This is why your SIBO isn't getting better despite treatment!

SIBO not getting better no matter what you do? This episode's for you! If you AREN'T dealing with SIBO, don't skip this one! There are gems of insight packed in this episode for you too.

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Transcript

Katie Lovitt: 0:00

So, there's a few reasons that I. C and then I've learned through my own personal experiences as well as my own research and coursework and the mastermind that I'm a part of for training that explain some of the most common reasons why you're not seeing any kind of an improvement with your SIBO despite treatment. So I wanted to run through those things today. Because I think it's really helpful for people who are in that boat. Now, if you don't have SIBO, Don't hang up because you're going to be able to pick up on some of these things as well and apply them in your own unique way.

0:37

Hey, everyone. Welcome to The Nourished and Thriving Show. I'm your host, Katie Lovitt. I'm a registered dietitian on a mission to help you increase your impact and legacy on the world while healing your gut and reducing your IBS symptoms. I'm so grateful to have you here. Each week I'll inspire you to live vibrantly and provide valuable resources and information that empowers you to take bold action towards your health goals. Before we dive in, make sure you follow or subscribe to my show wherever you're listening so you never miss an episode. Ready? Let's go!

Katie Lovitt: 1:16

Hey, guys, I am recording on my computer's microphone today because Life and done is better than perfect, right? And that's, I think, a lesson that a lot of you guys can take and apply to your own lives as well. Done is always better than perfect. So I really wanted to share this episode with you guys this week. And so even though the sound quality is not exactly what we're used to. Hopefully it's okay. So that warning aside, let's get going. So for those of you guys dealing with SIBO, I hear it a lot, you know, and SIBO is honestly kind of a bear to get through. Like I do not wish it upon anyone, not to say that it's without hope. I see people recover from this all the time, but it definitely takes some grit and some consistency and endurance and skill and really a partnership. And so. When I hear from people all the time on Instagram, you know, Oh yeah, I've been diagnosed with SIBO. I've done this, this, and this, and it's not getting better. I've worked with all these people. I've spent all this money and I feel just as bad as I did whenever I started. And that's frustrating y'all because you're spending a lot of money and a lot of time and resources into doing this. And you're just not seeing the results. And I get it now while I can never guarantee results for anyone because I just don't think it's ethical to promise something. I'm not God. Right. As much as I wish I could just make you feel better. I can't. Right. I don't know everything and there is, you know, a journey to it. And so I don't promise outcomes, but at the same time, if I can't move the needle for somebody at all, it's frustrating for me too. So I get it. So, there's a few reasons that I. C and then I've learned through my own personal experiences as well as my own research and coursework and the mastermind that I'm a part of for training that explain some of the most common reasons why you're not seeing any kind of an improvement with your SIBO despite treatment. So I wanted to run through those things today. Because I think it's really helpful for people who are in that boat. Now, if you don't have SIBO, Don't hang up because you're going to be able to pick up on some of these things as well and apply them in your own unique way. So whether you have any sort of a bacterial overgrowth or fungal overgrowth Canada, some sort of a bacterial infection or just, you know, dysbiotic microbiome, which means an unbalanced microbiome and gut symptoms like you still can have some takeaways today. So all of the examples and applications are going to be specific to SIBO. Thank you, folks. But you can read between the lines and apply it to your unique situation as well. So let's get going. Okay. So what is SIBO to begin with? So first of all, if you have not listened to my other episodes about SIBO, you definitely need to go check those out. I think I have two or three they're older episodes, but they're still really, really valuable. And those go over what SIBO is, what it isn't, what to do about it, all of that. So go listen to those for sure, but I'm going to sum it up for you here as well. So SIBO stands, it's S I B O. If you're not familiar with it, it stands for small intestine bacterial overgrowth. And what happens is these are not pathogenic organisms like, like a E. coli, you know, that causes food poisoning or something like that. They're normal parts of your microbiome. They're just in the wrong place. So we want our microbiome. to mostly be in our large intestine, and they're not supposed to really be in the small intestine. The small intestine is where your body continues digesting your food and then absorbs those nutrients. And then the waste gets passed on into your large intestine. And that's what the microbiome eats, you know, it's all the fiber and things that we didn't eat. So if you have organisms living in your small intestine, that means a couple of things. A they're stealing food from you. They're little beefs and be that foods not as broken down as it would be if it were in the large intestine. It's, it's a lot more fermentable. So if you've been on the low FODMAP diet, or if you've had the low FODMAP diet recommended to you you're eating. less of those highly fermentable foods and bacteria ferment food as they eat it. That's part of their metabolic process. So if you feel better on a low FODMAP diet, chances are you have some organisms in the wrong place. If you do the low FODMAP diet and you're like, I don't feel any different. Maybe you don't, you know, have SIBO. Maybe there's something else going on. There is a diagnostic test for SIBO. It is a breath test. That is the gold standard. There's a few out there. Your GI doc can order it for you. I order it for my clients when appropriate. But you, you shouldn't really just do it by yourself because even if you get the results by yourself, like knowing what to do with them on your own. It's just not going to be effective. There's a lot to it, you guys. So it is a breath test. It's diagnostic. And you're looking for a few things and there is a little bit of an art to reading these tests to, to know what you're looking for and understanding all of the most recent research and all of that. So you want somebody who's skilled and experienced with these tests looking at it for you. You know, just like with anything else. So. That's what SIBO is, is bacteria. They typically produce three different kinds of gases and you know what kind of organism is overgrowing based on the gas that is showing up on the test. Now, there is a test out there called the TRIO SMART that tests for all three gases. I personally, this is just my opinion. Do not love that test. There were, you know, some questions about numbers and guidelines for positives and all of that. And I just don't think it's quite ready for prime time yet. I really hope my opinion changes in the future. But that's where it is right now. So I use the traditional to gas test. It tests for methane and hydrogen. And then this is where you need a little bit of art and finesse to be able to read between the lines to see about the hydrogen sulfide. So there is a way to tell if it's hydrogen sulfide just by testing for these other two gases, but you have to know what you're doing. So that's, that's what the test is. There's also, I, I mentioned methane. So methanogens are a little ArcHa. They're actually not bacteria. They're ArcHa that produce. Methane gas. About a year ago, they were still lumped into the category of SIBO, and you'll still hear it referred to as SIBO, but now the terms have changed a little bit, so you have SIBO, which is bacterial overgrowth, and then you might hear the term SIBO. I M O or intestinal methanogen overgrowth. And that really is just at any place in the intestine, the small or the large intestine. So with that diagnostic test, it's really important to do a three hour test that you're getting a good look at the large intestine too, especially whenever you're suspecting methane. So that is the diagnostic test. Okay. That's what SIBO IMO is. You got it defined. Go back and listen to that other episode if you need more information. Okay. So what do you do? You test positive. What do you do? Well, you've got to kill the bacteria that are in the wrong place. You do that with a certain type of antibiotic that's been targeted and researched. For SIBO or IMO or some herbal antimicrobials, they've been shown to be just as effective as the prescription. It really just depends on your case your preference, your history and all of that, as far as which route you decide to go. The herbals take longer than the pharmaceutical, but there are some positives to them too. So that's kind of how you the first step. But that's not the only thing you have to do. And that's why I suspect a lot of you guys are not getting the results that you want to get. So first of all, you test positive, you need to kill whatever's overgrowing, whatever should not be there, right? The first thing that I see people doing or have been told to do is getting on the protocol protocol. That's not appropriate for the type of organism they have overgrowing. Okay. This is like, I like gardening examples and you guys know that this is like, you know, you have a sick plant or a sick garden or some weeds overgrowing. And you have to go about getting rid of those different kinds of pests in different ways. So you're not necessarily going to put a pesticide. On a weed. You guys know I organically garden, but this like conventional approach here was a really good example that just came to my mind. So go with me here for a minute. So say if weeds ever growing, you're not going to spray them with pesticides and hope that the weeds stop growing. Hopefully you don't spray them with pesticides at all. Hopefully use corn gluten mill or something like that. That's better for the environment, but you get my drift. And same thing, like if you have bugs growing, you're not going to spray herbicides on your plants to kill, to get rid of the bugs. Same thing goes for this. If you have methanogens, you need certain types of antimicrobials or antibiotics, antifungal combination that has been shown to be effective against those. If you have hydrogen sulfide, you need something effective against that. If you have hydrogen producing, you need something that's effective against that. And I think that People who maybe not, are not as experienced or who don't stay as on top of the emerging, emerging research may give more of a generic recommendation on treatment. That's not gonna be as effective as something else that's more personalized to your situation that's going on. And having said that, you also need to understand the full environment of your gut. Like what happens if you have sibo? And also Candida and also H pylori. Like you've got to know all of that information so that you can know what you're going to target first, in what order, what's the biggest priority, and what all to include in that. So it is possible to have SIBO and other things. So you really need a whole big picture of everything that's going on instead of just a tiny little snippet. Now we are humans. We are never going to know every single thing about every single thing. So yes, I realized that my, what I'm telling you is flawed, but, you know, as much information as we can gather is always best. And then seeing how it's all fitting together and coming at it from a strategic perspective is super, super important. So that's the kill phase. Like is the kill phase effective for your unique situation? And is. Everything else being considered that's going on, or you just targeting SIBO, you're like, it's still a reductionist viewpoint, right? Whenever you're looking at it like this, and this is a lot of GI dogs, right? You've heard me say before, conventional medicine is very reductionistic. Like they narrow it down to the one thing that it is, but really you need to zoom out and see the entire picture. And so I think a lot of the time people get a positive SIBO test and they're like, Oh, that's it. It's SIBO. That's what I have going on. But that may not be all that's going on. Got it? You really need to see the full picture. I think I've beat that point into the ground, so let's move on. So then second of all, are you doing treatment long enough? One round of either prescription antibiotic or anifungal or an herbal antimicrobial. is estimated to bring your gases down by about 30 parts per million. So if ideally you want it, your hydrogen gas less than 20 parts per million, and yours is up at one 61 round is not going to be enough to hardly even put a dent in that. Now that's a pretty high positive result. So it's an exaggeration, but you get my point. Like that's not going to bring you. Down enough to even maybe feel significant relief. So it's really under the important to understand your numbers and possibly even retest. If you have really high numbers, you're not getting results to see if you're making a dent in this. Okay. Then next from there. Are you really understanding everything that has led up to this point for you to get SIBO? Are you understanding all of the underlying issues? Why did you get SIBO? Why were you set up to develop this in the first place? And that goes for anything. We're talking SIBO, but that goes for anything. Now Of course, like I said, you're never going to know everything. There may be things you're leaving out, but you need to understand things as much as possible because any of those factors that are allowing that SIBO to persist, they need to be changed or removed you guys, because otherwise you're going to relapse. Like maybe you'll feel better during treatment. And then two weeks later, you feel bad again. If somebody comes to me and tells me that, like, I felt great for two weeks and then I felt bad again, something's missing. You're getting, you're relapsing really, really fast. And that can even be months later. Like I felt good for two months and then I relapsed. Something's missing. There's something that is allowing that to continue and you need to keep digging. Into that. I'm not going to go into all of those underlying conditions today because we just don't have enough time and there's a lot of them. But it could be anything like an autoimmune condition, thyroid condition. some strictures or scar tissue in your gut. It could be vagus nerve dysfunction like pots or something like that, or even just dysregulated vagus nerve because the vagus nerve controls motility throughout your entire gut. So that's really important. And then that really leads me to the other components of gut function have to find lasting relief. So. That means things like is your motility working? Because if food is just like stagnant in your small intestine because your motility is slow or your muscles in your gut are discoordinated and not effective at moving your, your food through your gut. You're going to allow the opportunity for those bacteria to overgrow again because you want things being pushed downward consistently. The next thing is, is your gut lining damaged? Is your gut lining, you know, needing repair from, you know, damage from these organisms being in the wrong place? That can cause a lot of pain and inflammation and all of that as well. And then, you know, is your microbiome balanced? Because a lot of the time that can actually be an underlying cause that people get SIBO. is they had dysbiosis and that caused a lot of inflammation and constipation and then things get backed up and yada yada. So it's really important to understand what does your microbiome look like? What can I be doing to balance that microbiome out? And that all comes after the kill phase. So if your doctor is just prescribing, you know, Rifaximin or Zyfaxin and saying you're fixed, that's all. That's really only like at best 25 percent of that healing process. So there's more work to be done. So I hope that this was helpful for you guys. Those are some of the biggest reasons I see people not getting better and things to consider. If you're dealing with this y'all and you need a different approach and you need some support, I'd love to talk with you. Go reach out to me on Instagram. As you can tell, I'm very passionate about this. I really want you to feel better. I'd love to have a conversation with you about finding you some answers, getting you some relief. You don't have to keep struggling with this forever. I know at a certain point it can just feel like you're never going to get better and things are never going to change. And that's just not true. You know, it may take time. Like I said, at the beginning of this episode, it's going to take time and consistency on your part and determination, but you'll get there. I promise you that. So. Keep moving forward. Keep looking for answers. Don't give up. Take all of this stuff that I shared with you. Go back and relisten to this episode and just consider like, what have you done and what still needs to be done? Make a list, right? Like make a list of all the things that you've already done. Make a list that I talked about of things that you still need to do. And then ask yourself. How can I make these happen? Is my current provider going to support me through this? Can I go ask them for resources to help me do these things? Or am I needing a different kind of support? And if that's the answer, like I said, I'd love to talk with you. So that's it for today, guys. We will talk with you soon.

17:34

Thank you so much for listening to the entire episode. I hope you are feeling inspired and empowered to take bold action towards your health goals. If you enjoy what you heard, don't forget to follow my show so you never miss a new episode. And it would mean the world to me, if you left me a review, so others know what to expect from my show. Last, get in touch. Let me know what bold action you're taking. Let me know how you're inspired. Follow me on Instagram@the_healthygut_dietitian. I've put a link in my show notes for you, so you can simply click and follow. Come say hi, I respond to all my messages and I can't wait to get in touch.