My Story with SIBO
WHAT IS SIBO (AND WHY IT MATTERS ON KETO)
You may have heard about SIBO. It’s a really terrible condition to have. Someone you know might suffer from it, or it might even be you. What is it exactly?
SIBO stands for Small Intestine Bacterial Overgrowth - which is basically when there are too many bad bacteria in the small intestine.
The small intestine isn’t meant to have a lot of bacteria (it has a small amount of bacteria naturally present)
The small intestine is, however, connected to the colon - where there is a lot of bacteria. Usually there’s a little valve between the small intestine and the colon that kind of acts like a one way door - stuff from the small intestine goes to the colon, but shouldn’t be able to come back through.
That’s where SIBO is different
In the case of SIBO, bacteria really start to build up in the small intestine - bacteria that doesn’t belong there, and too much of it, much of it coming from the colon.
And when you have bacteria overgrowth in the small intestine, it means that the small intestine is inflamed and can’t digest and absorb nutrients properly. It also means that it interrupts the flow of things, causing symptoms that can be very confusing.
Why are the symptoms confusing?
Because they’re polar opposites - constipation and diarrhea.
WHY SIBO IS HARD TO DIAGNOSE
The main symptoms of SIBO are related to stomach and gut issues.
Abdominal pain and cramping
Gas and belching
The problem is that you have two seemingly opposite symptoms - constipation and diarrhea are two very different problems.
If you try and treat one, then the other becomes worse. Which is why it’s hard for physicians to pin down SIBO as a diagnosis.
Unlike something like a peanut allergy - where eating a certain type of food (peanuts) gives a direct and very strong effect (hives and difficulty breathing) - SIBO is much more difficult to diagnose.
Let’s say that you eat a cabbage stir-fry, which gives you the diarrhea. So you stop eating the cabbage, only to continue to get diarrhea from other foods.
You think that it’s maybe due to yogurt, so you stop eating that. Only now all of a sudden you’re constipated for the next five days, until you get a bout of diarrhea again.
It ruins your quality of life. You’re always wanting to ensure that there is a bathroom nearby, because you might have an emergency situation.
You don’t know what to eat, because everything seems to cause your symptoms.
But what if there was a connection between the food you were eating?
For example, if you have SIBO and you eat onions - you’re going to have bloating and cramps due to the type of fiber in the onions. Maybe not right away, but maybe later on.
Let’s explore this a bit further
HOW SIBO SYMPTOMS HAPPEN
So we talked about the overgrowth of bad bacteria in the small intestine - they’re not supposed to be in there.
But how does that connect with the food you’re eating?
Well, since bacteria need a food source, they only get to feed on what you eat. And when you eat food that the bacteria like to eat, they’re going to get moving and shaking.
One of the results of bacteria feeding are well, certain byproducts. The same way that we exhale carbon dioxide, so do bacteria also create gas. Gases like oxygen, nitrogen, carbon dioxide, hydrogen and (potentially) methane - also known as a toot, a fart, flatulence, cutting the cheese, breaking wind.
If you feed a large population of bacteria a lot of food that they like, you’re going to get a lot of gas.
This is where the abdominal pain, bloating, cramping and flatulence comes from.
Even worse, if you have these bacteria present, they can also cause that one-way door, the ileocecal valve - to suddenly swing the wrong way, which introduces toxins into your colon.
Your colon as you may know, acts like an airlift - it gets rid of things. And when you get toxins into your colon, it’s going to evacuate things in a very quick and explosive way - what I personally call the oopsie-poopsies.
Catch my drift?
HOW DID THE BACTERIA GET THERE?
So we know that SIBO is due to an overgrowth of bacteria in the small intestine. But how did it happen? And why doesn’t it happen to everybody?
It’s hard to say exactly. There are a multitude of problems that may end up causing SIBO.
If you’re eating a Standard American Diet, then it stands to reason that you’re eating a lt of processed starches - which is a bad bacteria’s favorite food. When you feed the bad bacteria, it can make their population take over the entire gastrointestinal tract - from the stomach through the colon.
Or, let’s say that you have a bad acne problem. And your doctor prescribes you something like doxycycline that you have been taking for years. Doxycycline may certainly improve your acne - but it’s also wreaking havoc on your system, killing off bacteria both bad - and good. And unfortunately under antibiotics, the bad bacteria usually end up winning compared to the good bacteria - filling your entire gastrointestinal tract.
The way that SIBO happens is when your GI tract is off due to the bad bacteria taking up residence. And the way that the bacteria take up residence is when you create a nice and comfortable home for them, with plenty of food for them to feed on in the form of an abundance of starches and sugars.
And once they’re there, they are very hard to get rid of.
OUR EXPERIENCE WITH SIBO
I’m really passionate about SIBO, because it is a subject very near and dear to me.
For years I had been doing the paleo diet, then moved onto the keto diet - but I was still having issues with gas, bloating, cramping and constipation. No matter how hard I tried to change my diet, I wasn’t improving.
It was really frustrating - I’m trying to eat healthy, but it was actually making things worse. I finally got to the point where I was eating such a limited diet that it made life very difficult. And even when I ate perfectly, I was still having issues.
I knew that I couldn’t keep living like this. I needed a solution to my problem - one that would get me to a place where I could live my life without fear of needing to run for the bathroom.
HOW TO TAKE CARE OF SIBO
Here’s what I did.
Once finding out SIBO was an issue, I knew that we had to kill off the bad bacteria that were causing the issues. And since the gut isn’t a sterile area, I knew that I had to also replace the bad bacteria with good bacteria.
Luckily for me, the keto diet is the perfect solution. SIBO is usually created by a diet high in starch, sugar and carbohydrates - all those carbs creates an environment which the bad bacteria really love - so by switching to more vegetables with fiber, there was more food for the good bacteria to feed on and less for the bad bacteria to feed on.
Additionally, I knew that I would need to kill off the bad bacteria to give the good bacteria fighting chances. Just like you need to weed an overgrown garden before you plant the new plants, you need to tip things in the good bacteria’s favor.
After doing a lot of research and reading, I found two options: using an antibiotic (doxycycline, amoxicillin/clavulanate) or using herbal treatments. I’m not usually one to be super hippy, but the research found that using herbal treatments gave the same (or better) results for SIBO than the antibiotic - and with less side effects.
The way I think of it - the antibiotic is like using Round-up on your entire garden, killing off everything in its path nonselectively, while the herbal treatment was much more like being able to weed.
The two herbal treatments I opted for were allicin and berberine - from onions and barberry respectively, which are proven to work well together to eliminate the bad bacteria.
I also started trying to repopulate the gut with good bacteria. Foods with active cultures like miso, kimchi, sauerkraut and small portions of yogurt and kefir were introduced with the intent of seeding the gut with good bacteria.
I did keto for six months and saw some improvement- gradually certain vegetables were able to be reintroduced. However, things like green cabbage would still cause major issues, so I knew there was still work to be done.
After that, I wanted to get my bacteria profile even better, so I did an extreme form of fat fasting - I would only consume fat for several days at a time, usually three to four, and usually in the form of coffee or tea and doing a fasting refeed. I did this for around a month before slowly scaling back up to eating a meal once a day.
After the fasting period, the SIBO appeared to be cured! I can now enjoy onions, garlic, salad and cabbage without having any issues. In addition, I can digest a lot of other things much more easily now, being able to even eat safe starches like sweet potatoes and white rice without having major bloating.
SIBO is pretty terrible, but it doesn’t have to be a lifelong problem you fight against. The key is understanding that it is a bacterial problem and you have to both fix the symptoms and the cause.
Start on a keto diet, eliminating sugar and starches to starve the bad bacteria and feed the good bacteria with the low carb vegetables
Take herbal pharmaceuticals allicin and berberine to kill off the bad bacteria
Eat fermented foods like kimchi and yogurt to repopulate your gut with healthy bacteria
As another step, you can also perform a fat fast for several days at a time to get your bad bacteria under control