T Nation

Gut Health! Sort of a Log

Found this thread while searching for SIBO-related information. Thought I’d resurrect this thread to contribute to it.

To cut a long story short: I have SIBO and a host of other maladies that have been fucking up my life for the better part of three years now.

Let’s get started with listing a few SIBO-related symptoms, anecdotes and factoids, in no particular order.

  1. Extreme abdominal bloating: my gut circumference can increase by about 16 inches without having eaten a comparable volume of food. Sometimes this just happens after drinking a few glasses of water, regardless of the water being warm or cold.

  2. Temporary fat man biomechanics: waddle-waddle, stumble-stumble, almost tipping over when climbing steps, shortness of breath.

  3. Indigestion: sometimes constipation, sometimes diarrhea, but always incomplete evacuation. Shitty BMs, to say the least. On some days, I can’t have a BM without an enema.

  4. Fat gain: Since mid 2011, I’ve gained almost 40 lbs without having changed my training or diet parameters. Some of it is muscle, but I’d daresay it’s at least 30 lbs of fat I put on.

  5. Apparently, gut problems affect my psyche: every time I’m symptom-free, I’m my usual happy and upbeat self. Once zhe bloat rears its ugly head, my mood worsens. I have a good handle on it since I can compartmentalize and rely on an analytical mindset, but the fact remains: I become a dampened-down version of who I really am. And it shows.

  6. I’m only symptom-free during and shortly after a course of the antibiotic rifaxmin: http://en.wikipedia.org/wiki/Rifaximin

  7. I’ve dabbled in pre- and probiotics: soil-based organisms have been most promising in this regard, but still a let-down in the end.

  8. After conventional docs and medcare couldn’t help, I’ve spent most of my money on doctors who couldn’t help, all the while self-educating myself about this crap. To no avail. I literally wasted the equivalent of 2-3 mid-range muscle cars on this shit. Shit.

  9. I used to be a management consultant and travelled a lot. I still vividly remember how I wouldn’t fit in my suit one morning before I had to give a crucial presentation before an exec board. Thank you, extreme abdominal bloating. I put on my sweatpants, waddled out of the hotel over to the next pharmacy, bought a disposable enema. Back in my suite, I tried applying the enema, but both my bulging belly as well as my bulging biceps and bulging lats made the act of sticking the enema up my butt very herculean.
    Once done, nothing happened. I walked around, did a few squats and jumping jacks - still nada. Decided I’d need additional enemas. Waddled waddle-a-waddling to the same pharmacy and ended up applying four additional enemas (that’s 1000 ml of water for you) until I finally had a BM. The bloat dissolved some. I wriggled into my suit, still looking like the fattest ass ever - hello, Michelin Man. Got in the car, drove to the client, parked the car, got out - and zhe bloat was back, even worse than before.

  10. Diet-wise, I tolerate meat and poultry, jasmin rice and glucose and some salad. Fibre, fructose and starchy stuff is the worst I can give my gut. I miss my veggies. I miss my taters. I haven’t been eating bread for about 10 years (with a few exceptions in early 2011 when I dabbled in nutrition partitioning agents - I’m still undecided on whether that high-carb phase triggered my SIBO).

  11. It’s also of special note, that roughly 20% of T4 conversion to active thyroid hormone takes place in the gut. Did someone say vicious circle?

  12. Lately, the bloat’s become so bad that I can’t even train or leave the house when bloated. Sometimes, the Temporary Fat Man Biomechanics become so bad that the outer top of my right foot gets numb - some pinched nerve in my lower back would be my educated guess (had a few disc herniations in the L4/5 and L5/S1 areas over the years).

  13. Digestive enzymes didn’t do zilch. Dito Betaine HCL.

  14. Ever since getting some thyroid medication, my digestion improved some and my wound healing is through the roof (which had been horrible since 2005). The bloating perseveres, though and my BMs are still shitty.

  15. Sometimes, pressed garlic mixed in warm water can do the trick to stave-off zhe bloat - for a day, that is. That would be due to the allicin produced by pressing garlic - allicin being a natural antibiotic.

Mebbe someone can weigh in on all this crap.

[quote]FattyFat wrote:
Found this thread while searching for SIBO-related information. Thought I’d resurrect this thread to contribute to it.

To cut a long story short: I have SIBO and a host of other maladies that have been fucking up my life for the better part of three years now.

Let’s get started with listing a few SIBO-related symptoms, anecdotes and factoids, in no particular order.

  1. Extreme abdominal bloating: my gut circumference can increase by about 16 inches without having eaten a comparable volume of food. Sometimes this just happens after drinking a few glasses of water, regardless of the water being warm or cold.

  2. Temporary fat man biomechanics: waddle-waddle, stumble-stumble, almost tipping over when climbing steps, shortness of breath.

  3. Indigestion: sometimes constipation, sometimes diarrhea, but always incomplete evacuation. Shitty BMs, to say the least. On some days, I can’t have a BM without an enema.

  4. Fat gain: Since mid 2011, I’ve gained almost 40 lbs without having changed my training or diet parameters. Some of it is muscle, but I’d daresay it’s at least 30 lbs of fat I put on.

  5. Apparently, gut problems affect my psyche: every time I’m symptom-free, I’m my usual happy and upbeat self. Once zhe bloat rears its ugly head, my mood worsens. I have a good handle on it since I can compartmentalize and rely on an analytical mindset, but the fact remains: I become a dampened-down version of who I really am. And it shows.

  6. I’m only symptom-free during and shortly after a course of the antibiotic rifaxmin: http://en.wikipedia.org/wiki/Rifaximin

  7. I’ve dabbled in pre- and probiotics: soil-based organisms have been most promising in this regard, but still a let-down in the end.

  8. After conventional docs and medcare couldn’t help, I’ve spent most of my money on doctors who couldn’t help, all the while self-educating myself about this crap. To no avail. I literally wasted the equivalent of 2-3 mid-range muscle cars on this shit. Shit.

  9. I used to be a management consultant and travelled a lot. I still vividly remember how I wouldn’t fit in my suit one morning before I had to give a crucial presentation before an exec board. Thank you, extreme abdominal bloating. I put on my sweatpants, waddled out of the hotel over to the next pharmacy, bought a disposable enema. Back in my suite, I tried applying the enema, but both my bulging belly as well as my bulging biceps and bulging lats made the act of sticking the enema up my butt very herculean.
    Once done, nothing happened. I walked around, did a few squats and jumping jacks - still nada. Decided I’d need additional enemas. Waddled waddle-a-waddling to the same pharmacy and ended up applying four additional enemas (that’s 1000 ml of water for you) until I finally had a BM. The bloat dissolved some. I wriggled into my suit, still looking like the fattest ass ever - hello, Michelin Man. Got in the car, drove to the client, parked the car, got out - and zhe bloat was back, even worse than before.

  10. Diet-wise, I tolerate meat and poultry, jasmin rice and glucose and some salad. Fibre, fructose and starchy stuff is the worst I can give my gut. I miss my veggies. I miss my taters. I haven’t been eating bread for about 10 years (with a few exceptions in early 2011 when I dabbled in nutrition partitioning agents - I’m still undecided on whether that high-carb phase triggered my SIBO).

  11. It’s also of special note, that roughly 20% of T4 conversion to active thyroid hormone takes place in the gut. Did someone say vicious circle?

  12. Lately, the bloat’s become so bad that I can’t even train or leave the house when bloated. Sometimes, the Temporary Fat Man Biomechanics become so bad that the outer top of my right foot gets numb - some pinched nerve in my lower back would be my educated guess (had a few disc herniations in the L4/5 and L5/S1 areas over the years).

  13. Digestive enzymes didn’t do zilch. Dito Betaine HCL.

  14. Ever since getting some thyroid medication, my digestion improved some and my wound healing is through the roof (which had been horrible since 2005). The bloating perseveres, though and my BMs are still shitty.

  15. Sometimes, pressed garlic mixed in warm water can do the trick to stave-off zhe bloat - for a day, that is. That would be due to the allicin produced by pressing garlic - allicin being a natural antibiotic.

Mebbe someone can weigh in on all this crap.
[/quote]

  1. What is your diet like?

  2. What kind of probiotics where you taking?

I’ve been having really good luck with chicken broth and jello. I’m not sure why, I just know that elderly people with GI issues like it so I thought I’d try it and it works pretty well. I’ve read that that they both draw water into the gut which helps with digestion and they both have gelatin which helps heal the lining of the gut but I’m uncertain as to how reliable those sources are. A heating pad on my stomach works real well at night or whenever I have a bad stomach day. 10-15 minutes makes a big difference for a couple of hours.

I might have mentioned it on this thread before, but ultimately a year long round with pharma is what helped me more than anything. A low dose of the tricyclic antidepressant amitryptaline. This was after a battery of test for my blood work and gall bladder. Gall bladder because severe pain and discomfort were one of my symptoms and there’s a history in my family but it turned out that wasn’t the issue.

[quote]FattyFat wrote:
Mebbe someone can weigh in on all this crap.
[/quote]

I wont claim to know anything about your condition but I will offer you up this information that I found that is very interesting.

Resistant Starch

What does the research say?

Preferentially feeds ‘good’ bacteria responsible for butyrate production. It even promotes greater butyrate production than other prebiotics. Since the resident gut flora produce the butyrate, and everyone has different levels of the different flora, the degree of butyrate production varies according to the individual, but resistant starch consistently results in lots of butyrate across nearly every subject who consumes it. Butyrate is crucial because it’s the prime energy source of our colonic cells (almost as if they’re designed for steady exposure to butyrate!), and it may be responsible for most of the other RS-related benefits.

Improves insulin sensitivity. Sure enough, it improves insulin sensitivity, even in people with metabolic syndrome.

Improves the integrity and function of the gut. Resistant starch basically increases colonic hypertrophy, making it more robust and improving its functionality. It also inhibits endotoxin from getting into circulation and reduces leaky gut, which could have positive ramifications on allergies and autoimmune conditions.

Lowers the blood glucose response to food. One reason some people avoid even minimal amounts of carbohydrate is the blood glucose response; theirs is too high. Resistant starch lowers the postprandial blood glucose spike. This reduction may also extend to subsequent meals.

Reduces fasting blood sugar. This is one of the most commonly mentioned benefits of RS, and the research seems to back it up.

Increases satiety. In a recent human study, a large dose of resistant starch increased satiety and decreased subsequent food intake.

May preferentially bind to and expel ‘bad’ bacteria (this may be of interest to you). This is only preliminary, but there’s evidence that resistant starch may actually treat small intestinal bacterial overgrowth by ‘flushing’ the pathogenic bacteria out in the feces. It’s also been found to be an effective treatment for cholera when added to the rehydration formula given to patients; the cholera bacteria attach themselves to the RS granules almost immediately for expulsion.

Enhances magnesium absorption. Probably because it improves gut function and integrity, resistant starch increases dietary magnesium absorption.

What do user anecdotes say?

Improves body composition. I’ve heard reports of lowered body fat and increased lean mass after supplementing with or increasing dietary intake of RS. Seeing as how RS consumption promotes increased fat oxidation after meals, this appears to be possible or even likely.

Improves thyroid function. Many RS supplementers have noted increases in body temperature, a rough indicator of thyroid function.

Improves sleep, conferring the ability to hold and direct (in real time) private viewings of vivid movie-esque dreams throughout the night. I’ve noticed this too and suspect it has something to do with increased GABA (gamma-aminobutyric acid) from the increased butyrate. Another possibility is that resistant starch is feeding serotonin-producing gut bacteria, and the serotonin is being converted to melatonin when darkness falls.

Increases mental calm. Many people report feeling very ‘zen’ after increasing RS intake, with reductions in anxiety and perceived stress. The latest science indicates that our gut flora can impact our brain, and specific probiotics are being explored as anti-anxiety agents, so these reports may very well have some merit.

Where do you get it?

The richest food sources are raw potatoes, green bananas, plantains, cooked-and-cooled potatoes, cooked-and-cooled-rice, parboiled rice, and cooked-and-cooled legumes.

The most reliable way to get lots of RS, fast, is with raw potato starch. There are about 8 grams of RS in a tablespoon of the most popular brand: Bob’s Red Mill Unmodified Potato Starch. It’s also available at Whole Foods.

If you have’nt tired yet here’s another read…

Gut Instincts. Your Second Brain.

Some thought provoking ideas indeed…

Resistant Starch Vid

Thunderbump! That’d be a good name for a band.

Since starting this thread many moons ago, not a huge amount changed until recently. I have used glutamine, probiotics and digestive enzymes with fairly limited success, however lately I have added a small amount of resistant starch to my evening meal and things have gotten interesting.

IN DEPTH BOWEL MOVEMENT CHAT NOW BEGINNING - BE WARNED

So for pretty much my entire life my morning BM has been loose as all hell slightly more than 50% of the time. I recently turned 29, so that’s a long time to have such a symptom. Nothing really helped. Psyllium helped for a day or two then made things considerably worse. After hearing a bit about resistant starch from various places, I decided to try it. I heard that if you have gut problems you need to start out very slowly, so I started at half a teaspoon a day, and tapered up half a teaspoon every week.

When I got to two teaspoons, something magical happened. I had a diarrhea free week. Consider the significance of that for a moment. I went from having diarrhea 3 or 4 times a week for 29 years to having my first ever diarrhea free week!

I still get the occasional flare up, but things are looking good. It’s not all smiles and sunshine though - if I go above 2 teaspoons a day then the results are - ahem - explosive which seems to indicate that my gut flora is all fucked up. The studies done on resistant starch say you really need 3 tablespoons a day to really get the awesome benefits, but if I tried that I honestly think my bowel would rupture!

It’s looking like I may in fact have Small Intestine Bacterial Overgrowth (SIBO) which is where bad bacteria get all up in your small intestine and wreak havoc. The solution to this is to destroy those evil little fuckers. Apparently a decent SIBO protocol should have:

-An antimicrobial. Chris Kesser (whom I love) recommends monolaurin which is apparently a good natural one that doesn’t fuck with your gut flora.
-A biofilm disrupter. Very sci fi sounding. Biofilm is like some crazy force field bad bacteria surround themselves with. There’s a few supps you can take for this but the one I like the sound of best is N Acetyl Cysteine because it has about a zillion other benefits (google it if you’ve never heard of it. Seriously schmexy stuff).

Another really interesting thing I’ve learned about SIBO is that it is actually best to AVOID PROBIOTICS! Apparently lactobacillus acidophilus, which is the most common ingredient in probiotics, can actually contribute to the SIBO. Soil-based probiotics are supposed to work great but good luck finding them.

There is a medicinal treatment in the form of rifaximin which, as antibiotics go, doesn’t actually wreak too much havoc on your good bacteria, so it’s something I may consider eventually, but not until I felt I’d exhausted all of the natural remedies.

So, my current gut health plan is:

-monolaurin
-glutamine
-resistant starch
-N Acetyl Cysteine

I’ll try that for a month or so, and if I don’t see an improvement in symptoms, I’ll try the Intro Diet of the SCD diet that I mention in this thread:

After I do that, I’ll continue with the monolaurin, glutamine and NAC for a month or so, and if everything seems kosher I’ll start back on the probiotics and try and slowly build my RS tolerance up to the 3 tablespoons recommended.

If my protocol fails, and my intro diet + protocol plan B fails, then I’ll have to bite the bullet and go see a doctor, requesting some rifaximin.

Is it too much to ask just for consistently normal turds? I can’t help but think that if I got it all fixed then I’d make way better gains in the gym as I’d actually be absorbing and benefitting from all the nutrients I eat.

Time will tell. I’ll report back here with results.

ok, so after a little more deliberation, and reading this blog by Dr BG of Animal Pharm (great blog, by the way, you should check it out):

the final draft of my gut healing protocol is going to be:

-5 days (Mon - Fri) of the Intro Diet to starve out the evil
-After these 5 days I will add a very small amount of the “Bionic Fibre” mentioned in the blog (starting very slowly, like 1/2tsp of the RS and psyllium twice a day) and SBO probiotics (found some online that apparently don’t need to be refrigerated so I don’t have any qualms ordering them from a website) taken at the same time as the Bionic Fibre. Supposedly that helps the good bacteria get to where they’re needed.
-Will take glutamine, monolaurin, berberine, circumin and NAC throughout.

Boom! I’ll be turding out mighty oak trees in no time! Due to a few commitments (moving house and a few other disruptive life events) I’ll not be starting this until the second week in August, but I’ll report back as to how it goes. Apparently, depending on the state of your innards, the dying-off effect of the bad bacteria releasing toxins when they die can make you feel like shit, so knowing my luck it’ll make me feel terrible. Needs must! As they say.

oh, and I’m also going to make my own kefir…

I just ordered some kefir grains from the kefir lady. Should be here Tuesday. I will be using goat milk.

[quote]StevenF wrote:
I just ordered some kefir grains from the kefir lady. Should be here Tuesday. I will be using goat milk. [/quote]

why goat?

Great bump, Yogi.

I re-read the thread and back on page 6 and 7 there was some discussion about how best to get probiotics into the small intestine unmolested by stomach acid.

As was mentioned, taking the probiotics on an empty stomach is important. Then, consume at least 500mL of water to encourage stomach emptying. This will give your tiny little beasties the best chance of making it into the small intestine where they can do some good.

Goat (and sheep) milk is easier to digest then most cows milk, as it is A2 milk. Only some cows are A2.

[quote]Dr. Pangloss wrote:
Great bump, Yogi.

I re-read the thread and back on page 6 and 7 there was some discussion about how best to get probiotics into the small intestine unmolested by stomach acid.

As was mentioned, taking the probiotics on an empty stomach is important. Then, consume at least 500mL of water to encourage stomach emptying. This will give your tiny little beasties the best chance of making it into the small intestine where they can do some good.

[/quote]

yo Dr P,

I read somewhere the other day (think it might have been Marks Daily Apple) about taking your probiotic with a little bit of resistant starch. Apparently the starch helps it survive the acidic environment and make its way to where it’s needed.

[quote]Mr. AWEstomy wrote:
Goat (and sheep) milk is easier to digest then most cows milk, as it is A2 milk. Only some cows are A2.[/quote]

supposedly the fermentation process involved in making kefir or whatever neutralises the lactose and other allergens that mean people can’t tolerate dairy. I can’t comment on that as I’ve not tried it yet and only get issues with milk if I drink a shitload.

Great bump Yogi and some great added info, will definitely be researching what you just wrote.

I’m in a similar situation to yourself and currently I’m taking RS in the form of green bananas or green plantains wizzed up in 500ml of homemade keifer. I let it sit there so the probiotics adhere to the RS. The keifer is a commercial standarized polish product that came in a 1 litre carton ready to drink. Anyway I had some left over and decided to add it to some organic milk and within a couple of hours the milk had turned into keifer! Happy Days! I’ve been doing this for a week now just topping up the bottle with fresh milk and so far so good the keifer is chugging along nicely. Things in the cake hole dept. have solidified up nicely but I’m not quite there yet. I got myself some L Glutamine as prescribed by Berardi many moons ago in his gut healing protocol.

Previously I tried bitters, saurkraut, sourdough etc and thinking back I should have done all of this together but life gets in the way if you know what I mean…

Anyway I got my hands on some LP299v but my wife is taking it (another issue) and because its very expensive I’m leaving it for her. So right now I am looking into inoculating organic milk with a capsule and see what happens? If I can culture LP299v then I’m in business!

I was looking to get RS from Bob Red Mills over the tinternet but I am in Eire and the stuff has cranked up in price since everyone jumped on the same bleedin bandwagon so I’m looking into sourcing some Fufu flour down in the Asian Shop where I get my Plantains.

The guys over at freetheanimal.com do fantastic info on all this.

Keeps us posted!

[quote]SLAINGE wrote:
I’m looking into sourcing some Fufu flour down in the Asian Shop where I get my Plantains.
[/quote]

Check out west African markets if you have any by you. It’s also readily available on Amazon.

Ok, If i ever gave a good piece of advice on t nation it is this: look into berberine. Reduced my bloat, inflammation and improved my insulin sensitivity. It restored my four pack within the space of two weeks! The two lower abs are surfacing slowly, it is like a day and night sort of difference. I KNEW I COULDN’T POSSIBLY BE THAT FAT, the bloat/inflammation can really derail your physique goal. I used 3x 400 mg berberine hcl (got the cheapest brand).

I know it sounds too good to be true but it certainly worked for me.

[quote]SLAINGE wrote:
Great bump Yogi and some great added info, will definitely be researching what you just wrote.

I’m in a similar situation to yourself and currently I’m taking RS in the form of green bananas or green plantains wizzed up in 500ml of homemade keifer. I let it sit there so the probiotics adhere to the RS. The keifer is a commercial standarized polish product that came in a 1 litre carton ready to drink. Anyway I had some left over and decided to add it to some organic milk and within a couple of hours the milk had turned into keifer! Happy Days! I’ve been doing this for a week now just topping up the bottle with fresh milk and so far so good the keifer is chugging along nicely. Things in the cake hole dept. have solidified up nicely but I’m not quite there yet. I got myself some L Glutamine as prescribed by Berardi many moons ago in his gut healing protocol.

Previously I tried bitters, saurkraut, sourdough etc and thinking back I should have done all of this together but life gets in the way if you know what I mean…

Anyway I got my hands on some LP299v but my wife is taking it (another issue) and because its very expensive I’m leaving it for her. So right now I am looking into inoculating organic milk with a capsule and see what happens? If I can culture LP299v then I’m in business!

I was looking to get RS from Bob Red Mills over the tinternet but I am in Eire and the stuff has cranked up in price since everyone jumped on the same bleedin bandwagon so I’m looking into sourcing some Fufu flour down in the Asian Shop where I get my Plantains.

The guys over at freetheanimal.com do fantastic info on all this.

Keeps us posted!
[/quote]

good to hear things are improving for you.

I’ve actually dropped the RS and won’t add it back in until my gut’s a little healthier and can tolerate it.

[quote]juverulez wrote:
Ok, If i ever gave a good piece of advice on t nation it is this: look into berberine. Reduced my bloat, inflammation and improved my insulin sensitivity. It restored my four pack within the space of two weeks! The two lower abs are surfacing slowly, it is like a day and night sort of difference. I KNEW I COULDN’T POSSIBLY BE THAT FAT, the bloat/inflammation can really derail your physique goal. I used 3x 400 mg berberine hcl (got the cheapest brand).

I know it sounds too good to be true but it certainly worked for me.[/quote]

that’s excellent man. Berberine’s going to be a part of my healing protocol so I’m glad it’s worked out for you

I’d never heard of berberine 'til just now.

According to the wiki page it does just about everything but wash you car and make your morning coffee. I’ll definitely try it out.