There and back again: A SIBO journey

It's quarantine. I'm bored. I went with an overly dramatic title and visions of The Lord of The Rings in my head.

#firstcrush

It indeed feels like a #SIBO (small intestinal bacterial overgrowth) journey is more intense than a journey through Middle Earth.

I wanted to say, "from the depths of the bowels" but that seemed gross. Fun fact about me: not only do my kids make fun of me for talking about #poop all of the time, but now my kids' friends make fun of me for talking about poop all of the time.

I console myself with the idea that all of our children will need therapy anyways, for some reason or another.

So.

It's been a rough time for my gut lately. You didn't think my #health is perfect, did you? It's not. There are always things for me to be working on, just like there are always things that my clients are working on. Health, as it's said, is the infinite game. That can be depressing, or that can be a challenge. Ninety-five percent of the time, I see it as a challenge.

Five percent of the time, I console myself with a day of #depression + tortilla chips + reading #Amazon reviews of supplements.

I read and research for work constantly. I have clients who struggle with all sorts of issues. While #periodproblems and #hormones are the top issues I see, nearly all of my clients have concurrent #gut problems.

All disease starts in the #gut. It's true.

I want to fix my gut for good. I want to fix my clients' guts for good. Unfortunately, nothing is that simple. In fact, the further down the gut rabbit hole you go, the increasingly more complicated protocols and programs get. I was contacted by a supplement company that wanted to offer me a month-long gut healing protocol to the tune of a cool $1200. C'est bananas.

Lacking the funds for an extravagant protocol, I set off on a hero's journey to use diet to work on my poor gut.

Here were my issues:

Scalp #psoriasis

#Bloating

#Constipation

After hunting down and vanquishing the foes of period problems, thyroid issues, and chronic fatigue, I was ready for a bigger boss (my children tell me that this is the term for the final enemy in a video game).

I knew that all of these other issues would return if I could not get to the bottom of the gut issues.

Since my psoriasis was the most annoying, I started there.

Step One: Work on Psoriasis

I had read Dr. John Pagaro's Book on healing psoriasis naturally a few years ago in hopes of clearing my psoriasis. It seemed hard and complicated and I didn't really want to follow it. So I didn't.

But when my scalp starting flaring up again, I reread the book. I knew that skin issues like the big P were due to problems in the gut, and so I focused on following his program to the best of my ability.

In a nutshell, here is what I did:

• a three day apple cleanse (you eat apples. that's it).

• slippery elm tea + burdock tea each morning

• no coffee

• no alcohol

• no pork

• no red meat

This was not super pleasant at first, but I got used to it. I followed this for about 3 months and saw significant improvement in my psoriasis. I can now wear a bun on top of my head and have brought my beloved black clothes back into my wardrobe rotation without fear of flakes all over my shoulders. My scalp is mostly clear and I can tell when I eat something that irritates my #gut as I will start to itch and my scalp spots begin to reappear.

Verdict: Pagano diet works to mostly clear psoriasis.

Step Two: Banish Bloating + Constipation

In solving one problem, I had created another. Pagano recommends a plant-heavy #diet. Thankfully, he has nothing against meat and actually promotes consumption of nourishing lean proteins. He does state that #pork and red meat are too difficult for a person with psoriasis to #digest. I still have a little of both pork and red meat from time to time, but not as plentifully as I once did.

I cut down on my poultry as well, and tried to up my intake of #fish, particularly smoked salmon as it is easier to transport and I don't have to cook it (I suck at cooking fish!). Dr. Pagano also recommends oily fish as a helpful dietary intervention for flaky skin.

But I really, really upped my consumption of #plants. I loved sweet potatoes and ate plenty of them. I ate lots of #fruit and as many #veggies as I could. My scalp felt great and my skin was clear.

But I looked 9 months #pregnant by late afternoon every day.

I had introduced too much fiber, too quickly. Fiber is great for the body, if one can digest it. I overwhelmed my digestive tract and felt pretty cruddy. And I was still having trouble with constipation. This does tend to happen as one introduces more fiber. Fiber can swell and slow down transit time. I see it regularly in clients who switch over to healthier eating habits.

I reached out to another well-known functional practitioner and explained my history of gut issues. She recommended some further investigation into my gallbladder function. As most Americans have latent or diagnosed gallbladder issues, I thought I would work on my #gallbladder a bit as well. The liver and gallbladder really do regulate digestive function in the body, and if the correct acid and alkaline reaction can't happen while one is digesting food, or if bile has become sludgy and slow, constipation can be one of the side effects.

Bloating can also be one of the side effects. If one has insufficient hydrochloric acid in the stomach, food can sit, undigested. The slow fermentation of food will lead to bloating. The more fibrous a food is, the greater chance it has of fermenting the gut.

This was likely the cause of both my bloating and my constipation. A clean colonoscopy a few years ago set my mind at ease about any more insidious issues. I simply have low stomach acid and low bile function, like many of my clients.

I was pretty darn sick of the bloating, and decided to embark on a 6 day liver and gallbladder stone cleanse to jumpstart my gallbladder back into high gear. I drank apple cider vinegar and ate regularly but lightly. On the sixth night, I drank a copious amount of olive oil and grapefruit juice and spent the next day passing about 50 liver and gallbladder stones. Say what you will about the gallbladder flush, but it was productive.

Frankly, it was less productive than I hoped it would be. However, it's recommended that one engages in a series of gallbladder flushes over a 5-6 month period. When a flush produces less stones instead of more stones, the gallbladder is sufficiently cleansed. I will do my next flush in a few weeks. Anecdotally, many more stones are passed during the subsequent flushes than during the first. We shall see.

When the gallbladder is working properly, #bile is thin enough to flow through the common bile ducts. Pancreatic #enzymes can also move freely, ensuring proper breakdown of food. It's a reasonable assumption that after a few more flushes, my bloating and constipation will likely be reduced.

It's also recommended to have colon irrigation after each flush, just in case there are any gallstones stuck in the intestines. I had one, and my colon hydrotherapist asked about my digestion. When I filled her in, she shrugged and said, "It sounds like you just have a lazy colon.". Normally, I'd be offended if someone called me lazy, but I had to agree with her there. My colon is lazy.

That answer may not have been good enough for me a few years ago, but it's good enough for me now. Some people will always be B12 or B6 deficient unless they take a quality supplement. I will always have a lazy colon and may have to always supplement with some Betaine HCL and some gallbladder #support. Cool.

As I tell my clients, the body will never be perfect. Never. There will always be work to do. Right now, my work involves caring well for my liver and gallbladder. Maybe I'll always be bloated if I spend my days eating broccoli and lettuce. Some people are like that. I know what foods make me bloated and not bloated. Just because I want to eat cauliflower and figs all day long doesn't mean it's the best thing for my body.

My body does better on #protein, #vegetables, and easier-to-digest #starches like squash and rice. This is why the concept of bioindividuality is important, and why it's ok if your diet or lifestyle looks different from your sister's, or your best friend's. Bodies are weird, and bodies are different. It's good to appreciate that fact.

PS- In the middle of this journey, I also attempted the starch-based diet, the plant-based diet, and the nutritarian diet. I hoped some tweak in eating would fix my digestion issues. No dice. In fact, each one made my bloating especially worse.

So, I'm focusing on what is best for nourishment, balance, and happy hormones. I know these things to be:

• quality protein

• vegetables

• fruits (if bloating's your scourge, eat fruit at night only)

• time in the sun

• gentle long exercise sessions (walking, bike riding)

• using betaine HCL or apple cider vinegar as a digestive aid

• reducing alcohol

• swapping even small bits of coffee for hot lemon honey water

• probably finishing out a series of gallbladder flushes

Verdict: I cleared my psoriasis and I'm pretty amazed by that. That's good enough for now.

I can manage my bloating through diet and my constipation through supplements like magnesium and vitamin C.

It's always tempting to look forward and be discouraged by how far you think you have to go instead of looking back and seeing how far you have come.

But look at the progress you've made. Be thankful for it and proud of it!

I've had psoriasis since I was 15 years old, and it seemed to progressively only get worse. But now, after 22 years, it's pretty much gone. This is a huge win.

Many of my clients experience dramatic results in healing as they put consistent effort in to building new habits that are health-promoting instead of health-deleting.

Some make slower progress, but move forward nonetheless. And each one has very specific tools in her tool belt that allows her to make informed and results-oriented decisions when presented with new situations.

It's pretty empowering to realize that no doctor, specialist, or guru has the "answer" to your problems.

By making informed and consistent choices that lead you toward a nourished and balanced body, you can essentially become your own practitioner. That's what all of us functional medicine practitioners want from our client relationships. We want you to not need us anymore. We want to teach you to care well for yourselves. We want you to be curious, and passionate, and an invested party in your own healthcare.

There is no pill or procedure or program that will fix you. There is simply commitment and progress. Again, it is an infinite game. But you'll be playing that game anyways. You'll either be playing for the empowered, knowledgeable team that takes ownership and responsibility for the decisions they make, or you'll be playing for the other team.

You've got some great tools to get you started. And you're up at bat. Let's go!

update: reader question:

I read your blog. I like your honest writing style. I have a question. You mention your journey with SIBO but did I miss where you were diagnosed with it? Did you take the breath test? Getting a SIBO test in bakersfield isn’t easy. (Name) was supposed to be tested for it through Valley Children’s but with Covid it’s considered elective so not scheduled.

my response:

Thanks for reading.

I ran a biohealth 401H with my clinician during my FDN training that showed parasites and pathogenic bugs. FDNs can’t diagnose so I have no medical diagnosis. Then I ran a GI Map that showed an overgrowth of bad bacteria and insufficient good bacteria. While I can’t diagnose, the definition of small intestinal bacterial overgrowth is just that- bacteria in the small intestine. The small intestine is supposed to be sterile. But a weak ileocecal valve due to poor digestion can allow bacteria to travel from the large intestine into the small intestine.

I also ran a lactulose/mannatose sugar test that showed a positive result, indicating a leaky gut.

Finally, I have a personal SIBO breath device that measures hydrogen and other gasses post digestion.

There’s no money in SIBO which is why it’s theorized that many doctors don’t look too hard for it.

The GI map is $179 if insurance covers most of it. It’s the one I recommend now. As you’ve seen, unless there’s a critical or acute issue, most doctors won’t be your beat bet with SIBO. You can starve the bad bugs by eating a paleo ketogenic diet (PS- I know this young person and this person is the age and gender that can tolerate this diet for the particular set of symptoms presented with) and doing a gut clearing protocol.