BeADocToGoTo1
Senior Member
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- 536
Hi @outdamnspot,
It is beyond frustrating when you cannot find the help needed and people around you, including doctors, do not take it seriously. I went through all of that as well and had 20+ specialists tell me I was fine, or it was in my head. I also was sensitive to absolutely everything. Nausea for about 6 months straight, to the point I had to take anti-nausea meds to get some food down (mostly home made soup at the time). This is why I had been replying to your posts about looking into ruling out some of the malabsorption possibilities, including EPI.
EPI or Exocrine Pancreatic Insufficiency was the most important underlying cause of all my gut issues, food sensitivities, malabsorption, leaky gut, yeast and bacterial overgrowths, muscle and bone wasting, depression and a myriad of other symptoms. Symptoms started stealthily but progressively became worse.
In your case EPI absolutely needs to be ruled out by your gastro! Uncovering this literally saved my life.
It does not work that way. Bactrim will not magically make you feel better. If it is SIBO, it is a multi-month, multi-pronged approach that is needed as I mentioned in a prior post. I would be very careful with just throwing antibiotics at it. You could make things worse and be left with a bunch of resistant ones.
A dietician is not a bad idea at all, especially with trying different approaches. They may be familiar with very specific things to avoid or try and slowly build up.
However, I agree that if you cannot tolerate anything it may be something to try a little later.
If you can tolerate it, add it. Can of sardines in water or some smoked salmon perhaps. When you mention it is not filling enough I wonder again if that is more to do with your body signaling it is nutrient deficient and not breaking down the food properly.
I used a Tanita scale with body composition monitor for a rough indication of weight, body fat %, body water %, muscle mass, metabolic age, bone mass, visceral fat, and basal metabolic rate.
https://www.tanita.com/en/understanding-your-measurements/
It is something simple to try and can be lifesaving as it was in my case. It 100% resolved my food intolerances and food sensitivities, along with dozens of other symptoms. Before I became ill I could eat absolutely anything. At my worst I could barely tolerate even some clear bone broth or rice. Everything hurt my stomach and intestines and made me nauseous and doubled over.
It will just help break down food into usable nutrients. Get the enteric coated ones preferably. But over the counter ones are something you can try immediately. They are taken during the meal. A no brainer to try.
If you also have gallbladder issues, you can try an oxbile supplement to help break down fat.
For your gastroenterologist
Please discuss with him the following crucial elements.
1. EPI or Exocrine Pancreatic Insufficiency:
A simple unscientific test to approximate acid level is by drinking a quarter teaspoon of baking soda (sodium bicarbonate) mixed in a glass of water on an empty stomach in the morning. This creates bubbles within two to three minutes when mixed with the hydrochloric acid in your stomach. If after five minutes nothing happens, there is a very good chance the pH of your stomach acid is too high (i.e., low stomach acid).
3. Intestinal permeability
@hb8847 wrote some really good points above. Intestinal permeability (a.k.a. leaky gut) is something that your Gastro can also test for. The one I did was:
Cyrex Laboratories - Intestinal Antigenic Permeability Screen
It measures intestinal permeability to large molecules, which can cause autoimmune reactions, inflammation, food sensitivities, malabsorption, etc.
4. Gallbladder function. Yet another element that is important in breaking down food and thus any gallbladder issues can cause malabsorption.
5. SIBO and Candida overgrowth. Already mentioned before. With SIBO, both methane and hydrogen ones should be tested and tackled. Multi-pronged approach is needed as just antibiotics is not enough.
It is beyond frustrating when you cannot find the help needed and people around you, including doctors, do not take it seriously. I went through all of that as well and had 20+ specialists tell me I was fine, or it was in my head. I also was sensitive to absolutely everything. Nausea for about 6 months straight, to the point I had to take anti-nausea meds to get some food down (mostly home made soup at the time). This is why I had been replying to your posts about looking into ruling out some of the malabsorption possibilities, including EPI.
EPI or Exocrine Pancreatic Insufficiency was the most important underlying cause of all my gut issues, food sensitivities, malabsorption, leaky gut, yeast and bacterial overgrowths, muscle and bone wasting, depression and a myriad of other symptoms. Symptoms started stealthily but progressively became worse.
In your case EPI absolutely needs to be ruled out by your gastro! Uncovering this literally saved my life.
I'm feeling despondent today because I finished the Bactrim course last week and have seen no improvements. I spoke to the receptionist at the GI's office yesterday and expressed my concerns, and she said he would likely follow up with a different abx, but she left a message today saying she spoke to him and he thinks I should see a dietician. How will that help, though, if I can't tolerate any foods? As you said, if I have a methane overgrowth, Bactrim wouldn't have helped anyway, so I don't see how he can consider his work done. I will likely end up trying the Doxycycline I have saved, as it seems to be a more common SIBO treatment, but I am wondering what the minimum amount of time I should probably wait between courses is? 5 days for the Bactrim seems short anyway, as I've seen most SIBO courses going for 10-14 days. Alternatively, there is a probiotic (Symbioflor 2) that helped in the past as well, which I have a bottle of, though I am a lot more ill now than when I first tried it 2 years ago.
It does not work that way. Bactrim will not magically make you feel better. If it is SIBO, it is a multi-month, multi-pronged approach that is needed as I mentioned in a prior post. I would be very careful with just throwing antibiotics at it. You could make things worse and be left with a bunch of resistant ones.
A dietician is not a bad idea at all, especially with trying different approaches. They may be familiar with very specific things to avoid or try and slowly build up.
However, I agree that if you cannot tolerate anything it may be something to try a little later.
No, I don't really find fish filling enough so tended to avoid it.
- Does this include fish? If not, you might be lacking in omega 3, even if 100% grass fed.
If you can tolerate it, add it. Can of sardines in water or some smoked salmon perhaps. When you mention it is not filling enough I wonder again if that is more to do with your body signaling it is nutrient deficient and not breaking down the food properly.
How would I know if I'm losing bone or muscle weight?
- Are you losing muscle and bone weight, or fat weight? Weight loss should never be bone or muscle, and it is important to measure this, even if it is just roughly using a home scale.
I'm not sure.
- Are you at a healthy fat percentage, or are you losing weight to get to a healthy fat percentage?
- Have you measured how many calories you take in versus how much you would need as your metabolic rate? Your gastro should be able to help you with this as well.
I used a Tanita scale with body composition monitor for a rough indication of weight, body fat %, body water %, muscle mass, metabolic age, bone mass, visceral fat, and basal metabolic rate.
https://www.tanita.com/en/understanding-your-measurements/
No, I guess I was skeptical they would do much for intolerances?
- Have you tried taking enzymes with your meal to help with absorption? Your gastro again may be able to give you a prescription to something like Creon to see if it helps your symptoms.
It is something simple to try and can be lifesaving as it was in my case. It 100% resolved my food intolerances and food sensitivities, along with dozens of other symptoms. Before I became ill I could eat absolutely anything. At my worst I could barely tolerate even some clear bone broth or rice. Everything hurt my stomach and intestines and made me nauseous and doubled over.
It will just help break down food into usable nutrients. Get the enteric coated ones preferably. But over the counter ones are something you can try immediately. They are taken during the meal. A no brainer to try.
If you also have gallbladder issues, you can try an oxbile supplement to help break down fat.
No he didn't. Maybe I can ask my GP about it.
- I may have mentioned this before, but did your gastro do a comprehensive stool test which would include things like fecal fat level and distribution (checks if you have issues with different types of fat intake and digestion), pancreatic elastase (for EPI, pancreas enzyme marker)and chymotrypsin (for EPI, pancreas enzyme marker), parasites, pathogenes. You may also ask him for a fasted trypsin blood test (to see if you produce enough enzyme for protein breakdown).
For your gastroenterologist
Please discuss with him the following crucial elements.
1. EPI or Exocrine Pancreatic Insufficiency:
- PERT. Some doctors will prescribe pancreatic enzyme replacement pills like Creon to see whether your symptoms go down. You can also buy over the counter ones, but they will be unregulated in terms of strength. Better than nothing though, and they will help you break down food.
- Stool test: fecal fat level and distribution (checks if you have issues with different types of fat intake and digestion). A 24 hour collection test is pretty standard.
- Stool test pancreatic elastase
- Blood test fasting trypsin (to see if you produce enough enzyme for protein breakdown)
- Comprehensive Stool test for parasites, pathogenes, dysbiosis
- Stool test chymotrypsin (similar to, but not as accurate as elastase)
A simple unscientific test to approximate acid level is by drinking a quarter teaspoon of baking soda (sodium bicarbonate) mixed in a glass of water on an empty stomach in the morning. This creates bubbles within two to three minutes when mixed with the hydrochloric acid in your stomach. If after five minutes nothing happens, there is a very good chance the pH of your stomach acid is too high (i.e., low stomach acid).
3. Intestinal permeability
@hb8847 wrote some really good points above. Intestinal permeability (a.k.a. leaky gut) is something that your Gastro can also test for. The one I did was:
Cyrex Laboratories - Intestinal Antigenic Permeability Screen
It measures intestinal permeability to large molecules, which can cause autoimmune reactions, inflammation, food sensitivities, malabsorption, etc.
4. Gallbladder function. Yet another element that is important in breaking down food and thus any gallbladder issues can cause malabsorption.
5. SIBO and Candida overgrowth. Already mentioned before. With SIBO, both methane and hydrogen ones should be tested and tackled. Multi-pronged approach is needed as just antibiotics is not enough.
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