3 steps for treating small intestinal bacterial overgrowth (SIBO)
I am no doctor and do not give medical advice but after spending the past few years dealing with all sorts of gut and health issues, I finally have a clearer understanding of how to manage my SIBO condition. The below are the 3 strategies I used - you can read my full journey here.
1.Low Fodmap Diet
I ate a low fodmap diet and also reduced grains, starchy vegetables and all sugars for 2-3 months. After this time, I very (...yes very) slowly reintroduced some foods. I noted what worked and didn't work. A SIBO diet is something that must be customised for each individual - there is no one perfect diet for everyone. To this day I am still experimenting with certain foods and although I eat starchy vegetables and some grains / fodmaps, I try not to overdo them. Other diets that have worked for people with SIBO:
Specific Carbohydrate Diet (SCD)
Gut and Psychology Syndrome Diet (GAPS)
2. Herbs or Antibiotics
I took herbal antimicrobials in combination with Allicin (extract from garlic). I took the herb berberine in the form of phellodendron - the product was called Bactrex by Metagenics. This product is commonly used by Naturopaths in Australia. The Allicin is a critical component if you have Methane based SIBO - read how it was the missing link to my SIBO story here. Other options:
Other antimicrobials e.g. oregano, neem
Antibiotics e.g. Rifaximin, Neomycin
Prokinetics are herbs or drugs that enhances gastrointestinal motility. As a preventative measure after ceasing antimicrobials and relaxing the diet a little, I took prokinetic agents. I preferred natural options such as ginger, 5-HTP , however, I occasionally use Iberogast (which contains alcohol).
How to prevent sibo relapse?
Although my last SIBO test came back negative and I feel 10x better now than I did a few years ago, I still experience some digestive issues (namely constipation or gas when I eat certain foods). As I have a poor functioning migrating motor complex (MMC) and low stomach acid (these are actually some of the causes of SIBO) I continue to:
Largely eat a low fodmap diet;
Take herbal antimicrobials on a weekly basis (also helping to kill my viruses);
Take Allicin every day;
Take a herbal prokinetic agent every day;
Ensure I eliminate every day;
Take HCL and/or digestive enzymes with my food; and
Drink fresh celery juice first thing on an empty stomach.
I also employ some of the gut healing strategies I outlined here and continue to focus on treating other causes of illness in my body - namely Epstein Barr Virus (EBV) and Human Herpes Virus 6 (HHV-6). And don’t forget stress management - sounds obvious, but many of us forget the importance of ensuring our body has time in the parasympathetic state!
I am currently working with my practitioner to determine whether probiotics serve me or not. I recently did 2 months on Bioceuticals UltraBiotic 500 (which is the same as VSL 3 for those not living in Australia) applying the Michael Ash stewed apple theory. Although I had initial success with it, I later experienced some digestive discomfort, so I’m back on a stricter SIBO maintenance protocol at the moment! Stay tuned for future updates.
Finally, I would like to remind you that if you have SIBO and are frustrated by relapsing or the speed of recovery ...don’t be too hard on yourself. After approx 7 years of studying SIBO, Dr Allison Siebecker admits to not having “cured” herself of SIBO. For some people it is a simple fix and for others (usually those who have methane type and other health issues) it is a journey. Much of it is trial and error with foods, herbal supplements and lifestyle management.
I know it is frustrating, especially if you have been dealing with it for many years however if you do your homework and the hard yards - find your ‘right’ diet and take some maintenance herbs, I’m sure you will start to see improvement.
If you're interested in learning more about my health journey with SIBO, leaky gut, candida, epstein barr virus and hormonal imbalances, I've created Routines with Amy Evans, which lays it all out for you. Go check it out and let me know if you have any questions <3