Hello,
My daughter, who had been previously diagnosed with CFS/ME, FM and has other GI issues, was recently diagnosed with small intestinal bacterial overgrowth (SIBO), and has been generally symptomatic for the last 11 years. She also tested IgG positive to many foods and her practitioner said that it's not that she is allergic to these foods, but that it is an indirect marker that she has intestinal permeability (aka leaky gut).
To help eliminate the SIBO, my daughter has been on a FODMAPS diet (for 8 weeks), and has started on herbal antifungals. Neither have helped yet, but she is still ramping up on the antifungals, so it's a bit too early to see if these will help.
1) My first question is whether one should first treat the leaky gut with possibly glutamine (and other supplements) and then tackle the SIBO, or do the treatment in the other order.
Potential reasons for healing the gut first is that it allows 1) the gut mucosa layer to heal, 2) the cell walls to repair, and 3) a lessened immune response since the foods would not pass through the intestinal wall. A potential reason to treat the SIBO first is that treatment would remove this additional stress on the body. Also, if you don't treat it first, you will continue to "feed" the bacteria while you are treating the leaky gut. If you are on a FODMAPS (or other) diet that reduces fermentable foods while you are treating SIBO, then this should theoretically limit the SIBO activity.
2) So, my second question is whether my daughter should continue to be on FODMAPS (considering that it hasn't helped) while she is treating SIBO. I also realize that there are natural antifungals and antibiotics used to treat SIBO, so if the natural products don't work, her practitioner may want to consider the antibiotics. But besides redoing the tests that indicated SIBO in the first place (a hydrogen-methane breath test & certain markers from a urinary organic acids test), it seems like the way to tell if the products are ‘working’ is if you feel better, which she has not.
3) My third question also relates to the relative importance of limiting IgG/IgE foods. That is, if the leaky gut involves the immune response, should she continue to limit the IgG/IgE foods while treating the leaky gut/cells? On the other hand, if you fix the cell walls, and the leaky gut, do you really need a restricted diet anyway? Given whatever extent of intestinal permeability that she has, and the extent of her issues, I wonder if temporarily limiting/rotating IgG/IgE foods more of a ‘nice to have’ or more necessary?
4) My fourth question is whether anyone can comment on their experiences in SIBO treatment - either with synthetic or herbal antibiotics and whether they were helped or not on a low FODMAPS diet.
I realize I've asked a lot of questions here, but I also realize that this specific area is not necessarily straight forward to treat. Thank you in advance for any responses.
Sincerely,
Scotty81
My daughter, who had been previously diagnosed with CFS/ME, FM and has other GI issues, was recently diagnosed with small intestinal bacterial overgrowth (SIBO), and has been generally symptomatic for the last 11 years. She also tested IgG positive to many foods and her practitioner said that it's not that she is allergic to these foods, but that it is an indirect marker that she has intestinal permeability (aka leaky gut).
To help eliminate the SIBO, my daughter has been on a FODMAPS diet (for 8 weeks), and has started on herbal antifungals. Neither have helped yet, but she is still ramping up on the antifungals, so it's a bit too early to see if these will help.
1) My first question is whether one should first treat the leaky gut with possibly glutamine (and other supplements) and then tackle the SIBO, or do the treatment in the other order.
Potential reasons for healing the gut first is that it allows 1) the gut mucosa layer to heal, 2) the cell walls to repair, and 3) a lessened immune response since the foods would not pass through the intestinal wall. A potential reason to treat the SIBO first is that treatment would remove this additional stress on the body. Also, if you don't treat it first, you will continue to "feed" the bacteria while you are treating the leaky gut. If you are on a FODMAPS (or other) diet that reduces fermentable foods while you are treating SIBO, then this should theoretically limit the SIBO activity.
2) So, my second question is whether my daughter should continue to be on FODMAPS (considering that it hasn't helped) while she is treating SIBO. I also realize that there are natural antifungals and antibiotics used to treat SIBO, so if the natural products don't work, her practitioner may want to consider the antibiotics. But besides redoing the tests that indicated SIBO in the first place (a hydrogen-methane breath test & certain markers from a urinary organic acids test), it seems like the way to tell if the products are ‘working’ is if you feel better, which she has not.
3) My third question also relates to the relative importance of limiting IgG/IgE foods. That is, if the leaky gut involves the immune response, should she continue to limit the IgG/IgE foods while treating the leaky gut/cells? On the other hand, if you fix the cell walls, and the leaky gut, do you really need a restricted diet anyway? Given whatever extent of intestinal permeability that she has, and the extent of her issues, I wonder if temporarily limiting/rotating IgG/IgE foods more of a ‘nice to have’ or more necessary?
4) My fourth question is whether anyone can comment on their experiences in SIBO treatment - either with synthetic or herbal antibiotics and whether they were helped or not on a low FODMAPS diet.
I realize I've asked a lot of questions here, but I also realize that this specific area is not necessarily straight forward to treat. Thank you in advance for any responses.
Sincerely,
Scotty81
