Today I’m super excited to bring you a guest post by Dianne Rishikof. Welcome, Dianne!
Note from Sylvie: SIBO is one of my favorite topics (I wrote an entire series on the topic, as well as an ebook). The toughest thing about SIBO is that recurrence is pretty common. That’s right… that means that after you’ve treated it, you can’t just go back to pretending it never happened in the first place. Dianne is going to break it down for us and give some actionable ways you can keep SIBO away for good.
Some patients can trace the development of their IBS or SIBO, and remember it starting after an episode of a stomach bug or food poisoning. This is the key to understanding how SIBO develops for many. More importantly, this is the key to keep SIBO from returning!
Cleansing Wave
There is a migrating motor complex, more easily termed “cleansing wave” that happens in the gut. This is a muscular contraction from the top of the small intestine to the bottom (20 feet down the tract). The purpose is to clear out all the debris from the small intestine, where it doesn’t belong, and move it along to the large intestine. This cleansing wave happens every 90 minutes whenever we are not actively digesting. So, when you are digesting after each meal, there is no cleansing wave happening. But, a few hours later, if you are done digesting and do not eat again, then you will have a cleansing wave. A wave also will also occur every 90 minutes while you are sleeping or resting. It takes a few hours to digest a meal. So, someone who is snacking or grazing all day will not have a cleansing wave except while he or she is sleeping. Someone who eats breakfast at 7am and then lunch at noon will have a cleansing wave sometime in the late morning.
What happens to cleansing waves when we have SIBO?
Some microbes kill our ability to create the migrating motor complex. A virus or bacteria that causes the stomach flu or food poisoning can also release a toxin that kills the cells in our gut that control the cleansing wave. They do this for their own survival. If they destroy our ability to clean them out of our small intestine, then they get to set up camp and thrive. Even if we get over a bout of illness from a noxious microbe, the damage has been done. The cleansing waves won’t happen anymore, and we can develop an overgrowth of any microbes.
The cleansing wave is the key to keeping bacteria out of the small intestine.
You need to do whatever you can to restore cleansing waves and optimize the motility of your small intestine so the SIBO doesn’t return.
Things that promote cleansing waves
Waiting four to five hours between meals, no snacking.
o Since the cleansing wave happens only when we are not digesting food, we need to have a significant break between meals. This four to five hours allows a cleansing wave to occur after each meal. This means all the debris and bacteria from that meal are cleared out of the small intestine.
Nothing to eat between dinner and breakfast, no snacking at night.
o Nighttime is the best way to get a really good small intestinal clean out. Giving your digestive track 10-12 hours of rest not only will you have a few cleansing waves, but the digestive tract will get a break. It is stressful to digest and absorb. This rest is important for the digestive tract.
Probiotics.
Lemon juice or apple cider vinegar on an empty stomach.
Iberogast
This is a liquid herbal supplement.
Ginger
You can eat it as food, drink it as tea, or take a supplement.
5HTP
This supplement is the amino acid precursor to serotonin. Serotonin is the ‘feel good’ neurotransmitter but another lesser known function is motility in the digestive tract.
Motilpro
This is a combination supplement with ginger, 5HTP, and acetyl-l-carnitine. If you take this, you do not want to also take additional supplements of ginger or 5HTP.
Gargling
The vagus nerve is one of many important nerves in your body. You can stimulate the vagus nerve by gargling and this has been shown to help with motility in the gut. You have to gargle and hum at the same time. Do this every night before bed and try to do it for a few minutes even if you want to stop sooner.
Note from Sylvie: Check out Dianne’s incredible ebook, Health Takes Guts: Your Comprehensive Guide to Eliminating Digestive Issues, Anxiety and Fatigue. Get your copy today.
This article is an excerpt from the ebook: Health Takes Guts®: Your Comprehensive Guide to Eliminating Digestive Issues, Anxiety, and Fatigue. Dianne Rishikof, MS, RDN, LDN, IFNCP has spent years helping hundreds of clients as a functional nutritionist and gut health expert. Now, she has compiled her successful treatment methods into this book. It offers you the key to feeling better by fixing your problem at its root.
Have you dealt with SIBO recurrence? How are you tackling it? Let us know in the comments!
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Why did you cross out ginger and gargling?
I believe I have Sibo , my MD is completely clueless about it, doesn’t even know of the pharma antibiotics for it. She shook her head saying there is none:/
I have NO clue where to begin even.
Can your plan/diet work with someone who is vegan?
I have suffered chronic bloating for years, and I know I haven’t treated my body best in the past, looking for a reset button.
As well do you know does SIBO come back if you ate bad occasionally ? Like once a week or two?
What do you recommend for someone who struggles with low blood sugar and typically eats a snack between every meal? Is a small glass of homemade orange juice okay?
Thanks,
Jessica Stiger
Have. U found solutions yet? I. am having sleep problems with Xifaxin.
Hi! Just went to the Gastro. Got some Flagyl. Taking Antrantil and motilpro. Doing better. Had this back in 2011 when no one knew what SIBO really was. I get colonics sometimes and have fasted with medical liquid shakes for 7 days. All in all, you gotta get that motility working or else it’s just gonna come back. I kind of got rid of it with enteric coated oregano, peppermint, and Allicin. But just not realizing that my motility is the main problem. Magnesium does work so-so but I’m definitely doing 5htp now since I hv problems sleeping. I’m also getting organic ginger tea. Peppermint tea did wonders in the beginning. Organic is best because of higher potency in my opinion. Best to eat foods you are good with mainly. Everyone is different. Flaxseed does good for me. No probiotics right now. My vitamin D and B’s are low. I’ve done Xifaxin, Flagyl, Erythromycin, and doxycycline. I’m also a pharmacy tech so if there was anything else, I’d make my Gastro give it to me! I would literally go through everything on the shelf and see if it could fit. Xifaxin seems to be the biggest and latest. I just want my life back! I don’t do anything anymore away from home. I’m not even working because of it!!! It’s caused me so much depression and pain but I’m not loosing hope! You are not alone! ♥️
A doctor told me to eat every 2 hours because I became underweight after taking strong antibiotics. I think you should add more calories to add weight.
Magnesium is good against constipation.
Which are the safe foods that you can take with no fear that it would exasperate sibo?
If you eat a food and goes down well can it make sibo worse? Don’t your digestive system repels it and makes you taste it bad or have immediate reaction if it is no good for you?
Does sibo cause you to have night time acid reflux?
you may want to contact Dr Elizabeth Haymond in Mesa, AZ from Back in Balance who is treating me and I’m having good results.
Hi , I suggest noni capsules for sibo , and I have heard that iodine works well for sibo specially to prevent relapse
Hi Janice, I had a similar experience to yours. The thing that helped me the most was intermittent fasting. I had to start off with just 12 hours in the beginning and only once per week! That way, you may still do some of your snacking and not feel like you’re starving yourself all of the time. I also tried the nut butters and avocados and that did constipate me too. I substituted that with a blend of goat milk (Grazing Goat is a good brand) mct oil, a collagen supplement and stevia to sweeten. It is so much healthier and digestible and holds me over at night when I need to snack. I also went on the FODMAPS diet for just a couple weeks and that seemed to help as well. Over the years I’ve seen multiple naturopathic doctors and herbalists and they often tend to treat symptoms as well and I never really got better. I got worse in fact….not because of their recommendations necessarily but because they weren’t really getting to the root of the problem. So, again, the thing that helped the most was the intermittent fasting. Doing that once per week may be more manageable than always trying to make it to the next meal without a snack every single day.
Hi, I have a long question. My last SIBO test was 0, but I’m not sure it’s correct. I might have to do another breath test. In the meantime, I’m losing a pound a day and it’s getting pretty scary. My Naturopath originally put me on an SCD diet, and that might be part of the reason for loosing so much weight. Now she is telling me to eat as much as I can, but some foods make me sick. So I’m stuffing myself at every meal, and I still get very hungry after a couple of hours. So, I can’t really to the motility cleansing wave all the time, I don’t want to loose any more weight, but unfortunately I’m still losing weight. Plus, the fattening foods are constipating, like nuts and nut butters, bananas,and avocado. My doctor is kind of giving up on me because she wants me to drive to her office. I’m not sleeping at all, and she’s pretty far my my house, so I don’t think I should be driving.
Do you have any suggestions for me. I live in North Scottsdale, Arizona. I can’t find anyone else here that is good.I’m currently with Dr. Mona Mornstein. She is well thought of.
Thanks.