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elemental diet plan

Discussion in 'The Gut: De Meirleir & Maes; H2S; Leaky Gut' started by Solon, Oct 2, 2016.

  1. Solon

    Solon

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    My doctor prescribed xifaxan and neomycin to tackle my hydrogen and methane SIBO, but I am hoping to avoid the neomycin because I fear the possible ototoxic effects it can have. I'm planning to try an elemental diet first on my own, and am thinking about how best to proceed.

    A couple of years ago I tried an elemental diet with Vivonex Plus at the recommendation of a naturopath. While taking the Vivonex Plus, my aches in joints and gut got continually worse. My neck got increasingly stiff, my ears started ringing worse, and other symptoms deteriorated. Most distressingly, my heart would beat harder at times shortly after consuming the Vivonex. I would note that this heart beating hard feeling is the same one I had when I first got SIBO after taking acid reducing drugs, and is also a feeling I got at times from taking certain probiotics. After eleven days of worsening symptoms, I stopped the elemental diet (perhaps not the correct move) out of fear that it was making me worse. More recently I tried another dose of the Vivonex and shortly after could again feel my heart beating in my chest.

    At the time I assumed that I was feeding the bacteria. Now, with more experience, I wonder if it might have actually been a sensitivity to an ingredient in the Vivonex. Most of my symptoms are now ones that I associate with leaky gut and fibromyalgia. The maltodextrin in the packets comes from corn, and there's cornstarch as a major ingredient, so I wondered if this might be the culprit. However, a year ago I took some Cyrex Laboratories tests that were supposed to look at food sensitivities by measuring IgG and/or IgA, and they showed negative for corn, popped corn, and corn oleosin. At the same time, there's this warning in the results: "Due to +Spinach and Tomato AQUAPORIN it is advised to also exclude Corn and Soy even though you do not specifically test positive to those AQUAPORINS as they are cross reactive."

    I've seen that a number of people have tried doing antibiotics at the same time as an elemental diet, or just before the diet, or just after. (I've seen claims that bacteria are more vulnerable while eating, so before or after the diet might make more sense rather than during.) I have a xifaxan prescription, which I've found to be safe when I've used it previously. I also have herbal antibiotics such as Allimed which is reputed to tackle methanogens, though I've used it multiple times and it may have since caused the microbes to become resistant. I could also get other herbal antibiotics to take around the same time as the elemental diet.

    It seems that a prokinetic is a valuable addition, and might even be useful while on the elemental diet or antibiotics rather than just after. I have resolor and low dose erythromycin, and could also get herbal options such as Iberogast. The Cyrex array 10 test showed that I was positive for ginger, so ginger may not be an appropriate prokinetic.

    Now for some questions:

    Do you believe that there is validity in food sensitivity testing such as Cyrex Laboratories provides?

    Do you believe that the maltodextrin source (corn) might have been part of my problem?

    If so, I need a new carb source for my home made formula such as tapioca maltodextrin or dextrose/glucose from something such as wheat. I see a few possibilities on Amazon. Opinions?

    What do you think the cause of my heart beating hard was while previously taking the elemental diet, and at other times such as when I first contracted SIBO? There was no pain, but it was disturbing and could also make sleep very difficult. How do I prevent this?

    What do you think of the idea of taking antibiotics and/or a prokinetic during, just before, or just after the elemental diet?

    My best days are now a lot worse than my worst days were the last time I tried the elemental diet, so I'm looking for something that will be effective but also very safe. If I can come up with a plan then I'll try it this month and report back with the results.
     
  2. brenda

    brenda Senior Member

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    @Solon

    I don't agree with the advice you have been given, on the best way to tackle SIBO.

    You will not get down to the root cause of it, which has been claimed by some to be due to leaky gut. Unless you do that, killing the bacteria will only give a reprieve and it will come back and you will have damage to your gut biome due to antibiotics.

    For leaky gut, which is the basis of food intolerance, which is best diagnosed by elimination and reintroduction rather than lab tests which are unreliable, there are quite a large number of folk having success with the autoimmune protocol, a sort of strict Paleo diet and have seen their antibodies go down. Glutamine is helpful for those that can tolerate it.
     
  3. Solon

    Solon

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    Thanks Brenda. I do intend to include extra glutamine, both during the elemental diet and afterwards. I also intend to take other substances that might decrease the leakiness of my gut such as turmeric.

    I would like to try an elimination diet at some point. One problem with doing any special diet, including the elemental diet or an elimination diet, is that I travel a lot. October may be my only month in the next half year or more without a trip, so I plan to do an elemental diet this month while I have a good opportunity.
     
  4. NatBard

    NatBard

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    Hi Solon,

    How did things go on the elemental diet plan? Hope it helped you!

    I've been suffering from SIBO for many years and only this year realized what it was! I've been reading up on it and listening to Chris Kresser's podcasts which have convinced me to give Rifaxamin a go. Had to buy it over the internet as my GP refused to prescribe it to me as its not something they would normally prescribe but I also want to try taking Neomycin alongside as the success rate on their own is only 45%. Together its 87%!

    Where did you get your Neomycin from and are you UK based? Did you find it made you feel a lot more poorly whilst you were taking it? I hate antibiotics and have avoided them for the last 13 years since having a brain haemorrhage which has made me very sensitive. But I've been trying to tackle the SIBO for a couple of years using antimicrobial herbs so another approach is needed I think!

    Again, my GP won't prescribe me the Neomycin so I would really appreciate it if you could let me know where you got yours from.

    Many thanks!
     
  5. Eastman

    Eastman Senior Member

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    Do you know the root cause of your SIBO? As brenda said, if you don't address the root cause, the SIBO will return even if antibiotics eliminate it temporarily.

    This paper discusses various forms of SIBO.
     
  6. NatBard

    NatBard

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    Yes, I very much agree. Its very hard to say with me as I had a massive brain haemhorrage when I was 24 leaving my face and left side paralyzed after a 3 week coma. Was given pretty much every antibiotic under the sun after the 3 brain operations due to the swelling and inflammation in my brain and body and multiple infections.

    So that was the start of years of grand mal epilepsy and digestive issues. They saved my life but its taken a LONG time to heal! I've spent a lot of money on test to figure out the cause of the chronic fatigue I've had and all sort of other things and going by the symptoms I'm pretty sure the SIBO is methane related due to all the constipation I've had mitigated by chronic diarrhoea. I've struggled to function generally since all this happened in 2003 but have regained the motor use in my body, but not always my ability to cook or judge foods freshness and have had a LOT of food poisoning! Mark Pimentel mentions this link with Methane producing SIBO in his interview with Chris Kresser and his approach is just making a lot of sense to me.

    I hate antibiotics so very much, so its very much going against the grain with me but I've been wanting to do GAPS to heal and reseal my digestive tract and see if I can heal the epilepsy. been following the plan since mid August of this year and still having a histamine problem so I know the SIBO is still there and causing problems. There's no way I could have stock that's cooked for more than 3 hours or eat anything with Pork and some days Aubergine is a real problem! I don't mind living off soup but I know its not recommended for extended periods of time so my healing is getting delayed by this mean SIBO! Until I get it sorted my digestive tract can't heal and I won't reach the level of health that I do dearly wish to have and strive for. Giving up Chocolate has been incredibly hard, but that's ok, as long as I can move forward and gradually get better! I don't feel like I am at the moment.

    So did your doctor prescribe you the Neomycin? I've seen the validity of Dr Pimentel's approach from that Kresser interview. Its made me realize that by living on a low FODMAPS diet along with GAPS I have been starving all the bacteria in my Gut and so the mean ones have been withdrawing and hiding out waiting for conditions to improve before they replicate and proliferate. Meant my symptoms were more manageable - could have baths again, slept a little better sometimes (not that often!!) but that meant the bacteria were still there, waiting till conditions were more favourable. Dr Pimentel was saying we need happy feeding bacteria in order to kill them with the antibiotics so I think that's key in anyone's treatment protocol. Up till now I've been using a wide range from Lauricidin, Oregano oil, GI Microbx, Olive leaf extract, Garlic capsules, Cats claw, Pau d'arco etc......... Also trying out the Prokinetics now too - lots of ginger tea and now Iberogast and jumping up and down on my rebounder (when I have the energy!) seems to help bring on the die off feeling more so gotta hope that its doing some good. Full on diarrhoea as a result but I'm hoping better out than in - sorry! Bleurrrrgh!

    ;0)

    Am still wanting to give the Rifaxamin and Neomycin combo a go though. 45% success rate individually but 87% when taken together! Surely as they work locally in the intestines, and apparently don't affect the Colon they will wipe out any food poisoning SIBO bacteria and not affect the overall immune system and Large intestine's Gut flora? Need to find a way of getting some Neomycin. If anyone can help I'd be really grateful!!
     
    ljimbo423 likes this.
  7. Eastman

    Eastman Senior Member

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    @NatBard

    I guess antibiotics gave you dysbiosis.

    The damage from the brain haemorrhage may also have affected your neurotransmitters. In case you haven't seen it, there was a recent thread on serotonin, acetylcholine and gut motility.

    I have not taken antibiotics for SIBO. I used probiotics for a while, with best success with L plantarum, but I don't use them anymore other than the occasional cultured milk drink.

    I also noted that you took garlic capsules. I use raw fresh garlic for reasons explained here.
     
  8. NatBard

    NatBard

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    Thanks for the links Eastman Ill check them out.
     
  9. Solon

    Solon

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    Hi NatBard,

    I'm in the US and got both the rifaxamin and neomycin from my doctor. How did you get the rifaxamin online without a prescription? I may want to do that sometime if I need more.

    Unfortunately the elemental diet was not a success for me. I went for 17 days and felt worse as I went, with especially the constant pain in the back of my neck feeling worse, and other pains worsening as well. Afterwards it became clear to me that I had not removed the SIBO, and also brought back a candida problem that I had previously eliminated. I thought that this might mean that I had the infection in the proximal part of my small bowel since if I was feeding the bacteria and archaea then it must mean that it's high up, but I ordered myself a glucose breath test (which only tests the first 2 or 3 feet) and it did not test positive, so that's a bit confusing.

    I know for some people the elemental diet works quite well and I felt it to be quite tolerable, though of course unpleasant. I used a home made version that is similar to Dr. Siebecker's in order to use tapioca dextrose rather than corn maltodextrin. To make it more tolerable I would suggest doing 6 small drinks rather than 3 large ones, to drink it with a straw, and to do a better job than I did at mixing the salt in. Some people drink it cold, but this would slow digestion which may be counterproductive. I lost several pounds while on it which for me was a very undesirable side effect.

    I'm sorry to hear about your brain hemorrhage and partial paralysis. I wonder if the partial paralysis may affect your gut motility which may decrease the migrating motor complex, but perhaps this is not the case. I don't know enough about brain physiology.

    As I mentioned, I'm avoiding the neomycin for as long as I can because I don't want to chance the possibility of ototoxicity which neomycin can cause, but it may eventually become necessary to try it. Right now I'm reading about other things that can suppress or kill archaea and hoping they will be sufficient.

    Rifaximin however is far safer since it's not absorbable, seems to only act in the small intestine, is anti-inflammatory, is broad spectrum, etc. You asked if it made me feel more poorly while taking it, and yes, there were a few days where I felt so bad that I was nearly delirious. Many of us have had restless legs, but my whole body felt restless during the worst days on rifaximin and it felt a bit like a fever dream. However I'll gladly do it again when I have the chance. Unfortunately it's difficult to time it thanks to taking many business trips, and I also want to prep myself well with some herbal antibiotics first, in order to give myself the best chance of success.

    I've recently read about some antioxidants making some antibiotics less effective, and I wonder if this might have been an issue for me (though some antioxidants themselves have antibiotic properties, so that makes the issue more confusing). I wonder if this might have affected my chances of success in the past because I've made a point of often taking large amounts of a variety of antioxidants with the hope of minimizing some damage that SIBO and fibromyalgia do to me (but not with the hope of minimizing the damage done to the bacteria I'm trying to kill!)
     
  10. NatBard

    NatBard

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    Hi there Solon,

    Many thanks for your detailed reply. I don't know much about the elemental diet plan, am I right in thinking that you are drinking/consuming a formula instead of meals so that there is very little for your digestive system to do but your body has all the nutrients it needs for optimum nutrition?
    I can imagine that must be tough and you must have missed eating food very much - so congratulations for being so strong and seeing it through!

    One of the hardest things about all this is the amount of variables in every single factor of our human bodies. As you were saying one thing could mean this, but then there is that over there to think about too and how those two may impact on each other! It really is tough! I hate the feeling of confusion and not having a plan! As long as I know what to concentrate on and vaguely understand I can keep going but when it all goes so belly up it leaves me feeling lost.

    I think we are all amazing for putting so much effort into our health and trying to be as well as we can - not everyone does this! So we deserve to get what we are so desiring and I am sure we will in the end!!!

    For me, I've just slightly kinda abandoned the low FODMAPS GAPS diet that I have been religiously following for the last 7 months and am trying out Dr Pimentel's approach with feeding these mean SIBO critters with prebiotic food and so encouraging them to be happy and start to divide and then hit them with the antimicrobials as that's when they are easier to kill! It certainly is producing die off feelings so I will have to see!
    One of my biggest challenges is not being able to sleep well. I have been reading about the benefits of CBD oil recently and at first didn't want to go near it but after hearing how strongly anti-microbial it is and that it can help heal the Gut I thought I would give it a go. It's certainly very relaxing and I can feel it as work in my Gut gurgling around and then I often get headaches - which I'm assuming are die off symptoms so its another approach with the antimicrobials, if you feel comfortable with it. There's no THC so it just makes you feel very relaxed and happy and a bit floaty!!! And it has helped with my sleep a little, very anti-inflammatory and great pain reliever. My left leg which had the paralysis which can get very swollen reduces right down in size, almost the same as the other one, after a dose which it has never done before. Thankfully there is no more paralysis, but thank you for your empathy with that - very appreciated!

    I ordered the Rifaxamin online from inhousepharmacy

    https://www.inhousepharmacy.vu/search.aspx?searchterm=Rifaximin

    Just hoping I don't get hit with a customs bill - as they were already £71!

    I hate antibiotics so much so its a weird position I'm finding myself in asking people about the Neomycin. I've taken a look at the Ototoxicity concern and again, its an unknown isn't it! Our senses are so precious to us, especially hearing, I don't think I could live without music so its a tough one that. As there is no way of saying that it will affect either of us to a really great degree?

    I think the really key thing if you are going to take any kind of antibiotic is to have a plan to heal and repopulate the Gut during and after. Thus making relapse a lot less likely. I'm currently having home made organic stock 3 times a day with prebiotic food and increasing my probiotics and may include saccharomyces boulardii if I start on the Rifaxamin. I will basically follow Chris Kressers advice which I think is excellent!

    https://chriskresser.com/what-to-do-if-you-need-to-take-antibiotics/

    Hearing how successful it was in the studies makes me want to give the combination a go though! Not sure if I will be able to get hold of any though so for now I'm feeding all my bacteria with plantain root powder, Agar agar, and potato starch and eating sweet potato and leeks again! Had forgotten how nice they were!!

    Take care.
     
  11. Solon

    Solon

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    NatBard,

    inhousepharmacy didn't require a prescription? In their FAQ they claim that after you order they will have you send in your prescription before they will send you the medication. I'm hopeful that they will allow me to order without a prescription.

    Incidentally, £71 is extremely cheap. In the US a prescription can cost up to a couple of thousand dollars!

    I know that some people see some benefits with using probiotics and prebiotics with SIBO, but I am very cautious about that since that's what gave me SIBO. Generally speaking, there should be almost no bacteria in the small intestine, and trillions in the large intestine, so although people often talk about "good" and "bad" bacteria, I'm much more concerned with having them in the right place.

    I know people say that bacteria are more vulnerable while reproducing, but I'd be cautious about overdoing the process of intentionally feeding them. Most likely a relatively small amount of FODMAP or complex carbs should be enough for that, and I would be concerned about worsening my symptoms too much.

    You're correct, the elemental diet is basically amino acids, a quickly digestible carbohydrate, vitamins and minerals, and a small amount of fat, all mixed into water. It's meant to be absorbed very quickly and easily before it ever reaches the bacteria. Unfortunately it tastes awful...like sweetened vomit. Unpleasant, but if it had worked it would have been well worth it. It does take some willpower, but what doesn't with this illness?

    I'll be interested in hearing how your approach goes.
     

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