Kresser Institute

Tools, Training & Community for Functional Health Professionals

SIBO

With the Doctor’s Data stool test they give a list of the botanical and prescription agents for the isolated organisms in the dysbiotic or yeast categories. Do you use the information to modify the antimicrobial protocols? For example, G.I. Synergy has many botanicals on the DDI list, but if the organism is only susceptible to silver, then should we add or replace that to the protocol?

Dr. Amy Nett: I rarely even look at the sensitivities. I have found G.I. Synergy to be effective almost all...

I have a female patient with severe bloating since her teens. Starts the day with a flat abdomen, describes herself as looking pregnant by the evening. She has normal bowel movements and the bloating isn’t painful. Suggested a SIBO breath test but the results were equivocal. Decided to try a one-month therapeutic trial of the SIBO protocol, and she’s tried many other options in the past with no success. No change. So where would you go next for a case like this?

Dr. Amy Nett: Stool testing if you haven’t already. This could also be an issue where she doesn’t have...

This question is related to pancreatitis and SIBO correlation. Which do we assume comes first? Is it safe to treat the SIBO given the pancreatitis history?

Chris Kresser: Yeah, it’s a good question. We don’t know for sure which comes first. But as I mentioned before,...

So we have a 28-year-old female with significant bloating, stools that alternate between being well formed or hard and then loose. She opted to do a SIBO breath test, but the lab lost the sample. Because she hasn’t gotten better on a low-FODMAP diet, she’s not tolerating fruit or much carbs, we opted to go ahead and use the antimicrobial protocol with Iberogast, which she started this week. She had a full bowel movement today and felt more bloated after. Any tips for troubleshooting? Trying to keep her diet as diverse as possible, worried about the supplements because she seems sensitive. So we’re starting slow. What’s the time frame we see as far as turning a corner in gut health with protocols?

Dr. Amy Nett: Yeah, so bloating is often SIBO but it could also be fungal parasites, that sort of thing....

Are there any iron supplements safe to take with SIBO? Given the bacteria sequester iron for their needs. I ask because I frequently have female patients, often with low thyroid, who have low iron and ferritin. And in many of these cases, iron supplements don’t bring up their levels. Ferrochel Designs for Health. This makes me suspect SIBO, among other causes. If they do have SIBO, how do you raise iron without making SIBO worse, especially if they won’t eat liver?

Chris Kresser: So, yeah, very interesting question. Iron is used by beneficial bacteria as well, and I don’t know that...

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