By just engaging in the basic strategies in the Wheat Belly Total Health, Wheat Belly 10-Day Grain Detox, or Undoctored programs, many mild cases of small intestinal bacterial overgrowth, SIBO, reverse. These efforts thereby restore your ability to ingest prebiotic fibers without diarrhea, bloating, gas, abdominal discomfort, joint pain, and dark emotional feelings. Many people thereby are relieved of irritable bowel syndrome symptoms, fibromyalgia, or restless leg syndrome, or have greater power in reversing autoimmune conditions such as rheumatoid arthritis.
Unfortunately, not everybody enjoys reversal of SIBO with our basic efforts. For unclear reasons—severity?—in some people SIBO persists, continuing to yield telltale signs such as continued intolerance to prebiotic fibers, fat malabsorption, and unexplained food intolerances. And, to make matters worse, the insights gained into SIBO and related conditions such as small intestinal fungal overgrowth, or SIFO, are relatively new and 98% of mainstream doctors will advise you that there is no such thing, you’re nuts, wasting his/her time, blow you off, or waste your time and money by referring you to a gastroenterologist whose only interest is to perform better-paying endoscopy and colonoscopy while ignoring your questions.
It means that YOU have potentially enormous control, however, in identifying/confirming the presence of SIBO and SIFO and can even manage it on your own. Because there is a fair amount of detail and knowledge to do so, however, we don’t accomplish this via Facebook discussions. Introductory conversations are in the Wheat Belly and Undoctored Blogs, but the real deep dive occurs in the Undoctored Inner Circle that allows two-way video conversations to help guide you and detailed protocols to follow and guide you.
But what if you say, “This is simply too much. I’ll just live with it,” as some people have said once they hear these arguments. Once thing I cannot do is quote the statistical likelihood that SIBO will, for example, generate diverticular disease or rectal cancer, as the natural history of SIBO over someone’s lifetime has never been charted on a large scale. We do know with confidence, however, that uncorrected SIBO will over time lead to increased potential for:
- Type 2 diabetes
- Obesity
- Fibromyalgia
- Irritable bowel syndrome
- Worsened symptoms of ulcerative colitis, Crohn’s disease, celiac disease
- Autoimmune conditions
- Depression, anxiety
- Fatty liver
- Diverticular disease
- Colorectal cancer
In other words, modern populations have massively screwed up bowel flora composition. Yes, the Wheat Belly and Undoctored lifestyles can help undo some of this mess, but some people are left with severe SIBO despite our efforts. That’s when you should strongly consider intervening and taking steps to correct this situation before something irreversible happens to you. In brief, our efforts involve:
- Confirmation via the AIRE H-2 detecting device or formal H2-breath testing; consider methane breath testing if constipation is present; empiric efforts are also reasonable if telltale signs are present
- A course of herbal antibiotics such as the Candibactin AR/BR regimen
- Consider concurrent use of a biofilm disrupter such as N-acetyl cysteine to enhance antibiotic efficacy
- Consider concurrent SIFO and thereby adding anti-fungal efforts such as oil of cinnamon and curcumin
- Take efforts to reduce potential for common recurrences including a high-potency multi-species probiotic, prebiotic fibers, fermented foods, and our upper gastrointestinal tract-colonizing L reuteri yogurt.
Understand that insights into SIBO and SIFO and related conditions are evolving, but improving rapidly. In the meantime, it is foolhardy in my view to ignore the emerging insights that hold further promise to help restore magnificent health.
Recently, I’ve heard some interesting interviews with Dr. Mark Pimentel regarding the ibs-smart test (see https://www.ibssmart.com/ ). This has left me wondering if an immune modulating therapy, such as Low-Dose Naltrexone might restore motility?
John Es wrote: «…Dr. Mark Pimentel regarding the ibs-smart test…»
Here’s the paper on that (on which he was an author):
PLOS|ONE: Development and Validation of a Biomarker for Diarrhea-Predominant Irritable Bowel Syndrome in Human Subjects
Perhaps two key lines from it:
Studies suggest that after gluten exposure, IBS is the second most common cause of non-responsive celiac disease, and therefore, a test that could distinguish between these causes of symptoms would be useful clinically [42]
…
Anti-vinculin and anti-CdtB antibodies also appear part of the pathophysiology of post-infectious IBS and may identify a subgroup of D-IBS for directed therapies.
No new therapies are proposed, but it is interesting that they’ve turned up evidence for a new autoimmune (AI) involvement.
On the WB/Undoctored program, of course, Step 1 is to eliminate all sources of gliadin (in gluten), and analog proteins from other grains. This removes a prompt provocation for many forms of dysbiosis. The wider program also does a huge amount to restore intestinal health, quelling the “leaky gut” that is a pathway for enabling/triggering/sustaining AI conditions of all sorts.
The troubling fact about AIs, however, is that subsidence of the antibody titers is a somewhat unpredictable affair. It can take weeks, month, years or decades. Consider some deliberate vaccinations. A tetanus shot “only” lasts 10 years. A polio shot lasts a lifetime. What’s the prognosis for these newly-identified ABs? Does the AB titer even need to be unwound for satisfactory results?
So is this new test useful? Hard to say. You’ve probably noticed that WB/Undoctored doesn’t encourage testing for celiac disease, which is also an AI condition. That posture appears to be largely due to the fact that the programs here, for everyone, inherently include the most effective treatment: avoiding the provocative proteins. About the only reason to get celiac testing is to keep institutional dietitians under control, or to warn relatives (since there’s a genetic susceptibility component).
re: «This has left me wondering if an immune modulating therapy, such as Low-Dose Naltrexone might restore motility?»
If you’ve got leads on solid science for LDN in AI (or motility), I’d love to see it. I know it’s suggested in some AI strategies, but I don’t have a clear picture of the pathway. And by the way, anyone considering giving LDN a try needs to be aware that insurance carriers may fail to distinguish between an Rx for naltrexone (used in opioid addiction), and LDN, with the result that you get flagged as a drug abuser, which can be a huge problem if you need to change carriers.
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