How did I get SIBO?

It seems like no one really knows for sure.  For me it has been a perfect storm.  My digestion has always been sluggish.  8 years ago I had a c-section that left me with surgical adhesions and pain prior to bowel movements.  I found an ND who specialized in visceral manipulation who helped me break the adhesions and stop the pain.  About 6 years ago I had 2 bouts of gastroenteritis within 6 months.  Over the last 10 years my bite has continued to open more and more making it hard to properly chew food.  We started growing our own food and our diets got really clean, hello FODMAPs!  I eat pretty seasonally and it wasn't uncommon to spend my spring eating asparagus by the pound.  All summer long I ate HUGE salads.  My winters were full of sweet potatoes to the point where my sister complained because my skin gets an orangish hue.  And don't get me started with beans.  I love beans and ate them every day.  It took years of going to different Naturopaths getting different tests, trying different diets, before one of them put me on Heather's tummy fiber and when I reacted he said, "I think you have SIBO". 

My NDs think it's important for me to work on any of the issues I can resolve.  So I went to see an orthodontist this morning about my bite issues.  I've been putting it off because my dentist thought they were going to have to break my jaw in 3 places.  But if I can't chew my food properly then things are never going to get better.  The orthodontist thinks he can resolve my issues with braces and rubber bands and that I won't need surgery (yay!).  I really, really don't want to have my jaw broken and wired shut so was happy with the news. Maybe by the end of July I'll have braces.

I started working with an acupuncturist a few months ago to see if he could improve my sluggish digestion.  But I didn't feel like we were getting anywhere because he was just fighting against the methane producing bacteria.  I don't have a lot of acupuncture benefits so decided I would stop and wait until the bacteria was cleared or at least significantly knocked down to start back up.  For now, the low dose erythromycin is doing the trick. 

More camping prep

Made a batch of these granola bars today to take camping.  To make them FODMAP compliant, substitute macadamia nuts for cashews, omit the dates and the chocolate chips.  I add in cocao nibs in place of the chocolate chips because my gut is good and my ND says it's okay.  I also add in 1/4 cup of goji berries 'cause I like them.  I'm not sure where gojis fall in terms of FODMAPs but I only use 1/4 cup and get more than 32 servings out of a batch so I figure the amount I'm eating would be low anyway.  I eat these like dessert, not as a meal or snack since snacks go out the door with the SIBO diagnosis.

I made a version of these hamburger buns.  Again, substitute macadamia nuts for cashews. The updated version of the recipe in her cookbook doesn't require separating the eggs.  I make 8 buns instead of 4.  I don't like that much "bread".  If you can't use ghee, use palm shortening.  I think the coconut oil would make them flatten too much.  I keep these in the freezer and thaw them when I use them. 

I made these crepes for breakfast this morning.  I didn't use the arrowroot powder.  They are quite eggy but serve their purpose.  I topped them with peanut butter, bananas and chocolate.  I made the chocolate by putting about 1 Tbl cocoa with 1 tsp honey and 1/2 tsp coconut oil, microwave 15 seconds and stir.  

If you don't have Danielle Walker's cookbook Against All Grain I really encourage you to get it, it's only $9.99 on the kindle.  I've been able to make most of the recipes low FODMAP and they are all great.  I've checked out just about every paleo cookbook in the 4 library systems I have access to and her recipes are by far the most adaptable.  I used to love Elana's Pantry but she often uses large amounts of almond flour and to keep it low FODMAP the servings would be miniscule.  Spunky Coconut also has several ingredients she uses that are high FODMAP, dates for one, and she uses stevia in a lot of recipes, which is low FODMAP but I don't do well with it.

Elemental is Ketogenic

So I did some poking around last night because I was really curious about the quick weight loss and even quicker weight gain while on the homemade elemental diet.  Turns out the homemade elemental diet can be ketogenic if you are not eating enough carbs (in my case in the form of honey).  I tried my best to consume all the honey but it's so incredibly sweet tasting I just couldn't get down 2-3 tablespoons per meal.

For the first 1-2 weeks while on a ketogenic diet you end up losing a lot of water weight.  In real simple terms, cause I'm a simple girl :) your body burns off all the glycogen stores which releases a lot of water initially. Then your body turns to your fat stores for fuel and the byproduct is ketones which for some reason causes a diuretic effect on the kidneys and the water continues to go. Once you end the diet and start eating carbs again this whole effect reverses and you restore your water reserves.  

So it's interesting because you don't really lose much actual weight if you only do the homemade elemental diet for 2 weeks because in those first couple of weeks the only thing you really lose is water and it bounces right back within a week of stopping the diet.  Especially since you only do the elemental diet for 2 weeks and it takes longer than that to start to really burning off body fat.

I'd still do the homemade elemental diet again and will do it if it turns out I still have bacteria lingering around in my gut.  It would be much easier to pack food for camping if all I needed to bring was coconut oil, aminos, multis and honey :)

Camping preparation

We are going camping soon so I have been trying to plan food.  It's going to be hard to eat enough fruits and veggies while staying in low FODMAP territory.  My guess is I'll be living off of protein and nuts.  So today I am making beef jerky.  This is a good roundup of recipes.  You need to modify for FODMAPs.  I made a BBQ beef jerky using the bbq sauce recipe in this book.  I also made the carne asada beef jerky from the same book.  For the 3rd I wanted a smoked pepper jerky so I used tamari (or coconut aminos), liquid smoke, a touch of honey and lots of fresh ground pepper.  We'll see how that turns out.  I think all in all I sliced and marinated about 4 lbs of meat.  I really wanted to try this recipe but I wasn't sure my cookie press would do what a jerky gun would do :)  Store bought jerky is obviously out of the question since it always contains onion and garlic or sugar.

I continue to bloat during the day.  It's hard for me to tell if it's as bad as it was before I did the elemental diet.  Still waiting for test results but my guess is I starved some but not all of the bacteria.  Hopefully camping and further limiting my FODMAP intake will help.

Yesterday I actually drank coconut oil with my fruit and veggie smoothie.  I have been adding full fat coconut milk to the smoothie for the healthy fats but figured I'd just do a shot of oil instead.  I've been reading about the ketogenic diet.  My body did so well on the high fat/low carb homemade elemental diet that it got me wondering.  I'm not sure it's healthy longterm so I need to do some more reading..   Have any of you tried it??

4 lbs up post Elemental Diet

The weight is coming back on quicker than it came off.  It's really weird because I have been eating mostly blended soups and smoothies.  This morning I had scrambled eggs with a bit of low FODMAP salsa and avocado (staying well under the allotted amount of 30 grams), and a small side of sweet potato salad.  It's by far the most solid meal I've had since ending the elemental diet.  Potatoes and sweet potatoes are not SCD compliant but are low FODMAP.  All my tests have shown that other than the bacteria, my gut lining is healthy so I sometimes "cheat" and eat foods that are outside SCD but within FODMAP.

I made the salsa last night. I roasted about 6 sm roma tomatoes along with a bunch of tomatillos and a few spicy peppers.  While they were cooling I removed the skins from the tomatoes.  I threw them in the food processor with chives, cilantro, juice from one lime, and a good sprinkling of cumin and blended to the thickness I desire.  I wouldn't go crazy and eat a bunch since there is no information in the Monash University FODMAP app about limes or tomatillos but there are lots of low FODMAP recipes out there that use tomatillos instead of tomatoes so one could make the assumption that they are okay.  But I figure a tablespoon here and there as a topping should be fine.

I really have to say that things were so much easier while doing the elemental diet.  It was really nice not having to think about what to eat, not being hungry all the time and not having to plan ahead.  Just down the oil, aminos, multis and honey and go.  I would do it again in a heartbeat.  The post weight gain is really annoying because I like being thinner than I normally am, especially around the middle!  My stomach is a lot fuller looking.  Is it water?  Is it gas?  Is it just built up food lingering in my gut?

Speaking of which the Erythromycin 50mg at bedtime has been a very effective prokinetic whereas the herbal concoction Motilpro didn't do much of anything for me.  Not having to worry about getting backed up is so nice.

For those of you in the US, have a great 4th of July.  We usually don't get summer until after the 4th of July but it has come early this year and it's a beautiful day.

Let the gain begin...

On Sunday after my breath test I ate the blended vegetable soup for lunch and dinner.  Monday morning I work up and had gained a full pound.  I didn't do much physical activity on Sunday but I also didn't ingest many calories, probably not more than 1,200.  

Monday I started the day with a smoothie - spinach, carrots, strawberries, 1/2 banana, pineapple, blueberries, coconut milk and pea protein powder.  A good balance of fat and protein to keep me full but not too many calories, about 350. All the ingredients were weighed to make sure the FODMAPs were kept low.  I worked out hard lifting weights.  Had the blended vegetable soup for lunch and dinner, again around 300-400 calories..  Walked over 3 miles after dinner.  Gained another 0.6 pounds!  My husband is a science guy and believes calories in/calories out = weight loss or gain.  So he is pretty stunned that my body can gain weight when I have eaten so few calories.

The good part is I feel better.  Sunday was pretty rough.  My body didn't really like the quick transition back to eating.  Monday I felt pretty much back to normal.  I'm still sticking to the blended soup and smoothies for a few days.

Oh, and the reason for the pea protein is that I have a dairy allergy and yes, I am allergic to all of it, lactose, casein, whey, all of it.  I used egg white protein for a while but I was having a lot of problem with my stomach itching and thought it was the eggs in my diet.  In hindsight  I think it was just FODMAPs in general that made me itch.  Chris Kresser mentioned in a recent podcast that there is a new brand of beef protein powder out there called PurePaleoProtein by Designs for Health but it's 3 times the price (at $68) of your regular protein powder and is sweetened with stevia.

It's beautiful here today, sunny and close to 90, not something we generally see in the Pacific Northwest prior to 4th of July.  Hope you all have an awesome day!

Breath Test day and recipe

I took the breath test this morning.  I was jittery and weak during the test.  I've never experienced that before while doing the test so it's probably due to the lack of food for the past 13 days and then just water all morning.  Fingers crossed the results go well.  I made soup during the test to eat after.  I ate a big bowl when I was finished and 3 hours later I am starving.  I didn't feel hungry like this at all during the elemental diet.  Not at all.  I never really felt hungry at all.  Because I am coming off the diet, I put the cooked chicken through a meat grinder so my body could digest it easier.  I may have opted to leave it out entirely if I had amino acids to supplement with.  I double checked all my ingredients with the Monash University FODMAP App.  I trust this source above all else.

I adapted this soup from Rodale's Basic Natural Foods Cookbook.

8 Vegetable Soup

Ingredients

• 2-3 T garlic infused oil or ghee
• 2 bunches green onion
• 4 carrots, chopped
• 1 potato
• 2 sm or 1 lg sweet potato
• 2 sm zucchini chipped
• 1/2 lb string beans
• 6 cups homemade meat broth
• 2 med sz tomatoes or 40g sundried tomatoes
• 1 bay leaf
• 1/2 tsp dried thyme
• 3 leaves basil or 1/2 tsp dried basil

• 1/4 tsp pepper
• 8 leaves spinach, finely shredded
• 16 oz meat of your choice
• 1 cup canned coconut milk or dairy substitute of your choice (just be careful about FODMAPs)

Directions

1. Melt oil in large soup pot. Add green onions and saute. Then add carrots, potatoes, zucchini, sweet potatoes, and green beans. Stir in stock and tomatoes and bring to a boil. Reduce heat, add herbs and pepper, cover, and simmer for 45 minutes.
2. Let soup cool, then remove the bay leaf and puree using a hand blender. Return to stove and stir in shredded spinach, cooked meat, and milk. Adjust seasoning, if desired. Simmer until heated through.