Background

MY STORY

Going way, way back… My history with tummy troubles is a long, storied tale so I will paraphrase the main issues: I have had a dairy intolerance that started in high school (finally fully gave up dairy altogether in my 30s); I took antibiotics for years to treat acne; and I was diagnosed with hypothyroid in pregnancy, which can slow gut motility. Those issues alone or adding them  together have likely contributed to the stomach problems I have today.

I started taking thyroid medication during pregnancy and had a very healthy, very large baby (95th percentile). Alas, breastfeeding the very healthy eater (9 oz. at a clip) lead to me shrinking while he continued to grow and thrive. I looked like Kate Moss circa 1992 except with juicier boobs.

Not being a huge fan of medicine, I went to the endocrinologist and re-tested my thyroid (came back normal) and stopped taking the medication five months after the birth of my baby. Five months since I stopped medication, I now have lower thyroid T3 levels but not enough to declare I need medicine for it. But I have felt off my game – depressive (not my natural state!), lacking energy, having some eye strain, living in a brain fog and dealing with stomach issues for months. It is the shhhh stuff you don’t want to talk about – bad gas, yo-yo-ing constipation with diarrhea and severe stomach pains.

Then I started to get really sick – I had food poisoning at one restaurant and then another restaurant put butter in my food even after I stressed my dairy allergy. This made my stomach completely inflamed, making sounds I never heard before, and I had terrible diarrhea on multiple occasions. So much so that I wound up in the hospital for dehydration when I couldn’t keep anything inside me. I knew something was very wrong.

WHAT I KNOW NOW

After my initial office visit with a GI specialist, he correctly pointed me in the direction of SIBO and sent me home to research and keep a food diary. He wanted me to try to eat what I was eating normally and note any upsets. Sure enough – eating too many raisins, apples, certain nuts, grains, etc. led to me getting sick again.

The BRAT diet for diarrhea (that every doctor told me to do) was actually the worst thing for me except for the bananas part. Applesauce had high fructose and the grains are all bad for SIBO.

Feeding a very large baby – luckily (for him) my nutrition is going to him, and not so lucky for me, most of the leftovers goes to the bad bacteria – I am malnourished and have lost weight from being sick so many times. I am now maintaining weight because I have stopped the “sick cycle” through diet.

I did not learn my lesson fast enough and kept eating foods that I deep down knew were not agreeing with my system. Just like when I first realized my stomach didn’t like dairy but my desire for frozen yogurt kept me coming back for more pain and stomach trauma until I wised up. Now I was supposed to go from what I liked to eat to bone broth and meat? I’ll admit that when I was first poking around the internet to figure out my symptoms I did find the IBS diets and FODMAP (Fermentable Oligo-, Di-, Monosaccharides And Polyls) charts, but thought there is no way I am giving up mangoes, dried apricots, fruit/nut bars, beans, etc. Live and learn…

The thought of the diet while breastfeeding was a killer because I LOVE my dark chocolate, cashews, avocados, oatmeal, quinoa and dried fruit. All of those foods are super healthy and so are the apples, pistachios and dried figs that were hurting me. I can actually eat a few slices of avocado but I think the 1 1/2 whole avocados and the excess of nuts and dried fruit I was eating to keep weight on while breastfeeding were a BIG problem.

I had to request the SIBO hydrogen test from my doctor (felt like I had to demand it actually) and hope that other people just get tested right away if their doctor suspects they have it. I feel the delay led to a prolonged treatment time and a false sense that I should keep eating foods that were feeding the bad bacteria.

Once I got the test, I tested positive for SIBO with both hydrogen and methane gases – that explained the yo-yo of diarrhea with constipation. I was high on the methane chart, which led me to connect the constipation with slow gut motility likely brought on by the hypothyroid I had/have. My doctor confirmed this. I am currently borderline hypothyroid and will wait until I stop breastfeeding to see how/if my hormones balance out at all. Then I will determine if I should go back on thyroid medication so I have an increased chance of better gut motility and less chance of a relapse.

All of that brings me back to FOOD! How the hell do you eat with SIBO, not get sick and still have enough energy to walk around? Much less care for a 25 pound baby and work full time. I’m slowly cracking that code for myself. Nutritionists can’t really help as much as they would like to because individual trial and error with food is a must. But I am grateful to some people who did share what worked for them online.

There are so many conflicting diets out there for SIBO. Probably (I say probably because I am NOT a doctor) because every person and set of intestines is very different. So some foods that work for some people (like fruit and nut bars, which I LOVE but can’t eat now) can wreak havoc on others. Many SIBO recipes out there seem very Paleo like in that they still allow for dried fruits. Dried fruits are so high FODMAP that I think it would devastate the system of someone early in their treatment of SIBO. And the same goes for rice cakes, oatmeal, etc. which I was eating early on while I was still getting sick regularly until I figured it out through my food diary.

The one thing all of the conflicting dietitians can agree on for SIBO is spacing meals out, so that your slow moving gut has a chance to catch up on digesting food. This is incredibly hard if you are used to grazing and snacking whenever you feel hungry (especially when breastfeeding). You have to be diligent about eating a lot at meal times and waiting 3-4 hours between meals. Some advise 4-5 hours but I struggle with that – low blood sugar looks terrible on me. Chewing food thoroughly is also important so that it is easier to digest. It all sounds easy but when you are ravenous after waiting so long to eat you just want to wolf it all down. Gratitude for each bite is a great challenge.

I have accepted the SIBO specific diet for now while I heal myself and will test adding in a few foods in small portions after the bad bacteria is reduced. This specific diet is Dr. Allison Siebecker’s diet (www.siboinfo.com) that is a mix of the Specific Carbohydrate Diet (Elaine Gottschall’s “Breaking the Vicious Cycle” illegal and legal foods list) and a Low FODMAP diet. I am finally breaking through denial and making the best of this challenging diet and trying to gain some weight back. Everyday feels like an impossible climb but some days are better than others and I do have more energy now that I can at least keep food inside me. Note about my diet choice: I am under weight and cannot withstand the Elemental Diet that seems to work at starving the bacteria faster but also makes the patient lose weight.

I took oregano oil – a natural antibiotic – for a month along and continue to consume other tonics/drinks that are supposed to aid in digestion. These include ginger tea, rooibos tea, peppermint water, lavender water and apple cider vinegar water.

If I am not able to add foods back in – I will likely stop breastfeeding (my son is over nine months now) and take the two antibiotics – Rifaximin and Neomycin – prescribed at the same time for methane heavy SIBO. I’d love to heal more naturally through diet and the anti-microbial herbs. I’m trying!

HOPEFULLY, then I will be ready for the prevention phase so that this does not remain a chronic issue. This blog will document my journey to figure out probiotics (to use or not to use), prokinetics, digestive enzymes and more. And, of course, I will continue updating recipes and any tipsies and tricksies that I come up with or find.

Maybe after reading all of this you will hate my guts or love my guts. Join the club… eating is very love/hate for me right now. I wish everyone out there the best of luck and health!

UPDATE (As of June 2016): It has been a year and three months since my diagnosis and almost a year since I took the Rifaximin and Neomycin combo. I have not been retested for SIBO yet but I have had some flare ups along the way. At least, I definitely have IBS symptoms and can’t really go beyond “low FODMAP/no grains” yet.

I was still feeling off and because of my diet change, my bad cholesterol went up. Luckily, my good cholestoral was also high. (Special thanks to my guts for tolerating nuts, fish and a tiny bit of avocado!) But I have to cut out some egg yolks…

My TSH was also high again, so the Dr. prescribed Synthroid. Ouch. Going on medicine was not appealing, but what was worse is that only through my own research did I discover that most thyroid medications have lactose, gluten and other yucky irritants for sensitive guts. BOO to my Dr. and pharmacist!

I researched yet again and found the most pure prescription thyroid medication out there – Tirosint. My thyroid levels are now normal, so I will stick with my low dosage. It is a pricey medication, so look online for coupons…

I am healing! That is my mantra.