I've been a lurker here (and on the SIBO) forums for a while. It's taken me a couple years, but I finally feel I have overcome my IBS-C/SIBO troubles which were triggered by horrible work related stress and diet issues. The struggle has been horrible at times, but I finally feel like I can see the light at the end of the tunnel.
Here's the list of things that finally made a huge difference for me. If I could send a message back in time here's what I would say to myself:
- First, the basic, 101 stuff:
*Completely* eliminated wheat (I'm allergic to grass), lactose (*all* dairy: cheese, milk, etc. - lactose intolerance runs in my family), and Sugar
alcohols (such as mannitol, sorbitol, etc. - including in my toothpaste). Sadly, a lot of supplements and some gums have Sugar
alcohols, so you've got the check *every* label and ruthlessly eliminate anything with Sugar
Eat something with insoluble fiber after every meal (Larabar, fruit, etc.)
Drink a large glass of good water in the morning and evenings (I was very dehydrated)
I've also mostly, but not completely eliminated sucrose from my diet.
- After protein meals, or if a meal feels like it's sitting on my stomach: Take 4-10 Betaine HCL with Pepsin tablet, and 1 Bromelain tablet.
For a while I was also using various digestive enzymes, but they irritated the lining of my small intestine so I had to eliminate them.
- For gut irritation, or a SIBO outbreak: Take 1-2 tbs of Slippery Elm Bark with hot water, along with Activated Charcoal, Marshmallow, and Redmond clay. This cut down my pain in my small intestine considerably, and if it works for you the results should be fairly quick (in about 30-90 minutes if taken on an empty stomach).
This stuff works amazingly well to cut down an irritated stomach or small intestine.
Also, Redmond (bentonite) clay has some pretty powerful antibacterial properties.
- I tried using a small dose (200-400 mg) of Magnesium Citrate to help with constipation, but after a couple weeks or so the lining of my small intestine was becoming more and more irritated so I had to stop.
How to tell if the lining of your small intestine is irritated: you'll see some mucus-like strings in your bowl movements the next day. (You'll also feel the irritation too, which lasts for 2-3 days.)
- Eat only 3 meals a day, *period*. No snacking. I found 2 large meals+1 snack suits me.
- I've had zero results, even some horrible flares, taking probiotics. I've tried tons of different products, and nothing helped (even a little). I now think purposely swallowing tablets of bacteria to deal with SIBO is not smart at all, at least for me. IMO, until you get your gut's motility under control you shouldn't take probiotics.
- I took tons of herbal and several prescription Antibiotics
(Rifaximin, Flagyl) and anti-fungals - occasionally this would help but I would always flare again. For a while, I thought the constipation was triggered by the bacterial overgrowth, but I came to realize that I had it backwards: constipation and slow motility was permitting/encouraging the overgrowth. Also, I realized I was treating symptoms of my problem, not the true cause.
- So now I get into the real breakthrough for me - add in a Prokinetic, which is critical:
I added 20 drops of Iberogast to each meal (10 before, 10 after), and 10 drops at night. Wow, what a difference!
Iberogast targets the 5-HT(4), and to a lesser degree 5-HT(3)), muscarinic M(3), and opioid receptors:
Iberogast literally woke my digestive tract up from the dead. I still had some constipation in the first week or so, but it slowly went away.
- After taking Iberogast for a week and researching it, I decided to add several amino acids and vitamins to my diet: methyl B12, B6, Folic Acid, Niacin, ~1.5mg Melatonin at night, and several essential amino acids (tryptophan and methionine) with excellent results. Google the formula devised by Dr. Ricardo de Souza Pereira, the product "Protexid" (you don't need this product - I just got the individual ingredients), or this article:
Melatonin for the treatment of gastroesophageal reflux disease
I also take Omega 3's (Krill Oil), vitamin C, and vitamin D 5000.
- Before I started Iberogast, I noticed my constipation symptoms seemed to peak when I didn't get enough sleep. Also, the flares would sometimes correspond with bouts of minor, unexplainable depression, that usually went away after 8 hours to a day. I'm convinced that my IBS-C/SIBO problems stemmed from several essential amino acid and/or vitamin deficiencies (all brought on by tons of stress, eating bad, etc.)
I now believe after firsthand experience that gut serotonin (and other neurotransmitter) levels have a lot to do with IBS and other digestive issues like SIBO.