Blandat
http://www.blogtalkradio.com/search?q=sibo&pageIndex=2Dr Siebecker
Förkortningar:
SI tunntarmen
LI tjocktarmen
UC ulcerös kolit
August 25 2011, SCDLifestyle (audio player at bottom of post)
1:25 How
she used SCD to overcome IBS – then discovered why it works for SIBO
8:25 What
exactly is SIBO… so you know what you’re up against
12:50 The
symptoms that you have SIBO and the specific tests to know for sure
20:21 What
to do if you have SIBO and how to choose the treatment option that’s right for
you
26:35
Shedding light on the “die-off’ mystery – with clinical experience on what to
expect and how long it lasts
30:56 Using
SCD as a treatment for SIBO – and whether or not antibiotics are really
necessary
34:40 The
pitfalls to avoid if you want to cure SIBO with SCD – and the mistakes that can
work against your healing progress
38:27 The
best answer when figuring out how long it takes to CURE SIBO
45:22 The
specific steps to follow for the next 30 days, 90 days, and 1 year to overcome
SIBO AND make sure it doesn’t come back again
51:56 How
to become a SIBO expert by gaining access to the latest treatment strategies
being taught to medical professionals
September 5 2011, Underground Wellness Radio- SIBO Undiagnosed and Under treated (interview at 10:00 min)
- Siebecker har själv haft IBS, läste Breaking the vicious circle (BTVC) (Gottshell) och A new IBS solution (Pimentel). Båda handlar om SIBo. Mycket forskning på PudMed.
- Olika bakteriekoncentration i SI/LI. Mekanismer som håller låg konc i SI:
- HCl
- Enzymer
- Galla
- GALT (immunförsvar)
- MMC
- ICV
- SI innehåller mest anaerobiska bakterier som är svåra att odla. Det är inte nödvändigtvis patogena bakterier som växer i SI.
- Symtomen kan vara väldigt blandade.
- Test för SIBO: utandningstest med laktulos- (rekommenderas, visar hela SI) eller glukoslösning (tas upp för snabbt, visa bara övre SI).
- Att andelen gas ökar kraftigt inom 2 timmar tyder på SIBO.
- Behandling: antibiotika som inte absorberas, påverkar både SI & LI.
- Att sibo kommer tillbaka inom 2 veckor efter avslutad antibiotikabehandling är vanligt.
- Följ LCHF-diet: GAPS/SCD/FODMAP/Cedar Sinai
- Använd en prokinetisk läkemedel, t.ex. lågdos av antibiotika. (Retromycin, iteromycin?)
- Elemental diet kan användas isf antibiotika
- Probiotika: BTVC:undvik bifidus. Men det finns studier som säger att bifidus-stammar är bra vid IBS. Dock individuellt.
- Undvik prebiotika (t.ex. FOS, inulin)
- Beror på dosen, många tål dem om de står under övriga ingredienser, och inte som huvudingrediens med mg-angivelse.
- Benbuljong kan ge symptom, dosberoende. Innehåller mucopolysaccarides. Använd köttbuljong istället (om symptom).
- GAPS: mindre bönor, fruktjuice och bakpulver (basisikt), fokus på näring enligt WAP än i SCD. Båda är bra.
- Siebeckers SIBO-bok på gång, tar upp kopplingen mellan SIBO och alla andra sjukdomar som SIBO är kopplat till.
- Tar bl.a. upp Crohn's. (Både SCD och FODMAP utvecklades för Crohn's-patienter). Koppling Crohn's <-> SIBO, studie med Rifaximin.
- Webinar för läkare tillgängligt på hemsidan.
- Q&A:
- Förstoppning efter att ha gått över till SIBO-diet. Laktulos på recept kan göra SIBO värre. Magnesium att föredra för symptomlindring vid förstoppning. Öka dosen om det inte fungerar.
- Ökar total colosectomi pga UC risken för sibo? Inga studier, men SI anpassar sig och delar av SI börjar ta över funktioner som tjocktarmen hade.
- Dödar kokosolja bakterier om man äter det samtidigt som fermented foods? Antagligen inte.
- Koppling Hashimoto's och SIBO. Det finns ett paper på det, se hemsida. Hypothyroidism saktar ner MMC vilket leder till SIBO.
- Svaga muskler på VLC-diet. Kolhydrater kan hjälpa, men toleransen varierar mellan individer. Testa t.ex. vitt ris om du inte tål pumpa.
- Kan också bero på elektrolytnivåer, som kan vara låga på SCD. Kolla recept på electrolyte replacement.
- Vegetarian och SCD/GAPS. Kräver mer kolhydrater för att få i sig näringen. Testa 1 månad. Om inget resultat, överväg kött.
- Elemental diet. Vivionex sub-optimal, kan man göra egen med benbuljong?
DIY: aminosyra-pulver (inte vilket som helst), olja, honung. Kaseinintolerans kan vara ett problem med kaseinpulver, men de innehåller mindre laktos än vassleprotein. Aminosyraprofilen i benbuljong är inte komplett. Köttbuljong är det. Tillsätt olja och en monosaccarid. - Det finns definitivt en koppling mellan hudåkommor som psoriasis och SIBO. Studier på acne vulgaris och SIBO.
- Stark koppling SIBO/leaky gut. Mekanismen bakom många associerade sjukdomar.
- SIBO ur ett evolutionärt perspektiv:
- Håller vi på att utveckla en slags idisslar-mage med extra bakterier pga. att vi äter mat som vi själv inte har enzymer att bryta ner (bl.a. spannmål)? Uppstötningar vanligt.
March 14, 2012, Underground Wellness Radio- Ask the Digestion Doc with Dr Allison Siebecker
September 2012, Dr Siebecker explains the art and science of the FODMAP diet (audio player at bottom of page)
3:32 How
FODMAPS was created to treat Functional Gastrointestinal Disorders
10:34 The
campfire effect: why beans give everyone gas
15:05 The
nitty-gritty of FODMAP Intolerance is…
19:38
Intestinal Gas can speed up or slow down digestive motility
29:30
Fructose is malabsorbed when this happens…
32:33 How
would you know if you had a FODMAP problem?
40:55
SHOWDOWN: Comparing SCD vs. FODMAPS
51:23 SIBO
has been shown to cause Fructose & Lactose malabsorption
October 16 2013, Super Human Radio- SIBO: Is your bacteria stealing your food and poisoning you in return?
(starts at 1:03) (You Tube clips)
November 12 2013, Patrick Timpone One Radio Network- SIBO
December 3 2013, Dr Lo Radio- The Digestion Fix with Dr. Allison Siebecker
- SIBO Symposium -14
- IBS- PI, testing, SI microbiome skiljer sig från LI mocrobiome, low dose Naltroxone as a motility anhancher, SIBO related to other conditions as acne rosascea, diet, herbal Abx, treatments used in clinics
- Intermittent fasting for digestion
- Pro: (if BG regulation ok) rests digestion, detox, kills microbes
- How often is induvidual
- Con: due to toxic environment, IF can release toxins too fast.
- Excessive gas, bc of fiber?
- yeast produces CO2, easily absorbed
- Bactaria in the SI or LI
- Probiotic bacteria produce mostly acid, which other bacteria might convert to gas
- Inbalance might be the broblem, and/or overgrowth
- Cruciferous veggies -> gas
- low fodmap diet, or SCD (-grains, sugars, starch) + low fodmap for sibo.
- Fodmaps are higly individual
- Feeling good after 5 d juice cleanse, then bloated from real foods.
- SI or LI problem? -> test for sibo. if Neg.-> dysbiosis. -> Use low fobmap, probiotics and herbal Abx to shift things around
- Dual stool testing:
- Culturing stool tests misses parasites (recommended: biohealth labs), complement with:
- DNA (Genova)
- Sensitivity testings helps select appropriate treatment(?). Dual tests are worth the cost.
- 4 Treatment opitions (depending on individual circumstances):
- Everyone does SCD+FODMAPS.
- Elemental diet: absorbs in upper SI. 10-15 lbs weight loss. Not alwaays appropriate bc Px underweight due to malabsorbtion and/or difficulty eating. Effective in 2 w. 14 d -> test. if Pos -> +1w. -> test.
- Antibiotics: more studied
- Herbal Abx: worse die-off
- For hard-to-treat patients many rounds might be required.
- A limited diet gives great symptoms relief, but is very restrictive.
- Preventative diet: SCD+fodmap for 1 month.
- Cedar sinai diet is prventative, not really for treatment.
- Lower carb
- Leaky gut heals fast once sibo is treated
- Serotonin SI/brain
- many receptors in intestines
- healing the gut -> better mood
- depression from eating certain things. See GAPS book for more on food-mood connection.
- Probiotics
- Individual. Rotate and find one that works.
- On avg 25% benefit. You notice it if you stop taking them. Some few feel really good, or bad.
- "Align" brand w. B. Infantis helpful for many patients, despite sub-optimal ingredients. Not as good results with isolated B.Infantis (bc patented strain?).
- In most cases no need to avoid bifidus.
- Renew life/Advanced naturals 100 bn ultra potent, helpful in IBS
- Overgrowth concern: studies show that probiotics only is successful, at least not bad, for SIBO. They might be affecting motility.
- D-lactic acidosis concerns in the GAPS comunity
- Not seen in Siebecker's patients
- Can be tested for
- SBOs: limited experience, but more expensive and no real advantage over other probiotics.
- FOS is bad for SIBO
- Concerns about having to feed bacteria
- If you have SIBO, getting rid of it is most important
- If you eat some plants and fruit, it's usually enough. Bacteria can also feed on amino acids from meat and mucus in the intestines.
- No one knows hos to get the right balance
- Prebiotics feed both good and bad bacteria
- Constipation
- Is going every 2 days ok? Yes, if you feel good. Try Magnesium and go every day and see if you feel better. Every 3 days is not normal.
- Can bad gut health make you overweight?
- Yes, e.g. FMT as both cause and treatment. Other causes: e.g. topical hormone cremes.
- Chlorin dioxide as a treatment option for SIBO?
- No experience, but keeping mind open. Needs all tools in her practice.
- Takeaways
- If blood sugar control is good, then don't snack between meals. Go 3-4 hours with only water.
- Keep a regular eating schedule. Variation causes stress.
1:30 How
many times is it normal to fart in a day?
6:30 Diane’s Embarrassing SIBO story – Really?
It’s not fat! 6 pack abs may be easier to build than you think!
10:00 How
to test for SIBO and why Dr Allison encourages you to work with a practitioner
to get rid of it (CONTACT DIANE www.dianekazer.com/schedule
if you’d like her help with this)
11:50 What
is SIBO? Listen to the signs and symptoms. Might you have it too?
16:30 What
are the causes of SIBO?
18:25 What
is the difference between IBS and IBD
20:30 20%
of us will NEVER see our 6 pack unless we fix this! Exercise and Acid Reflux.
GAS at the GYM sucks. How to fix it? Listen til the end ;)
26:00 How
Proton Pump Inhibitors can impair (aka jack up) your digestion and cause SIBO.
29:30 Is
your Acid Reflux from too much or NOT ENOUGH stomach acid. How to test to tell.
Listen to this BEFORE taking ANY PPI’s.
32:30 Could
antibiotics cause SIBO and incessant belly bloat?
35:00 How
to treat SIBO (aka belly bloat)? 4 options for you to try!
39:00 Bone
broth? Healthy or not for SIBO? Things to avoid while healing.
43:00 “I
thought FIBER was GOOD for us?” Learn why it’s not in this case! Nuts too?
47:00 “I
stopped eating gluten OR I tried juicing OR I’m eating more vegetables OR I
started a Paleo diet AND I don’t feel better!” WHY?
51:00 Which
probiotics are BEST and which ones do damage?
54:00 A
carb-accident ‘weighting’ to happen! If carbs make you feel worse &
bloated. White flour is ok to eat? Huh?
1:00:00
Hormone imbalance and digestion issues are teammates. Which to address first?
1:03:20 How
to build your baby’s immune system EARLY. Why these 3 things MUST be addressed
BEFORE and AFTER you have a baby!
1:13:00
Could SIBO be caused by a physical or genetic imbalance?
1:17:00 How
to work with your doctor to treat SIBO?
- Sammanfattning
April 17 2014- Balanced Bites: Episode 135: special guest Allison Siebecker (Transkribering via länken.)
1. Updates [3:16]
-
2.
Introducing our guest, Dr. Allison Siebecker [4:07]
All the
SIBO diets are versions of paleo. We just see phenomenal results.
Kost har inte riktigt fått fäste hos läkare.
3. How to
tell if you have SIBO [7:31]
The key
symptoms of IBS and SIBO are bloating, constipation or diarrhea or a mixture of
the two, and then pain which could be discomfort.
Distention
means physical swelling. But it is possible to have a feeling of bloating
without the swelling
SIBO: GI: bloating,
altered bowel movements, pain. + more
Leaky gut
symptoms are systemic
4. SIBO and
leaky gut [9:50]
SIBO, among
other things, can cause leaky gut
About 50%
of people with SIBO get leaky gut
Leaky gut
healed in almost all patients in 1 month, without other intervention than Abx
for SIBO.
Mixed IBS
type
5.
Diagnosis options for SIBO [18:34]
Best way to
test: lactulose breath test. lactulose is a prescription item. Sometimes,
depending on state regulations, the doctors aren’t allowed to order this test.
The order the urine organic acid test instead, that actually can’t diagnose
sibo.
You can’t
really distinguish the organic acids that indicate a bacterial abnormality, you
can’t distinguish between the small and large intestine very well on that test.
Too few
studies have been done to validate UAA testing.
Glucose
more common than lactulose in Europe
glucose is
absorbed in the first 2 feet of the intestines, and so it can only diagnoses
SIBO in the top 2 feet of the small intestine, so that’s the duodenum. But very
accurate for that part of the SI. Can be ordered by anyone.
Lactulose doesn’t
get absorbed, it actually goes all the way through into the large intestine
Most people
have the overgrowth in the lower, or distal part, of the small intestine
Endoscopy +
culturing only reaches top 3 feet of SI. Invasive, more expensive than breath
tests. Anaerobic bacteria can’t be cultured.
6. Why is
there a bacterial overgrowth in the first place? [24:25]
Decreased
motility – MMC
Most common
cause: acute gastroenteritis
Physical
obstruction impeding the path of clearing away bacteria out of the small
intestine
Non-draining
pockets after surgery or diverticuli
SIBO is an
overgrowth of nonpathogenic bacteria. It’s an overgrowth of the bacteria that’s
normally within us. Pathogenic bacteria are not normally within us. When they
come into us, they give us gastroenteritis. Pathogenic bacteria secrete a
toxin, and it’s called cytolethal distending toxin. And it’s abbreviated as
CDT. All these bacteria have the same toxin. It turns out that the B portion of
this CDT toxin; there’s an A, B, and C portion of this toxin. The B portion
looks like a protein on one of the nerve cells in our small intestine. And so
through an autoimmune process, an autoimmune mediated process of
cross-reactivity or molecular mimicry, as it’s also called, our immune system
attacks the protein on our nerve cells in our small intestine at the same time
that it’s attacking the CDT toxin, because they look very similar. This protein
on the nerve, it’s called vinculin, and the nerve cell is called the
interstitial cell of cajal, and abbreviated as ICC
And these
cells are pacemaker cells in the small intestine that are necessary for doing
the migrating motor complex. And what they have been able to figure out is that
the damage is successive oftentimes, so it depends on how severe the
gastroenteritis was, or is. So, these cells will be damaged by a bout of
gastroenteritis. But they may not get to the threshold at which SIBO develops.
It’s actually been figured out exactly the amount of cells that need to be
damaged, and that need to be still there when a person will then develop SIBO.
So I think what can happen for a lot of people is, most everyone has had
gastroenteritis in their life multiple times. In fact, young children get sick
like this a lot, you know vomiting and diarrhea, and I think we even lose
count, who even knows before 5 if we can even remember, we probably all had it,
you know? {laughs} So I think damage can accumulate for people, setting a
stage. Which is why some people don’t get SIBO or IBS until adulthood, and it
might just be that they have a triggering event, like one last bout of
gastroenteritis, and that was enough to do it.
How come
one goes on to develop SIBO or IBS and the other doesn’t? Well, it might have
to do with the accumulation of damage that one person had and the other didn’t.
This is
also called post infectious IBS. And what Dr. Pimentel’s theory is that
post-infectious IBS is none other than SIBO.
About 50%
of the people who develop post-infectious IBS or SIBO, will spontaneously
recover within 5 years. It can take some time; it can take quite a bit of time.
The interstitial cells of cajal are very plastic. When there’s some sort of
assault to them, they switch from a nerve cell into a muscle cell. They can
switch back.
7.
Preventing possible SIBO when you get gastroenteritis [36:46]
We are
realizing how very serious gastroenteritis can be. Now, we did already know
this, because in the non-industrialized world, gastroenteritis is still a major
cause of death, actually
So what
doctors are saying to do is basically take some kind of antibiotic, whether
it’s natural or pharmaceutical, as soon as you think you’re having this. In
fact, what a lot of doctors is recommending is to take them prophylactically
when you go traveling. Because it’s very common to get gastroenteritis when
traveling, particularly in a non-industrialized countries. So, for the
pharmaceutical option, what’s recommended is the same antibiotic that is used
to treat SIBO, which is rifaxamin. And then, if you’re wanting to do the
natural option, then you could use any of the natural antibiotics we use for
SIBO as well. One doctor I know recommends, we use Allicin that is extracted
out of garlic. The one we use is called Allimed. One of my doctor friends
recommends to his patients that are traveling that they prophylactically take
that daily. I think he recommends 6 a day
Many people
get SIBO because of having a disease that slows motility. And some common ones
are diabetes and hypothyroid. And surgery. And drugs (opiates).
Simplifying
sibo pdf from SIBO symposium
Rifaxamin,
that’s used has been studied to be shown to be not very damaging at all. And
that’s because it stays only in the intestines. it is broad-spectrum, but it
doesn’t absorb into the blood system. I do need to use it with many of my
patients.
That means
you’re much less likely to get urinary tract infection or some other thing as a
side effect from the antibiotic, so that’s good. And also, rifaximin is
anti-inflammatory, and it’s been studied and shown that it doesn’t cause yeast
overgrowth, and lastly it’s been studied for up to, I think, 6 repeats without
antibiotic resistance developing.
I generally
love the idea of using the natural antibiotics, but what I can say is that
there are pros and cons to each, and the patients that I see, because I’m a
specialist in SIBO, I happen to see often more severe patients, particularly
patients who have been to many other doctors for the SIBO, and the treatment
has failed. So I get a lot of complicated cases, and I have to use anything and
everything I can. I need my toolbox to be as big as it can to help these
people. So, I think, for someone who is starting out with someone who has never
had any treatment, please by all means, start with the naturals! Go with the
least offensive thing first. But, just know that there’s other options if that
fails.
8. Approach
to treating SIBO with food [44:39]
I usually
get to see people who have been on one of the SIBO diets, and I’ll explain them
in a minute, for many years actually without enough help. SCD is grain-free,
and therefore, of course, gluten free. It does emphasize all home cooking, and
it takes away all sugars except honey and maybe a little bit of stevia.
SCD emphasizes
easy-to-digest foods and cooking methods. Paleo emphasizes raw foods, salads
etc., that might not be good if you’re having digestive issues. the SIBO diet
deemphasize and decrease fiber because fiber is an exclusive food for bacteria.
So it can worsen the problem.
9. SIBO and
FODMAPs [50:57]
Patient
after patient tells me; it’s almost like a keynote of how you could know if you
have SIBO, is basically carbs bother me.
And the
carbs could be anything, but honestly for the most part I find it to be grains
and baked goods. That’s the number one thing that bothers people. The simple
sugars, the single sugars, if it’s really just that that’s bothering someone, I
tend to think a little bit more about yeast.
There’s a
spectrum of which diet you use based on the severity of the person. And what I
would say is, when someone is really having a lot of trouble with their diet,
nothing is much working, what I go to is a combination of the specific carbohydrate
diet with a low FODMAP diet. Somewhere in the middle would be the specific
carbohydrate diet and GAPS.
If people go
grain free, so long as they’re not overeating fiber and raw foods, and they
feel better, absolutely they should be thinking about SIBO.
10.
Treatment of SIBO [55:09]
The four
options are: antibiotics, herbal antibiotics, elemental diet, and diet. Because
I see more of the challenging cases, I have never been able to see diet alone
be enough. I don’t believe that it couldn’t, I just don’t get to see it.
Herbal
antibiotics, what we’ve been using is the Allimed, we use oregano like you do,
we use goldenseal or other berberine containing herbs, and we use neem, and
sometimes cinnamon. What we haven’t found to work as well is those big
combination formulas, with everything but the kitchen sink in there. A lot of
times they’ll have antivirals, they’ll have antiparasitics, and a lot of real
antifungal focused herbs, and I think it just waters down the potency of the
treatment. We have to use pretty dang high doses of the herbal antibiotics I
just mentioned, and we usually have to do it for 4 weeks, if not longer, and
that’s only one treatment course. One round. When people come in with a pretty
severe case, where the gas is very high, it could take multiple treatment
courses to get their SIBO gone.
Elemental
diet kills them by starvation, but yet you get fed. But this treatment is very
tough, because you’re not actually eating for 2 weeks. And that’s hard to do.
Plus the drink tastes very bad. But it’s extremely effective. if somebody has
very, very high gas levels, like in the 100s, normally if you’re going to use
antibiotics or herbal antibiotics it could take multiple courses to get that
gas level down, where as elemental diet might be able to do it in 2 weeks.
11.
Resistant starch and SIBO [1:00:09]
There was
someone saying that they thought resistant starch could actually help SIBO that
was disturbing to me. I followed all the links through and found so many
mistakes and so many erroneous, so much erroneous information. And the links
were so tenuous, it was like someone else posting someone else’s comments from
something. But when I read this study that, whomever it was that was quoting,
it had actually gotten quite a lot of the information directly backward.
Resistant
starch is a fiber. So, there are many different definitions of fiber, but one
of the key definitions is indigestible to humans, which means we don’t produce
the enzymes to break the bonds that hold the sugars that make up the fiber. We
don’t have the enzymes to break that apart. So indigestible to humans, but
digestible to bacteria. That is one of the core definitions of fiber, and that
is what resistant starch is. There are four types; I’m sure you’ve all been
reading about it. So, resistant starch is a fiber, and it is fermentable. There
were some comments about people saying it only feeds good bacteria, that
doesn’t matter. Because normal bacteria is what is overgrown in SIBO. And also,
certain prebiotics, they get touted as only feeing a certain type of bacteria,
and that’s just not the way it works, and there’s plenty of studies to show
that. So, what I would say is this. We don’t have to make it be a scientific
thing, really. All that matter is, if a person wants to try it, go right ahead
and see how it affects you.
12.
Prevention, avoidance, maintenance of SIBO [1:03:44]
Don’t take
a proton pump inhibitor. Or any acid blockers. Next would be if you have any of
the diseases that decrease motility, do whatever you can to treat those
diseases. Don’t over consume carbohydrates, particularly processed ones. Don’t
overindulge in alcohol. If you’re traveling, or if you do get gastroenteritis,
take some Allimed to see if you can prevent anything from happening.
There are
some studies that show that probiotics really help in the treatment of SIBO,
and then there are some expert doctors that think that they may not be so good.
So the jury is out, but I generally think it’s a good idea to eat fermented
foods and probiotics because there are studies that show they help motility.
I just want
to encourage for anyone who thinks they have SIBO, or has SIBO and has trouble
with it, to just not give up. Because so many doctors, they’re not methodical
about they’re treatment. And many patients aren’t either. Life overwhelms us,
and we have to stop what we were intending to do. But particularly when it
comes to your working with a doctor. If somebody gives you one treatment, and
that’s it and they don’t see you again, don’t stand for that and don’t give up.
Go back, get yourself retested, and keep going until you get it gone. That’s
what I would say.