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How to heal the gut without provoking SIBO

Discussion in 'The Gut: De Meirleir & Maes; H2S; Leaky Gut' started by Scotty81, Sep 6, 2015.

  1. Scotty81

    Scotty81

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    Hello,

    I have a question about what one can do to heal the gut without provoking SIBO. I've read that, ideally, one should first kill the SIBO (small intestinal bacterial overgrowth) before one attempts to heal the gut. My 22-year old daughter has tried 2 supplements to kill the SIBO, and even though her lactulose breath test is a bit better (but still somewhat positive), her symptoms remain the same. So, she plans to go on something that would be gentler, and so it may take longer to have an effect.

    While that is happening, she is also interested in looking at supplements that heal the intestinal mucosa (i.e. for leaky gut), but won't provoke or otherwise cause SIBO to worsen. Does anyone have any suggestions that both heal the gut but don't aggravate SIBO?

    • I've read about zinc and Vitamin A. My daughter is already on zinc carnosine and beta carotene to correct some nutritional deficiencies. Although the zinc has not helped, the beta carotene has fixed some other GI issues.
    • I've read that bone broth would be good to heal the gut, but that it is not recommended if you have SIBO. However, I think natural gelatin does help heal the gut, and I don't think it can cause SIBO, but not sure.
    • There is glutamine, which my daughter hasn't tried yet, but if she did, she would want to watch out for any potential effects from possible conversion of glutamine to glutamate, especially since she is still dealing with general overstimulation and sleep issues.
    • I've also seen positive things about mucilaginous herbs (e.g. slippery elm, marshmallow, arrowroot, etc.) and fermented foods, but that they might encourage SIBO.
    Thank you in advance for information you can provide.

    Sincerely,
    Scotty81
     
  2. Richard7

    Richard7 Senior Member

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    Hi Scotty,


    There is quite a lot of advice out there I found http://drmyhill.co.uk/wiki/Fermentation_in_the_gut_and_CFS and http://drbganimalpharm.blogspot.com/2013/11/how-to-cure-sibo-small-intestinal-bowel.html useful.


    I am, of course, just a sample of one but in my case it seems that the biggest problem was that I was not producing enough acid in my stomach. I understand that this is common in CFS both because it requires a lot of ATP and because it requires zinc and other minerals that someone with low acid will not be absorbing properly.


    The acid kills most of the microbes your eat.


    The acid is necessary to prompt the release of intrinsic factor, without which we don't absorb b12 from our diet.


    The acid is also necessary to prompt the release of the bile which allows you to absorb fats and fat soluble vitamins (A, K, D, E) and CoQ10.


    The bile also inhibits the growth of yeasts and bacteria in the small intestine.


    I take Betaine HCL as my source of acid, and Ox bile as my source of bile.


    When things are going well, I release enough bile to not need to supplement, or to not need to supplement much but that is rarely the case. If you are releasing enough bile you will have dark stools.


    What you eat is also really important. I found that I developed a lot of food intolerances, and found AIP paleo useful. Though I hesitate to recommend it, because I do not agree with all of Ballantyne's advice. She is the sort of person who recommends that people drop tea and coffee because caffeine increases cortisol, without acknowledging that the research shows that tea (the whole food) reduces cortisol, and helps people respond to stress.


    She places a theory ahead of the evidence.


    And that is a problem that I have faced. In desperation I have often followed theories that my body rebelled against. The GAPS diet was a good example of this.


    If I was starting from scratch I would probably get some ox bile, the some 500mg and 125mg capsules because I would need to start at the higher dose, and then drop down when I developed the dark slimy stools one gets when one takes too much bile.


    I would buy a bunch of Betaine HCL. The method I used was to start with one 600mg tablet, and then increase by one tablet per meal until I felt a burn, then drop back one tablet. A bunch because I take 8 with a meal and 3 or 4 with a snack, so I go through a bottle every 10 days.


    I would spend a few weeks following Myhill's advice about taking large doses of vitamin c to sterilise the upper gut, and eat a diet with very little in the way of available carbs, but continue to eat the fiber my lower gut needed. When I did this I ate a lot leafy greens, low gi veges and fermented veges.


    I would avoid major allergens nightshades, wheat and so on. I would avoid any foods I did not like or felt uncomfortable about.


    I would move onto something like the diet that Terry Wahls recommended in her TED talk

    In doing so I might start with pureed cooked vegetables. I heard an interview in which Wahls spoke about needing to start a some patients this way before they could tolerate whole cooked foods, and then work through to fermented and then to raw foods.


    I have found that pureed food works well when I am particularly exhausted, particularly with PEM. But I also eat a lot of food that is whole and raw. I play it by ear, listening to my body and placing evidence ahead of theory.

    There is also a place for supplementation, but this has taken quite a while to write and I need a break.

    Hope this helps
     
    Last edited: Sep 6, 2015
    Kathevans likes this.
  3. Richard7

    Richard7 Senior Member

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    Scotty,

    you may also want to look into low carb/ ketogenic diets for a while. This area is pretty complex but you basically switch out fats for most of the readily available carbs, myhill has some stuff on this on her website.


    http://drmyhill.co.uk/wiki/Ketogenic_diet_-_a_connection_between_mitochondria_and_diet


    I used a lot of creamed coconut (aka coconut butter) and MCT oil worked well for me. The important thing to note is that if you switch over too fast you will get loose stools, and you will probably feel worse (the low carb flu) for a month or so.


    I made the mistake, backtracked and switched over slowly.


    I used the ketogenic approach before I got the betaine hcl, and though my carbs have increased gradually over the last 6mnth or so I still tend to produce a some ketone bodies (as measured by a Ketonix breath acetone meter).


    I don't know if the ketogenic diet would have been necessary if I had started with the acid. But if you reduce the amount of readily available carbs in your diet your body has to switch to burning fats, it had to become ketogenic.


    Supplementation.


    I know that a lot of people on this forum are super sensitive to supplements. I was not one of those people. I took Myhill's recommended supplements for about 6 mnths when I was first doing this. My only reason for stopping was the cost.


    I did the same again for the first 3 months I was taking betain HCL, and am still supplementing but at a lower level. I am now more sensitive to the supplements, probably because I am absorbing them.


    The idea is to take them with meals, acid, bile and large doses of vitamin C in an attempt to best absorb them and deny them to the bacteria and in the small intestine.


    I also made sure that my meals contained things like rosemary and garlic, which are meant to kill off bacteria and yeast, and took other things like turmeric, ginger and galangal (all related) which are meant to help the gut.


    These are all things I like. I wouldn't have taken them if I did not feel like it.


    I make a point of always taking some fat with my meals to make sure that I absorb the fat soluable vitamins. I also supplement vitamin K and take cod liver oil for A and K. I have some vitamin E on hand but rarely feel the need.


    I came from a low fat diet, in the sense that I had always had much less than was normal without being aware that this was the case. I used very little oil when cooking, didn't use margarine or butter on sandwiches, and had only ever dressed a salad when making it for someone else.


    Until mid 2012 I had no idea that some vitamins only soluble in fat, and was probably low in those vitamins for most of my life.


    I have been taking 1 g BCAAs (branched chain amino acids) 1 g glutamine and 1 g arginine for years. The doctor who diagnosed me with CFS back in 2003/4 recommended these for gut health.
     
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  4. Richard7

    Richard7 Senior Member

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    digestive enzymes.

    I should have mentioned that I have been on digestive enzymes since 2003/4. And that I took plant based digestive enzymes during the first couple of months I was on Betaine HCL.
     
  5. Richard7

    Richard7 Senior Member

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    re animalpharm.
    I think that the 7 steps are pretty good.


    contrary to step 1, I certainly wash my veges before fermenting them.


    Fermenting should work well when you are trying to starve microbes out of the upper gut, because it removes the readily fermentable carbs.


    But people are also doing it as a source of commensal or beneficial bacteria. Most of these bacteria are transitory but while they are there they take on some of the roles of the bacteria missing from people's bowels.


    Obviously taking betaine HCL and bile salts work against the second aim. I still eat fermented foods, but I also took and take fermented drinks such as beet kvass between meals.


    http://www.nourishingtreasures.com/index.php/2013/01/29/beet-kvass-photo-tutorial/


    On theses issues I found a series of articles by Art Ayres useful

    http://coolinginflammation.blogspot.com.au/2015/01/gut-microbiome-2014-diet-inflammation.html


    click on the links entitled health diagrams I - III to go through to the articles


    Step 2, I avoided much of step 2. I ate cooked and cooked sweet potato, carrot parsnip and beets. But could not tolerate nightshades at the time and had no access to more interesting tubers.

    I was not ready for legumes until about 2 months ago, and have added back them slowly. I can now eat potatoes, but prefer the legumes.


    I found an research article showing that raffinose in black beans could be reduced if they were fermented for 2 days at 40 something degrees. The article also showed that if they were then cooked by boiling in water at a ratio of 1:12 (if I remember correctly) they lost a lot of their resistant starch.

    I don't want the raffinose, but do want the RS3, so I ferment them and then steam them in a pressure cooker for an hour (counting from when the pressure cooker come up to presure) before allowing them to cool.

    To ferment them I just put them in salted water in a la parfait jar and allow them to ferment for about 3 days to a week or so. (shorter in summer, longer in winter) (1.5 - 2 tbs coarse salt to about 400- 500g beans/ chana dahl/ chickpeas to a 1.5 litre jar)


    step 3, I used some of her recommended probiotics, flora balance seemed good and is meant to take out candida. I also took the prescript assist and AOR and a locally available 10 strain lacto and biffido. I also took some others.


    Step 4, I had issues with raw potato starch, and psyllium but liked inulin and acacia fibre. I like the green powders but cannot afford them.


    This page provides a nice rundown on fibre.

    http://www.vegetablepharm.blogspot.com.au/p/dietary-fiber-info.html


    These days I take nutritional yeast as a source of beta glucans, and lactose (because I am hoping that I will be able to eat dairy again and want to maintain my lactose digesting bacteria).


    Mostly I just rely on diet, my diet was providing about 25g/s day when I started on the betaine hcl (up from 5g a day when I was on GAPS a year earlier) these days it is 50g plus.


    Note: I am huge. I have lost a bit of muscle over the last 12 years but before all of this I had an estimated lean mass of about 90 kgs (a little under 200lbs) so 50g is probably about about RDI for my size and low for the target on the vegetablepharm site.


    step 5 is obviously no good for people with CFS/ME
     
  6. Richard7

    Richard7 Senior Member

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    Somewhere above I should have noted this is meant to heal the gut both by taking out the microbes in the upper gut, and producing butyrate in the lower gut.

    The AOR probiotic includes bacteria that feed on resistant starch and produce butyrate.

    you can read the articles on the animalpharm site to see why RS3 from cooked and cooled foods may be better than RS2 from raw foods/ raw potato starch.

    the butyrate helps with the tight junctions to make the gut less permiable.
     
  7. Richard7

    Richard7 Senior Member

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    Scotty,

    I am aware that I am the only person active on the thread at the moment, and would feel horrible if this was a phone conversation, but if no one complains I am just going to dump all of the relevant information I think I have.

    Hope that is OK.

    re bone broth. I have a friend who is a major fan of doing chicken feet long and slow in a slow cooker. She swears by it.

    I mostly use beef or lamb bones in a pressure cooker. I have not been very scientific but by a bit of trial and error I have found a system that works. I put 2kgs of bones in my 7 litre pressure cooker with 4litres of water and cook them for 3 hours.

    If I get bones with a lot of meat on them I roast them and remove the extra meat before putting them in the pressure cooker. This should reduce the cooking time but I usualy forget.

    I then filter the stock to remove any small fragments of bone, and reduce the stock to about 1 litre, and put it in jars that I have heated. I treat it like jam. Putting boiling stock into hot glass jars with metal lids. turning them upside down to sterilise the lids. I keep it in the fridge and stays good for a couple of weeks.

    On could in theory pressure can it and store it a room temperature indefinately, but I try to make stock every two weeks.

    I add another 4 litres of water to the bones and run it for another 3 hours etc. I can go for a third wash, but that stock becomes thin so I don't bother.
     
  8. Richard7

    Richard7 Senior Member

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    re mucosa,

    low carb diets can apparently lead to dry eyes, reduced mucose production etc.

    This seemed to be the case for me.

    I had about a year of needing to use eye drops. Then at some point in Autumn that ceased to be the case. I suspect that it was to do with adding more "safe starches".

    http://perfecthealthdiet.com/2010/1...ucus-deficiency-and-gastrointestinal-cancers/

    But I do not know the science. I remember that when I looked into this that there were arguments against this. I do not know what they were.

    I only mention this so you will have some idea of where to look if your daughter runs into this problem.
     
  9. Richard7

    Richard7 Senior Member

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    oh, and If you get into fermenting I found this useful

    http://www.nourishingtreasures.com/index.php/fermentation-information-and-supplies-needed/

    also

    http://www.wildfermentation.com/ Sandor Katz's site. The forums are slow, but useful and you can search out some of his videos on youtube.

    I use really acidic ferments (zucchini for example) in thai curries in the place of lemon/lime juice.

    I don't know what it is like in your area but commercially available unpasturised sauerkraut and other vegetable ferments are really expensive. I wouldn't even think of buying them.

    But if fermenting seems to difficult you can also buy some fermented foods at reasonable prices. I use black beans (the chinese fermented soy beans) pretty often, and I have recently started using a local unpasturised miso in situations where I would usually use soy sauce, and am planning to buy some unpasturised korean bean paste and chilli paste to see how they work for me.

    I think that is everything.

    Hope every thing works out.
     
  10. Scotty81

    Scotty81

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    Richard7,

    Thanks for all the useful info. it'll take me a while to sift through all of this. Even Dr. Myhill's article that you first linked to takes quite a while!

    Thanks again.

    Regards,
    Scotty81
     
  11. ebethc

    ebethc Senior Member

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    Hi @Scotty81

    why is bone broth supposed to be bad for SIBO?
     
  12. Scotty81

    Scotty81

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    Hi ebethc,

    The reason I had read that bone broth is bad for SIBO comes from a comment posted on a website for an interview that Dr. Sarah Siebecker gave about SIBO. The website link is here. In particular, a person named Dan said and I quote:

    "bone broth made with cartilage bones such as knuckle bones are rated high on the FODMAP and therefore, suggested to be avoided. However, marrow bones and meaty bones are perfectly ok."

    So, that is the extent of my knowledge on your question. So, it would appear that you could be feeding the SIBO when trying to heal the gut. I do believe that one can buy unflavored gelatin from grass-fed cows, and that this would OK to use in SIBO patients. That's on my daughter's list to try, but she has not done so yet.

    Regards,
    Scotty81
     
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  13. ebethc

    ebethc Senior Member

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    thanks... sounds like beef broth might be better
     

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