SIBO

I have patient who has been on PPIs for over 20 years. She has stomach discomfort, eats very little, complains of occasional nausea, allergies, and skin eruptions. Endoscopy in 2012 showed no ulcers and no Helicobacter pylori. Recently tested positive for ANA, and doctors have mentioned Gilbert’s syndrome to her as well. What tests do you think of to do initially? I was thinking of SIBO, Doctor’s Data, Cyrex 3 and 4. Also, after 20 years of PPI, can we expect her to wean off the PPIs and go back to making HCl?”

Dr. Amy Nett: With Gilbert’s syndrome, I think you can probably toss that out the window just because that’s fairly...

I have a client diagnosed with polychondritis of the ear. She came in months ago. I suggested food elimination and she disappeared. She is back now after beginning some food elimination. I suggested the Paleo reset and avoiding nightshades and eggs. What testing would you think of right away? She’s also very sympathetic nervous system type and was interested in what HPA testing you might suggest if you use one.

Yes, absolutely. Polychondritis of the ear, so uncommon chronic disorder of the cartilage that’s characterized by recurrent episodes of inflammation...

A 42-year-old female, normal weight, good general health. Five years ago, she had double vision in one of her eyes. About two weeks ago, she lost vision in the other eye. Both times she went to her ophthalmologist and was treated. The neuro-ophthalmologist recommended she see a multiple sclerosis specialist. She presented with a history of mild chronic constipation since childhood and chronic low hemoglobin levels. Other than that, she claimed to be a very healthy person, remarkable given the fact that as a child she lived in Belarus close to Chernobyl at the time of the disaster. I ordered general a general blood panel and SIBO test to begin my intervention. Gave her the 30-day Paleo reset and puzzled about what route to take regarding the radiation exposure and the possible effects on her health.

Dr. Amy Nett: Yes. Radiation exposure is a really difficult one because I don’t know how much can be done...

A 40-year-old with a history of breast cancer, status post radiation and chemotherapy, come six months after chemo and radiation with a primary complaint of abdominal distention described as feeling like she’s pregnant. She has been to a gastroenterologist. Was prescribed rifaximin, did two rounds and felt great while on it, but then the problem came back. Do you know how long those rounds of treatment run? The gastroenterologist did an in-office breath test, said she was negative — never heard of an in-office test. Two weeks maximum for the two rounds. Maybe she did four weeks, and she felt great on it. Cyrex lab shows casomorphin, gluten, and yeast sensitivities. Cyrex 2 shows occludin/zonulin IgGa and LPS. I also suggested the Doctor’s Data stool test. Should I consider another SIBO test? What do you think about her feeling good on the rifaximin? She has another prescription of rifaximin ready. Can they mix it into the fold?

Dr. Amy Nett: Yes. Some gastroenterologists do in-office breath testing, but remember, we prefer to look at them from the...

I’m a fan of that old-fashioned practice of a large glass of warm water with a fresh squeezed juice of a whole lemon upon first rising. In considering the initial acidity of lemon water and SIBO protocol, do you think this practice would interfere with the mechanism of action of InterFase Plus and/or Prescript-Assist?

Kelsey Kinney: Okay, good question. So I’ll start with what I think the easier one of these is, which is...

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