Augmentin temporarily cured constipation; but now it's back with a vengeance

[Zpol]

I'm wondering if anyone here can offer advice or perhaps suggest someone that may be able to help? Please :)
I suppose I have acquired some sort of antibiotic derived SIBO or something.

Last December, I had a fairly severe sinus infection. My doctor prescribed a 10 day course of Augmentin which surprisingly cleared up my life long constipation issue! (It did not clear up the sinus infection however). I was able to completely discontinue the cascara that I had been using daily for years (I had been taking approximately 1/2 teaspoon daily). This effect lasted for a good 3 months or so after completing the Augmentin course. Another thing I noticed was that there was no odor accompanying my BMs. It was crazy... I thought I was cured. But, the effect was not long lived. Now the constipation is back and it's considerably worse. I have begun taking cascara again at 3x the dose I used to take. It's a lot of cascara to take on a daily basis, and it's not pleasant to be taking this much.

There were some bad side effects that happened after the Augmentin as well so I don't really want to take it again. I'm hoping to figure out some alternative treatments. The side effects included severe dry mouth (which lead to some dental issues) and fungal overgrowth. The latter seemed to clear up on it's own but it was quite freaky at the time (TMI... stools were covered with white dots and mucus, plus I had a minor yeast infection). On a side note; I have used both doxycycline and rifaximin (not simultaneously) in the past with zero effect on gut health.

Other than the constipation, my health is pretty good. Occasionally I have other SIBO symptoms like bloating or heartburn but they are minimal.
I managed to clear up the nightmare sinus infection through other means fortunately.
My thyroid is in pretty good shape; TSH is at 1.14 uIU/mL which could be better but my temps are in good range so I'm not too concerned with trying to get it down to 0. My morning temp on average is 97.7 F and gets up to at least 98.6 F by late morning (99 F when I take progesterone) my pulse is pretty much always in the 80's per minute.
My energy level is good. I go for inclined walks pretty much every evening after dinner. My my 25OHD is in the 50's.
My diet is zero starch. I eat organic, extremely ripe fruits (usually grapes, oranges, apples, over-ripe bananas, dates, mangos, canned pears and peaches), eggs, beef, fat free chicken and fish, coconut oil, ghee, daily carrot salad w/ EVOO, bamboo shoots, well cooked greens, coffee, Uncle Matts OJ, organic additive free grape, apple, and pomegranate juice, coconut water mixed with juice and salt, Jennies coconut bites and chocolate chips, occasionally Mexican Coke or sugar gingerale. I avoid casein since it has caused autoimmune flare ups in the past.

I figured the Augmentin probably threw off some nutrients, particularly thiamine, so I've been taking 100mg Thiamine Tetrahydrofufuryl Disulfide every day for the last month or so in addition to the other B-vitamins (except folate).
I'm in process of researching to find out if Augmentin is known to deplete any other vitamins or minerals. Or if it affects bile flow or other organ functioning. Maybe someone here has some knowledge on this?

 

[Peachy]

I’m mainly commenting to follow, but what about trying colostrum?

It contains casein but also immunoglobulins so you may not react and it could even help resolve the intolerance. It can help with constipation - or diarrhea.

 

[Zpol]

I’m mainly commenting to follow, but what about trying colostrum?

It contains casein but also immunoglobulins so you may not react and it could even help resolve the intolerance. It can help with constipation - or diarrhea.

I've tried it before but there's so many brands out there, maybe I didn't use a good one. I used the Dr. Ruscio brand which just the immunoglobulins (the allergens were extracted out). It could be that the extraction process denatured the colostrum in some way. I had some weird side effect that I can't remember; it could have been unrelated but it wasn't psoriasis which I get from casein so that's good.
Do you know of a particular brand that is good quality?
Thank you for your thoughts!

 

[Peatful]

I have two thoughts.

(Mind you- undereating from age 13-43 completely wrecked me digestively, so
Im far from an expert- but on the same journey as yourself.)

That’s a lot of fruit and or fruit fiber.
I personally would need to add root vegetables and cut way back on the fruit and juices.
Juices and liquids I found very hard on my digestion. And to me- it looks as if you’re drinking a lot of your diet? Coke. Juices. Coffee. CW. Etc.

Hop off the missing nutrient train- and get on board with fixing through eliminating troublesome foods and adding therapeutic foods.

Lastly, honestly- look into FODMAPS. Its not too off the track and it offered me some valuable data about which particular things troubled me.
Its an easy tool in your information collection phase.
Heck- it could be as simple as your EVCO or pomegranate juice etc.
But - you have to really sleuth this out laboriously.

 

[Zpol]

@Peatful thank you for the response. I should have mentioned that the fruits and juices I mentioned are on rotation, I'm not really eating lots of them on daily basis. I make a dedicated effort to maintain balance with fruits and protein sources. I eat the foods that I can eat without direct stomach pain or other issues and try to get 80grams protein, enough good fat to cook with and taste good, and fill the rest with well tolerated fruits to achieve 2000 cal's per day. I only drink juice based on thirst because I don't want to dilute stomach acid or over hydrate.

I've tried all the diets over the last 20 years, elimination diets, therapeutic diets, low FODMAPs, SCD, AIP, hi carb, low carb, vegan, vegetarian, eliminate one thing add in another and track track track. Doing this, I have been able to fine tune my diet to eliminate multiple issues and resolve others but the constipation issue has not budged, not even a little. So, I'm at a weird spot. I can't really change my diet too much more or I risk the resolved issues coming back.
Actually, there is one thing that will probably help but I've been terrible at implementing, that is to stop snacking between meals. Can't seem to get past 2 or 3 hours without needing a snack. I know this messes up the migratory motor complex.
But, I tell you, nothing, I mean nothing, has come close to that feeling of being regular like the Augmentin did. Like it was some sort of miracle.

 

[Peatful]

@Zpol

So your current diet is not working- and you want to restrict more; ie no snacking?

If you’re hungry in two-three hours, that also points to your current diet choices not sustaining you optionally right?

Objectively reading your two brief posts- it seems obvious that a high fruit or no vegetable diet isn’t suitable.
I didn’t want you to go on a Fodmap diet- just trying to isolate what is troubling you.
Ex. Cantaloupe im fine with. Watermelon is a no.

Your hx of restricted diets got you here.
I honestly would be open to adding root vegetables for fiber, butyrate and or bulk.

Slowly for sure.

It’s hard.
I have good days and bad months.

 

[Zpol]

you’re hungry in two-three hours, that also points to your current diet choices not sustaining you optionally right?

Yes. This is true. I keep trying to add more foods. Hoping that more variety will be helpful in some way.

So your current diet is not working- and you want to restrict more; ie no snacking?

I don't want to restrict calories or foods just modify the frequency. Not even sure if it would help.

honestly would be open to adding root vegetables for fiber, butyrate and or bulk

My body has a love/hate relationship with root veg. Potatoes for example, they're great, they are temporarily satiating and make me feel warm and nice at first, but then a couple hours later my BG tanks and I'm starving. Plus they keep my guts in a perpetual state of inflammation. Quiting starch was difficult but reduced my stomach pain by about 75% in less than a week. I suppose I could try something more borderline like winter squash.

I have good days and bad months

Right. I hear that!

I appreciate your comments, and like you, I keep trying and keep tweaking in hopes to figure out what the best thing is.

After 20 years of thinking there's some magical single food or group of foods that I can simply eliminate or add in to solve constipation and getting nowhere despite all the efforts (I'm seriously systematic with this), makes me feel like I'm chasing a carrot on a stick. Plus add in raw verses cooked. Finding the exact right combination is basically like winning the lottery id say. And then when you do get it just right, how do you sustain that. There's an infinite amount of circumstances that affect what foods and cooking methods you have access to. How would you control all that? Point being, I think there comes a point in which you run out of options as far as possible dietary modifications and at that point you've got to get creative and figure out something else.

 

[Peatful]

@Zpol

Yes. Winter squash is a great option.
Beets. Sweet potatoes. No need to do traditional white potatoes. Roasted root vegetables. Casseroles. Etc.

I make a pumpkin custard that does really well for me.

Best.

 

[Zpol]

Yes. Winter squash is a great option.
Beets. Sweet potatoes. No need to do traditional white potatoes. Roasted root vegetables. Casseroles. Etc.

I make a pumpkin custard that does really well for me.

Pumpkin, sweet potatoes, don't digest well for me and made my skin yellow. They did not improve constipation at all though so no loss. Now beets, I have not tried faithfully. I gave up on them because I was worried about increase in nitric oxide , but I suppose that's orthorexic thinking. I know a few people who eats beets daily, purely because they help with digestion. The taste is pretty bad but I'm going to give it another go.

 

[Matestube]

I'm wondering if anyone here can offer advice or perhaps suggest someone that may be able to help? Please :)
I suppose I have acquired some sort of antibiotic derived SIBO or something.

Last December, I had a fairly severe sinus infection. My doctor prescribed a 10 day course of Augmentin which surprisingly cleared up my life long constipation issue! (It did not clear up the sinus infection however). I was able to completely discontinue the cascara that I had been using daily for years (I had been taking approximately 1/2 teaspoon daily). This effect lasted for a good 3 months or so after completing the Augmentin course. Another thing I noticed was that there was no odor accompanying my BMs. It was crazy... I thought I was cured. But, the effect was not long lived. Now the constipation is back and it's considerably worse. I have begun taking cascara again at 3x the dose I used to take. It's a lot of cascara to take on a daily basis, and it's not pleasant to be taking this much.

There were some bad side effects that happened after the Augmentin as well so I don't really want to take it again. I'm hoping to figure out some alternative treatments. The side effects included severe dry mouth (which lead to some dental issues) and fungal overgrowth. The latter seemed to clear up on it's own but it was quite freaky at the time (TMI... stools were covered with white dots and mucus, plus I had a minor yeast infection). On a side note; I have used both doxycycline and rifaximin (not simultaneously) in the past with zero effect on gut health.

Other than the constipation, my health is pretty good. Occasionally I have other SIBO symptoms like bloating or heartburn but they are minimal.
I managed to clear up the nightmare sinus infection through other means fortunately.
My thyroid is in pretty good shape; TSH is at 1.14 uIU/mL which could be better but my temps are in good range so I'm not too concerned with trying to get it down to 0. My morning temp on average is 97.7 F and gets up to at least 98.6 F by late morning (99 F when I take progesterone) my pulse is pretty much always in the 80's per minute.
My energy level is good. I go for inclined walks pretty much every evening after dinner. My my 25OHD is in the 50's.
My diet is zero starch. I eat organic, extremely ripe fruits (usually grapes, oranges, apples, over-ripe bananas, dates, mangos, canned pears and peaches), eggs, beef, fat free chicken and fish, coconut oil, ghee, daily carrot salad w/ EVOO, bamboo shoots, well cooked greens, coffee, Uncle Matts OJ, organic additive free grape, apple, and pomegranate juice, coconut water mixed with juice and salt, Jennies coconut bites and chocolate chips, occasionally Mexican Coke or sugar gingerale. I avoid casein since it has caused autoimmune flare ups in the past.

I figured the Augmentin probably threw off some nutrients, particularly thiamine, so I've been taking 100mg Thiamine Tetrahydrofufuryl Disulfide every day for the last month or so in addition to the other B-vitamins (except folate).
I'm in process of researching to find out if Augmentin is known to deplete any other vitamins or minerals. Or if it affects bile flow or other organ functioning. Maybe someone here has some knowledge on this?

Have you tried a true no starch / no fiber diet without fruit to see how you fare?

How much coffee do you drink/day?
Augmentin is notorious for being hard on the liver, and may have caused a long lasting fatty liver. Upping your coffee dose or performing liver flushes may do your liver good.

 

[Zpol]

Have you tried a true no starch / no fiber diet without fruit to see how you fare?

Yes I have. It did not affect constipation, just gave me severe GERD.

How much coffee do you drink/day?

Usually 2 cups

Augmentin is notorious for being hard on the liver

I spent the day researching today and I did come across that info. Thanks for the tips. I do believe some improvements with my liver function would be beneficial.

 

[Peachy]

I've tried it before but there's so many brands out there, maybe I didn't use a good one. I used the Dr. Ruscio brand which just the immunoglobulins (the allergens were extracted out). It could be that the extraction process denatured the colostrum in some way. I had some weird side effect that I can't remember; it could have been unrelated but it wasn't psoriasis which I get from casein so that's good.
Do you know of a particular brand that is good quality?
Thank you for your thoughts!

Sorry for the delay! I've only experimented with colostrum a little and it's not a variety you'd want because it's mixed with other things, but for your casein issue, maybe goat colostrum like this one?

If potatoes make your sugar drop, are you having them with protein/fat? Maybe have a little fruit/fruit juice at the same time so the fructose can ease the blood sugar drop once the glucose is used up.

Also, you may do better with potatoes at certain times of the day - breakfast vs lunch vs dinner. Cold potatoes might be something to try for the resistant starch - who knows, maybe it'd help. I hear you that going starch-free reduced your issues. I'm thinking out loud in case you want to experiment with small amounts since it seems you also get some benefit from them.

Do you eat any oysters? The zinc in oysters is very good for both gut lining and skin health. How about liver? I eat both liver and (canned) oysters for the balance of zinc/copper.

A little taurine supplement for liver health?

Wishing you clarity and improvement!

 

[ecstatichamster]

L Reuteri seems to cure constipation. Mutaflor was helpful for me also.

 

[Nokoni]

Couple months ago I ran across Haidut saying the following:

Providing insoluble fiber in the diet (cellulose) or antibiotics, prevented the development of HCC.

So I finally had a good clue about insoluble fiber. Found NutriCology Dietary Fiber Cellulose, a powder, on Amazon, and within a couple days having a BM became a whole new experience. Turns out fiber actually is essential for a healthy gut. So I can continue to skip all the horrible fruits and veggies while still having tip-top bowel function. Feels good man :)

 

[Zpol]

Sorry for the delay! I've only experimented with colostrum a little and it's not a variety you'd want because it's mixed with other things, but for your casein issue, maybe goat colostrum like this one?

Thanks for all your input! I'll give it another go with the colostrum. Perhaps it was just the brand that was the problem for me.

L Reuteri

Weirdly, L Reuteri had almost the same positive effect on constipation as the Augmentin. I didn't get completely off the Cascara with but it helped tremendously. Unfortunately, the effect only lasted for about 3 months and the bad bugs took over again.

Mutaflor

I'm a little worried about the possible genotoxic effect of the Escherichia coli Nissle 1917 strain. I don't feel like I have enough knowledge on the topic to ascertain the true risk level of it. Have you got any insight on this? I'm in process of researching it but if you'd like to share any nuggets of wisdom in the meantime; I'd sure appreciate it.

So I finally had a good clue about insoluble fiber. Found NutriCology Dietary Fiber Cellulose, a powder, on Amazon, and within a couple days having a BM became a whole new experience. Turns out fiber actually is essential for a healthy gut. So I can continue to skip all the horrible fruits and veggies while still having tip-top bowel function. Feels good man :)

Thanks for the link (Not sure how I missed that thread)! Indeed, I have not tried a primarily insoluble fiber diet. And the only fiber supplements I tried were of the soluble fiber variety. So this would actually be something new to try; thank you!

 

[Nokoni]

thank you

YVW. Hope it helps you too. The label says one teaspoon two/three times per day. I started at 1/8th teaspoon 3 times per day and soon noticed improvement. Bumped it up to 1/4 three times per day and have gotten pretty much complete relief. At the risk of TMI, it noticeably changes the stool also. Sort of quite firm but well lubricated. Also makes for quick and easy cleanup. Overall I'm astounded at the improvement. Very beneficial supplement, at least for me.

 

[Dolomite]

Couple months ago I ran across Haidut saying the following:

So I finally had a good clue about insoluble fiber. Found NutriCology Dietary Fiber Cellulose, a powder, on Amazon, and within a couple days having a BM became a whole new experience. Turns out fiber actually is essential for a healthy gut. So I can continue to skip all the horrible fruits and veggies while still having tip-top bowel function. Feels good man :)

Thank you for commenting on this product. I have been using it for two weeks and am having good results, too. I use one teaspoon in the morning but I think I will try taking 1/4 teaspoon three times per day.

 

[Nokoni]

Thank you for commenting on this product. I have been using it for two weeks and am having good results, too. I use one teaspoon in the morning but I think I will try taking 1/4 teaspoon three times per day.

Yeah it is so easy and so beneficial. It actually surprises me that it is not more well known. Digestion problems seem common enough. Does it have adverse effects that only show up over time? Or what? Is it not well tolerated by many? I had never even heard of it. But I'm sure glad I found it, and glad that you have found it helpful too.

 

[Dolomite]

Yeah it is so easy and so beneficial. It actually surprises me that it is not more well known. Digestion problems seem common enough. Does it have adverse effects that only show up over time? Or what? Is it not well tolerated by many? I had never even heard of it. But I'm sure glad I found it, and glad that you have found it helpful too.

I used to use a wheat bran because it was an insoluble fiber but when I finally got rid of all gluten and wheat I had to quit using wheat bran. Soluble fiber, like psyllium, doesn't work for a lot of us. And even though vegetables have lots of cellulose, like cabbage and broccoli, they also have other things that counter the insoluble effects. There are posts by Haidut that mention insoluble fiber being beneficial and even Peat has said that wheat bran is okay but you are right that there aren't many sources like this. I hope it doesn't cause long term problems but I can't see how as it speeds up motility rather than slowing it down like soluble fiber.