Alternative and natural therapies for SIBO and GP

I've learned so much from the people on this forum, and from many other sites and blogs, and wanted to organize and share what I've found, in the hope that I'll be able to offer some of the help I've gotten. I've been into alternative treatments my whole, now rather long, life, since my mother was into them, too. I was diagnosed with small intestinal bacteria overgrowth and mild gastroparesis in December. Prior to that I was operating on the idea that I had candida, and did much better on a candida diet. The gastro I saw in December doesn't believe in candida, and said the reason I felt better was that I wasn't feeding the bacteria in my small intestine. He didn't convince me not to believe in candida, but he did convince me to go along with the SIBO protocol: 2 weeks of riflaxamin and 10 days of neomycin (since my SIBO is C, not D.)

Before I did that, I cut way back on carbohydrates for a month, even coming up with a stuffing recipe for Christmas dinner that only had veggies in it. I wanted to avoid a heavy detox reaction, which I did. I did the protocol, which I'm certain helped eliminate bacteria, but since I'm so sensitive to all medications and, really, anything I put in my mouth, it's taken me a couple of months to get my system back in order, and I'm still working on it.

I'm still taking a very small dose of erythromycin, since it stimulates motility, which is why a full dose gives so many people diarrhea. I take it at night for the SIBO, so the small intestine will fully empty during the night. And I take it before meals if I feel my GP needs help, which is usually just at dinner. I'm hoping to be able to stop the erythromycin as other things take over.

That clue -- that things that give you diarrhea stimulate motility -- led me to what may be the most important thing for me, which is raising my serotonin levels. I was reading an excellent book on dealing with anxiety and depression, The Chemistry of Joy, and the author recommends raising serotonin levels with 5Htp, and mentioned that it can cause diarrhea. That led me all over google, discovering that we have more serotonin in our gut than our brains, and that, among other things, it regulates motility. So now I get to heal two birds with one stone! It's a great book for helping to keep overall emotional balance, as is his second book, The Chemistry of Calm.

I now use ginger before meals, because it's a gastric stimulator. I've bought bitters, but prefer munching on a mouthful of arugola so far. The idea is that the bitter taste stimulates the stomach to produce acid, which is often low in people with motility disorders. I take enzymes, though not with every meal, so that the pancreas doesn't get the idea it doesn't have any work to do. I take a small amount of HCL when I feel like I need to, again especially at night, or with harder to digest proteins, like lamb. That helps digestion in all sorts of ways, including making the environment too acid for the bacteria in SIBO. I've just started dirt-based probiotics, called Prescript Assist, since they are thought to be better for SIBO and for constipation than lactobacillus based ones.

I've been using pharmaceutical grade glutamine and DGL to soothe and heal the gut lining. I've started taking serrapeptase for other reasons, but one of its benefits for SIBO is helping to break down the biofilms the bacteria make to protect themselves while they nestle into the gut wall.

I've also started to take Triphala, which is healing and toning for the entire gut, and is also a motility stimulator. I've long needed a lot of magnesium in my life, so use Calm at night, which helps with anxiety, sleep and constipation, so it's a real winner.

I'm using the Specific Carbohydrate Diet, which eliminates foods that get digested too far down in the small intestine, and thus ferment and feed the bacteria. Since I'm used to the low carb, no sugar candida diet, and perfectly happy to eat good protein and veggies, this is not as challenging for me as it might be for others. Still, I've been surprised to find that I don't miss grains at all. All cravings for them have disappeared (it's the bacteria doing the craving, after all!) and I don't miss them. I've lost weight, which I'm happy about, since the weight from grains is just bloat and inflammation. There are several great websites to help with this diet.

I've done acupuncture for many years, and especially recommend the NAET protocol, which finds and helps to eliminate food sensitivities and other allergies that affect our guts. I can't recommend that strongly enough. If you're into alternative healing, it won't be news. If you're not, it may see like voodoo at first, but bear with it! If you are in southern NY, let me know and I'll recommend someone. Otherwise you can find someone close here: http://www.naet.com/Patients/locator.aspx

I've also gone to chiropractors all my adult life, and was surprised to find, when I went the last time and specifically asked for adjustments I'd found recommended on the web, that they made a huge difference in my comfort. Mine were cranial and upper cervical and thoracic region of the spine.

I know there are people here who are so worn out they can hardly walk, but I do find that exercise is key to having a functioning bowel. For me it's the key to a functioning life! I walk and do yoga. Stress is a very crucial component of my digestive problems, and both walking and yoga are great stress reducers. So is slow breathing, deep into the lower gut. Still working on that!

And always working on drinking enough water, slowly enough throughout the day to not overwhelm my stomach, and not with meals. These days I add a combination of ginger and chamomile teas to my water, since both are so soothing for digestion.

I'm still working on all of it. I have all sorts of jars and containers around, to see what works and what I can let go of, and a list of websites that grows every day. I am definitely not suffering the way some people here are suffering, and my heart is wrung by so many of the stories I read here. I would love to think that I can help the way I've been helped.

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Hi L-Bet, thanks for all the info. I have Traphala, but I don't do too well with pills or capsules, so I have been opening the capsules and trying to crush the pills-the pills have fiber in them though, so I wondering if I should just do the capsules (opened)--I don't have a problem with constipation (now, have had in the past) and used Calm-do you think it increases motility because I would be happy for more motility and not worry about the rest. Do you take liquid erythromycin? Does it truly help-so you feel things moving after you take it? Does it mess with your bacteria, gut flora? Do you have ginger tea before meals or another ginger product (I ask because I diabetic and can't do the cyrstalized kind-I have not tried it though)..I have more questions, especially about 5htp-but I will be patient.

Hugs,
Mo

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Hi Mo, I don't use the crystallized ginger (though I love it!) because of all the sugar. For a while I was putting a 1/4 tsp straight from the spice jar into a glass of water. More than that is a little strong, taste-wise, I find. So for more power, I found drops at Vitacost.com. There are different ones -- I got the alcohol free one from Nature's Answer. In the process of becoming drops, they've lost the nice ginger taste, so I put it in a tiny bit of grapefruit juice, which I use to hide any number of bad tastes. I also love ginger tea, and use Yogi Tea's Lemon Ginger, which is a little softer than their straight ginger. I know there are people who chew slices of fresh ginger, but I haven't tried that yet. I like the pickled ginger you get in Japanese restaurants, but I think we need more power than they provide for motility. I seem to remember that the study I found used 1200 mg. of ginger. If I take that much in capsules, it's a little strong for my stomach's current state.

I've read that the traditional way to take Triphala is as a tea, and in the Ayurvedic tradition it comes from, the taste is an important part of the process. So opening the capsules is presumably no problem. It's supposed to be bitter and astringent, so it might be another candidate for grapefruit juice.

I don't think Calm helps with motility. I wish it did. It pulls water into the bowel to help keep stools soft.

I take regular erythromycin tablets, cut into 4 doses with a pill cutter. If my gastro wants me to continue, or at least to have some on hand if I need them, I'm going to get 60 mg tablets made up by a formulary pharmacy. I'm sure it does my gut flora no good, but it does help with motility. I don't feel it in the moment, but if I'm feeling like a meal is going to be a problem (stressed out, tired, etc.) then it does help me feel more comfortable, so I know it's working.

A few years ago I went through a period when pills and capsules were really hard to swallow. I'd put all my vitamins into the bottom of a blender and blend them, and then make a smoothie on top of them, with frozen berries and George's Aloe, which is like water. I'm doing better with them now. I find they go down more easily with juice than with water. It's like my throat opens up more when I'm drinking juice. No idea why!

Hugs back to you!

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L-Bet, I would be interested to know what your diet is, do have milk products like yogurt? Coffee? I assume by your mention of lamb you eat proteins, have you found some types better than others, have any foods made you sick (nausea). Do veges and fruits agree with you or just some? Does the DGL you take come in chewable form (I looked it on Amazon and they seem to come that way)-but you said pharmaceutical grade glutamine and DGL-it that different?

Thanks so much!
Hugs,
Mo

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I'm also curious about your diet. How many carbs do you allow yourself and in what form?

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Much good information

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L-bet, thank you so much for all that information. I go to an alternative medicine MD, and she is in to all of that. Will be reviewing it with her. Thank you for sharing your whole experience. I used to drink Natural Calm every night but found that it began irritating my stomach and causing my GERD to act up. I had to stop it.

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L-bet, thank you SO much for this information. I have more questions too, but first, I too would like to hear more about your diet. I have done many of your ideas off and on, and have severe candida issues... so I am trying to go back to a strict candida diet. Problem is I am type 1 diabetic (with hypo episodes) and also have severe malabsorption - so my "dieting" is tricky. Thanks for any input!!

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Wow!!!what an insightful and helpful post...You are right on in everything you addressed. Although i am in a definite setback or flare, your post just reminds me of what I need to do to begin healing again... Right now I am just in the frustration and fear of my circumstance. First time around in 2011, I went to accupuncturist weekly and visited my alternative medical doctor monthly...i am on my way to work but plan to read your post again this afternoon...thank you

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How much 5htp do you take, and do you experience any side-effects? Do you have nausea with any of your supplements?

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I'm commenting so I can follow this conversation! So much of what you said resonates with me. My story is very similar - mild GP and SIBO, antibiotic treatment, following SCD, & taking many of the same supplements you are. Still, there is a lot more you are doing that I am confident I would benefit from adding to my mix. Thank you so much for posting. I'll be back to write more! I know I'll have some questions!

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I was doing a little reading on SIBO and IBS-everything, and noticed that one "alternative" (non-pharma) product that is actually being medically evaluated right now, are enteric-coated peppermint oil capsules. I have a problem swallowing pills (dysphagia), and everything I take that is in a pill has to be non time-release. Yes, the taste sucks, especially Triphala (yuck), but choking on a pill is worse. Apparently the SIBO inducing bacteria that has taken up residence in our gut against our wishes doesn't like peppermint oil.

Here's one link to a peppermint oil study: http://www.altmedrev.com/publications/7/5/410.pdf

For what its worth. This/these G.I. diseases suck, and it is quite difficult to find any doctor who truly understands how they are affecting us daily, and nightly, monthly, yearly; if I ever find someone who doesn't look at me like I just came from Mars, and actually listens and helps, I'll broadcast that across the internet.

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Hi all, so glad I could add to the conversation! I'll start with the SCD diet. You don't have to count carbs on it, instead you limit the types of carbs you eat. It was developed for IBS patients (before they called it that) in the 50's, and Elaine Gottschall took it further and wrote a book called Breaking the Vicious Cycle, which is also a website (http://www.breakingtheviciouscycle.info) with a list of legal and illegal foods. The idea is to try to eat foods that get digested higher up in the small intestine, so that they don't linger and ferment on their way to where the bacteria are eagerly awaiting them in the lower part of the SI. So the simpler carbohydrates (the monosaccharides), which include most veggies (including winter squashes), fruits, nuts, and protein, are 'legal.' The more complex carbs (di- and poly-saccharides), like grains and certain root veggies (white and sweet potatoes) are not. Lactose, the sugar in milk, is considered the absolute worst, but cheeses that have been aged, and thus had the lactose eaten by the bacterial aging agent, are fine. Homemade yogurt is considered a very important food, but commercially made ones don't have all the lactose removed.

These days I'm eating either smoked salmon (from Costco, so it's affordable) with sliced tomatoes, cukes, and avocado for breakfast, or eggs with turkey bacon or sausage, and sauteed greens, like spinach. For lunch I have a big salad with lots of sliced veggies and dark green lettuce like romaine, arugula, or spring mix, and chicken. The dressing is olive oil and lemon. For dinner, which is the hardest meal for me to digest, I'll have turkey, eggs, or fish, with sauteed veggies of some kind. I like lamb and eat it occasionally, but I don't go out of my way for it. I don't do well with beef, and haven't for a long time, but sometimes ground beef is okay. I think I'm better off without cheese for now, and find I don't miss it.

I often eat butternut squash, for either lunch or dinner, which I've known for years is great for my bowel. A vet told me last year that pumpkin is good for dogs because it gives the gut bacteria the perfect food, so that may be true of other things in the squash family, and for us, too. I mash it with coconut oil, and sometimes add cayenne pepper to spice it up. I'm pretty liberal with my use of olive oil, avocados, coconut oil, and other good oils, so there's plenty of calories and energy to burn.

What you can't eat, and most people think they will miss, is grains -- so bread, pasta, cake, cookies, brownies, etc. etc. are all out. They're also out because of the sugar in them, of course. I had to stop eating wheat in my 30's because it got so debilitating, but there are so many rice products available I was still eating a lot of carbohydrates. On my anti-candida diet I stopped all grains, but eventually got back onto rice and quinoa. And many people, once they have healed their gut on the SCD diet, do go back to some grains. But lots, like me, are finding that they're simply better off without them.

The SCD diet has a fair amount in common with the paleo diet, and though I don't follow all the ins and outs of paleo, and it's too much heavy protein for me, there are lots of good recipes on paleo sites, like paleomg.com. I tend to read recipes and then go my own way, but do get good ideas.

On the DGL -- my favorite is Enzymatic Therapy's Ultra DGL because it tastes like chocolate. However, it does have inulin, guar gum and milk (in the flavoring). I'm not sure the tiny amounts in a tablet are doing harm, but it's worth thinking about. I was taking Jarrow's glutamine (from Vitacost.com), but an acupuncturist gave me a product that has glutamine and dgl, with some other soothing things, and I've been using that, breaking the capsules into water first thing in the morning. Glutamine formulations tend to be pricy, but the straight Jarrow is inexpensive. Don't get the kind that body builders use -- that's the idea behind pharmaceutical grade glutamine.

Calm works well for me, but I've wondered if it's the cause of various other irritating things. I'd love other good magnesium ideas. I do best when I'm taking a lot of it. 3A Magnesia is supposed to be good, but I didn't find it as effective as Calm. There's a very interesting blog, chriskresser.com, and he just recommended 600-900 mgs of mag glycinate. The queen of magnesium is Carolyn Dean (drcarolyndean.com) and I think her book is up next.

Right now I'm taking 150 mg of 5HTP. I worked up to that, and also to figuring the best time to take it. I seem to be one of those people that get revved up by it, at least for now, so I'm taking it in divided doses, one with each meal. You need adequate B6 for it to work best, but that really revs me up, so only the morning dose has a little B6 in it.

I'm going to read up on the peppermint. I've avoided it because it's bad for GERD, though that problem is much less now. But the enteric coated would avoid that.

I occasionally come across references to zinc in the healing of the gut, but haven't found anything conclusive. Somewhere I read about a gastro who prescribed 200 mg of zinc for the first month after SIBO antibiotics. Does anyone know anything about supplementing with zinc?

I like my current gastroenterologist, and am lucky to have stumbled across him, because where I come from they know nothing about SIBO. But he's not into alternative things. He does give a handout on Dr. Pimental's diet, but when I asked about it, he suggested I just go and enjoy life and come back for the antibiotic protocol every 6 months, which is what a lot of people do, I guess. I told him I wouldn't enjoy life if I had to go on antibiotics every six months!

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I want to piggy back here & recommend the SCD diet. I have IBS & GP. Nothing else helped me. After dropping way too much weight, taking a leave of absence at work, & thinking I would never function again, I learned about SIBO. I began researching treatment. Dr. Pimentel’s book, The IBS Solution, was an interesting read. He kind of invented the Xifaxin treatment & required a strict diet while on the antibiotics (something like TPN type fluid, but drinkable) & then a looser low carb diet after with a prokinetic medication like erythromycin (keep things moving in the gut). He admits most people end up with SIBO again & must be retreated. I was not going to drink his recommended aspartame filled fluid, but knew he was on to something. I did SIBO testing through www.hydrogenbreathtesting.com. As I waited for my test results I found www.SIBOinfo.com & decided to try SCD even before I got my test results. The website, www.scdlifestyle.com helped me get started on the diet. After about a week on the diet I found out, sure enough, I had SIBO. I had tried other diets (low FODMAP, gluten-free, etc) & had experienced no real improvement, so I was skeptical. I followed the Xifaxin treatment protocol (550 mg, 3 times a day for 10 days) & continued SCD. Most of my doctors denied that diet would have much if any of an effect (despite the research). However, within 2 months of following SCD nearly all of my symptoms were gone!

I continue to stay on the diet (going on 9 months) to heal my intestinal system, reestablish healthy gut flora, & prevent reoccurrence of SIBO, but am steadily increasing the foods I can tolerate (many intolerances & sensitivities had developed prior to following SCD). I am working again. I have energy. I spend a lot more time shopping for food & in the kitchen making pretty much everything from scratch, but I have my life back! It’s all about eating REAL, clean/pure food that is easy to digest. It has shown me how critical what we put into our bodies is. I thought I was eating “healthy” before, I even taught classes on healthy eating for hospitals, but the Standard American Diet (SAD), even filled with whole grains is sad! The kind of diet most of us with GP adapt to is often even worse! I eat quite similarly to L-bet, except I have added & can handle beef (all pretty much all cuts), aged cheese, fruit in moderation, and baked goods made with almond meal/flour, coconut flour, & sweetened with a bit of honey. The baked goods help me feel “normal” – muffins, crackers, breads, pancakes, pizza crust, flat bread, cake, etc – only without the sugar & grains! It is important to make these a treat, not the stables of the diet. I also do lots of the famous SCD homemade yogurt and have started fermented veggies (GAPS diet way to get the good bacteria without dairy) in order to help re-establish a healthy gut flora. I cannot emphasize how important that aspect is. Times when I have traveled & not had my daily dose of yogurt or fermented veggies I can feel the difference! If you have any questions as recipes, making the yogurt, etc, I would love to be a resource.

I retested for SIBO 6 months after treatment & tested positive again, despite feeling great. Needless to say I was frustrated & confused! I redid the course of Xifaxan & continue the diet. It's been 3 months since my re-test & my doctors & I agree that if I continue SCD which is starving the bad bacteria & replenishing with good bacteria from the yogurt, & I feel great, then there is no need to keep retesting. Funny to hear them say that when they were so skeptical of the diet in the first place. I think my gut just needed longer to heal in order test negative. I do sometimes wonder about taking low dose erythromycin as "insurance" that the bad bacteria is being killed & my SI is motility is increased, but I'm hoping to get pregnant before too long, so less medication is best. I struggle with D more than C, so I don’t want things moving too fast. My upper GI is too slow, but my lower GI is too fast, so it is a balancing act.

On the supplement front, I do take digestive enzymes with meals I know will be harder to digest, but again not regularly to avoid my pancreas getting lazy. I also do L-Glutamine for healing (I take Jarrow). I take ginger capsules (at least 550mg 3 x day), ferment my veggies with ginger, season my food with it, & drink ginger tea. I love crystallized ginger, but obviously don’t do that anymore because of all the sugar! I take Betaine HCL with high protein meals, but have apple cider vinegar with the mother (unfiltered) on standby in case I get GERD type symptoms (this takes care of it). I also take Jarrow’s d-Limonene, which is orange peel oil at bedtime as it is supposed to help with motility. With all supplements & vitamins, be sure you are reading labels for additives like starches & sugars which will undermine what you are avoiding with the SCD diet. There are some vitamins made specifically for SCD. The only one I have purchased is the SCD Prenatal vitamin by Freeda. If I am not feeling great from eating later in the evening or too much (things I try to avoid), I take Iberogast (a clinically studied, homeopathic bitters mixture). I try to do yoga & walk or jog regularly, but need to work on this! Thankfully winter’s end will help!

L-bet & others, you have given me great ideas on things to add. I plan on experimenting with liquid ginger drops, DGL, Serrapeptase (one of my GI’s just told me to research biofilms!), Triphala, enteric coated peppermint oil & caraway oil (mentioned in the study linked in this thread). I am also going to look into finding an acupuncturist and chiropractor. I need lots of people on my team (especially those who aren't all about big pharma & aren't afraid of pregnant women) & tricks up my sleeve, especially as think about pregnancy. I am so grateful to have all of you to talk about this with.

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Oh, I forgot to mention... I called Libby's to get verification that their canned, 100% pumpkin, is indeed just pumpkin with nothing added in the canning process. I felt very good about it after talking to their nutritionist & getting a letter in the mail. I eat it a lot now. Mixing it in the homemade yogurt is great way to get a veggie in at breakfast without having to cook (sauté spinach, etc). I also use that mix of yogurt & pumpkin to make SCD legal frozen yogurt. The pumpkin keeps it creamy rather than rock hard. It's also great for breads/muffins, as is zucchini.

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Greetings All~

I'm not clear how the SCD or Paleo diet can be successful for those of with us with reduced motility since they call for so much meat.

Can you guys with GP, CIP, or IBS successfully break down meat before it too becomes fermented and toxic? I certainly can't! Input please.

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I had to start slowly with the meat & in the beginning it had to be very well cooked & fine in texture. Think, chicken broth with chicken so finely shredded because it cooked so long in the broth that it looks more like egg drop soup. You can do that in a crock pot. In the beginning I would do that with chicken & add carrots to broth. Once it was all well cooked, I would blend the entire thing. Then you can sip on the broth all day. Ground meat was the next step up. You can also do tons of vegetables. It doesn't have to be so heavy in meat. In the beginning all of my vegetables were peeled, deseeded, cooked very well, & then pureed in the blender with some bone broth in order to form a smooth puree. Yes, it's like you are eating baby food, but that's ok, & it's not forever. You spice it up with herbs & seasoning. Gingered carrot puree. Italian green bean puree. Cinnamon apple puree. Salt & lime avocado. Butternut squash soup. You gradually work your way up. I would add in one food at a time, with several days in between to watch for reactions. I kept a food & symptom journal to keep track & look for patterns. Baby steps. Taking the digestive enzymes help you digest things too. Please check out www.scdlifestyle.com for more info. They can guide you in getting started - including a grocery list, meal plans, recipes, etc. It was a vital tool for me in getting started. I know it seems crazy to think it could work, but it had made a huge difference in so many lives! www.breakingtheviciouscycle.com also has all kinds of testimonials you can read. I couldn't keep down crackers, baked potato, toast... the standard stuff you eat when you are sick.... Now I know why! It was feeding the bacteria not me & causing immune responses because it was leaking into my gut! I was trying to keep down Ensure type meal beverages to stop my weight loss. Woah! That stuff is filled unnatural ingredients & lactose, sugar, whey, soy... all kinds of things that are super processed & hard to digest! Once I started eating SCD & the food was processed higher up - out of the reach of the bacteria & wasn't breaking down into the bacteria's favorite molecular forms, I felt so much better because I was finally feeding my body not the bacteria! I never dreamed I would be able to eat a raw salad or spicy chili again! But, now that I have begun healing I can eat so many things!

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Essentially, SCD removes the foods that are the worst offenders when it come to fermenting. Plus, if you add in natural or otherwise herbs/supplements/meds that increase motility that helps even more!

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Determinedgirl,
I have a question about the digestive enzymes. You mention that you are planning to become pregnant in the near future. Are digestive enzymes safe to take when pregnant? I am also TTC, and have been reading about the digestive enzymes. I want to try these, but haven't been back to the dr to ask if it is ok. I am back to my mostly normal diet after a few years of really watching what I ate due to GP. I also feel like after my gut healed I've been able to tolerate way more in the last year. I appreciate your information you have included on this post!!

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Just a side note on the peppermint oil capsules... if you have bad _stomach_ motility, enteric coatings are often completely useless, because the pill sits in your stomach long enough for the coating to dissolve (the pill moving into the small intestine before the coating breaks down is entirely dependent on normal motility). Pre-GP I used to LOVE enteric peppermint oil capsules for intestinal cramps - it's a very effective antispasmodic/smooth-muscle relaxant - except for the "tingly bum" part, of course, although the mint-scented farts amused the heck out of my ex-husband. LOL When GP joined the party, my beloved peppermint oil capsules had to be dropped because they caused *intensely* painful burning in my stomach and esophagus - peppermint relaxes the lower esophageal sphincter, allowing reflux of ordinary gastric contents laced with that peppermint oil which is some mighty strong stuff. Shop somewhere where you can return it and save your receipt, in case it "backs up" on you.

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I just ordered this SCD book and am just wondering how long it took for you to feel a difference...I have pain all the time in my upper left abdomen and around to my back ribs...did adhering to the diet help you with this type of pain?

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