Everything You Need To Know About SIBO

Introduction to SIBO and Chronic Gut Conditions 0:00

Welcome back. I'm your host, Sinclair Kennally And we are continuing our conversation on Reversing Chronic Gut Conditions. And joining me todayis my wonderful friend Shivan Sarna, who is the founder of Chronic Condition Rescue, the founder of the author of the bestselling book Healing SIBO. We think of her as the SIBO lady because she is a tireless advocate for folks who have been afflicted with this condition and also helping you to understand the deeper reasons behind it. So that's what we're going to do. A deep dive on today.

Welcome, Shivan, It's so fun to have this conversation with you. Oh, my gosh. Sinclair, thank you so much for all your good work and for doing this event and the health help that you've helped me with. Oh, my gosh. To truly, truly move the needle for me. Hi, everybody. Let's talk SIBO. So for those of you who are going SIBO, SIBO, what are you two talking about? It's small intestine, bacterial overgrowth, and it's the number one underlying cause of IBS. And 20% of the world's population has IBS.

Therefore, this is a really important topic. And if you're like, Oh, that's interesting, I do have or do you have bloating, constipation, diarrhea, alternating bloating, alternating diarrhea, constipation with bloating. Yeah. Your belly may be flat when you wake up, but by the time you get home from work, you're like, Oh my pants are a different size, like. So bloating. That is often the overgrowth in the small intestine, gobbling up your nutrients, farting out gases of either hydrogen, hydrogen sulfide or methane, and robbing you of your lunch, basically because you're so uncomfortable and you have a variety of what almost feels like random, unrelated symptoms.

Right. You see it all the time. And that questionnaire you give out to your patients like, oh, yeah, check, check, check. Oh, there it is. But you can't just guess or even do that checklist to determine whether or not you have SIBO, because it's also a mimicry.

What SIBO Is and How It Shows Up 2:06

It mimics parasites and it mimics Candida. And there's a very specific way to test to see if you have it, which I do recommend that you do. So you don't guess because it could be those other things and even other things that are more serious based on those symptoms. And that is the breath test. And they're couple of labs like Trio Smart Gemelli Labs, Arrow Diagnostics. These are all very high quality labs. You can also get a blood test, which is called the IBS Smart Test, which will show you whether or not you have the antibodies that were created when you had food poisoning, which now we're just going to connect those dots.

Food poisoning is the number one underlying cause of SIBO, IBS. And so it has to do with the motility called the migrating motor complex and it sweeps out the debris and the bacteria from the small intestine. And when that's impaired through adhesions, like caesareans, injuries to the gut and belly physically so that your body makes adhesions scar internal scar tissue, which holds you together, but also can pull the tissue out of the way. Right. It could be from that migrating motor complex impaired by the antibodies.

It could be from scleroderma, Gud forbid, it could be from endometriosis, it can be from a variety of things. Okay. The main thing is you got to keep that migrating motor complex, moving The MMC baby. I'm so glad to hear you talk about this because, you know, this is something that ends up getting glossed over or talked around when we're talking about reversing gut chronic conditions like. Oh, yeah. And by the way, gut motility. And then on to the next point. But let's slow down right here, because this is one of the biggest factors in issues with SIBO, isn't it?

It is. It's not just about constipation or diarrhea, but what are those? What's down river? Why did that happen? And because of the impaired migrating motor complex. That's really where we're all that's the vortex. So you can address SIBO symptoms by altering your diet, but that's typically what people do, right? They go to a nutritionist, hopefully they get a food sensitivity test. Oh, everything I'm eating, I'm sensitive to. That's weird. Okay, I'm going to get on a low-fodmap diet limiting. But yes, I do feel better because it's reducing my symptoms.

But that's just because you reduce the fermentable carbohydrates that are going to elicit those gas reactions from the overgrowth of the microbes in the small intestine. It does not reduce their existence, which is what you do. And you do that through three major ways. One is the most effective and the most difficult, and it's called the Elemental Diet. And it is a food.

Testing and Root Causes of SIBO 4:46

It's a medical food. It's really powder of amino acids in a variety of nutrients that get absorbed so high up in the intestine that those those organisms don't get a chance to utilize them as fuel. And so over about 2 to 3 weeks they die. All you're doing for nutrition during that time is a liquid diet. Good news is the taste has been vastly improved the past few years because it tastes like vomit and the original amino acid combination. Bad news is you're just doing a liquid diet for three weeks and there's some it's not concerns, but you need to be careful, right?

You need to make sure you're getting enough of it and that you're having enough calories there. Emotional and social implications. Of course. All right. Once they do it, though, they're like, oh, my SIBO is gone or they have to do it again. Depends on how high the levels of other gases. But thank goodness and like it was worth it for them to do difficult in the beginning to then get relief. So that's one. Right. Oh go ahead. And we'll the other two just quickly is specific antimicrobials, herbs, and then you do that for about a month.

And then the other one is Rifaximin, which is a very special antibiotic. It stays in the small intestine. And if you have methanogens overgrowth,which is the gas producers of methane, you could also combine it with neomycin or a fragile and you have for two weeks. So they're very specific. All three have been studied and they all have their pros and cons. After each treatment, it's good to get retested to see how much progress you actually made right before that. And then you'll know, you know, that you have to do another round.

Here's the thing the symptoms are not always associated with the amount of the gas production, the amount of the overgrowth. So you can do a treatment. You're like, I still feel kind of the same, but whoa, you just drop the overgrowth dramatically from that treatment and you probably only need one more treatment so you don't want to quit before the miracle, right? So that's why getting retested is really helpful. Yeah, that's so we're on the same page is going to ask you to unpack further the expectations around SIBO because there's a lot of language from people who have been dealing with SIBO for a long time.

It's like, Oh, you know, I did this protocol and then it dropped down and I thought it was gone, but then it came back. Can you speak to that? Yes, it's very common because you have to go the distance. You have to get it down to that to negative. And you have got to screaming from the mountaintops here. You have got to get on a pro kinetic and a pro kinetic. After treatment of a negative SIBO breath test is what's going to get that migrating motor complex moving so it does not have a laxative effect.

It can in certain doses. But the the primary thing here is to get that migrating motor complex going and that can be done through thingslike ginger, modal pro. There are a variety I Barrow Gas which doesn't have ginger in it because not everyone can do ginger because of reflux or ginger burns of the esophagus. And there's also prescriptions like pickle upright, which is not as much maturity in the United States. So if you sit there and you think, well, I'm on LINZESS

Treatment Options and Retesting 7:56

or I'm on, you know, I do magnesium every night, that's cool. But if that works for you, but that is not a pro kinetic. It's a very specific harmonizer of the migrating motor complex and synchronizes it with the rest of the digestive system. So that's where I see most people in our 30,000 person Facebook group and our huge community. That's where I see a pitfall when people do not get on a pro kinetic and they don't understand why they relapsed. So this is super interesting. And I also want to give you a chance to talk about these hidden factors related to SIBO that often get overlooked.

So no, this is so important and part of how people get stuck in the SIBO cycle, the culture, right? Yeah, the cycle, the flare and then, you know, following back after an incomplete treatment. So what are those hidden factors related to see? Well, that you see getting overlooked the most a mold. Definitely mold. If you have mold, it's very, very hard to resolve your SIBO. I hate to say that because I worked in a moldy building and I was very resistant to this idea for other times. So it was I and looking back, I don't know why I couldn't possibly be my problem.

So I have an answer for you. I have an answer for you, Dr. Jill Crista, who wrote the book Breaking The Mold, who's a genius and brilliant. And is that her own mold experiences? I told her, I talk to her about this, about my mold denial and how resistant I was. She goes, Oh, that's it's supreme intelligence. The supreme intelligence the mold is to exist. So it is a great masquerade and if you know anything about like animal medicine, it's a coyote. It's a, you know, it's the clown, it's the one who's going, look over here.

Don't pay attention to the fact that you have mold. Look over here. You don't want to leave the house because then maybe you're going to get in the sun. It is an exercise and get a treatment and that's not going to be good for me. The mold that is existing in you, my host. Yeah, I think that's really well said actually. So mold is a part of your history? It was part of mine and I absolutely considered it a major driver for SIBO and it to clarify guys, our listeners right now we're not just talking about current mold exposure and living in it, we're also talking about prior mold exposure, right?

Yeah. You want to talk about that a little bit? Yeah. I mean, depending on your DNA, your genetics, your detoxification, your health in general, your immune system, your stress factors, you may, myself and my sister could be walking into the same moldy hotel building, and I go down with a migraine. She's like, Fine. She's like, Are you okay? What's going on? Well, even though we have very similar DNA, her life experiences are different than mine. She wasn't in a multi building for 24 years. And so, you know, it depends on who you are.

And then maybe someone else doesn't even like phase them or another person goes in there, they're exposed once and it colonizes. So it really has to do with also multiple exposures is your car what do you have mold in the air conditioning of your car? How are the events of your home's air conditioner? What's going on at the office? What was that convention like? I went to a convention once and the convention, the woman who was running it was a good friend of mine.

Why Relapse Happens and the Role of Prokinetics 11:16

She's like, I can't believe how many migraines people were having. And I had a terrible one. That's why she mentioned it to me. And I don't I don't have evidence that that building had mold in it, but that it made a lot of sense. You wonder? Yeah, it. Makes you wonder. Exactly. Yeah. So it's really important to know, is mold going to cause SIBO? I don't have evidence of that, but what I do think is that it can mess up and just regulate your gut a lot and it can impede healing into the long term.

So you do everything right? Right. You do your treatments doing the tests on time. You're eating nice and low fermentation diet. Everything's going smoothly. It's all on paper. And you're like, What? I have a negative. I have a positive test, a negative result positive test, which is a negative result. Meaning bummer. And what? What could it be? I did everything right. I did exactly what the studies have said. Look, a lot of factors, but one of them could be mold. Yeah. So glad to hear you shine a spotlight on us because it's I think it's one of the most overlooked issues when it comes to Cipro.

And people really haven't connected the dots yet in most of natural health, even and even in the functional medicine world, understanding just how much mold can drive chronic issues. So make sure you guys check out my talk on that here in this event and spend a little time getting mold literate and super important. So important and know that it has a supreme intelligence. And we'll try to be. Cynical trying to make you deny it. Yeah, that's such a good way to say it. Okay, so what other hidden factors do we need to understand when it comes to see? Well.

I think that you really need to get that bile moving, especially if you are doing some rifaximin. The it is more efficient when there is good bile. That's why when taking some partially hydrolyzed guar gum, it was a small study, but they did find that when you took that partially hydrolyzed guar gum, not just any with the rifaximin, it seemed to help with efficacy if that's an issue. And I think that the diet is don't fall into the myth that the diet will fix SIBO because it won't. I'm not talking about the elemental side.

I'm talking about eating low-fodmap a low fermentation diet. It just it doesn't fix it. It really doesn't. You could feel better, which is fantastic because you're not creating so much fermentation that it's not going to fix it and you'll be beating your head against the wall. I people say, I eat this way. I'm only down to five foods, which is not good. You know, I, you know, my symptoms are gone. But I say, well, are they you know, I still well, are they, you know, also I need to talk to you about Zebo panic.

Okay, so CBS, I think I just envisioning you people and myself included, it's when you start to go, if I eat this bite of food, what's going to happen to me? Because where did you get that medicine from an organic GMO free on a Wednesday facility? Like. Like I've asked so many

Hidden Drivers: Mold, Bile Flow, and Diet Myths 14:16

micro granular questions my mind would raised. It would keep me up at night because my hyper vigilance ended up working against me. And I say this to you all. My company is called Chronic Condition Rescue because I had a ton of stuff wrong with me, primarily being driven by mold, but I've had SIBO since I was five because I have the food poisoning antibodies and all that. So I just want you to know that it's good to be appropriately vigilant, but if you start to go to the point where you're hyper vigilant and you're traumatizing yourself and I understand because you don't want to feel bad, I get it.

I just want to have you take a breath with me. Yeah, you're okay. You're okay. Your body is an amazing, intelligent being. Smarter than all smarter than microbes overgrowing in your gut. It is amazing. Follow your intuition. Get hooked up with a good practitioner that really knows what they're doing, that you have confidence that you can partner with. You can do a lot of it, do DIY, and I applaud you all for being here at the Self Education Summit. That's amazing. But if I mean it ruled my life, I was on a quest which had an upside because I created Siebel as a lesson, wrote this book and all that.

But on the other side of it, I look back and I realize how much joy I lost, right? How much of a cost it had, not just financially but in my life of not being present because I was so preoccupied and it was valid. I was not feeling well. However, you know, once you get in that that place, it can also lead to paralysis where simply buying the supplement feels like, well, I just treated it because I bought that. I like, okay, maybe that was only me. But I don't have a supplement graveyard that could really be a test to bed.

At least I know my absence does. No, no, no. I had one too. I just have recently done like two levels of purging of it. I said like 2017 that I'd never opened this line, so I just want to ask you all as a call to action to learn what you can use your wisdom, make a plan and wear it loosely. Oh. That's so beautiful. I don't think we talk about this enough, especially those of us who have who are now being advocates and sharing this information, who have been on a very serious health journey. It's so important to remember what it feels like to be in somebody's shoes and where you're missing out on the joy of life.

And you're literally experiencing a new layer of trauma that is just medical trauma. Right. We have to. Go for that and be really gentle on ourselves. Exactly. Yeah. Yeah. Well, that's a beautiful well, one of the reasons why I love you so are there any other hidden factors? Because I want to make sure we also get to talk about the downstream health effects of cyber today. Let's get back to that, because I know we're going to be on time here for a second. Yes. So here's what some of the studies show.

And here's also my just observations. I'm not a doctor. I'm a patient advocate. I'm an author. And I have been paying a lot of attention to this. And I've also spoken to world experts in a variety of topics. So I'm a good listener. It can impact fatty liver. It can if you drink a lot of alcohol, a lot of alcohol leads to see. Think about it. It slows you down. It's it slows down your metabolism. Hmm. Sugar cane, sugar. Certain sugars are fine in small doses, but if you think about what, it's already fermented, and then you're trying not to ferment yourself, right?

So there's fatty liver. I just wanted to mention the alcohol thing. What is feeding dental issues? Is it gut up or is the term is it mouth down? So dental issues are definitely on my radar. I've done a whole biological dentistry summit, which, you know, came from

Hypervigilance, Trauma, and Staying Grounded 18:16

these conversations, periodontal disease has been shown to be linked. But then the person I talked to was like, I I'm not totally standing by that. So anyway, I'm just going to say theoretically right now. Something potentially to explore. Exactly. And I'm so sorry, but how could it not be connected? Okay, fine. So let's not be connected. Oh, my gosh. Oh. That sinuses dripping down as well. What do you you're just one couple of tubes. People were tubes. And and then the other thing is rosacea, restless leg syndrome.

I had a very interesting conversation with Naturopathy, who specializes in fertility, and she found that when women clear their SIBO, they more easily conceived after years and years of trying about what is interesting. Well, very. Interesting. Yeah, it's fascinating because we're not acknowledging enough that especially the female reproductive system is essentially the same microbiome as your digestive tract. You know, look at how everything is mashed up together. Like it's it's actually deeply intertwined.

It is a technical term. Yes. You'll find it in all of your medical textbooks. It's important. So there I think that there some implications there. I think that that weight can be an issue, both being underweight and some evidence of being overweight. The think about it, though, there is malnutrition happening because those overgrown organisms are robbing you of your nutrients. That's where the connection to hair loss also has been revealed. Say more about that? Yeah. You know, it's I've had it myself and I've seen it I've seen a lot of people talk about it.

It's not overly common. I think it really depends on how is your iron? So SIBO also tends to have a lot of people with reduced ferritin levels, reduced iron. So anemia where B12 levels and partly because are the overgrown organisms eating your B vitamins. This is like right. And then simultaneously I've had really high crazy B12 levels without supplementation like in the thousands and the concept was, well, it's in your serum, your blood serum, but it's not getting absorbed. So and that I hear a lot of people say that not everyone, but I do hear a lot of people say that.

So those are just like when I think about someone who has weird ferritin levels, weird B12 levels, some hair loss, a lot of inflammation, brain fog.

Downstream Health Effects of SIBO 21:06

Hello? There's lipopolysaccharide. I'm telling you, that brain fog is real and there have been some studies, but you and I both know it is frickin real lymphatic stagnation that that swelling that happens the the okay, let's get into the meridians then. When you have the stagnation, you often get, you know, those meridians can light up me pain. This is like I'm going a little broader now, but knee pain, foot pain, shoulder pain, there's just it spreads. Fructose intolerance. This is where I wanted to really like sort of and which was leaky gut.

So leaky gut is often cleared up when SIBO clears and as as do a lot of food intolerances. So tomorrow I really want to motivate people to clear their SIBO so they can eat more food. They can re inoculate their microbiome with diversity. And often when the CIBO is cleared and this I spoke to Dr. Marc Pimentel, the world's leading researcher, about this at Cedars-Sinai, who I believe will be the person that figures out the cure for us. It's very exciting. When the SIBO clears, he sees that the microbiome goes back into harmony because those bad players are removed.

It's the overgrowth of these particular players that are causing havoc, right? So in all of us, we have E coli or large intestine in a certain amount. It's normal and other things that are causing they've been able to identify which are these players that are overgrown. And so when they are reduced because they are like a gatekeeper of the microbiome or they're like a bully, right? And a gang taking over when they're reduced. Feel more accurate for a. Lot. Harmony comes back to the microbiome. And I said, Well, how long does that take? You know?

And he's like, You know, I've seen it in a couple of weeks. So he and Dr. Ali Rezaie at the mast program at Cedars-Sinai and the Pimentel on the Brazilian laboratories. They actually created their own devices like Scopes to be able to do cultures from the small intestine so that they can really get uncontaminated samples. And they have been able to truly map this small intestine microbiome, which is astonishing and is quite different than the large intestine microbiome like really different. Certainly similar strains. Certainly the same strains.

But it's like a it's like a whole different ecosystem, even though they're all. Going to make it just different functions. So of course the microbiome would be different. Right. Right. Yeah. Yeah. So anyway, those are, you know, those are some of the things that are happening right now. And I just want to encourage everyone to listen to the summit, listen to it over and over again, make sure you're learning those jams played in the background. Because one day, you know, I call it sacred repetition.

One day you hear something differently and you're like, Oh, that makes total sense. Now the puzzle is coming together. The put a lot of pressure on yourself to just like, listen to it. All right. The second. Because that's also like too much, right. So played a lot of times give yourself plenty of time to absorb it and then be able to come back to it because you're going to be changing right? What you need right now is going to be different than what you need in the near future or even years from now.

But this information is cutting edge and it is going to serve you so well.

Microbiome Recovery and Closing Thoughts 24:36

So I really thank you, Sinclair, for doing this and for giving me the opportunity to share my story and to hopefully inspire some people to really resolve their SIBO. That's my pleasure. I just so appreciate you as an advocate in this space and I know that you feel the same way I do, that every one of these interviews is a love letter to, you know, the people who are going through what we went through. And yeah, it's just it's one jam at a time, one next step at a time. And for all the practitioners listening, bless you for expanding your toolset and for acknowledging that, hey, just by your very presence here, you're acknowledging just how important this is that we expand our toolkit right now, because what we went to school with and learn is simply not enough to handle these challenges today.

So love it. Yeah, it's just about listening to it over and over again because talk about brain fog as you're healing. Look at I remember vividly listening to a Stephanie Seneff interview who's also on this event. You know, she's world's leading glyphosate researcher and all that she talks so fast and she's so smart. I was so mad at her as a listener because I was so brain foggy. I had to like, stop it. Well, you know, pause, play, pause, polite. Wait, what did she just say? You know, it was so bad.

But there's just. The speeds of how you listen. I love that technology. Now, which is going to. Protect or like speed it up. I think one of the top takeaways, though, from your interview today is just how quickly the field is advancing and how much more we understand now than we did before, how fast the dots are connecting. And that really, if you keep at it and you keep gathering the information on events like this, healing could be inevitable because the body's so brilliant. It's not too late, right? Yes.

I'm so glad you just said that. Inevitability. I love that idea. And, you know, inch by inch, it's a cinch. And you deserve to be well, your body wants you to be well for not to get in the way and give it as much help as possible. And there is so much hope. Love that. Thank you for joining us today. Thank you.