Kindle Notes & Highlights
by
Shivan Sarna
Started reading
September 2, 2022
When the vinculin is compromised, it damages the nerves that help create the migrating motor complex (MMC), a type of peristalsis that sweeps through your intestines after you’ve finished digesting and moves any leftover particles from your small intestine into your large intestine and, eventually, out of your body through elimination. It’s often called the “housekeeper wave” and I think of it like someone coming through and sweeping all the crumbs out of your small intestine and into your large intestine.
HERBAL/NATURAL Iberogast (see this page) Ginger Root. There have been many studies on the use of ginger as a prokinetic. Many people swear by it, but it can cause “ginger burn” in some people, which is a hot feeling in the esophagus. If you have acid reflux, this would probably not be a good choice for you. Dr. Siebecker recommends the following prokinetics that contain ginger, as well: Prokine (Vita Aid) MotilPro (Pure Encapsulations) Motility Activator (Integrative Therapeutics) GI Motility Complex (Enzyme Science) SIBO-MMC (Priority One) Bio.Me Kinetic (Invivo, UK)
But then I learned that too many endotoxins—the outer layer of bacteria—could be responsible for some of these feelings of fogginess. Gram-negative bacteria, the most common type in the world, can be found in your gut, and their cell walls contain lipopolysaccharide (LPS), which is an endotoxin and one of the most potent inflammatory substances known to man. When you have an overgrowth of bacteria in your small intestine (SIBO), and those bacteria die (either through treatment or on their own), they release their LPS.
Some people are able to resolve all of their symptoms with probiotics alone. In fact, I know many people who have had total SIBO remission from introducing the “right” probiotic.
And, according to Dr. Rao, “probiotic bacteria have the unique capacity to break down sugar and produce D-lactic acid. So if you inadvertently colonize your small bowel with probiotic bacteria, then you have set the stage for potentially developing lactic acidosis and brain fogginess.”
And, finally, some probiotics can enhance secretory IgA, the major antibody found in bodily secretion that helps control bacteria populations in the gut.
Some people with SIBO find them extremely beneficial while they just make others feel worse. If you want to try probiotics, you’ll have to be prepared to go through some trial and error.
The following probiotics have been well studied and shown to be useful for people with IBS and/or SIBO. Megaspore: a spore-based probiotic containing very hardy strains that can survive the stomach acid and arrive intact in the small intestine. Saccharomyces boulardii: a yeast-based probiotic that is ideal for people with SIBO, IBS, immune deficiency, travelers’ diarrhea, and more. Jarrow Formulas Ideal Bowel Support 229v: ideal for people with IBS, abdominal pain, and bloating. Visbiome: for people with IBS symptoms, IBD, and other more severe intestinal dysbiosis. Metagenics UltraFlora Acute
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Dr. Siebecker recommends Iberogast again and again because it helps alleviate not only gas but also many of the other symptoms of SIBO, including pain, nausea, bloating, constipation, and diarrhea. You can take it before you eat, while you’re eating, after eating, or at bedtime. According to Dr. Siebecker, if something’s bothering your gut, take it (even if you hate the taste, as I do).
So, what causes that? Once again, it’s complicated. It could be inflammation in the gastrointestinal tract, whether due to bacterial imbalances, dysbiosis, or SIBO; permeability of the gastrointestinal tract; particular infections; or hormonal imbalances. It could also be related to the mind-gut connection in a way we don’t completely understand just yet. As a result, treatments are also complex and can include anything from pre- and probiotics to mind-body medicine, acupuncture, even abdominal massage, and, of course, treating the SIBO.
Prebiotics are often mixed with probiotics to help the probiotics do their job. If you’re not sure, these terms on the label indicate that your probiotic contains prebiotics: FOS (fructo-olgiosaccharide) GOS (galacto-olgiosaccharide) Inulin Dextrin Lactulose
There is no actual evidence to show that what you eat actually increases the number of bacteria in your small intestine. SIBO is not caused by eating fermentable carbohydrates (even in large quantities). So don’t worry that you’re making your SIBO worse—or that you gave it to yourself—by eating the wrong foods. All that eating the wrong foods can and does do is to make your symptoms worse. You’ll know rather quickly if you’ve eaten something you shouldn’t have.
Remember that when you have SIBO your body is basically a small brewery, so, to put it simply, you want to stay away from foods that are highly fermentable because they feed the overgrown bacteria in your gut and are hard to digest. As I’ve already mentioned, some—in fact many—of these foods are actually very healthy for most people. Whole grains, beans, and most fruits and veggies are just some of the foods that are great for healthy microbiomes but tough on those with SIBO.
So, what should you avoid to help keep SIBO symptoms under control? Raw foods in general. Cutting out raw salads is probably the easiest thing we can do to reduce our symptoms right away. Raw vegetables contain a lot of fiber that is difficult to digest; cooking them begins to break down ...
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Dairy products, including milk and milk products, soft cheeses, and most yogurt (except for 24-Hour Yogurt), because they contain lactose, which is a type of sugar (that is, a carbohydrate) that is highly fermentable.
Finally, as I’ve already said, quantity counts. Just because you’ve made a giant batch of something you really like that isn’t supposed to exacerbate your symptoms doesn’t mean too much of a good thing can’t be bad.
Luckily, eating a small amount of anything is not likely to have a significant impact on how you feel. That’s a very important thing to remember. And experimenting is not going to make your SIBO worse; it may make you feel worse for a little while.
Stabilized allicin extract, which comes from garlic and is particularly helpful for the methane type of SIBO. (Garlic itself is off-limits on most SIBO diets because it contains FOS—fructooligosaccharides—which are fermentable in the intestine and can, therefore, cause bacterial fermentation, but allicin extract does not.)
