Although some of these takeaways are not new information for seasoned SIBO folks, I believe they are important reminders (such as #s 1-7). For those who are newer to SIBO, some of the terms used may seem like a foreign language. I encourage any and all questions in the comment section. There is no such thing as a dumb question as we are all at different stages in the healing process. So please do not hesitate to speak up!
- SIBO diets are intended for symptom control, not cure.
- If a large amount of foods show up on a food sensitivity test, leaky gut should be suspected. SIBO can cause leaky gut.
- Cocoa (such as in dark chocolate) is usually well-tolerated with SIBO. Additionally, I have learned elsewhere that cocoa may be supportive for individuals with autoimmune conditions. Yay for chocolate…but don’t go overboard with the sugar (since it weakens the immune system)!
- SIBO is a chronic condition. For the majority of people, it cannot be cured, but the symptoms can be greatly relieved both short-term and long-term.
- “Once not tolerated doesn’t mean never not tolerated.” This applies to food, supplements, exercise, etc. The goal should be on trying to introduce new items in a strategic manner, not fearing food.
- Probiotics do have a place in SIBO treatment and prevention of relapse. The different probiotics on the market are highly variable.
- Environmental toxin overload is something to consider in chronic relapsing SIBO.
- Probiotics have been shown to be anti-biofilm agents (especially lactobacilli species).
- Curcumin (found in turmeric) has anti-biofilm properties and is also commonly used to help heal the intestinal lining (leaky gut) that can be caused by SIBO.
- Slow transit time/constipation can cause SIBO, but SIBO can cause constipation. It is a double-edged sword.
- Rifaximin has an anti-inflammatory, not just antibiotic, effect.
- Generic forms of Rifaximin have equal efficacy to brand name Rifaximin, but their safety is a concern in regard to creating bacterial resistance.
- Cardiac side effects from Resolor (Prucalopride) would require a dose 100 times more potent than what is typically prescribed as a prokinetic.
- The effectiveness of low dose naltrexone (used as a prokinetic) is dependent upon having adequate vitamin D levels.
- Rifaximin continues working in the gut two weeks after it is discontinued.
- It may be warranted to consider chronic lyme disease in continually relapsing SIBO that involves multi-organ symptoms and neurological issues.
- In patients with inflammatory bowel disease (IBD) who present with a flare of symptoms but normal IBD markers, SIBO may be causing the onset of symptoms.
- After treating SIBO, approximately 45% of patients relapse within 9 months if they do not use a prokinetic. Use of a prokinetic delays, but does not necessarily evade relapse.
- Lactulose (the solution often used for a SIBO breath test) increases motility, which may cause diarrhea. It is my opinion that presence of this symptom while taking the breath test should be considered when interpreting the test results.
- Above all, trust your own body (and gut!).
For those of you who would like to view the 2016 symposium recordings, they will be available for purchase in the next few weeks from the NCNM website. If you have not seen the 2013, 2014, and 2015 recordings, I would highly recommend you browse through the talks and consider purchasing and watching the ones that interest you.
If you would like to read a more in-depth analysis of information from some of the talks, check out this thorough post by Tim Harris.