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As a nutrition and healthy lifestyle coach, living well—having a balanced, vibrant, happy, and whole life—is my jam.
I consistently cook and eat real, whole foods (and balance them out with some of my favorite indulgences—like wine, dark chocolate, and pizza), move and sweat almost every day, get eight hours of sleep every night, meditate and use a gratitude journal, regularly connect with friends and family, and make it a priority to tune into my body and give it what it needs.
So you can imagine how puzzling and disheartening it was when I began experiencing intense stomach pains and digestive issues last spring.
And I’m not talking a little cramp or bloating every now and then—I’m talking stomach pains in my lower abdomen so intense I would lay on the bathroom floor clutching my stomach and writhing in pain. Sometimes I would throw up, sometimes I experienced diarrhea, and sometimes nothing happened other than a sharp, jabbing discomfort in my stomach that kept me up all hours of the night.
At first, the painful symptoms happened every couple of weeks, then weekly, and gradually, they turned into an almost daily occurrence. I was living in total fear, trying to figure out (and prevent) whatever was causing the pain. The weirdest thing was I would often feel the worst after eating some seriously healthy, nutrient-dense meals like salmon with roasted broccoli or huge salads with quinoa and avocado.
The worst episode I experienced was a night last May, when I made a huge bowl of pesto zucchini noodles with grilled salmon. Less than an hour later, I could feel saliva building in my mouth and knew something wasn’t right. I ran to the bathroom to throw up. I stayed there, on the floor, the entire night, crying and praying for the pain to go away. When it eventually subsided the next morning, I knew it was finally time to seek professional help.
How I found out:
Upon doing my own research, I hypothesized I either had a condition called “small intestine bacterial overgrowth” (SIBO) or endometriosis, but I knew this was something I needed to get tested to confirm. I was lucky enough to be referred to a naturopathic physician through a former client of mine who specializes in gut health, and he ordered a series of tests from a local lab.
I took two fecal tests (to screen for digestive disorders like Crohn’s or Colitis), two blood tests (to measure levels of C-reactive protein, a biomarker for inflammation in the gut), and one hydrogen breath test, which—real talk—was by far the most frustrating and inconvenient test I’ve ever taken. It requires you to follow a strict diet leading up to the test, fast for 12 hours, then blow into a series of tubes in 20-minute increments for a total of three hours. I know it sounds crazy, but by following the protocol, the test is able to measure different gases (hydrogen and methane, specifically) produced by the bacteria in your gut. Depending on the levels and gases produced in your breath, the test can detect bacterial overgrowth. (3)
I’m not going to lie—this test (and all the others) were an absolute pain to take, but I’m so grateful I did because I finally had answers. The results came back positive for SIBO.
Understanding small intestine bacterial overgrowth is gaining traction in the wellness world, but it’s still a pretty foreign concept to many. For those who aren’t familiar, SIBO is an abnormal condition in which bacteria overgrows from your large intestine to your small intestine. While it’s important we have a diverse amount of bacteria (both “good” and “bad”) in our large intestine, the bacteria should not be present in the small intestine. (1)
When bacteria does build up in the small intestine, it can inactivate bile acids (which help you break down and properly digest your food) and pull water into the colon, causing diarrhea and inhibiting fat digestion. The bile acids are also toxic to the intestinal lining, and can cause inflammation and release pro-inflammatory cytokines. (1)
Eating often exacerbates the symptoms of SIBO because the bacteria in the small intestine leads to excessive fermentation of carbohydrates, producing too many short-chain fatty acids that lead to intestinal damage and inflammation, while also simultaneously reducing motility (i.e. bowl movements) which contributes to bloating and distention (which I also experienced). (1)
Nutrient intake and body weight may also decrease (I lost 10 pounds quickly), because of poor absorption due to low-grade inflammation, bacterial consumption of vitamins, and fat malabsorption. (1)
As someone who practices such a healthy lifestyle, it was a shock to learn I had such an unhealthy gut. After all, wasn’t I doing all. the. things. already? Shouldn’t I be the healthiest person alive? I felt like a fraud and worried I would be a letdown to my clients and incredible community. Would they feel discouraged and lose hope upon hearing the news, ultimately resorting back to unhealthy habits?
I soon realized this type of thinking was not serving me or others and only keeping me stuck in a low-level vibration, so I decided instead to look at this as an opportunity to learn and heal myself so that I could empower others to do the same.
I also learned there are so many risk factors involved in SIBO, many of which were out of my control or happened long ago, before I shifted my lifestyle to one around wellness.
Risk factors of SIBO can include:
>> low stomach acid (mine was diluted)
>> motility disorders like irritable bowel syndrome, or IBS (which I was diagnosed with in college)
>> autoimmune diseases such as diabetes, hypothyroidism, and immune deficiency syndrome
>> untreated celiac disease (I ate gluten regularly up until my mid-20s)
>> small intestinal diverticula
>> surgical altercations of the gastrointestinal (GI) tract
>> use of antibiotics or birth control (check and check)
>> traveling out of the country (most definitely)
>> irregular eating patterns or disorders (I had an issue with binge eating and strict dieting in high school and college) (2)
Making a change:
A common course of correction for many people who have SIBO is to follow a low FODMAP diet. This particular diet restricts foods that contain complex molecules: fermentable oligosaccharides, disaccharides, monosaccharides, and polyols—which tend to be poorly absorbed in the small intestine and thus susceptible to fermentation, causing IBS symptoms like bloat, gas, pain, and other digestive issues. (1)
While I don’t doubt this type of diet works to help many people struggling with SIBO or other gut imbalances, my doctor advised me against going this route as it only addresses and alleviates the symptoms instead of the root cause.
Instead, we focused on the following lifestyle practices to balance and heal my gut for good.
My SIBO treatment protocol:
I began taking Berberine Synergy (a nutritional supplement) twice per day and oregano oil capsules once per day to reduce bacterial counts in my small intestine. (5)
While I already exercised regularly, I switched up my routine from high intensity workouts like CrossFit (which is linked to intestinal permeability) to vinyasa flow yoga (a more moderate exercise that stimulates GI motility and can help with elimination and bloating). (1)
Fasting and Proper Meal-Spacing
One of the most problematic things you can do with a gut condition like SIBO is to continuously graze or snack. I made sure to space meals at least four hours apart and fasted a minimum of 12 hours every night (from dinner to breakfast) to allow my migrating motor complex (MMC—essentially, the housekeeper of the gut) to initiate a cleansing wave of the small intestine. (4)
Adequate water helps with elimination patterns and transports nutrients to cells. I aimed for 90 ounces daily. (1)
While acupuncture is great for promoting relaxation and reducing stress, it also helps to increase gastrointestinal muscle contraction and relaxation, reduce gastric acid secretion, regulate small and large intestine function, and restore stomach acidity to normal levels. (1)
While my doctor advised against going on a low FODMAP diet, he did recommend I eat “paleo-ish” and limit my consumption of grains, legumes, sugars, and fruits. These foods can ferment particularly quickly in the small intestine, leading to many of the symptoms I experienced. (5)
The more food you eat in one sitting, the harder your digestive system has to work to break it down, meaning it sits in your intestine for a longer period of time and there is more opportunity for food to ferment and exacerbate SIBO symptoms. I made sure my portions were reasonable, especially in regard to super fibrous foods (like the broccoli and zucchini noodles which seemed to cause me so much pain). (1)
Stress and Sleep
This was an easy one for me since I already had a regular sleep schedule and tools to manage stress. My doctor advised I stay consistent as both stress and sleep can change the bacterial makeup of your gut.
After several months of this program, I began to feel tremendous relief. My stomach pains stopped occurring, which was huge for me; however, I still struggled with feelings of puffiness, bloat, and constipation. I still felt like there was something lingering, and I wanted to kick SIBO to the curb for good.
After discussing with my doctor, we decided the next best step was to take Rifaximin, a specific antibiotic designed to only kill certain types of bacteria in your gut (versus most antibiotics which kill off all bacteria, both good and bad). (5)
I took the antibiotics for 14 days and noticed a big difference in my digestion and elimination patterns. I finally began to feel like myself again.
Favorite SIBO-friendly meals and snacks:
While what works for one person may not work for another (and I highly encourage you to chat with a professional to design a nutrition program that addresses your specific needs), these were some meals that seemed to promote optimal digestion and alleviate pain with SIBO.
*Note: while many of these foods could be considered low FODMAP, not all of them are, so do not follow if you are on a low FODMAP diet. This is just what worked best for me.
Because smoothies are already blended, the nutrients are more readily available and easier to digest. I found the smoothies that worked best for me were ones that were low in sugar/fruit and incorporated steamed, then frozen veggies (as too many raw fruits and vegetables can also be harder on your digestive tracts). My go-to was a creamy smoothie bowl that tasted like pumpkin pie.
Blended soups were also another soothing option for me to digest. My go-to was a pumpkin and apple soup that was free of dairy, legumes, and gluten.
Tacos or Burgers in Lettuce Wraps with veggies
I seemed to do really well with clean meat proteins like organic, pasture-raised, and grass-fed chicken, lamb, and turkey, especially paired with non-starchy veggies like greens or a salad. This food combination can be easier on your stomach to digest.
Eggs were another go-to protein that I seem to digest easily. I like to scramble them with veggies like spinach and sweet potatoes and top with a bit of avocado.
Life beyond SIBO:
It’s been almost a year since I was diagnosed with SIBO, and while it was a challenging bump in the road, I can honestly say I’m truly grateful for the experience. It opened my eyes to how complex and diverse the gut is, and how gut health is truly the key to overall health.
As Hippocrates said, “all disease begins in the gut,” and I’m so glad I was able to take the opportunity to listen, trust, allow, and receive what my body needed instead of ignoring, fighting, or resisting until it became a bigger issue. If there’s one thing I learned throughout this entire journey, it’s that if we listen to and take care of our bodies, our bodies will take care of us. Lean in and trust it knows what you need.
It is my genuine hope you find the encouragement, support, solace, or motivation you need. I know how frustrating it can be to not feel like yourself or like your body is betraying you, but please remember there are many health professionals and healing modalities out there to help you improve your health and well-being. As much as you can, try to trust the process and be grateful for what it is teaching you about yourself.
Author’s note: While I am accredited as a certified holistic health coach through the Integrative Institute for Nutrition, I am not a doctor and it is not in my scope of practice to diagnose or prescribe specific tests and procedures to clients. I’m choosing to share my journey and what worked best for me in the hopes that others experiencing gut pain or issues can find support and get the proper medical help they need to feel better.
1. 2015, Kare Scarlata RDN, LDNM, For a Digestive Peace of Mind
2. Leonard Weinstock, MD, Associated Diseases and Syndromes of SIBO
3. Drs. Siebeker & Sandberg-Lewis, “SIBO: The Finer Points of Diagnosis, Test Interpretation, and Treatment”
4. Dr. Leah Hassall, ND (May 29, 2017) Dysbiosis, Gut-Brain Connection, Leaky Gut, SIBO
5. Dr. Allison Siebecker (2013), “Small Intestinal Bacteria Overgrowth: Often Over-looked Cause of IBS”
Bonus: The Heart of Natural Products Expo.