Interesting perspectives on SBO's and gut healing

On the pro side there's this:
soil-based-probiotics-plus-fermented-foods-heal-gut

And on the con side:
the-problem-with-soil-based-organisms

We go 'round and 'round about this and the bottom line seems to be no one really knows for sure.  Bottom line seems to be, proceed with caution!

Aquaporins

FInally got off my butt and asked NCNM for the spec sheet on aquaporins.  I came up positive on the Array 10 for corn+aquaporins and tomato+aquaporins.  Tomorrow will be the first full day of elimination (my old digestive enzymes had egg white, the replacements came today).  Anyway, here is an excerpt from the Cyrex spec sheet on aquaporins:

Aquaporins are found in all cells and help move water through the cells in an organized manner.  Aquaporin 4 (AQR-4), is a water channel protein in the CNS and is expressed in astrocytes, particularly in the astrocyte food processes at the blood brain barrier.  Some environmental proteins such as spinach, soy, corn and tomato contain aquaporin that have similarity to the brain AQR-4. Generation of antibodies against AQR-4 in general may contribute to the development of immunity and/or progression of multiple sclerosis.

Well alrighty then, I guess that ends that. Even if that paragraph is overblown I don't see any point in risking it. So, no corn or tomato until these antibodies go away which means SIBO gone and gut healed (if that ever happens!).

Clinical Pearls from the SIBO Symposium

The webinars from the SIBO Symposium have finally been released. They are a bit hard to hear but I spent a couple of hours last night listening to the Clinical Pearls section that we missed. Providers had the opportunity to come up and talk about cases and things they are trying or noticing in their patients. They each had 5 minutes. Some takeaways: Farshid Rahbar, MD presented on SIBO and tick borne illness (Lyme). He found that patient with abnormally high levels of hydrogen or methane often had tick borne illness. 65% of people that he has seen that have tick borne disease also have SIBO. Dr. Morstein (ND) uses the generic Rifaximin from Canada and has great success but she always pairs it with 1 tsp of guar gum in 8oz of water. She never treats SIBO without including Lactoprime Plus. She has the client take them with lunch. She felt that if you just treated the SIBO you would end up creating a dysbiosis in the large intestine and then you would be stuck fixing that next. (I have to say I kind of agree, after last summer's war against the archaea I ended up with a bad dysbiosis in my colon.) She also uses Hercius Erineus and Acetyl L-Carnitine to help heal any nerve damage in the small intestine. (My guess is this is the product she uses.) Whitney and Stephanie Hayes, NDs presented on SIBO and infertility. They found if they got rid of a woman's SIBO she often became fertile again. Pretty fascinating since you wouldn't think they would be linked. They think SIBO testing should be considered in any woman with pelvic pain/dysfunctions. Dr. Elena Guggenheim talked about autoimmunity and how the bacteroides seem to modulate the immune response. She presented a case on RA and said that once she got the woman's SIBO under control (only symptom was diarrhea), her RA symptoms greatly reduced and she was able to resume normal activities without daily use of medications. Kelly Reis (sp?), ND was great. She bought her own Quintron so she could get results fast. She also does thermography and finds that people with autoimmune issues have a cooling spot above their T2 thoracic spine. (I had this done before my SIBO diagnosis and I didn't have anything blue (cold) in this area. Fascinating!) She runs a facebook page for clinicians which is a valuable resource since everyone seems to be guessing a bit on the harder cases. Nora Jacoby, ND talked about diet. She has a diet handout that she gives patients and there is access to it for clinicians only on her website www.sibotest.com. She gave no details to say how it was different that the SIBO specific diet. She strongly recommends Dr. Kharrazian's gargle/gag method, breathing exercises and use of cascara sagrada. She also mentioned Heart Math (which I really want), to help you get into rest and digest mode before meals and to help train yourself overall to easily get into parasympathetic mode. Using a Squatty Potty or step stool will help retrain the bowels. If you like local and sustainable (aka expensive) go herehttp://gostool.com/shop/ Dara Perkins, MD has found that with low weight SIBO patients she often has them eat high quality fermented sourdough bread and organic corn products such as polenta for a starch and most have success. One of her patients found that if you combine LDN with antihistamines you may have nightmares. Dr. Ruscio came up and talked about how he tracked patients taking biofilm agents and some who were not and so far hasn't found any difference in effectiveness. He will release his finding later this summer. BIofilm disrupters are a must if the overgrowth is fungal.  He brought up how the microbiota is the next big thing but that a lot of the information going around on blogs is not based in research. He's not ready to jump on the feed the microbiota carb bandwagon. He said prebiotics need to be taken on a case by case basis and you should be gunshy with SIBO patients. He is beginning a study of prokinetics in the next 2-4 months. To be in this study you have to be ending your treatment and SIBO clear when he starts his research. Information at www.drruscio.com Mark Davis, ND talked extensively about FMT and said that even when people swallow (ewwww!) an FMT capsule it does not cause SIBO. He bases this on a study where they sprayed fecal material into the duodenum of people and the bacteria migrated back down to the colon. Allison Siebecker, ND indicated that any kind of self care whether it be acupuncture, massage, yoga, meditation, colonics, deep breathing, etc improves patient outcome. Dr. Moore, ND uses a food allergy test to see if patients have leaky gut, if there are lots of positives or mildly positives it indicates leaky gut. (other NDs mentioned this as well). Expressed need for mentoring program for clinicians treating SIBO (the new GastroANP.org for providers will provide some of this). A doctor asked a question about how to regenerate nerve function in the small intestine. The same herbs were brought up (as above) by Dr. Morstein, acupuncture, colon hydrotherapy, cranial-sacral therapy. Dr. Ruscio brought up again that ICC cells will regenerate on their own once SIBO or antibodies are gone. Steven Sandberg Lewis, ND brought up the whole gut brain connection. He said if there has been any mild traumatic brain injury - former soccer player, non-diagnosed concussion, black eye, broken nose, whiplash (me two or three times), any of those impacts can affect the gut neurology. Neurofeedback is a great way to address it. The general consensus with all the providers was SIBO is either easily treated or very, very difficult. There doesn't seem to be a lot of middle ground. Guess I know where fall!

Hello 2am

I have been waking up at 2am just about every night, gut bloated and gurgling, sometimes all sweaty, sometimes not.  I'm hoping this is an epic nightly battle where the antimicrobials are winning out, killing off the archae and bacteria.  I'm sure part of it too is my liver trying to keep up with cleansing all this crud out of my system.  I'm still taking LiverCare to help support my liver.  Fingers crossed it's all doing something good!

Elimination Time

In my last Skype appt with Dr. Keller we talked about my Cyrex Array 3, 4 and 10 results.  She wants me to eliminate all Out of Range foods, obviously, but she always wants me to eliminate all the Equivocal foods for at least 6 weeks and then slowly reintroduce them.  She said that many of these reactions are because the foods are FODMAPs and should resolve with the SIBO but the others are just causing inflammation in the body and we need to reduce that.  Could be due to intestinal permeability, that would be my guess, but I never eat things like cooked tuna or squid and those certainly aren't FODMAPy, so who knows.  She really cautioned me about the Aquaporins and said the response to them should be taken seriously.  She said she would send me a spec sheet about it.  All the Google links lead to long research articles that I really don't feel like reading right now.

Out of Range:

• Sesame
• Teff
• Corn
• Rice Cake
• Wild Rice
• Kidney Beans
• Celery
• Corn + Aquaporin, cooked
• Popped Corn
• Pea, cooked
• Pea Protein
• Tuna, Cooked
• Squid, Cooked
• Thyme (wonder if this means I can't do Candibactin-AR)
• Clove
• Beta-Glucan (polysaccharide)
• Gum Tragacanth (polysaccharide)

Equivocal:

• Oats
• Tapioca
• Egg White, cooked
• Wheat + Alpha-Gliadins
• Garbonzo beans, cooked
• Soybean Agglutinin
• Brazil Nuts
• Artichoke, cooked
• Chili Pepper
• Lettuce
• Onion + Scallion (raw and cooked)
• Pumpkin + Squash, cooked
• Tomato + Aquaporin
• Tomato Paste
• Apple Cider
• Apricot
• Kiwi
• Mackeral, cooked
• Salmon, cooked
• Tilapia, cooked
• Trout, cooked
• Shrimp, cooked
• Parvalbumin
• Lamb, cooked
• Gelatin
• Paprika
• Mastic Gum + Gum Arabic

I'm definitely going to have to hang this list to avoid some oops!  Most of the foods listed I don't even eat so it's not a big deal really.  But I did like to eat salmon, shrimp and eggs on occasion.  And I love spicy, so the chili peppers make me sad.

Time to change things up - New Protocol

So I'm sticking with the Biocidin for now.  I think I like it.  It has tea tree oil in it which helps get into those pesky biofilms.  After looking at Bio-botanical Health's Comprehensive Cleanse program I decided to add Olivirex to the mix .  As much as I hate to, I'm keeping in the Allimed.  Everyone says you need it for methane but I wonder if it works is all.  I've taken sooooo much of it and it's so expensive.  I'm trying the tincture this time for kicks.  For those of you who dearly miss garlic, the tincture is super yummy.  After looking at all the various biofilm busters I decided to give Serrapeptase a try.  I really, really want to try Lactoferrin but the milk.  Dairy brings my digestion to a complete and utter halt.  Not helpful even if it is kicking the biofilm's butt.

So this is everything I take 20-30 minutes before meals:

• Digestive Bitters
• Iberogast - 20 drops
• Vital-zymes (2)
• Biocidin (working up to 20 drops)
• Olivirex (2 capsules)
• Allimed (15 drops)
• Serrapeptase (1)

I've also added Triphala between meals to help with my motility.  I need to do more research on this as I saw on a fb group that it can hinder T4 to T3 conversion.  That is mostly the liver's job.... hmm.  I'm still taking tumeric and fermented cod liver oil to help with inflammation.  And I am taking Betaine HCL with meals to help my body break down protein since it struggles with this.  I'm also taking LiverCare to help support the liver.  Both Biocidin and Olivirex have Milk Thistle so there is support there as well.  SIBO and the treatment of SIBO can be rough on the liver and I want to make sure I am supporting it.

At night I'm taking:

• LDN
• Iberogast
• 5-HTP

I seriously would not recommend jumping into the protocol I've outlined above.  I never experience anything resembling die off but many, many people do, not to mention I made this protocol up myself.   AND my ND at the SIBO Center pretty much told me I was crazy, especially when I said I was taking MegaSpore Biotic and eating fermented foods.  They really like to stick to things that have been researched and mostly formulas that contain few ingredients so they know what is working.  

I've been doing this protocol for approximately a week and things seem to be going well.  Feeling a bit tired but I'm losing weight which to me is a good sign.  The methane producing M. Smithii love to make you hold onto calories and therefore weight.  The fact that I'm losing little bits makes me think I'm making some headway in killing them off.  Now to decide when to test again!

Peanut Butter is back!!

I heard rumors that there was a brand of peanut butter out there that actually tests to make sure there is no aflatoxin in the peanuts.  I saw blog posts but wasn't sure where their information came from so I emailed the company and this was the response:

Thank you for taking the time to contact us regarding our Arrowhead Mills® Creamy Organic Peanut Butter.

The peanuts are tested for aflatoxins to ensure they are safe prior to using in the manufacturing of our peanut butters.

Thank you for your continued support. If we can be of further assistance, please feel free to contact us at 1-800-434-4246, Monday through Friday from 9AM - 7PM Eastern Time.

Gino
Customer Care Representative

Ref # 2992351

** This e-mail is sent by The Hain Celestial Group, Inc. and/or one of its subsidiaries. The information and attachments contained in this e-mail message may contain privileged and confidential information and is for the exclusive and confidential use of the intended recipient. If you are not the intended recipient, you are hereby requested not to read, distribute, copy or take action 
in reliance upon this communication. If you have received this communication in error, please notify us immediately by telephone or return e-mail and delete this e-mail and any attachments from your computer system. **

Peanuts are lower in FODMAPs than the other nuts out there which is strange since they are a legume and almost all legumes are high in FODMAPs.  I'm glad to find a brand that cares about this as much as us health conscious people.  I've already taken away my son's bread and cheese, taking away his peanut butter at this point would be just plain mean.

Vegan Dining

I ate lunch at a local vegan restaurant with my son today.  I'm on a new protocol and sometimes when I am taking herbal antibiotics I throw caution to the wind and hope the bugs come out to feed and more get killed.  The restaurant is awesome for vegan fare.  No gluten, beans or grains that I could find on the menu.  Obviously no dairy since it's vegan.  My son was recently diagnosed with an intolerance to dairy and wheat and our solar panels were being hooked up today so we were without power all day, hence the lunch out.  He was excited to go to a restaurant where he could eat anything on the menu.  I opted for the enchiladas because they are sooo amazing.  I had them before this whole SIBO thing came along.  The tortillas and sour cream is made out of cashews.  Hello FODMAPs.  They are filled with walnut meat.  It came with pico which I'm sure had onion and garlic in it.  It was topped with lettuce which in hindsight I should have asked them to leave it off since I can't really chew it and it gets stuck in my teeth.  I didn't seem to have any reaction, a bit of belching, no bloating, then 5 hours after the meal I started to itch and discovered this.  It's always my dang belly that gives away my cheating.  I'm definitely taking Endozin (zinc carnosine and glutamine) tonight.

White Fudge is my current obsession

I have always had a HUGE sweet tooth.  Going to a low carb, high fat diet has helped this tremendously but I still love a treat.....  with every meal :)  So I make fatty mildly sweet treats.  I found this recipe a while back.  The amount of maple syrup in it would kill me so I adapted it to make it way less carbs and low FODMAP.

White Fudge

6 oz raw organic cacao butter

3-4 oz coconut oil (4 oz will make them softer)

75 grams coconut butter (or coconut manna)

1 T vanilla (ground vanilla beans are best but so expensive)

2 T honey

1/8 salt

I mix all these things together in a double boiler.  Before I had a double boiler I would just place a stainless steel bowl over a pot with boiling water in it.  Stir until everything is melted together.  The honey never seems to mix in very well and I love this.  The more you let it sit, the more solid it gets at the bottom of the pan.  I then pour the fat off the top into a 12 muffin  or 24 mini muffin pan (silicone works awesome).  I then scoop the honey off the bottom and distribute it between the 12 (or 24) cups.  You can add unsweetened cacao nibs at this point to add a chocolately crunch. I then place it in the freezer over night to solidify.  When you pop them out in the morning the honey will have formed a little caramel like layer.  So yummy!  I put them in mason jars for storage and keep one in the refrigerator and one in the freezer for later.

If you are the kind of person who can't stay out of treats then don't make them, you will just eat too many and regret it.  

SIBO as an autoimmune disease

First of all, can those people with an actual autoimmune version of SIBO get something new to call it?  An actual name, not an acronym.  The bacterial overgrowth is just a symptom of the actual problem.  The actual problem being the damaged vinculin and ICC.  Any thoughts on names?  Just please not Pimental's Syndrome.

Dr. Ruscio podcast on IBSChek

I have to say seeing Dr. Ruscio at the SIBO Symposium was quite fun.  People flocked to him, handsome and smart.  Hilarious!  It was like there was a rock star in the room.  LOL!

He recorded this podcast before the SIBO Symposium.  After Dr. Pimental's presentation I wonder if he has changed his thinking at all??  I'm sure he'll do a podcast about the SIBO Symposium soon. 

I waiver on this one.  Do I want to know if I have antibodies?  Would it actually change my course of treatment? (NO!)  Is satisfying curiousity worth the $$$? Given that I did the Cyrex Array 3, 4 and 10 you probably know the answer to that!!

new-sibo-test-just-released-episode-15/

Breath Test #7

I knew I'd still be positive but it doesn't suck any less, especially since my (methane) numbers are a little higher than in September.  At least the hydrogen is down.  Oh, and based on the Breath Test Interpretation section at the SIBO Symposium, my guess is that the dip at the 180 mark is the dip where the lactulose transitions to large intestine.  You should see a double peak and the dip between the double peak is the ICV (ileocecal valve). Hello slow motility!

Pity party over, time to move on...  Do I choose a protocol or wait to talk to Dr. Keller. Hmmmm, I'm not very good at patience..  Stay tuned!

Another great perspective from the SIBO Symposium

From my friend, Tim.

http://www.dharmaworks.net/Tim/sibo-symposium-recap/

My notes from SIBO Symposium

I should preface this by saying that on Thursday I received my son's results for the Cyrex Array 3 & 4.  Turns out he was off the charts sensitive to both wheat (interestingly enough the lectins way more than the gluten) and dairy (casein but not whey).  My family loves their bread products and dairy products and they are a staple in our home (I don't eat them of course due to SIBO and dairy sensitivity).  We talked on Thursday evening and Friday morning after they guys left I cleaned all the dairy and wheat out of the house, jumped in the shower and left for the symposium.  Needless to say all this was heavy on my mind during the weekend since I didn't know what the results actually meant in terms of autoimmunity. Our ND can't see us until July.  Thankfully I ran into the Cyrex Rep at the Symposium and she talked me through the results.  Not specific to him or diagnostic but what each value measures, translates to (eg - wheat germ agglutanin is a lectin), and how symptoms may manifest in the body for people.  After talking with her I was able to breathe because I think that Celiacs and IBD are likely off the table. Phew!

Dr. Pimental spoke first about the Underlying Causes of SIBO.  He has teamed up with the military to study IBS because the majority of soldiers get food poisoning on deployment, as if they don't have enough stress!!!  In these studies they have found that 10% of soldiers returning have IBS from one deployment. You can imagine the rates for soldiers going through multiple deployments! They ruled out stress as a cause by asking question such as - did you fire a weapon, did you shoot another human, were you injured, etc. Through these studies he has determined that IBS is not caused by stress (and therefore is NOT all in your head).  His belief is that the majority of SIBO is caused by food poisoning.  Based on a study, 60%+ cases of IBS are caused by SIBO.  They determined this using both duodenal sample and the breath test.  This number is likely low because if the breath test was positive and the sample negative they said negative for SIBO.  Dr. Pimental mentioned that the duodenum is just a small sample of the upper small intestine and often the bacteria is lower down so this percentage is likely low.

Dr. Pimental has done A LOT of work looking at how food poisoning causes SIBO.  He found that when you get food poisoning often from Campylobacter Jejuni, E. Coli, Salmonella or Shigella they can all cause SIBO.  The bacteria produce CDT (Cytolethal Distending Toxin).  The toxin attaches to the wall of the small intestine and the our immune system creates antibodies (Anti-CdtB and Anti-Vinculin), these antibodies go to attack the CDT and in the process destroy the vinculin which in turn damages the Interstitial Cells of Cajal (ICC).  These ICC cells are responsible for motility.  Dr. Pimental found that if you remove CDT from bacteria before injecting it into the mice they still got gastroenteritis but did not get lasting intestinal damage or SIBO.  This is where Dr. Pimental's new test comes in that measures these antibodies. It's his first step in finding a way to cure SIBO. These antibodies - cause SIBO, the greater the antibody the greater the SIBO so can predict treatment length and if we measure antibodies perhaps we can learn how to decrease them and heal the ICC/motility.  Dr. Pimental stated that if you remove the antibodies the body will heal in 3 weeks.  He also said it is imperative for people with SIBO to NEVER get food poisoning again.  He advises some type of antibacterial while traveling with every meal (of course he said Rifaximin but that's only because it's his weapon of choice and he's rumored to get kickbacks, personally I will stick to Biocidin).

Other takeaways from his talk:

• 10 times more people with IBS have an abnormal breath test than normal people.
• Methane slows transit time in the small intestine 69%.
• You are 5 times more likely to get IBS if you have had food poisoning.
• Also, the breath test is not good at measuring methane under 3 so if your hydrogen is elevated and you still have constipation assume it's positive for methane and keep treating.
• If the breath test shows methane in the colon it's still a positive because you shouldn't have methane produced anywhere!
• Stomach acid (and Betaine HCL) slows motility but kills bacteria so take it if you need it!!
• PPIs increase motility but they are NOT recommended because the decrease acid (which kills bacteria)

Dr. Pimental and Dr. Siebecker then presented Elemental Diet Treatment for SIBO.  Dr. Pimental noted that he only has a 50% success rate with methane producers using Vivonex.  Sometimes people don't feel better until 10 days after they stop the elemental diet.  It's important to reintroduce foods SLOWLY, starting out with soups.  Antibiotics don't work during the elemental diet because the bacteria can hibernate.  The elemental diet is effective in 80% of people in 2 weeks, 85% of people in 3 weeks, there is no benefit in going longer.  Thrush can be a side effect of Vivonex due to "all the nutrition being swished in the mouth".  There have been no studies yet on Peptamen but it appears to have the same effectiveness.  Dr. Siebecker has done no formal studies on the homemade formula but she has found virtually the same effectiveness as Vivonex and says she has found it is effective with Methane.  You can find the recipe here.  Can I just say she is so tiny and absolutely adorable?!?!

I skipped Dr. Pimental's presentation on Rifaximin.  Been there, done that, wouldn't do it again, wouldn't recommend it.  I've found herbals much more effective.

Prokinetic Prevention of SIBO presented by Drs. Pimental, Weinstock, Siebecker, Keller.  I didn't take any notes on the prokinetic discussion because I've used most of them :)  The only one I haven't tried is Resolor because it's expensive and you have to get it from Canada.  Dr. Siebecker does a good job outlining prescription options here.  Dr. Pimental likes Resolor the best.  Dr. Weinstock talked about LDN. Dr. Siebecker seems partial to Iberogast (even for kids).  Dr. Keller presented on Motilpro.

Herbals include:

• Iberogast 20 drops with meals and/or at bedtime
• Motilpro - no instructions provided
• Ginger - 1000-1500mg daily

They all seemed to feel that there may not be a benefit to starting prokinetics early.  Often the methane overrides the benefit of the prokinetic and you are just wasting your money.

Steven Sandberg Lewis and Dr. Shaver presented on Beyond the Breath Test: Other tests for SIBO patients.  My takeaway from this was that a provider should never assume it's just IBD, or Celiacs that if the patient doesn't get better they should always check for SIBO (and in some cases vise versa).  Dr. Shaver indicated she likes to r/o celiacs, non-celiac gluten sensitivity, do food sensitivity testing and a stool test.  Celiacs and SIBO often seem to go hand in hand.  Food sensitivity testing helps you identify and remove foods causing symptoms and/or inflammation, stool testing can help identify parasites/pathogenic bacteria/fungus, bacterial imbalance, inflammation, and sIgA ("a key marker of humoral immune status").

Larry Wurn presented on Physical Treatment for SI Obstruction and all I have to say about this is if you feel like surgical scarring/adhesions are an issue for you, you need to check them out.  I have a friend that has been to their clinic and had treatment and it changed her life.  There technique has been well studied and it's no bull!

Sunday was a bit more of a blur.  The conference started at 8am and the presentation was done via video (for an hour and 15 minutes).  It was hard to follow along.  My friend Tim will do a much better job of summing up Dr. Mullin's presentation and I will link it when he does.  Dr. Mullin spoke on a wide variety of topics, one was using D-Limonene 1000g daily as a prokinetic. I don't recall timing but prokinetics are usually at bedtime.  He also talked about use of the Smart Pill to measure PH in various parts of the digestive tract, in addition to measuring motility, pressure and the ICV.  Sound intriguing!  I also wrote down S. Boulardii increases SigA (which is a good thing!).  I think I tossed mine out long ago however so can't add it in now and again.  He spoke about adding in fermented food but I glazed over :(. His uses the garden metaphor, first kill all the weeds (SIBO), support the soil (gut) so good plants can grow, then reseed (pre- and probiotics).  I'm on the probiotics, the prebiotics still scare me a bit!!  Oligosacchararides promote bifido and lacto, discourage growth of clostridia, prevent constipation, etc.  Sounds kind of important.  Oligo's are found in artichoke, asparagus, broccoli, brussel sprouts, fennel, garlic, leek, onion and cabbage. It was interesting, Dr. Mullin seems to be willing to try anything and if I am remembering right he talked about patients ending up in the hospital (one due to use of biofilm buster EDTA) and said "we discontinued use of that treatment" a handful of times. Which is both awesome and frightening.  We need strong SIBO fighters but I'd hate to end up in the hospital!  He has a new book tomorrow!

Dr. Weinstock spoke again about leaky gut and SIBO.  The feeling is that pretty much everyone with SIBO has leaky gut and if your intestinal permeability test comes back negative it's only because the SIBO has eaten all the lactulose/mannitol before it leaked through to the blood and could be measured.  I believe he said they use 10g of lactulose for the breath test and only 5g of lactulose/mannitol for the intestinal permeability test.  Other ways you can look at intestinal permeability is butyrate, lower levels imply impaired barrier, the other ways, measuring LPS (lipopolysaccharide) is difficult, Anti-LPS only shows in acute phases and the endotoxin test requires measurement in the portal vein.  Bottom line, assume intestinal permeability and support repair using the following supplements:

• Serum Bovine Immunoglobin (SBI) - binds and removes microbial components
• Zinc (I use Endozin) - supports tight junctions between cells
• Glutamine - nutrition to support mucosal integrity
• Curcumin - reduces inflammation
• Probiotics - increases zonulin

The Lactulose Breath Test Interpretation was fascinating and we all pulled out our breath tests to follow along.  It went really fast though.  The only takeaway I had was that you want to see a double peak, the dip between peaks indicates that you have moved from the small intestine to the large intestine.  

That pretty much sums it up.  Phew!  Let me know if you have any questions!

Here's an excellent post from the Symposium

Dr. Keller's ......  office manager (that word just doesn't cover it), she does everything and is so awesome, wrote an excellent blogpost wrapping up the symposium.  Find it here:

 http://sibowithhope.com/2015/06/07/sibo-symposium-2015/

Home again, home again...

Oh how my bowels are happy to be home.  TMI :)  Sorry!  Not sure if it's related but I rolled a ball under my foot while sitting in the symposium this morning and things finally started moving. Phew!

What an amazingly fun weekend hanging out with online friends (in person) who are just like me!  Last night we went to the The Brooklyn House for dinner last night.  They are well versed in dietary challenged people and are rumored to have a copy of the SIBO Specific Diet in the kitchen.  My meal wasn't spectacular, but really what can you do with white fish if you can't use butter, garlic, onions, etc.  I should have tried the rabbit.  The rib eye steak looked fabulous too but my chewing it would have been too difficult.  They messed up and accidently gave me a side of grilled cauliflower instead of grilled vegetables but with the huge amount of fish and the potatoes I knew it would be too much so didn't request them.

Today we went to The Cultured Caveman on the way home.  I chose wrong again!  I'm just not accustomed to eating out.  I had hot dogs (off the kids menu) and they were scrawny things with a pretty tough exterior.  I had zoodles on the side, bone broth and a shot of fermented cod liver oil.  I usually take this fermented cod liver oil but in capsules. They had the same brand in liquid form.  It was so disgusting and I burped fish for the rest of the 3 hour ride home.  But the restaurant was so cool and they had so many paleo products to browse and buy, including cookbooks.

I'll update on everything I learned tomorrow.  It's going to take time to put my notes together and I am exhausted!

On My Way.....

to the SIBO Symposium in the paleo mecca Portland, Oregon.  I can't wait to meet all my facebook friends in person and learn a ton of new information about how to eradicate the scourge that is SIBO.  Stay tuned!  I will be sharing it all here, of course!

Cyrex Array 3, 4 and 10

There was a package deal on Cyrex and I fell for it hook, line and sinker.  Everyone drools over the Cyrex tests because they think they will get some magic piece of the puzzle.  I'm not sure that's the case.

My Array 3 shows I have no issues with wheat.  I came back equivocal on Transglutaminase-3 IgG, which is a negative but a little on the high side so it could possibly be a positive.  

The Array 4 (wheat cross reactives) showed I have issues with sesame (which I knew from previous testing), teff and corn.  Guess I'll have to clean the cupboards and get rid of all those products with teff!  Ha!  The corn hurts a little because on the Array 10 I can up positive for popcorn as well.  *sniff*  Not that I was eating it because it's hard on the ileocecal valve but I had hopes of sitting in a dark movie theatre snacking on popcorn again.

The Array 10 showed the I react to the following:

• rice cake (not rice or rice protein, just rice cake)
• wild rice
• kidney beans
• sesame
• celery (yuck! thank goodness, now I have an excuse!)
• corn
• popped corn
• pea, cooked
• pea protein (makes sense since sometimes my smoothies sit in my gut like a brick)
• tuna (just cooked, not raw - phew!  I love sashimi and eat it when I know it's been sustainably fished)
• Squid (calamari), cooked
• thyme, raw (wonder if this has to do with all those essential oils I took??)
• Clove, raw (I was rubbing this EO on my liver for awhile, seems related)
• Beta-Glucan (some kind of gum)
• Gum Tragacanth (some kind of gum)

The good news is that coconut came back okay, as did chocolate and green tea.  These are my priorities :)  Ha ha!

There were a number of equivocal items as well which can happen if you eat something all the time.  Thankfully most of the stuff that came back are items I never eat.  

Update - just got back from Costco and all the organic sausage like meat products have celery as a natural form of nitrates/nitrites.  Uh oh!  Looks like I'm going to be making my own sausage!

More ferments

Love having a Whole Foods 10 minutes away.  I can pop in and browse and find great deals, especially since they just opened.

Yesterday I popped and found all their Kevita fermented coconut waters on sale for 50% off! 50% off!!!  My 9yo son thinks they are the best thing on earth.  Yay!  I would much rather give him fermented foods or beverages than a pill.  The only problem I have is making sure he doesn't drink too much.  For those watching FODMAPs you'll need to read the label because ingredients vary.  I saw one bottle that even had sugar!!! What the heck??  It must have tasted pretty bad for them to add sugar just to that flavor :P  So far his favorite is the pineapple/coconut.

I'm doing fine with ferments, thankfully.  I tried a little resistant starch (potato salad) over the weekend and I just don't think I'm ready yet.

The Depression Sessions

I know, I know, you're not depressed.  I purchased the Depression Sessions and have seen clips from this upcoming event and I can tell you it is not to be missed.  It's all about the gut, healing, detoxification, supporting the body, etc.  I've added broccoli sprouts to my repretoire after watching Tom Malterre.  Little powerhouses for sure.  Ben Lynch is coming on to talk about methylation.  It's gonna be awesome!  And seriously, it's free!  How much better can it get??

And I mean really, can anyone deal with SIBO without being at least a little bit discouraged and down on occasion?!?!  I've had my fair share of wallowing moments for sure :)

http://thedepressionsessions.com/