Recalcitrant SIBO ongoing for 3 years

[dogtrainer]

Yes, all B vitamins are important. If you are deficient in one, you are probably low in others as well, so a good B-complex is helpful.

Yes I’ve tried high, medium low doses of progest-e. Both luteal phase and Throughout the entire Menstrual cycle. Still can’t digest anything

I take a couple of B complex pills daily along with megadoses of B1. As I said, this worked for a short time and now it doesn’t matter how much B I take the food just sits.

 

[dogtrainer]

Have you tried pharmaceutical prokinetics? There’s a bunch of them. Low dose erythromycin is used also. Low dose naltrexone I think is also has that effect. For me ginger worked.

I’ve tried prucalopride; it works to empty stomach but usually gives me headache. It’s a seritonergic drug; not sure how much I want to get myself hooked on that for normal gastric emptying.

low dose erythromycin did not work

ldn did not work

ginger works pretty good I can feel my stomach at least try to move when I take it. Often though when guts are paralyzed I’ll just burp ginger all day and I still feel a rock in my tummy.

 

[mostlylurking]

Yes I’ve tried high, medium low doses of progest-e. Both luteal phase and Throughout the entire Menstrual cycle. Still can’t digest anything

I take a couple of B complex pills daily along with megadoses of B1. As I said, this worked for a short time and now it doesn’t matter how much B I take the food just sits.

The progest-e will lower your estrogen and that will lower your inflammation; if your gut is paralyzed due to inflammation I guess it could help in a round about way. Aspirin is recommended for swollen intestines and it's helped me in the past.
link: Aspirin, brain, and cancer
also this on cascara: Cascara, energy, cancer and the FDA's laxative abuse.

I got the most improvement with high dose thiamine though.

 

[dogtrainer]

Hey all,

ive decided I am going to undertake a long course of rifaxamin alongside the elemental diet. My doctor thinks it is worth a shot to see if I can regain some type of appetite while I await a GI appointment. I am aware the elemental diet isn’t ideal but it is the only thing I can really stomach at this point.

alongside the antibiotics and elemental diet I will do

bismuth subsalicylate, 2 pills 3x day
Diatomaceous earth 1 tbsp 1x day
High dose B1 for motility

I am currently researching the validity of adding probiotics at the end. It seems people’s experiences have been mixed - some claim probiotics completely cured them, others claim massive damage.

i will update here with results

 

[dogtrainer]

Results from my most recent Rifaxamjn course.

rifaxamin 550mg TID
AllicinMax Pro 6 pills per day
Neem Plus 6 pills per day
berberine 6 pills per day
Elemental Diet, 2-5 shakes daily

results: almost no change. There were one or two days where bloating went down, but after two weeks I am still unable to feel hunger, I still have to osmotically force BMs, and I’m bloated off of any food. Now I am bloating crazy bad off of what we’re formeraly “safe” foods like mushrooms and carrots. The elemental shakes themselves also cause bloating, can’t really drink them much anymore.

I am currently exploring the possibility of SIFO in addition to SIBO, and trying some new prokinetics:

Pro kinetic: B1 + choline + artichoke extract + ginger

antifungal: SF 722

Anti-Inflammatory: systemic enzymes, aspirin, pepto bismol, cat’s claw

considering somehow trying to introduce cyprpheptadine even though it’s constipating. Perhaps cryptoheptadibe and lots of cascara.

 

[Korven]

Results from my most recent Rifaxamjn course.

rifaxamin 550mg TID
AllicinMax Pro 6 pills per day
Neem Plus 6 pills per day
berberine 6 pills per day
Elemental Diet, 2-5 shakes daily

results: almost no change. There were one or two days where bloating went down, but after two weeks I am still unable to feel hunger, I still have to osmotically force BMs, and I’m bloated off of any food. Now I am bloating crazy bad off of what we’re formeraly “safe” foods like mushrooms and carrots. The elemental shakes themselves also cause bloating, can’t really drink them much anymore.

I am currently exploring the possibility of SIFO in addition to SIBO, and trying some new prokinetics:

Pro kinetic: B1 + choline + artichoke extract + ginger

antifungal: SF 722

Anti-Inflammatory: systemic enzymes, aspirin, pepto bismol, cat’s claw

considering somehow trying to introduce cyprpheptadine even though it’s constipating. Perhaps cryptoheptadibe and lots of cascara.

Hi! Have you gotten any gut microbiome labs done? It could be a good idea to check if there's some sort of dysbiosis going on.

I'm thinking that if you were dealing with "just regular SIBO" then symptoms should've improved with the Rifaximin + all the other antimicrobials + prokinetics. Of course it's possible that you need a different antibiotic (e.g Augmentin), TheBeard has a lot of posts on antibiotic protocols.

If you don't get better on the kill the bugs/speed up transit time/low fiber approach, perhaps it could be worth looking into using specific prebiotics and probiotics, or even FMTs. I'd stay far away from the standard 20 strain lactobacillus + bifidobacterium (they suck) but instead use a more targeted 1 strain approach depending on what's going on with your gut flora. I don't agree with all he says but Jason Hawrelak has more information on this.

 

[DrJ]

Have you tried raising stomach acid with histidine and zinc?

 

[LLight]

I would advise intermittent dry fasting (yes, I have read your first post ).
The more I read about it, the more I see a link between fluid consumption and digestion.

Plus I have read multiple testimonies of people curing/improving their digestion issues with dry fasting/water restriction.

 

[S-VV]

Some doctors now see sibo primarily as a gut motility impairment and advocate for prucalopride, a serotonergic prokinetick

 

[dogtrainer]

Hi! Have you gotten any gut microbiome labs done? It could be a good idea to check if there's some sort of dysbiosis going on.

I'm thinking that if you were dealing with "just regular SIBO" then symptoms should've improved with the Rifaximin + all the other antimicrobials + prokinetics. Of course it's possible that you need a different antibiotic (e.g Augmentin), TheBeard has a lot of posts on antibiotic protocols.

If you don't get better on the kill the bugs/speed up transit time/low fiber approach, perhaps it could be worth looking into using specific prebiotics and probiotics, or even FMTs. I'd stay far away from the standard 20 strain lactobacillus + bifidobacterium (they suck) but instead use a more targeted 1 strain approach depending on what's going on with your gut flora. I don't agree with all he says but Jason Hawrelak has more information on this.

I got a GI MAP done last year, showed high bacillus, high strep, high pseudomonas.

everything else unremarkable. No h. Pylori.
I’ve tried single strain b. Longum, single strain S. Boullardi. No change.

do you know of any others that seem to work for my symptoms?

 

[dogtrainer]

Some doctors now see sibo primarily as a gut motility impairment and advocate for prucalopride, a serotonergic prokinetick

I think this would be harmful over time dont you?

 

[dogtrainer]

I would advise intermittent dry fasting (yes, I have read your first post ).
The more I read about it, the more I see a link between fluid consumption and digestion.

Plus I have read multiple testimonies of people curing/improving their digestion issues with dry fasting/water restriction.

You really think this will make a difference? I will try anything at this point. How long of a dry fast are we talking about?

 

[dogtrainer]

Have you tried raising stomach acid with histidine and zinc?

Yes. About a week. No change. I’ve been on supplemental zinc for over a year.

 

[Rafael Lao Wai]

Have you ever tried to take niacin, as in nicotinic acid( not niacinamide)? I've been using it for 4 or 5 months now, and the difference in digestion( especially stomach acid) is really great. It doesn't help with bloating though.

I personally use 250 mg of niacin( immediate release) twice a day, and it's effective at this dosage for me.

 

[dogtrainer]

Have you ever tried to take niacin, as in nicotinic acid( not niacinamide)? I've been using it for 4 or 5 months now, and the difference in digestion( especially stomach acid) is really great. It doesn't help with bloating though.

I personally use 250 mg of niacin( immediate release) twice a day, and it's effective at this dosage for me.

Yes. 250mg per meal for weeks. No effect other than the flush

 

[LLight]

You really think this will make a difference? I will try anything at this point. How long of a dry fast are we talking about?

I cannot promise anything because I don't have population wide representative data but if you have nothing to loose, I would advise you to try it.

If I'm not mistaken, the testimonies I have seen were mentioning long dry fasts, rather than intermittent, but I don't have data allowing me to make a comparison to know what works best in such a situation.

For example, @TheBeard had good improvement of his health after a prolonged dry fast:

I too had tremendous health and cognitive benefits after a 4 day dry fast.
My gallblader and liver dumped a lot of stones, my mental clarity and my sense of relaxation improved greatly and have lasted to this day.

Other testimonies that I have found on the web regarding dry fasting/water restriction and gut/liver health:

Spoiler: DF testimonies

The first time I realized that all this "weird talk about autophagy" was real was when I did a 6 day dry fast. It completely fixed a massive amount of digestive issues that I had been having for the past year. I honestly don't know if you need to do something insane like what I did but if you haven't done non stop OMAD then it can't hurt right?

[...] Other benefits I noticed that my cravings are gone and my stomach isn't as bloated anymore. I've been on NoFap since I started and working feels amazing. I haven't lost any strength. I feel I can lift more but I'm sticking to a slow build up. My confidence is through the roof and I'm planning to do another dry fast again.

my hemorrhoids were gone and never returned after a 5 day soft dry fast

I developed a pain i estimated around my pancreas and waited a couple weeks before going to ER and they ran an ultra sound. Didnt see anything, all other tests came back normal. I told them I was convinced it was pancreatic cancer. They said, usually peoples skin turns yellow with that. So being non-yellow but still in pain, went home disappointed.

Still in pain, I came across dry fasting and how animals fast when they are injured.

I dry fasted for two days.

On the third day I took a poo. It was a black log. Not like old blood cells but like witch hat black but still in good looking poo form.

Pain disappeared.

Not a stupid question!! but I 100% believe candida isn't a 'just kill the candida' solution as your body and all its organs are completely ill and poorly functioning. I also believe that low stomach acid is one of the key elements to fixing this puzzle. I used to struggle with stomach acid but after a few dry fasts I feel like my functioning is so so so much better. Thanks for the heads up!! will do some more reading into it.

I do IF (intermittent fasting) dry fasting. It has helped me tremendously. I am not constantly thirsty or need to take alot of bathroom breaks. I don't suffer from dehydration and my digestive system is in good health. My doctor was impressed. I do want to say if you are constantly sweating or live in hot climates, dry fasting is not recommended. Just be cautious and conscious & if you want to start dry fasting, I recommend doing it in increments.

Only dry fasting fixes my heartburn, acid reflux and ulcer.
Title says it all. Dry fasting, even for short periods of time heals my awful gut issues.

Who else has had success this way?

Not dry fasting but water restriction:

Tried the 36 hour dehydration you mention on another post about 10 days later. This was challenging to complete. I did have a few tiny sips of water during that day, but mainly abstained even though I was thirsty all day. Over the next week my digestion reset itself and cleared up intestinal pain I didn’t realize was a problem until it was gone. Skin texture is smoother. Inflammation in my joints gone. Gums sealed to my teeth better than a dental cleaning.

I've had really bad acne between my shoulder blades and on my chest for years. Dry Fasting help me tremendously to clear it up. After my 3rd 7 day dry fast it completely disappeared and hasn't come back since. I attribute it to a combination of dry fasting, staying on top of my diet and a number of other factors. The acne had disappeared almost completely after my first prolonged dry fast, but after refeeding for 2-3 weeks I've started to occasionally eat crap again (fast food, sweets etc.) so it didn't take long to flair back up. Staying on a mainly plant based diet and eating only high quality meat and fish to get some animal proteins after heavy workout sessions seems to be the key for me. Also don't forget probiotics, I make my own kimchi, water kefir and kombucha now, a healthy microbiome was an absolute game changer. Ever since even my weekly cheat days don't change my skin anymore. I believe it's mainly due to finally having fully healed my gut. Work out hard, breathe deep, sleep well, eat a variety of good food with loads of probiotics and you'll be golden my friend.

Yeah first day is terrible... but mostly due to caffeine withdrawal as I am giving it up as well in this month. Last year doing this got me rid of my fatty liver disease. I am hoping soon I will catch the rythm and it will be smooth sailing!!

There are two studies about Ramadan fasting that I posted somewhere that tend to show that gastric acid pH is significantly increased during Ramadan. But there are confounding factors as there are lots of changes along with dry fasting I believe (different foods and the quantity consumed).

From a theoretical standpoint, the FXR and LXR transcription factors (sensors that induce gene transcription) seem to be linked to water homeostasis. These transcription factors are also involved in gut/liver detoxification and gut immune system.

Also, dry fasting could increase the production of oxytocin and vasopressin as they are involved in water homeostasis in the body. They could be involved in increasing "gastric and duodenum motility via OTR" (in rabbits) and regulating the phasic contraction of the gallbladder during the interdigestive period, which is thought "to be important in stirring the bile, facilitating the bile concentration and preventing the gallstone formation" (still in rabbits). I have also seen a study where vasopressin seemed to be involved in bile flow control in rats. Glucagon is also an hormone that could be increased due to dry fasting and that is linked to bile circulation ("chronic glucagon administration stimulated the production and enterohepatic circulation of bile acids.") and the FXR.

Finally, I've recently found an interesting publication (in Drosophila, but it is deemed a relevant model for metabolic diseases) that I have yet to digest properly :

A nutrient-responsive hormonal circuit controls energy and water homeostasis in Drosophila

The regulation of systemic energy balance involves the coordinated activity of specialized organs, which control nutrient uptake, utilization and storage to promote metabolic homeostasis during environmental challenges. The humoral signals that drive such homeostatic programs are largely...

www.biorxiv.org

Here we show that three pairs of central neurons in adult Drosophila respond to internal water and nutrient availability by releasing Capa-1 and -2 hormones that signal through the Capa receptor (CapaR) to exert systemic metabolic control. Loss of Capa/CapaR signaling leads to intestinal hypomotility and impaired nutrient absorption, which gradually deplete internal nutrient stores and reduce organismal lifespan.

Capa-1 is considered to be an homolog of the human neuropeptide Neuromedin U (NmU).

NmU reduces gastric acid secretion and delays gastric emptying. It also increased electrogenic ion transport in isolated porcine jejunal mucosa without contraction of muscles. This action is dependent upon chloride channels and is mediated by non-cholinergic enteric neurons. The physiological and pathophysiological roles of this remain to be fully defined. Dass et al. demonstrated that NmU via NmU-R1 exerts nerve-mediated, prokinetic activity in the mouse colon and this may represent a molecular target for the treatment of deficits in intestinal motility.

In my limited understanding, capa/NmU production in neurons could be boosted during water restriction and released when water is consumed. I guess the oscillation between lack of and consumption of water (and thus the oscillation of NmU release/levels in the blood) could allow the production of gastric acid and promote intestinal motility.

 

[LLight]

[The observance of Ramadan and its repercussion on gastric secretion] - PubMed

The influence of the Ramadan on the gastric secretion has been assessed in 13 volunteers. Their basal and pentagastrin-stimulated secretion has been collected before, during and one month after the Ramadan. Gastric activity, pepsin activity, sialic acid bound to glycoprotein, choline and...

pubmed.ncbi.nlm.nih.gov

[Effect of Ramadan fasting on intragastric pH recorded during 24 hours in healthy subjects] - PubMed

This study shows that the conditions of feeding imposed by Ramadan are associated with an increase of the gastric acidity mainly in diurnal phase. These results do not explain the origin of the healthy volunteer digestive symptoms encountered during Ramadan.

pubmed.ncbi.nlm.nih.gov

Here are the sources regarding gastric acid pH during Ramadan.

 

[dogtrainer]

Here are the sources regarding gastric acid pH during Ramadan.

Wow, thank you. Maybe I will take off work for a few days and give it a shot.

 

[Bluebell]

mostlylurking said:

have you tried the carrot salad? with a little vinegar?

Every day for nearly three years.

carrot salad with coconut oil

Have you tried giving up coconut oil?

Years ago I had terrible stomach pain, really bad, and burping from the top of the stomach (and usually I don't get stomach pain and hardly ever burp), day after day. It turned out it was coconut oil, which I had started a few weeks earlier. I'm sensitive or allergic to the coconutty flavour part of coconut oil. I stopped the virgin coconut oil and the problem completely disappeared. I think the ultra refined stuff is OK for me though I haven't tested it in detail.

Other than that, what is your diet in detail including all drinks, and what is the full list of supplements you are taking?

 

[dogtrainer]

Have you tried giving up coconut oil?

Years ago I had terrible stomach pain, really bad, and burping from the top of the stomach (and usually I don't get stomach pain and hardly ever burp), day after day. It turned out it was coconut oil, which I had started a few weeks earlier. I'm sensitive or allergic to the coconutty flavour part of coconut oil. I stopped the virgin coconut oil and the problem completely disappeared. I think the ultra refined stuff is OK for me though I haven't tested it in detail.

Other than that, what is your diet in detail including all drinks, and what is the full list of supplements you are taking?

You know I have never tried giving up coconut oil, actually. That’s something I could try.

food list (when I’m not very symptomatic):
Meats including oxtails and bone broth
Cheese
Raw carrot salad
Honey
Butter
Eggs
White sugar
Cocoa powder
Coffee
Mango, oranges
Coconut water
Coconut meat
Spinach
Onions
Capra mineral whey powder

when symptomatic:
AbsorbPlus powder
maybe a bite of eggs or steak
I usually fast for a day or two until appetite returns/ bloat passes

supplements, pharma: T3 40mcg in 8mcg doses throughout day

Supplements, OTC: Gas-X, FDguard, pepto bismol, lipase or ox bile with food

vitamins:
B complex liquid (Higher dose B1 via TTFD)
zinc sulfate, 10-20mg daily
Citicholine 200ishper meal
Magnesium glycinate: 400-600mg
Taurine & glycine occasionally
mitolipin ocasionally

Herbs:
Cascara 1 pill nightly
Artichoke leaf, 2 -6 per day before meals
Ginger capsules, or fresh ginger tea
Allicin 4-6 pills most days
Berberine Occasionally (Only take with meals)
Neem occasionally

Just started cat’s claw, and SF722

Failed:
turpentine, castor oil, CamphoSal, activated charcoal, Rifaxamin 6 courses, Biocidin