This blog post is all about my personal experience of the SIBO Elemental Diet for Small Intestinal Bacterial Overgrowth. I’m going to be talking about my experience, my results in terms of symptoms and also taking you through my breath test results. So stick around for the big reveal!
- Video version of this post
- Brief background about SIBO and my positive results
- What the Elemental Diet is
- Why choose the Elemental Diet rather than antibiotics or herbal antimicrobials
- Contraindications and cautions for use in SIBO
- Overview of how I did the Elemental Diet
- How I fared on the Elemental Diet
- What I would do differently next time
- How I feel now
- Reveal of my breath test results
- Where to from here?
- Are you looking for natural treatment of your SIBO?
Video version of this post
For those who prefer video content, I also recorded a video about my experience of the Elemental Diet for SIBO which covers the same content as this post.
If you know anyone with IBS or SIBO, feel free to share this blog post, my Instagram videos or account with them as there’s just not enough accurate information out there.
Brief background about SIBO and my positive results
Around 6 months ago I did some breath tests and tested positive for SIBO. You can check out my previous videos on Instagram. My main symptom was bloating and I also experienced occasional constipation.
Here is a video I recorded all about that:
I also have Psoriatic Arthritis and Endometriosis which are both linked to gut dysbiosis and SIBO. So it was imperative for me to get the SIBO appropriately treated. There is a massive connection between gut health and autoimmunity because most of the immune system is in the gut. SIBO is linked to all sorts of chronic health conditions. I also have endometriosis, so that’s another really important factor for me is ensuring that is better under control.
I took rifaxamin antibiotic for 2 weeks, alongside a prebiotic which helps it to work better and then did herbal medicine for around 8 weeks but still felt like I had symptoms, especially bloating.
Because the arthritis symptoms were coming back and getting more painful - including plantar fasciitis - that was a huge motivation for me to get the SIBO under control with the Elemental Diet. It took me a while to mentally come to terms with having to do it because it’s not an easy thing to do. Who wants to replace all their food for 2-3 weeks with a powdered formula?! Not me! Being a foodie and recipe developer was a mental barrier I had to overcome.
Ultimately, I didn’t want to be unable to walk and in pain in various parts of my body. Psoriatic arthritis often presents with moderate fatigue, which I have plenty of experience with. There's nothing like diminished quality of life to get me motivated. I wanted to knock the SIBO down comprehensively. I’m a big believer in taking full responsibility for our health, within our means. I also want to be a part of removing stigma from various health concerns. Anything gut related carries significant stigma - after all, who wants everyone to know the finer details of their digestive function!
What the Elemental Diet is
- The SIBO Elemental Diet is a specially formulated powder that is mixed in water to make a drink - it can be taken as many times a day as needed
- It can be used for many conditions outside of SIBO, particularly those where digestion is significantly impaired
- Contains most of the nutrition we need but it doesn’t contain anything that will feed bacteria - so it basically helps to starve the bacteria that have overgrown in SIBO
- 2 weeks of treatment typically has an 80% success rate, 3 weeks around 85%. So it’s considered a more successful treatment than antibiotics for example. Herbal antimicrobials have about the same rate of success as antibiotics although they are taken for longer
- I used Bioclinic Naturals brand, available in both tropical and chocolate flavours. Integrative Therapeutics is another good brand
Why choose the Elemental Diet rather than antibiotics or herbal antimicrobials
- The SIBO Elemental Diet is generally used when someone has failed antibiotics (eg. rifaxamin) or herbal antimicrobials OR they have relapsed quickly after finishing treatment.
- It's generally a quicker route to eradicating SIBO than either the rifaxamin or the herbal antimicrobials.
- It might also be better as a first line treatment for those with quite high levels of gas. SIBO does have a high rate of relapse which is why getting to the bottom of why it has occurred is really important for prevention of relapse.
- In some cases it may be cheaper than rifaxamin, eg. in the US where rifaximin is incredibly expensive.
- Some people experience superior digestive symptom relief using the Elemental Diet.
Contraindications and cautions for use in SIBO
I don’t recommend doing the Elemental Diet on your own/unsupervised.
Here are the main reasons an Elemental Diet may not be suitable for an individual:
- history of disordered eating or a diagnosed eating disorder
- underweight (although it can be helpful for weight gain in other scenarios)
- nervous system issues or debility
- advanced age or young age
- if they aren't able to minimise their commitments during the required period, although it really depends on the individual
This is why it’s very important to work with a practitioner trained in SIBO diagnosis and treatment.
Overview of how I did the Elemental Diet
- I used Bioclinic Naturals brand and rotated the flavours to minimise boredom
- I did the diet for 3 weeks, but I did eat some eggs at Day 14 otherwise I wouldn’t have been able to continue
- Funnily or crazily enough, I was watching food shows while I was on the Elemental Diet. Some of my friends thought I was torturing myself, but it actually made me feel like I was still enjoying food without actually eating it
- I took time off from client consultations because I knew I wouldn’t be performing at my best for my clients. So I was mostly doing research and admin. I work from home so this was easier for me than it might be for others. Because I have a history of fatigue, I felt it really important to take things easy during this time
How I fared on the Elemental Diet
- Better than I thought, but there were definitely ups and downs
- I wasn’t able to get all the necessary calories I normally would because after about a week, I found it hard to take the drink as much as I should have. I was probably having half or less of my usual caloric intake, so most negative things I experienced on the diet were probably due to that
- The significantly lower level of calories meant my sleep was pretty bad the whole time and I did feel weak at points. I was careful to rest as much as I could and I only left the house if I absolutely had to
- I did experience a little mild nausea and pain if I drank the mix too quickly and on Day 14 I actually vomited it up! I think I drank it too quickly on that occasion.
- Day 14 is when you can either stop or keep going. I really wanted to keep going and the thing that helped me to do that was to eat some eggs because it broke the monotony and gave me some mental strength to keep going. There's a lot of debate about whether a full elemental diet is actually required or a if a partial one is sufficient, so it will be interesting to see if some research pertaining to this topic relating to SIBO is done.
What I would do differently next time
The list of things I'd do differently is pretty short. I hope they help other people planning to do the Elemental Diet or other practitioners guiding clients.
- I would definitely consume more of it even if I had an aversion, so that I was getting closer to my usual calorie intake. That would have minimised the fatigue and insomnia for sure. Fingers crossed I don’t need to do it again!
- I noticed a slight return of a small patch of psoriasis and even some acne during the Elemental Diet, which was so odd to me. The most likely cause was that the amounts of zinc and Vitamin A are lower than what I would normally get in my diet or from supplements. These nutrients are both related to skin health. That means that I believe some supplements may be necessary for some people to take alongside the Elemental Diet - I was trying to keep things simple, so didn't take any supplements.
- When re-testing the breath, I would try to be more mindful when taking a breath sample as I screwed up some of my samples. Thankfully it didn't interfere with accurate interpretation, but that could have happened. So, if you are in the process of getting tested ensure to take the time to properly take samples and count in your head the full 1-2 seconds for each sample.
- I also had planned low key, relaxing month after finishing the Elemental Diet but that didn't happen unfortunately, for reasons outside my control. So my nervous system definitely needs some TLC after that period of lower calorie intake and stress afterwards.
How I feel now
I'm happy to say that my bloating is so much better. Getting rid of the last of the hydrogen will no doubt help more on that front.
The psoriatic arthritis and plantar fasciitis are both gone completely which is frankly amazing. I am still being pretty cautious with my diet - see the notes at the end of the post if you're interested. I imagine if I started to stuff myself with refined starches and gluten - don't worry, I won't! - that the pain would quickly return.
I'm taking good care of my nervous system. The Elemental Diet can be taxing and the lower calories, combined with unavoidable stress afterwards, means my nervous system took a bit of a hit.
Reveal of my breath test results
- I re-tested lactulose and fructose as those were the sugars I initially tested positive for. Because there are 2 gases measured on each, there are 4 markers in total I was looking at
- On testing, 3 out of 4 markers show SIBO has cleared - this is especially great because methane is normal now (it’s quite challenging to treat)
- I still have some hydrogen gas left to clear, as per the fructose test
Check out the results below - please note the readings in red are where I somehow messed up the collection. Thankfully, it didn't affect the accurate interpretation of my results, but it's a good reminder to ensure to breath in to the collection tube for a full 1-2 seconds before removing!
Where to from here?
- I'm taking some herbs to finish off the last of the hydrogen gas
- I'm prioritising relapse prevention with prokinetics, stress management and meal spacing
- Large intestine microbiome restoration is also a priority - after the elemental diet, the large intestine microbiome needs some diverse plant foods and prebiotics.
- Testing out different foods to see how I respond to them - eg. small amounts of dairy, starchy foods. Starchy foods trigger the psoriatic arthritis, so I'm currently eating amylopectin type starches as these are digested quickly and not usually sitting in the gut long enough for negative effects of bacterial action.
Are you looking for natural treatment of your SIBO?
Are you struggling to have your SIBO tested and treated with lasting results? I'd love to help you.
I have completed advanced SIBO training with SIBODoctor.com - The Practitioner Mastery Program - and have also completed courses presented by microbiome expert Jason Hawrelak, PhD.
I also have the personal experience that means I can genuinely empathise with your struggles and walk with you on the treatment path.
Find out how I treat SIBO as a Naturopath and Clinical Nutritionist.
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