being in the upper half of the reference range.
Your fT3 is in the lower half of the reference range while your fT4 seems to be fine. This could indicate a sluggish conversion from fT4 to fT3.
This handout will help you guide in what nutrients are important for healthy thyroid hormone balance.
The values concerning female hormone health are a bit dependent on when in your cycle you took your blood. Do you remember? One thing that does stand out to me is the elevation in prolactin. This can happen with pregnancy, and breastfeeding, but also with stress and a low fT3.
Do you recognize symptoms of a slow thyroid? For example, are you feeling cold easily? Are you feeling fatigued? Do you struggle with weight loss or do you have unexplained weight gain? Do you experience hair loss? Are you constipated?
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Thank you Daniel
How would you explain the high Vit B12 and the high prolactin??
Also please re attach the handout as I couldn’t open the file.
Thank you very much
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Hey ,
I uploaded my answer by accident, but it is corrected and finished. Are you taking any B vitamins or multivitamins? What about other supplements (like iron containing supplements perhaps)?
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Hi,
No I have not been taking any multivitamin or vitamin B, but I have a history of high B12 since I started having my gut issues and no practitioner or dr was able to explain why.I did the test on my 3rd day of period so we can rule out pregnancy or breastfeeding for prolactin, but I do have lots of stress in my life.
As for the thyroid I don’t necessarily have any weight gain and I just had some constipation right before my period when I got the sibo attack .
Sara
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,
Are you having sources you might not be aware of? Sometimes vitamin B12 is added to foods, drinks or protein powders/bars.
Do you know if your older serum B12 levels are much elevated? Some people are able to absorb B12 much more efficiently because they produce more haptocorrin (which is a protein that transports vitamin B12 into the body).
Some bacteria in the colon also produce vitamin B12, which could contribute to elevations in vitamin B12. It might not be the only factor at play in this case though. The amount of B12 produced by the gut microbiome is usually pretty low.
Several liver issues can cause elevations in serum B12. Your liver enzymes look low normal, but just slightly. Vitamin B6 is a cofactor that is needed to produce liver enzymes. If you’re low in B6 your body might try to produce liver enzymes but lacks the building materials. This then can hide potential liver issues. An ultrasound to examine the liver to rule out a fatty liver or liver damage is advisable. Again: this is to rule out stuff.
Did your doctor also look at your kidney function? Also, healthy kidneys are important to clear vitamin B12.
If stress is a big player in your life right now this handout could provide you with some relief. But tackling the stress source is where the real focus should be of course!
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