In 2013, soon after I had my third baby, I started to experience strange things with my body. When I would eat, I would get this terrible pain that moved from one side of my abdomen to the other. I developed unexplained rashes and brain fog too. But the worst thing was the extreme bloating. I had never experienced anything like it before! I would start eating a meal looking like my normal self, and then by the end I would have to unbutton my pants, because it looked as if I was eight months pregnant.
Over the next two years, I saw several doctors in New York, and they couldn’t find anything wrong with me. They assumed I had postpartum depression and suggested I see a therapist. I started to think that maybe they were right and it was all in my head. But something inside me knew that wasn’t it. A friend recommended that I see Frank Lipman, M.D., who practices a mix of Eastern and Western medicine. He listened to me describe my symptoms, looked at my eyes and tongue, and within minutes said, “I’d bet anything you have SIBO.” It was astonishing—I had been looking for an answer for two years, and he figured it out in five minutes.
First: the test that showed what was really happening
I soon learned that SIBO stands for “small intestinal bacterial overgrowth”; it’s a condition that can cause all the symptoms I was experiencing. I went back to my GP and told him about it, and he gave me a breath test to do at home. I had to eat a very neutral diet for 24 hours, then breathe into a tube every 15 minutes for about an hour and mail the tubes to a lab to see if there was excess hydrogen or methane in my breath created by bacteria in my gut. Dr. Lipman’s instinct was right—the tests came back positive for SIBO. My GP told me that the best doctors treating this condition were Mark Pimentel, M.D., and Ali Rezaie, M.D., at Cedars-Sinai in Los Angeles, and by chance I was doing some work in L.A., so I went to see them. After confirming that I had SIBO by doing a second breath test, the doctors recommended a course of antibiotics.
More From Prevention
Now I know that antibiotics are a standard treatment for SIBO, but my doctors told me that antibiotics could cause SIBO, and we believe that’s how I got it: When I had my third C-section, I developed a dangerous MRSA infection in the hospital and had to take very strong antibiotics. They saved my life, but also probably caused the SIBO. So I asked if there was any other treatment I could opt for. I have three kids and I work, and I didn’t want to be messing around with this for years, so I said, “What can I do that will just knock this out?”
Then: the special diet that gave me relief
My doctors put me on an elemental liquid diet, which meant that I consumed nothing but horrible-tasting shakes for 28 days. It was one of the hardest things I’ve ever done in my life, but by the time I was done, I’d say 90% of the symptoms were gone. After that, for two years I followed a low-fermentation diet, which limits fiber, dairy, and fruit and allows proteins and easy-to-digest carbs such as rice and potatoes. I had a few more flare-ups and had to do the elemental diet two more times, but now I am completely SIBO-free.
The low-fermentation diet was so helpful for me, but it was really hard to create meals that would work with the diet and that the rest of my family would enjoy. So I joined up with a nutritionist, Robin Berlin, R.D.N.; we tweaked the low- fermentation recipes and combined them with family favorites, and we just published the result, The Good LFE Cookbook: Low Fermentation Eating for SIBO, Gut Health, and Microbiome Balance. I hope it can help other people who are struggling with SIBO feel better while eating food they love.
What is SIBO?
SIBO, or small intestinal bacterial overgrowth, occurs when the small intestine, which is usually relatively sterile, gets overrun with bacteria that would normally be swept out. “When you eat, some of the food gets digested by the excess bacteria in your small bowel rather than by you, and that creates gas,” explains Ali Rezaie, M.D., medical director of the GI Motility program at Cedars-Sinai, in Los Angeles. The bacteria can also gobble up some of the nutrients your body needs, which can eventually lead to malnutrition. SIBO is most commonly triggered by food poisoning, Dr. Rezaie explains. It can also be caused by abdominal surgery, prolonged use of antibiotics or proton pump inhibitors, conditions such as celiac disease, or structural problems in the small intestine.
Nonabsorbable antibiotics are a common treatment for SIBO, though many patients will need maintenance therapy with pro-motility drugs or low-fermentation eating. “Most people who are properly treated for SIBO can have a very comfortable life, and many can be completely cured,” Dr. Rezaie says.
The main symptoms of SIBO include:
- Abdominal distension
- Abdominal pain
- Weight loss
Tell us about your diagnosis: Did you have symptoms that took a while to get properly diagnosed? We’d love to hear your story. Write to firstname.lastname@example.org.