The long awaited post. The long awaited answers. The long............ journey.
I've been waiting to write this post for awhile. I wanted to figure out what was going on with my body and get as many answers as I possibly could before taking you along this wild ride with me. I think the easiest way to describe my SIBO journey is to go step by step in the order of my symptoms, diagnosis, and treatment.
** I first want to preface that many of my symptoms may be something YOU experience, but before self-diagnosis.. please consult a doctor. The diets and testing I've gone through are strictly for managing SIBO. This is not a weight loss method or anything I'd wish on upon anyone.
When I moved to Michigan, my body and heart were in a good place. Good, in my terms. Underweight and deprived, in my terms as well. Besides that point, I was in my normal body that I had been in the past 10 years. I started a job that required me to get up at 4 AM and drive 45 minutes to run a fitness center. It was boring and not challenging/fulfilling. I was only allowed to train a certain number of professionals that worked at this site and taught 2 group fitness classes (where previously I had taught 4 a week). After work, i'd speed to my second job where I waitressed until getting "cut" each night. No telling sign if it was 8 pm or 11 pm. But I was f***ing TIRED. My first 1.5 years in Michigan I experienced this terrible cycle of getting 4.5-5 hours of sleep. I made no friends because I couldn't stay up past 8 on weekends and I was irritable when I was awake. My diabetes was not in control as I was eating to stay awake... which was ALL the time.
Now, yes... I am a fitness professional. Your girl did not go over her 2,000 calories. But I was eating from 4 AM until 11 at night. Spread throughout the day. Sprinkled in with long run days and being on my feet constantly. I was drinking diet coke by the minute and Fridays were treated as my "off nights" where I didn't work at the restaurant. So I would sit on the couch, eat pizza and not move. I was tired. Mentally, emotionally, physically.
Noticing a change...
I started to notice changes in my body, which I have heard termed "happy weight". I instantly gained 4ish lbs the first 3 months of living with this new job. Again, I thought nothing of it as I was finally eating more and drinking less. Mike has had a great influence on this.
I specifically remember though, when my first severe stomach pain occurred. Mike and I walked to Ale Mary's on a weekend night and I had gotten the garlic hummus plate for dinner. Tons of raw vegetables, pita, and a big bowl of hummus. I remember leaving there and basically wobbling home, my stomach was so large and in pain. I remember telling Mike I think I ate a whole cucumber and thats why it was hurting.
For months following, I started getting these really weird symptoms after eating:
- bloating to the point of pregnancy looking
- pain in my abdomen because I have a SMALL frame, so expansion like this was terribly uncomfortable
-constipation. I have never been one to go to the bathroom frequently but I was going days without going #2.
-rosacea! I noticed that my cheeks would turn super pink after eating for no reason
Having an extensive background in nutrition, I started eliminating things I knew were upsetting my stomach. Raw vegetables, dairy/cheese, just to name a few. I even tried to skip meals to combat feeling "too full" at night.
After the 1.5 years of working in that very toxic state, I got a new job at a gym as a full time personal trainer. I was THRILLED. I was able to create my own schedule, sleep more, work less, and hopefully feel/be a better human. And this was indeed the case. My commute was cut to 20 minutes. My earliest client was 5:30 AM, and I never allowed myself to work past 7pm. I also had "short days" where I'd be done by noon.... and get to leave work and do whatever the hell I wanted!
Unfortunately, my symptoms didn't change.. They only got worse. To add to the symptoms I was experiencing prior, I now was GASSY. I would go to bed every single night STINKING up the bedroom. I couldn't help it and I couldn't keep it in. No matter how healthy I ate, my stomach looked like I was in my second trimester. The worst of all is I would still be hungry. It was awful.
I can figure this out myself (JAN 2020)...
I spent a year trying to figure out what was wrong. I had other health professionals listen to me and give me their tips. It just seemed like nothing helped. My bloating was beginning to just never go down. I remember being at work one day, and a fellow co-worker commented on my body and how my stomach always looked bloated despite the fact I was tiny. It was hurtful. I felt like the trainer that was trying so hard to build muscle and look lean, yet I had this awful bloating I couldn't get rid of.
I decided it was time to seek help because their was legitamtely something wrong with me. I couldn't keep cutting foods out because eventually their would be nothing left.
Naturally I googled all of my symptoms and the more I read about SIBO, the more certain I became. I finally read an article discussing SIBO and skin irritation and that was the last straw... I knew this was ALL connected.
What Is SIBO?
SIBO stands for Small Intestinal Bacteria Overgrowth. Basically, too much good bacteria has accumulated in my small intestine. When I eat certain foods, I get the symptoms I had been experiencing. To test for SIBO, one must take a breath test to see if either a) their hydrogen levels are elevated or b) their methane levels are elevated. BOTH mean you have SIBO. The main differences between elevated hydrogen vs. methane:
- Hydrogen-SIBO is when the bacteria has accumulated in the small intestine and most people get bad diarrhea, bloating and pain from this.
- Methane-SIBO is when too much bacteria has accumulated in the colon and produces bad gas, along with bloating and pain.
I read that SIBO is treated with antibiotics to kill off the bacteria as well as following a LOW FODMAP diet. FODMAPS are highly fermentable carbohydrates. This sounds easy, but this diet is extremely limiting as it cuts out some of my favorite foods: broccoli, cauliflower, brussels, garlic, onion, apples, bread, hummus, beans, gluten, most cheeses.. Every article suggests that finding out the root cause of SIBO is the #1 most important thing. Or else, this comes back.
The Changes I Made (APRIL- JULY 2020)..
With this information, I immediately began implementing the FODMAP diet. It was a LONG summer of eating primarily meats green beans, and potatoes. I tried to reincorporate foods slowly but each time, it never worked. I was getting ancy and upset. I couldn't eat out and I hated eating with other people because of how limited I was.
I found a GI doctor in Michigan immediately. He was the WORST doctor I have ever experienced. I went to him and told him what I thought I had, showed him pictures, told him all of my symptoms, and he stated that I should "eat better and workout more". Um... does he know who he's talking to? Anyways, I set up an endoscopy with this doctor and he found the following:
- Acid Reflux
- H Pylori Overgrowth
This photo I showed my GI doctor. I had fasted all day and ate one meal that night and this is what happened 20 minutes later.
We treated the overgrowth immediately with antibiotics, but he did not do the traditional breath test that I knew SIBO diagnoses required.
Need More Answers... (August 2020)
I still had to follow the diet as I did not feel any different. My endocrinologist recommended that I see the GI specialists in Columbus and I followed suit, setting up a consultation with a doctor at Ohio Gastro. As soon as I told this doctor what I had been experiencing he sent me home with comfort, saying we'd do the breath test, we'd do a gastroparesis test, a test to see if the H.Pylori was killed, AND medication for the acid-refulx (which the last doctor never did).
Dr. B called me once he had received all of my tests through the mail (the breath test was a grueling 4 hours of breathing into tubes) and confirmed that I indeed had SIBO.... BOTH hydrogen and methane levels were severely elevated. So he put me on a 2 week antibiotic.
For the next two months I was living my best life, loosely following the FODMAP diet, but experiencing absolutely no bloating. Below is a picture in the same shorts, just 3 days after taking the antibiotic.
SIBO Round 2...
In November, I remember specifically one week of eating Mediterranean food, crackers with garlic and onion, and having a cookie cake, and my SIBO came back with a vengeance. I absolutely could not get my bloat to go down and I started getting really gassy at night again. I cried almost every night wishing, praying that this didn't come back so fast.
I called my doctor in Columbus who ordered me another antibiotic but recommended that I talk to their dietician that works specifically with SIBO patients. That is when I met Paula (@thegutsyrd),
Paula explained to me why I had SIBO.
Why I have SIBO and The Rules I Need To Follow...
Paula explained to me that SIBO occurs my MOTOR MOVING COMPLEX (MMC) .. a complex that completely cleans out our small intestine and colon of food/ sweeps it out... becomes stressed and stops working as efficiently. This happens when our body doesn't have time to rest and digest before adding more food into our system.
So thinking back to the year and a half of getting 4.5 hours of sleep, my body was constantly eating for fuel to stay awake. Food was always in my small intestine. So, the good bacteria in my colon saw this and all the fermentable foods I was eating and made a home in my small intestine. This is why bloating, stomach pains, and constipation happens. My MMC never has a chance to clean my system out because the MMC requires at least 5 hours of fasting time to turn on. In normal humans, that comes with sleeping at night. But, I disrupted this for 1.5 years and my body now doesn't "clean out" as efficiently as normal. THAT is why I have SIBO.
Paula gave me specific rules to follow to treat SIBO. If I follow these rules, I should not have problems.
1) I MUST fast between meals. This means 5 hours of not eating or drinking anything but coffee or water between meals. This allows my MMC to turn on and clean my system out.
2) Follow the SIBO diet strictly for 1 month and start the reintroduction process that lasts 7 weeks. I am currently working on gluten, but successfully passed fructose (tested with honey 3 times with 3 different amounts) and passed Galactans (tested with blackbeans, 3 times with 3 different amounts). I also can tolerate lactose at small amounts. Larger amounts cause me constipation but not much bloating.
3) Take Sunfiber supplement for fiber that does not have fermentable carbohydrates present.
4) BioGaia Probiotic
5) Prokinetic, which helps speed up the MMC process. This stuff is kinda gross but I take it 3 times a day.
The number one thing that works for me is fasting. I thought it would be hard, sometimes it is... but it truly makes me feel normal. I instantly lost 5 lbs of bloat and I'm sure weight from not snacking, but it feels good to feel normal again.
Why I Am Sharing This..
I am sharing this because I think a lot of people have GI problems and this took 2 years for me to finally get answers. I encourage you to not give up. I am still battling what works for me, but the best thing that has happened to me is finding out the root cause of my SIBO and treating it from there. Paula has been a blessing and meets with me virtually once a month to make changes or talk through what is working. Find a doctor that works with you and wants to help you.