Welcome to the Love Your Gut Podcast. I'm your host, Dr. Heather Finley, registered dietitian and gut health specialist. I understand the frustration of dealing with GI issues because I've been there and I spent over two decades searching for answers for my own gut issues of constipation, bloating, and stomach pain. I've dedicated my life to understanding and solving my own gut issues. And now I'm here to guide you. On this podcast, I'll help you identify the true root causes of your discomfort. So you can finally ditch your symptoms for good. My goal is to empower you with the knowledge and tools you need so that you can love your gut and it will love you right back. So if you're ready to learn a lot, gain a deeper understanding of your gut and find lasting relief. You are in the right place. Welcome to the love your gut podcast. Hello, and welcome back to the next episode of the Love Your Gut podcast. If you have ever wondered if your SIBO test was wrong or you still felt awful despite testing negative, then this episode is for you. So in the first episode of this little SIBO series, we talked about what SIBO really is and what it's not. So if you miss that one, I highly recommend going back and listening because. The biggest takeaway from that episode is SIBO is not a root cause. It's only a symptom or a red flag that something deeper in your digestion isn't working the way that it should. So if you didn't catch that episode, definitely pause this, go back, and then come back after you have finished that episode. For many of our clients, the journey that leads them straight into the confusing world of testing is symptoms that. Are unresolved or SIBO tests that are negative or positive and look kind of wonky. Or maybe they've done SIBO treatment and just have never gotten relief. So that's what we are gonna dig in today. Maybe you've done breath tests, you've done stool tests, you've had no normal blood work, sometimes dozens of labs, and yet you still feel miserable. So let's unpack what testing is actually helpful. When it might not be worth your time or money, and what kinds of sneaky root causes like maybe adhesions or gallbladder dysfunction that you won't catch on a SIBO breath test. There's just so much more to the picture. So I always think about, I mean, so many clients that we've had, but this one particular client comes to mind. We'll call her Emily. She came us, came to us, just convinced that she had sibo. She'd done a breath test twice, and both times she had completely just flatline results, but she had all the classic symptoms. She was bloated after every meal, progressively more bloated throughout the day, painful gas fatigue, constipation. She was even starting to have skin issues the longer her GI issues went on and. Felt like, okay, if my Sibos negative, then I don't know what else is wrong with me. And what I told her was, what I shared in the previous episode is that SIBO ISS just one tiny piece of the picture. You could, it could look like sibo, but it actually could just be something completely different. So when we found. When we did some testing on her and we ran a GI Map, comprehensive stool test, we found that she had an active, like extremely high h Pylori infection. She had sluggish bile flow. Her gallbladder had actually been removed years prior, and no one had really ever connected the dots for her on her gut symptoms. So, no, she actually didn't have sibo, even though she was convinced because she was reading all of these things online, saying, if you're progressively more bloated throughout the day, you have sibo. If you are constipated, you probably have methane, sibo, et cetera. But she had major upper GI dysfunction that looked exactly like sibo. So this is why where other testing can be really helpful. Of course, not necessarily diagnostic. But when we zoom out and use the right tests, we really stop chasing symptoms and finally start addressing actual causes. So that's what we're gonna cover in this episode. When SIBO testing is helpful, when it might be doing more harm than good, what to look for on other labs like the GI Map or even mineral testing, sometimes blood work that can reveal deeper imbalances. And then often overlooked causes of sibo. We're gonna talk about adhesions, pelvic floor issues, bile flow problems, stuff that you're just not gonna get on standard testing. So let's get into it and start with breath testing. So we briefly covered this in episode one, but I just wanna circle back because one of the most common questions that we get is, do I need a SIBO test or should I just start treatment? And here's the truth. Breath testing can be helpful. But really only in the right context. It's not always necessary and it's definitely not the end all be all for figuring out what's going on. So I would say that SIBO breath testing can be helpful if you're experiencing symptoms for the first time and you wanna understand what's going on. You have sulfur like gas, brain fog, fatigue, et cetera, and you suspect hydrogen sulfide sibo because that's a whole different beast. If you've already had a workup on digestion and motility and you still feel stuck. Sometimes this just gives you clarity and almost just peace of mind of okay, there is something going on, but I would never stop there. In those cases, breath testing is gonna give you insight into whether you have hydrogen methane or hydrogen sulfide gas, and that can help guide the strategy a little bit. If you're going to test, I would recommend the trio Smart. This is not sponsored in any stretch of the imagination by them. But it's really the only test that's gonna look for all three gases. So if you're gonna go through the headache of following the prep diet and doing it, then just go for it and do the trio Smart. In my opinion, when testing is probably not worth it, is if you're just retesting just to see even if you've already tested negative a couple times, there's other testing that is gonna be way more worth your while than going through all of that. Poop law again, if you haven't addressed the foundational issues like motility, mineral status, nervous system regulation, blood sugar balance, et cetera, then maybe weight and see if some lower lift things can help you resolve your symptoms. And then I really don't think it's worth it to keep testing SIBO if you've already done multiple rounds of treatment and you're still stuck. Okay, probably you still have it if you still feel the same way. And another test isn't gonna change the outcome unless your strategy actually changes. And I know that that sounds really harsh, but just trying to save you some headache and dollars by like, let's just not keep doing the same thing over and over again. And breath tests, definitely there's quite a bit of prep involved and they're not foolproof. There's lots of false positives, flatline results. Or even just completely normal results that can make you feel a little bit crazy even though you're not. So here's a reminder. You don't need testing over and over and over again to start healing, because again, SIBO is a symptom, not a root cause. So most of our clients do not start with the breath test. We focus on the why and why the gut became that vulnerable and support it from the top down. So sometimes your se, your symptoms aren't sibo. They're just something that looks like it, just like the client that I described earlier. So let's move a little bit beyond breath test and talk about two labs that I think give us kind of the Terrain report, the GI Map and HTMA. The think of these like high resolution satellite images of your gut ecosystem. They don't just tell us like there's a weed here. They tell us why the weeds keep coming back, and that's really important. So there's so much that we could dig into. I could probably do an entire episode on like multiple, probably another series of episodes on all of these tests, which maybe I should, if you want me to send me a message. But I whittled it down to four things that stand out on a GI map that scream fix the terrain. Number one is h pylori. Like I mentioned earlier, you've probably heard me use my North to South digestion analogy. If the traffic light at the top of the highway is red, every car behind it backs up and low stomach acid caused from h pylori. Suppressing digestion is that red light, so h pylori is flipping that switch by suppressing stomach acid. So food is not sterilized or broken down. Motility, crawls, fermentation, explodes. Hence the gas and bloating. And suddenly you look six months pregnant by dinner. So here's the kicker. Conventional biopsies often miss low grade h pylori, but the GI map will catch it. We see this all the time and our clients whose breath test said, Nope, you don't have SIBO yet. The root cause was quietly just camped a little bit up higher in their stomach. The next thing or number two is low pancreatic elastase. So if stomach acid is step one of digestion, pancreatic enzymes are step two. Low elastase tells us that your pancreas is not clocking in for work. The causes of this can be chronic stress. Long-term vegan diets don't hate the messenger. Persistent low stomach acid, so no enzymes or low enzymes means proteins and carbs just drift downstream, half digested, which is a prime buffet for overgrowth. You cannot starve sibo. If you keep feeding it free lunch, and you really can't fix SIBO with diet alone anyways, but you certainly don't want to address your SIBO while your body can't even digest your food, which is a really, really common thing that we see with our clients that have treated sibo 2, 3, 4, 5 times. The next one, or number three is heist, derate, or fat in your stool. So. I mentioned this on the previous episode. My kids this summer have been like very into anatomy, and this is all them, not me. I guess they're fellow nerds, but we've been having anatomy lessons where we break down different organs and learn what they do. And it's been really fun. And so my 6-year-old calls the gallbladder a squirt gun. And honestly, it's the perfect analogy. When you eat fat, that squirt gun should be shooting bile to emulsify it. If SCR is elevated, that squirt gun is jammed, which totally ruins your summer pool time. Fun. So maybe your gallbladder's been removed, maybe your bile is thick and sluggish. Research shows that people without a gallbladder up to 10 times, literally that's so much, 10 times more likely to develop sibo. So this is not a death sentence, it just means that we need to intentionally support bile flow. Using maybe bitters trine, sometimes ox bile, rather than just like throwing another antibiotic at it. That's probably gonna make the situation worse. So whether you have a gallbladder or not, you can have bile flow issues. I posted a reel probably a couple months ago now that went completely viral. It has like 1.5 million views or something. And it was about having sticky peanut butter stool. So in case you didn't see that reel. Maybe you feel less alone, that 1.5 million people struggle with that just from my real alone. So this is a really, really common thing is we have our livers and our gallbladders need a lot of extra love from our lifestyle, from different medications, from our diet, and our bile flow is struggling. Your bile is like the, it's the antimicrobial that coats your small intestine. And so this. Really sets up the stage for bacterial overgrowth if you don't have adequate bile flow. But that's a story for a different day. The last one that I want to mention here is high beta glucuronidase and possibly dysbiosis as well. So you wanna picture your liver as like the neighborhood trash man. That's the other analogy that my kids have come up with. If the trash man doesn't come one week, what happens? Your trash pile's up. The alley stinks. The rats move in, right? So high beta glucuronidase means that the liver microbiome trash service is backed up. So estrogen and toxins recirculate in the gut. Inflammation rises, motility will slow down, and a backed up liver is a terrain issue, and SIBO really loves a messy terrain. So these are four things that we often see on a GI map. There's so much more that I could dig into. And you probably realize here that I didn't even mention bacteria. Um, of course there are bacteria in the large intestine that can impact this, but all of these things take priority because they're top of the chain. They're north to south, and we have to fix how digestion is working first if we actually wanna see improvement. Okay? Another thing that we often see on mineral testing. Which might seem kind of weird, like why? How would minerals affect sibo? But I can tell you from now looking at probably, I don't know, hundreds, thousands of mineral tests, so many people are so depleted in the minerals that are needed for digestion, for motility, and for overall stress resilience. So let's talk about sodium, potassium, and magnesium. These are the spark plugs for your nervous system and for your gut muscles. So when sodium, potassium, magnesium are low, or maybe you're having a really high magnesium loss, your peristalsis will slow down or the contraction of your gut muscles and like movement of things, your blood sugar will be wobbly, your anxiety's gonna be higher, and most motility supplements often won't work for you because the electrical wiring is shot. You have to have minerals. They're like the spark plugs of energy for your body. They turn the electricity back on, and so you can take all the ginger, all the moeity, all the motility, either medications or supplements, but if the electricity is off, things aren't working. So we have to support minerals and the gut will then have energy to actually move. Another thing that we see on testing is low copper or cobalt. Okay, copper is helpful for stomach acid production. Cobalt is tied to B12 and nerve conduction, so low levels can equal weak motility, poor acid, brain fog, constipation, that looks exactly like, especially methane, sibo. And then the last thing that I'll mention that we see a lot is high calcium. So some, I've heard people describe this as like body in a cast. So if you ever feel tight, stiff, constipated, high tissue calcium is a classic stress pattern that literally casts quote unquote smooth muscle. So your transit time will be slower. You actually will physically like or mentally feel more frustrated. And when we can lower tissue calcium, this can be the single biggest breakthrough for our chronically constipated clients. These are the clients that are like taking, I mean so much magnesium and literally nothing's moving because their calcium is way too high. So here's the bottom line. Minerals build stomach acid. They keep bile flowing. They fire the vagus nerve, they drive detox, and without them you're kind of gardening in concrete. If we're sticking with like this terrain analogy. So why does this matter? This matters because we need precision, not guessing, breath tests, shout, Hey, there's a problem. Whereas other testing, whether you're doing a GI map, GI X, there's so many comprehensive stool tests. We just prefer the GI map. GI Map, HTMA. They whisper why it happened, and that's why we can get such good results with our clients. It also stops the merry-go-round. You can clear SIBO a dozen times, but if you leave everything that I mentioned not working, guess what? It returns and then it just guides smarter protocols. Maybe you need to eradicate h pylori. Maybe you need to use bile supportive ingredients. Maybe you need visceral therapy, mineral repletion. You probably don't at this point, need more antimicrobials. There's a time and a place for that, but if you've already done it a bunch of times. It's time to approach it a little bit different. So if your breath test is negative or positive, again, I want you to pause and just ask what is the terrain telling me? Because a perfect SIBO result is really useless if your squirt gun is not working. If you have low stomach acid, if your mineral flat battery just keeps setting the stage for overgrowth these are the cases where you keep clearing the sibo, you feel great for two weeks, and then your symptoms start coming back. You don't want that. You wanna actually clear it for good. So let's zoom in on some of these sneaky mechanical root causes, like adhesions and pelvic floor dysfunction that labs can't capture, but your body will feel every single day. Interrupting this episode really quick to tell you about our Christmas in July sale. I'm so excited. We have never done this before, but we have not opened the doors to our HTMA package since Black Friday and decided to do this fun Christmas and July promo to give you access to HTMA testing because I know so many of you want it and so many of you need it. So what is gonna happen is on July 25th, so this coming Friday, if you're listening to this episode on the day that it comes out, we will be opening a select few spots for our Christmas and July HTMA bundle. The sooner you enroll, the more you'll save. So the first 10 people will get$50 off the HTMA bundle. We typically only do that$50 off at Black Friday. And then the next 20 people will get$25 off, and then the doors will close again until Black Friday. So if you have been ready to get your minerals tested, get custom insights into why you feel the way that you do, possibly a missing piece of your SIBO puzzle. Then set your alarms. If you have downloaded the mineral guide, then you're on the wait list. You will get an email at nine o'clock central time on Friday morning about the HTMA bundle opening for Christmas in July sale, and I'm so, so excited. I. So stay with me a little bit. Let's dig into first abdominal adhesions and scar tissue. So we see this a lot in clients with C-sections, laparoscopic appendectomies, endometriosis endometriosis, surgeries, even repeated like pelvic infections. They can leave behind type tiny fibrous bands that like tether the intestines and they can mimic SIBO because they can kink or pinch sections of the bowel. They can slow motility. Create just cul-de-sacs where food can ferment. So some red flag symptoms, maybe you have one-sided bloating. After any meal you have cramping or like stitching, pain. What can be helpful if this is the case for you is in addition to addressing other root causes is possibly visceral manipulation pelvic floor or abdominal myofascial pt. Castor packs to soften the tissue over time. All these things can be really helpful. No antimicrobial is gonna kill scar tissue, so you're gonna need a dual approach here. The next one that I mentioned earlier, but we see just so much, so I wanted to make sure that we talked about was gallbladder dysfunction. So back to kind of the squirt gun analogy if the squirt gun never fires, then we're not getting that antimicrobial. Coating that we want missing a gallbladder or just a sluggish one means that bile dribbles instead of sprays. And this matters because bile emulsifies fats and it acts like an antimicrobial detergent in the upper gut. And then also in the small intestine. So if you have poor bile flow, you have poor fat mal absorption, that could be part of the reason that you have chronically low vitamin D. We might see high scr on a GI map. And then we might see lots of bloating and gas and burping and possible sibo, SIBO overgrowth. So some telltale signs would be bloating, burping, nausea, 20 to 30 minutes, especially after high fat meal floating, sticky, greasy stools. Right shoulder pain can also be a sign of gallbladder dysfunction as well. And so we really wanna focus on bitter herbs, touring phosphatidylcholine possibly oxil. And not necessarily fearing fats, but making sure that your body has the tool to actually support them. So like I mentioned, post gallbladder patients are dramatically more prone to sibo. It's not a death sentence. It doesn't mean that just because you had your gallbladder removed, you're gonna get sibo. It's just a sign that you must intentionally support your bile, even though your doctor probably told you you're good. There's no need to change your diet. You don't have to do anything different since you got your gallbladder out. Okay, next one is pelvic floor dysfunction. It's really hard to clear bacteria if your pelvic floor is too tight or not functioning correctly. We see this a lot in runners or like high impact sport athletes. If you have high stress like bracing, like kind of the suck your tummy in culture chronic straining from being constipated. So if you have overly tight or poorly coordinated pelvic muscles, it's gonna stall evacuation. So your pelvic floor PT is gonna be your best friend to help you actually coordinate those muscles. Make sure that you can pass stool. You can do biofeedback relaxation drills, diaphragmatic breathing, humming, gargling to engage the vagus nerve. You can also use mineral support, but possibly seeing a pelvic four pt. To get assessed if, especially if you have chronic constipation and it's very hard for you to relax. It's often the one of the most missing referrals after you've had a lot of workups. Okay, and then last one is just liver sluggishness and kind of this whole like detox overwhelm. Like I mentioned, we don't want our trash man skipping a week because things start to stink. No matter how many candles you're burning, et cetera. So why this is connected to SIBO is your liver packages up excess hormones and toxins into your bile. If phase one and two detox is stalled, the bile thickens up, it backs up. This can lead to bloating, fatigue, histamine flares. Sometimes on HTMA testing, we'll see that high calcium, like I mentioned, we'll see low zinc. Lo molybdenum or sulfur showing that detox pathways are under supplied. Sometimes you'll even see them really high. If you're waking up between one and 3:00 AM you have nausea with supplements. If you have headaches after high fat meals, this can be signs that your liver's just overloaded, rashes, et cetera. So we really wanna make sure we're supporting our liver. Bitters beets, dandelion tea, castor oil packs, adequate minerals, especially zinc and sulfur donors. Getting lots of cruciferous vegetables if you can tolerate those. Broccoli sprouts are probably my favorite thing for liver support, and they're really easy to grow and you can get them at the store as well. Okay, and then just a couple honorable mentions that I won't get into too much, but ileocecal valve dysfunction. If you have a stuck valve connecting the small and the large intestine, this can lead to bacteria backflow. Mold and mycotoxins, that can be a whole episode in itself. But this is really gonna overload your detox pathways. It's gonna disrupt the microbiome. So testing your environment if you suspect this. And then foundational minerals. We covered this, but really this is often a missing piece for a lot of our clients. So here's the big picture. A breath test is not going to see your adhesions if you have those. Antibiotics are not gonna thin your bile. Low FODMAP is not going to relax a clenched pelvic floor and all that to say real healing is going to happen when you fix the real root of your problem, which is going to require a lot more than just testing your SIBO after everything we've covered, hopefully it's kind of coming together for you that when a SIBO test. Might be worth your money. Maybe it might be worth looking at other avenues maybe exploring, possibly the underlying root causes, especially if you have treated it before. So I always like to tell our clients before you go and do another SIBO test, ask, will this change my plan? If the answer is no, maybe just wait. Go back to the foundations. Let your body's feedback just be the guide and try to understand the whole picture before you just go constantly taking antibiotics, waiting for your symptoms to come back. So the main takeaway that I want you to take from this episode is it's the terrain, not the protocol that determines whether SIBO sticks around. Your gut is like a garden. If the soil is compacted, it's bone dry, full of trash. You can spray weed killer every week, but the weeds are gonna keep coming back. The major terrain disruptors are gonna be stress, slow motility, low stomach acid, mineral depletion, hidden scar tissue, pelvic floor issues, gallbladder dysfunction, that they turn that soil into a perfect. Breeding ground for overgrowth long before any breath test turns positive. So this is why we have to support the whole body. We have to support minerals. We have to hydrate, we have to get the quote unquote irrigation system flowing, motility bile enzymes, and then we have to reseed the gut with diversity. Colorful plants, prebiotic fibers, eventually targeted probiotics, so antibiotics and antimicrobials. And kill protocols definitely have their place, but a resilient, balanced terrain is going to keep the SIBO or the weeds from returning. So I hope you found this episode helpful. Stay tuned for part three. Next episode and part three, we're gonna dive deeper into the terrain approach. So, how to rebuild diversity without flaring your symptoms, practical ways to support bile and motility in your liver on a day to day. I'm gonna share some case studies. On clients who have had repeated SIBO and been able to find relief. So make sure you are subscribed to the show so you don't miss an episode. If today's episode hit home, share it with a friend, share it with your GI doctor, whoever who's still stuck on the SIBO merry-go-round, and I would absolutely love it if you would leave a quick rating and review on either Apple Podcasts or Spotify. If you screenshot it and email it to Happy gut@drheatherfinley.co, you will be entered to win a free HTMA test in consult with our team. I would love for you to experience the magic that is this test, so please leave a review. It helps other people find the podcast who maybe don't know about it yet, who are struggling with the same symptoms that you are. So. As a token in my appreciation, you'll be entered to win that HTMA package. And then of course, if you need personalized help, if you're listening to this and just ready for a different approach, a more comprehensive approach, I would invite you to apply for a gut together. Just a reminder, the investment is going to increase on August 1st, so now is the time to apply. As long as you apply before August 1st, you'll lock in the current pricing, even if you apply and set your discovery call for after August 1st. So now is the time we would be honored to work with you, and I will catch you on part three of the series.