23 Steps I Took to Overcome SIBO
Small intestinal bacterial overgrowth (SIBO) was a pain in my butt (and intestines) for a long period of time.
Not only was it causing me to look 6 months pregnant after eating but it was also messing with my immune system, hormones and mental health too!
If you aren't familiar with SIBO or its connection to hormonal health (specifically PCOS!), then give this post a read first.
I first developed this condition several years ago after several bouts of food poisoning whilst working at a summer camp in America.
It took me several months (and a lot of money) to overcome it, because I wasn't addressing the driving factors of my issues, which were low stomach acid, high stress levels, being on the birth control pill and having several nutrient deficiencies.
Eventually I managed to clear it completely and it stayed that way until several months back, when I noticed symptoms like acne, food sensitivities and reflux starting to rear their ugly heads again.
I knew SIBO was back in town.
The reason it had returned, is that I had stopped supplementing with zinc for a few months, and I was going through a stressful period. My immune system was compromised, and SIBO had the opportunity to develop.
Luckily, I now had a much better understanding of this condition after several years of research and experience with clients who had SIBO. With these tools in my tool belt, I was able to easily clear the infection within 6 weeks and I am taking all the action steps to prevent it returning any time soon!
In this post i'm sharing the 23 steps I took to overcome SIBO, both initially, and during my recent experience...
#1 I tested myself
It is so important that you test (not guess) when it comes to SIBO. Many other conditions such as yeast overgrowth, parasites and poor digestive enzyme production can look similar to SIBO. You need to know if you are hydrogen or methane dominant, and how severe the overgrowth is, as this determines your treatment protocol.
#2 I took digestive enzymes
Supplementing with ox bile, digestive enzymes and HCL provided me with symptomatic relief and allowed me to fully digest and absorb the nutrients from my food. When food isn't broken down completely, this allows bacteria to feed on the left overs and when we aren't absorbing our nutrients correctly, this can lead to depletion and poor immunity.
#3 I ate mindfully
At each meal time, I turned on a podcast (not the TV or Instagram) so that I could look at my food and fully appreciate each bite I took. I paid close attention to my hunger and fullness signals to prevent over eating. I tried to take a minimum of 20 minutes to consume my meals, so that my body wasn't rushed and had time to process the foods.
#4 I chewed my food
Each time I ate, I chewed my food until it was liquid. Even with smoothies and soups, I made an effort to keep them in my mouth long enough so that my salivary enzymes could start to break this food down. With SIBO, our digestive tract is already compromised, therefore I wanted to take the extra load and stress of my gut by breaking my food down physically, before swallowing.
#5 I managed my stress
I did a lot of work on my mindset, emotions and relaxation techniques. When we are stressed, this can lower our digestive enzyme secretions, slow down peristalsis (movement) of the intestines and reduces secretory IGA, which is a marker of gut immunity. The goal is to keep your nervous system in the parasympathetic state (rest & digest) as often as possible, when we are struggling with SIBO. For me, this included epsom salt baths, meditation, yoga, reading and walking in nature.
#6 I took antimicrobial herbs
I used high quality herbal supplements such as garlic, oregano, berberine, grapeseed extract and neem, to help eradicate the overgrowth of bacteria. Unfortunately, diet alone can't really help to clear gut infections like SIBO and it does require a protocol containing some of these natural antibiotics. The type of herb, dosage and duration depends on your type of SIBO, how long you've had it and the other health conditions or medications you might be taking.
#7 I tried conventional antibiotics
When I first developed SIBO, my symptoms were quite severe and I wanted to get rid of the overgrowth as quickly as possible, therefore I paid privately to try the conventional antibiotic treatment which was a combination of Rifaxamin and Neomycin. Although this did work to reduce the level of overgrowth, it didn't clear the infection completely and I did still have to use herbs for several weeks afterwards. When my SIBO came back years later, I solely used herbs to clear it again.
#8 I used a prokinetic agent
In order to keep my intestines moving and stimulate the migrating motor complex (MMC), I took supplements including ginger, 5HTP, triphala and magnesium citrate each night before bed. Slow motility can allow food to 'back log' in the intestines and provide food for bacteria, which allows them to overgrow. A common mistake I see is that people fail to incorporate a prokinetic agent into their protocol, post SIBO. This is one of the reasons relapse occurs so frequently. Methane dominance is usually associated with slow motility, as is hypothyroidism, magnesium deficiency, diabetes and vagus nerve dysfunction
#9 I spaced my meals 4-6 hours apart
Frequent snacking can also create a 'back log' of food in the intestine. Spacing your meals throughout the day allows the action of the 'cleansing waves' from the migrating motor complex to take place. This process only occurs once the stomach is empty, every 90 minutes. Similarly, I always leave at least 12 hours between my evening meal and breakfast the next day. Intermittent fasting for longer durations may also be beneficial, but only if you have strong adrenal function and no issues with blood sugar.
#10 I boosted my stomach acid
I believe that low stomach acid has been the root cause of my SIBO struggles. This is likely due to times of high stress and/or zinc deficiency, which I am very prone to. Hydrochloric acid should be as strong as battery acid and this helps us not only breakdown our food, but also protects our gut against pathogens. It also triggers the release of other digestive enzymes in the intestines and promotes regular motility of the gut. For many months I supplemented with HCL capsules which helped a ton! I recommend you read this post before trying it yourself.
#11 I improved my thyroid health
The thyroid is our master metabolism gland and one of it's roles is to keep our digestive health strong, and keep food moving through the intestines. My thyroid was a little sluggish because I had been on the birth control pill for 2 years and I was nutrient depleted because of this (and my 'not so great' diet). I supported my thyroid by eating nutrient dense foods, sleeping more, managing stress and taking supplements of the nutrients my body was lacking.
#12 I supplemented with magnesium
Most people are deficient in magnesium and this can lead to slow gut motility and constipation. Although I tried to eat a lot of magnesium rich foods, I just found that it wasn't enough for me, therefore I took a blend of magnesium glyincate and citrate each night to help my gut 'clear out' the waste and food from the day, whilst I slept. I also had regular epsom salt baths as this provided me with magnesium sulphate directly through my skin, which is a great option for someone who has impaired digestive function.
#13 I supplemented with zinc
Zinc is a mineral which helps with the production of hydrochloric acid (HCL) in the stomach. As I already mentioned, I believe that low HCL was one of the major causes of my SIBO struggles. I believe that I am prone to zinc deficiency and require ongoing supplementation for me to maintain proper hormonal, immune and digestive health. If you take doses higher than 50mg or have to take it long term, like me, I recommend you purchase a supplement that also contains copper as these two minerals need to be kept in ratio.
#14 I took spore forming probiotics
The use of probiotics for SIBO is quite controversial, however I found that supplementing with a spore forming probiotic actually helped me to clear my bacterial overgrowth, without having a detrimental affect to my other gut bacteria. Certain strains are actually believed to act as low dose antibiotics and can regulate the microbiome. I also have issues with a histamine intolerance, therefore I cannot tolerate certain strains of bacteria in a lot of conventional probiotic supplements, however I can tolerate spore-forming probiotics very well!
#15 I moved my body
If we aren't exercising or moving our body at all during the day, this can promote stagnation within the gut. We need to MOVE for our gut to move too! At the time, I couldn't tolerate intense workouts because I was a little depleted, therefore I stuck with restorative activities like yoga and walking. Stretching in some of the common yoga poses can really help with the digestive function. I tried to walk 10,000 steps every single day, which helped not only my physical health, but also my mental health, as walking is great at lowering cortisol levels and promoting serotonin production!
#16 I reduced my fibre intake
There are many diets used by practitioners when trying to overcome SIBO. I had tried the low FODMAP and a very low carb diet, however I struggled to keep weight on and felt too restricted and drained with these options. Diet changes alone are not enough to eradicate gut infections like SIBO, however they can definitely help in symptom management and reduce the food substrates that the bacteria love to thrive on. I personally just reduced my fibre intake as before I was consuming a TON (which was unknowingly just making matters worse!). I focused on consuming meat, eggs, fish, healthy fats and smaller portions of fibrous vegetables. I was still consuming enough fibre to prevent constipation, but it had lowered significantly from what my gut bugs had been used to.
#17 I ate high quality protein
We need high quality amino acids to keep our immune system and gut lining strong, therefore I made sure to consume a source of high quality protein at each meal. Because my digestive system was a little compromised because of this overgrowth, I made protein easier to digest by eating more shredded meat, slow cooked stews, pressure cooked proteins and soups. I also supported my stomach acidity by taking HCL supplements, to ensure that I was breaking down the delicious organic meats.
#18 I ate healthy fat
Alongside the high quality protein, I consumed lots of healthy fats, as this macronutrient doesn't tend to feed pathogens or bacterial overgrowths. Fats like coconut yogurt, nut butters, grass fed ghee, eggs and olive oil , provided me with nutrients to support my thyroid health and the epithelial lining of the gut, which can be damaged by SIBO. They are also important at lubricating the gut and supporting motility. Taking digestive enzymes and nutrients like ox bile, helped me to absorb the fats and fat soluble nutrients, that come alongside these foods.
#19 I avoided hard to digest or raw foods
Because my digestive 'fire' and gut health was a little 'weak', I avoided raw vegetables, most fruits, grains, beans and un-soaked nuts, as these are difficult to digest for most people with SIBO. I was also dealing with fructose malabsorption, therefore I could only really tolerate berries as my fruit option for a good few months. In Chinese and Ayurvedic Medicine, they often discuss the negative effects of 'cold' foods on the system, especially for someone struggling with digestive issues. It is much better to focus on warming and nourishing foods during this time, in order to take the stress of your gut.
#20 I made sleep a priority
I have always been a pretty good sleeper, but when my gut health was a wreck, I really made it a priority to sleep 8-10 hours each night. Our body only physically heals and repairs when we are asleep, especially during the hours of 10pm-2am. These are known as the 'golden hours' and we should all try our best to be in a state of deep sleep during this window, in order to receive the health benefits. When we are sleep deprived, this affects our cortisol levels, immune system, food choices, cravings, appetite and energy levels the next day, all of which are important factors to address when trying to overcome SIBO.
#21 I got support
Even though I was a nutrition student at the time, I really understood the importance of working with a skilled practitioner for my health issues, especially when it comes to gut health. Even when my SIBO came back recently, I turned to colleagues and experts in this field to guide me and offer their advice. If you have a full time job, family and a ton of other life commitments, it can be so overwhelming, confusing and time consuming to try and address this alone. Even though you may be hesitant to work with someone when trying to overcome SIBO, because you think you can figure it out on your own, you will likely spend more money, time and stress in the long run! It is often hard to see the wood for the trees when it comes to our own health. When someone has an outside perspective, they can often identify important factors that you have overlooked.
#22 I had patience
These things take time. We are so used to having a 'quick fix' mentality when it comes to our health issues, that we can feel disheartened and frustrated when things take longer than planned to resolve. Sure, conventional antibiotic treatment for SIBO can be over in 10-14 days, however a lot of the time, multiple courses are needed or symptoms can return within just a few months. Herbal antimicrobial protocols usually range from 4-12 weeks (depending on degree of overgrowth and strength of the supplements), however for full symptom resolution and healing of the gut environment, this may take 4-12 months (even longer in more serious cases!) Think of how many years (or decades!) you have been eating the wrong foods, suffering with symptoms or treating your body badly. You can't expect all your problems to resolve overnight.
#23 I rested after treatment
Do not forget this point!! Even if all of your symptoms have improved and you are feeling great, please retest! It works the other way too. You may feel like nothing has changed, you are still bloated and don't feel great after your protocol has ended, however SIBO may have cleared and your symptoms could just be due to an inflamed gut or another issue! SIBO has a high rate of reoccurrence, partly due to people failing to addressing the root causes and/or not taking prokinetic agents, however I also believe it is due to the fact that people don't retest and they never actually cleared the infection fully. Over time, the bacteria are just going to repopulate and you will likely be back in the same position.
Are you struggling with Small Intestinal Bacterial Overgrowth (SIBO)?
Did you find any of these recommendations helpful?
Let me know in the comments section below!
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