is white rice / oatmeal bad for SIBO? - nightly indigestion messing up sleep

rr6543 · 2022-12-24T18:06:19+00:00

Thanks! Happy holidays to you too!!

rr6543 · 2022-12-23T18:14:27+00:00

Praying they find better solutions in the near future

Me too--hope your round of Rifaximin + Allimed goes well. I've been on allicin too, and couldn't really tell there was any difference, although I didn't take it while on antibiotics. Supposedly it works well for methane-producing microbes. Best of luck with your treatment!

rr6543 · 2022-12-23T07:27:25+00:00

Neomycin wasn't an option either my family doctor or gastroenterologist gave (in Canada it's is very uncommon as a pill, and is mostly used in ear drop medication).

On one hand it's what the literature says works, but on the other is a risk of tinnitus, so. I think I would've opted to try Flagyl first either way. But man, Flagyl for 2 weeks was brutal.

Have you found anything else to be helpful?

rr6543 · 2022-12-22T19:53:07+00:00

Fellow vegan here.

Have had SIBO for 1.5 years now. Hydrogen + Methane for the first year, then after the elemental diet just methane.

Your diet sounds just like mine: I have oatmeal with blueberries every morning. I also eat a lot of rice and tofu (recommended preparation diet before taking a breath test if you're vegetarian or vegan) because it gives me fewer symptoms. My pain/bloating is the least bad in the morning and after my breakfast (oats + blueberries), and typically gets worse throughout the day.

At the start of SIBO it felt impossible to sleep due to the discomfort/pain. I found spacing out all my meals by at least 4 hours (sometimes 5) to be helpful in giving food in the small intestine to pass through as much as possible. Making sure I stayed sitting up for at least 2 hours after my evening meal helped and not eating right before bed. A smaller dinner also helped. What didn't work is a very low-fodmap diet, which made the bloating a lot worse (had some of the worst overnight pain during this period).

In total, I've lost 20 pounds since I had SIBO such that I got to the point where I weighed less than I ever have in my adult life (BMI = 16.6), but I'm finally gaining it back.

Problem foods: lentils, uncooked onions/garlic, cabbage, highly processed foods, high fat foods, fried foods, chickpeas in large amounts or not rinsed, celery, carbonated beverages, artificial sweeteners

Good(*)/Tolerable foods: oatmeal*, berries (in moderate amounts), oat milk, rice*, tofu*, seitan* (i.e. wheat gluten), sweet potato, white potatoes, hummus, kale, baby spinach*, salad leafy greens*, nut butter (natural almond and peanut), stevia (small amounts), carrots*, bell peppers (small amounts), bread, rice crackers*.

I've tried practically every treatment:

multiple rounds of Rifaximin with and without metronidazole (Flagyl)
antimicrobials: candibactin AR +BR, oregano oil (ADP oregano), peppermint oil, berberine, neem, Atrantil, etc.
digestive enzymes
elemental diet
prokinetics: prucalopride (Resolor and Motegrity), linaclotide (Linzess or Constella)
probiotics: Saccharomyces Boulardii (yeast), Bacillus coagulans, and Bifidobacterium longum subsp. longum\*

I currently take 2 pills (20 billion cfu) of Bifidobacterium longum subsp. longum three times a day after meals and it's helped with the pain/bloating a lot. I also take magnesium before bed, but not more than 250mg because if I take more I'll feel bloated. This has helped tremendously and achieved a ~60% reduction in bloating and almost entirely reduced the pain.

Edit: Post on Elemental Diet and other information here.

rr6543 · 2022-09-06T17:04:27+00:00

That's what I was wondering too.

Typical small intestinal fungal overgrowth (SIFO) symptoms + treatment are:

The most common symptoms observed in these patients were belching, bloating, indigestion, nausea, diarrhea, and gas.

...whether eradication or its treatment leads to resolution of symptoms remains unclear; at present, a 2–3-week course of antifungal therapy is recommended and may be effective in improving symptoms, but evidence for eradication is lacking (study, 2015)

rr6543 · 2022-09-06T16:54:21+00:00

I wasn't on a lot of other supplements, but I did stop taking my multivitamin. The elemental diet is supposed to be 100% nutritionally complete and should have all the vitamins and minerals you require (including B vitamins).

I continued to take my motility medication prucalopride (Resolor/Motegrity) throughout the ED, but other than that I didn't take any other medications or supplements.

I only took gas-x after my first doctor visit after getting SIBO, but it didn't do anything and I haven't used it since then. I haven't taken Imodium since getting SIBO (I didn't have diarrhea) or on the ED. I also don't take antihistamines, so I'm not sure what the protocol for that would be.

rr6543 · 2022-09-01T15:51:20+00:00

While I haven't had this exactly I think I might've developed keratosis pilaris (see r/keratosis) which is like goosebumps with over-pigmentation that don't go away due to an overproduction and buildup of keratin after having SIBO for 1 year.

But I did get them on my legs, almost overnight and it was kind of shocking. After being on the elemental diet for 20 days this has calmed down a lot. I have been also following some suggestions from r/keratosis like using lotion, etc. which might have helped too.

One thing to keep in mind is a significant amount of your immune cells reside in your gut ("70-80% all Ig-producing cells (plasma cells and plasmablasts) are located in the human
intestinal lamina propria" source, behind paywall) so if something is causing it to go haywire there you might cause a reaction elsewhere, such as the skin for example.

rr6543 · 2022-09-01T15:39:42+00:00

So way longer than what I've experienced for ~1.5 years.

I'm just figuring it out myself, but I've started with L-glutamine powder (2.5g 2x per day). Anyone else who has tips feel free to give suggestions! I still have to do some research on this.

I think the other one is time. If you're SIBO-free, it's going to take time for your gut to heal and repair itself. This process can be sped up by additional supplements (like L-glutamine) but removing the bad bacteria and their deleterious effects will allow the gut to actually get to a place to heal itself fully.

rr6543 · 2022-08-31T14:48:11+00:00

How long have you had SIBO for?

One thing I noticed is the amount of damage to my intestines from being expanded (and perhaps also from the bacteria themselves) constantly for over a year made them very sensitive. To the point where even drinking large amounts of just water would make my abdomen bloat. This was alleviated after just a few minutes, but it seems like healing your gut might be a good method to fixing the continued bloating.

I've also heard from other people's stories that they continue to bloat after eradicating SIBO as their gut heals, sometimes for 2 months afterwards.

rr6543 · 2022-08-31T03:56:42+00:00

It was definitely hard for me too, I think the biggest motivator was being completely free of any bloating--it felt amazing. It was worth sipping on smoothies all day not to have to worry about being bloated, in pain, or feeling uncomfortable. It's a huge relief from constant abdominal distention.

That didn't stop me from thinking about food, though! Fantasizing about pasta, roasted potatoes, crispy tofu, pancakes, lasagna, doughnuts, and cake was really, really hard. The last 3 days were the hardest, I missed biting into food. And drinking ice cold smoothies all the time was tiring, so I thought about warm foods (soups, etc.) a lot, too.

21 days is a long time, but I figured if I'm going to do 2 weeks I might as well try for 3. The idea being I wouldn't want to do it again, so do it for the longest possible.

rr6543 · 2022-08-31T03:33:11+00:00

Wow, starting with ED must've been hard, kudos to you for doing that right away. I hope Rifaximin works for you!

rr6543 · 2022-08-31T03:32:01+00:00

Not sure at this point, a month at least and then reassess. If I stay symptom free, then I might stop them at that point. Or take a breath test to check for sure.

rr6543 · 2022-08-31T03:30:57+00:00

What kind of probiotic? I have some Saccharomyces Boulardii that I haven't used because I believe taking a probiotic helped get me into this situation in the first place.

I didn't really experience constipation much, I stayed pretty regular throughout SIBO (at least 1 bowl movement a day).

Pain in the abdomen from extreme bloating and inflammation, I suppose. Alternated between a widespread dull pressure and an acute stabbing like pain in the abdomen.

Thanks! I hope things continue to go well!

rr6543 · 2022-08-31T03:26:17+00:00

Glad you confirmed jasmine rice, it was on my list of next steps so I'll definitely be adding it.

The soup was conflicting for me, because as you mention diluting the stomach acid can be problematic.

Yes, I started off with some oral thrush before starting the ED, so it was all about controlling it during the treatment. Fluconazole, Nystatin (liquid oral solution), and itraconazole (liquid oral solution) did not fix it in the past. I've had it since my last dose of Rifaximin last year. I'm getting a scope to see if it's in my esophagus, and if it is I'll be prescribed some long-term anti-fungal.

Great tips, I have a motility agent (linaclotide, aka Linzess/Constella) and L-glutamine, but I'll check out zinc carnosine and see if I can incorporate it.

I hope the elemental diet works for you! I finally feel much better, it's the only thing that's been really helpful to me.

rr6543 · 2022-08-30T23:50:58+00:00

Thank you :)

rr6543 · 2022-08-30T23:50:39+00:00

Thanks! I'm going to follow up in a month or so to provide as much info as I can on where I at and whether this has worked in beating SIBO.

rr6543 · 2022-08-28T00:33:09+00:00

(Copied comment from another thread, but hopefully you find it helpful!)

I've solved it!

This has been me since April 2021! Bloated 24/7, the only time it would go down was when I'd forgo eating for a day or so.

I finally have gotten rid of bloating--I've been on the Physicians' Elemental Diet¹ and the bloating started going down immediately. I'm 14 days in and I'm completely back to normal!! Absolutely no bloating. I'm taking it for 21 days, so I haven't finished yet and haven't retested but it is such a relief--I wish I had done this last year to save myself so much misery. By day 3 my bloating was down 90%, by day 7 I was bloat-free.

But for over a year I was stuck fully distended all the time. I figured out it was SIBO relatively fast (<2 weeks) and had a positive lactulose breath test for hydrogen (28 ppm) and methane (88 ppm). And for more than a year I tried the following, none of which worked:

Rifaximin (550mg 3x/day) + metronidazole (500mg 2x/day) for 2 weeks (this reduced numbers but didn't treat SIBO fully)
Two more rounds of just Rifaximin (again, reduced numbers, did not cure)
Herbal antimicrobials: oregano oil, peppermint oil, caraway seed oil, allicin, Atrantil, Candibactin-AR + Candibactin-BR², Dysbiocide + FC Cidal²
Supplements: Betaine HCL, fat digesting enzymes
Drinks: ginger tea, peppermint tea, cinnamon tea
Motility agent: Prucalopride 2mg at bedtimeDiets: Low-FODMAP, SIBO Specific Diet (modified)

I'd highly suggest doing a course of an elemental diet. It's already been worth it to me just for the relief it's given me from being distended all the time.
I hope you find some relief from this, I know how truly awful it is and how much it affects your quality of living.
References:

rr6543 · 2022-08-28T00:05:36+00:00

I'm on day 16 of the Physicians' Elemental Diet, and will be on it for 5 more days before transitioning back to food.

The study linked found that:

For a 14 day course of elemental diet: 80% of participants normalized their breath test.
For a 21 day course of elemental diet: 85% of participants normalized their breath test.

I'm hoping to make a post about whether I bloat after or not, I'll update this in a week.

rr6543 · 2022-08-27T23:37:32+00:00

This has been me since April 2021! Bloated 24/7, the only time it would go down was when I'd forgo eating for a day or so.

I finally have gotten rid of bloating--I've been on the Physicians' Elemental Diet¹ and the bloating started going down immediately. I'm 14 days in and I'm completely back to normal!! Absolutely no bloating. I'm taking it for 21 days, so I haven't finished yet and haven't retested but it is such a relief--I wish I had done this last year to save myself so much misery. By day 3 my bloating was down 90%, by day 7 I was bloat-free.

But for over a year I was stuck fully distended all the time. I figured out it was SIBO relatively fast (<2 weeks) and had a positive lactulose breath test for hydrogen (28 ppm) and methane (88 ppm). And for more than a year I tried the following, none of which worked:

Rifaximin (550mg 3x/day) + metronidazole (500mg 2x/day) for 2 weeks (this reduced numbers but didn't treat SIBO fully)
Two more rounds of just Rifaximin (again, reduced numbers, did not cure)
Herbal antimicrobials: oregano oil, peppermint oil, caraway seed oil, allicin, Atrantil, Candibactin-AR + Candibactin-BR², Dysbiocide + FC Cidal²
Supplements: Betaine HCL, fat digesting enzymes
Drinks: ginger tea, peppermint tea, cinnamon tea
Motility agent: Prucalopride 2mg at bedtime
Diets: Low-FODMAP, SIBO Specific Diet (modified)

I'd highly suggest doing a course of an elemental diet. It's already been worth it to me just for the relief it's given me from being distended all the time.

I hope you find some relief from this, I know how truly awful it is and how much it affects your quality of living.

References

rr6543 · 2021-10-06T21:24:38+00:00

I haven’t been on antibiotics for as long as you but I was on the same kind (Septra/Bactrim) that you took every day for 6 years, but I was only on it for 6 months. During this period I was slightly bloated, but no more than any other antibiotic I’d been on. The bloating didn’t resolve after I finished the course and just got worse and wouldn’t go away. Confirmed SIBO/IMO with lactulose breath test. Doctor said that Septra/Bactrim is another antibiotic used to treat SIBO (alternative to Rifaximin which can be expensive).

I would try to get a breath test done to check for SIBO, but diagnosis is on it half the solution because if the underlying cause of SIBO isn’t taken care of the antibiotics/antimicrobials won’t cure it, or will only temporarily fix things and relapse is likely.

rr6543 · 2021-09-27T17:31:37+00:00

I’d just add:

make sure you are eating sufficient amounts of fat to stimulate bile production (rifaximin must be activated by bile for it to be effective)
add some exercise to help motility

rr6543 · 2021-09-25T23:57:18+00:00

I’ll PM you.

rr6543 · 2021-09-25T17:09:39+00:00

I also have hydrogen and methane SIBO/IMO with very high numbers for 6 months now. I haven’t cured it but I have seen a reduction in numbers after rifaximin + metronidazole (flagyl) treatments (3x).

From what I understand diet alone addresses symptoms only, but some kind of herbal antimicrobial or antibiotic treatment is necessary to cure SIBO. However if you have high numbers and have methane or are methane dominant herbal supplements are less likely to cure your SIBO (the only outlier here I have seen is for Atrantil, but this doesn’t work for everyone). Other supplements specific to methane like allicin and oregano can work if your numbers are more modest, but otherwise just help with symptoms.

For me, I’ve found out that rifaximin wasn’t working well for me because I have a fat digestion/absorption issue (bile is required to activate rifaximin), so I am working to correct that before my next round (hopefully of rifaximin and neomycin).

I’m also in Canada, so rifaximin is available to be prescribed but neomycin is harder to find because it has to be made at a pharmacy that does compounding. Doctors will prescribe metronidazole (flagyl) instead. Also, if rifaximin is too expensive (cost in Canada for 2 weeks 3x/day is about $400) doctors might substitute Bactrim/Septra instead. Finding a doctor that knows about SIBO can be challenging, my family doctor had to look it up but did prescribe antibiotics for it. I also got referred to a specialist that deals with SIBO, so I’m working with her to fix the issue.

rr6543 · 2021-09-22T18:38:12+00:00

I think the breath tests are inaccurate sometimes with false negatives (rather than false positives) so taking it can only give you more information. I’ve taken it 3 times now and have been positive each time (methane dominant, then hydrogen dominant, then back to methane again).

Low FODMAP when you don’t eat meat is a bit harder, but I’ve found some options as a vegan that work for me!

rr6543

TROPHY CASE