SIBO and Gut Motility

Hey Everyone

I really need some advice if there is anyone else here that has, or is currently going through this. I had Lap RNY in June of 2015. Last year, I suffered through 2 severe bouts of c-diff due to antibiotics. For a few months after I was doing better until I started having severe nausea and fullness after eating only a few bites of food. I had the nausea whether I ate or not, but mostly occurred at night. The GI practitioner I've been seeing diagnosed me with Gastroparesis even though a swallow study was not performed. Long story short, since the beginning of February I've been having lots of pumpkin colored loose stool and diarrhea, along with right sided abdominal pain and severe nausea. I've had several CT scans, blood work, and colonoscopy which have all come back negative. Now my surgeon has diagnosed me with SIBO and started me on antibiotics. I've been doing a lot of research on the connection between altered gut motility and SIBO and it seems that impaired gastric peristalsis can lead to SIBO due to stasis of food and bacteria in the upper GI tract.

So here's my question(s), Does the gastric bypass cause altered gut motility in some patients? I never had this issue until after my surgery. And if so, is this because we no longer have a pylorus? Would I have the same issues with a DS? I do understand some people are able to control SIBO through diet effectively. I just don't want to have to take antibiotics long term or for the rest of my life. I still have a good 80 pounds to go to meet my goal, but this is about getting my quality of life back not so much about the weight.

Any advice or suggestions are very appreciated. Thanks for taking the time to read.

After weight loss surgery, we seem to have problems with simple sugars and carbohydrates. Whether they call it SIBO, bloating, gas or some other term, we just cannot process sugar, grains, and starchy vegetables. I don't think a DS will solve the problem.

Probiotics and a diet of meat and non-starchy vegetables are where to start. Just my personal advice would be to also add fiber. I recommend Citrucel fiber because it does not cause gas and flatulence like other fiber supplements. It will make your stools firm again.

We have members that have been through SIBO and can speak from experience. I believe you can get away from having to take antibiotics long term. I hope I am right. The very low carb, high protein diet will also help with the weight loss.

I found this article an interesting read. http://www.mindbodygreen.com/0-11020/10-signs-you-have-small -intestinal-bacterial-overgrowth-sibo.html

I know C-dif can be difficult to recover from. Active culture yogurt was something we added to the diets of patients in long term care right away to help bring back the balance of bacteria.

Don't be afraid of antibiotics if that's what you need. (I know that's what got you here in the 1st place!) I took antibiotics for 5 years to treat chronic lyme disease. My Dr. rotated different ones in and out so there wouldn't be a problem with resistance or overgrowth. Right now I'm off because symptoms are stable.

My husband had SIBO treated with I think? Flagyl for 10 days and had to eat active culture yogurt daily for a month...so far, so good for 4 years now.

I don't know how our rerouted intestines figures into this.

Good Luck!!

Thanks for your responses. I've read that an anti-inflammatory diet can help. Maybe there's a way to modify that to be high protein low carb. Right now trying to eat anything is a chore to keep down. I was originally given Cipro and Flagyl but it made the symptoms worse so it was changed to Xifaxan. I can't tell any difference yet but I just started it yesterday so I'm trying to be hopeful. I've also been taking VSL#3 since the c-diff issues and trying to eat greek yogurt more.

That was a very interesting article on SIBO. Thanks for posting it, and thanks for the words of encouragement. I don't want to go through another surgery, but I would like to know people who've had the DS have encountered similar issues. Honestly, I just want to get over this and get my life back. It's hard to work and maintain any normal kind of life when you live in the bathroom 24/7. Sorry for the pity party lol. No one close to me can understand. They think it's just like having a stomach virus. It's nice to be able to talk to others on here that can relate. Thanks.

Very few with DS post in this site. You might want to cross post to the DS forum.

Hopefully our long term member H.A.L.A. will chime in on your post as she is quite experienced and knowledgeable about SIBO. Use the search function at the top of the site in both this forum and the general forum and I am sure you can see some of her previous posts about this topic.

Hope you are able to get a handle on things and don't need an additional surgery. Good luck!

Long . (this is on a tablet that often does autocorrect-so ignore typos - )

I deal with SiBO. Yea..It is a challenge.

But slowly I am getting better control of my gut.

Google SIBO, FODMAP diet SCD diet GAPS diet. All of the above.

Unfortunately - once you get SIBO - it is close to impossible to get rid of it. Antibiotics may control how bad this thing would become - but unfortunately - some bacteria become resistant to antibiotics and these will thrive while you kill the others.

Beside bacteria there is also candida - when you kill bacteria - candida flourish and takes over.

SIBO can also contribute to leaky gut - and cause food allergies and intolerances. Controlling SiBO and candida is my daily chore.

With SiBO and candida - more probiotics and fiber may have the very opposite effect that in healthy people. These things may make my condition much much worse. Actually - most fiber and prebiotics are contraindicated for SIBO. Because those are supposed to feed the bacteria in your colon - but they would also feed the bacteria in your small intestine leading to more of them there, more gas, bloating, pain (pain to the extreme) and less motility.

There are natural practitioners who can help people deal with SiBO, but it is a very lengthy process. And it can be expensive.

I learned to live with it for now. One way I control it is with diet, diet, diet. If - intermittent fasting, supplements to support gut healing, and ... Occasionally I may get antibiotics+antifungals? treatment (like I am on now - )

To help with gut motility - I take miralax and magnesium and follow IF - where I "fast" every 14-16 hours in every 24 hours, while pushing a lot of liquids during that time. I make sure my gut gets "empty" every day. If it doesn't- I take more miralax, limit solid foods and take it easy for a day or 2 .

I try to avoid high FODMAP foods, and too much fiber. I got allergic to dairy, soy..And I don't tolerate grains ...So I try to avoid that. Once in a while I get tempted - and sometimes that is ok, but other times my gut gets really twisted and I may end up in severe pain.. 10 on a scale 1-10. That makes me rethink my choices next time I eat.

I found foods that my gut tolerate and I stick to that. Meats, fish, eggs, some veggies (mostly cooked with exemption of cucumbers) are my staple. Plus nuts, nut butters - but they may be hard on the gut lining- if you already have gut inflammation.

I got allergies tested and chided foods I knew I was not allergic to.

When I was healing my gut I made chicken soup with organic chicken, carrots, celery.. mostly chicken. I ate that 4 times a day...For 3 days. Then added some sauted mild fish. Then added sauted (with organic- coconut oil) zucchini. Next I added eggs and avocado...

Slowly I tried few foods and found out what I can or can't tolerate.

I take up to 3-4 serving of miralax a day. Most of it in the morning. I also have good morning BM. That's how I know how much miralax I need to use. And what and how much I can eat.

I was slacking on my diet - and become "adventures" with my food choices...And my SiBO got out of control... So now I am on 2 week treatment- 2 antibiotics 3x a day...And antifungal stuff and once the treatment is over - I will work very hard to rebuild my good gut flora.

I am not a medical professional- and everyone is do different - I can tell you what I do and what work for me - but it does not guarantee - it would work for you.

One thing for sure - making sure my gut moves...Is a key. Whatever it takes. But once it started moving - it gets so much easy. Often I get abdominal massages. When gas gets trapped - it may take some manipulation to get it moving. A professional massage therapist can help.

My SO is good to "mash my gut" . The noises my gut makes when he does that "scares him" lol... But that really helps. Deep breathing, abdominal breathing, walking, abdominal exercises, etc etc... all contribute to gut health.

When I get really stuck - I use enema - sometimes- high enemas or colonics to help move stuff...

As many times as you post on this, I always appreciate reading what you have to say. Always good reminders. I am glad you said you take 3-4 doses of miralax a day I take anywhere between 2 and 4- like you said, depending on what is happening. Makes me feel better in that it is not unheard of to take that much. I do self massage at night often...to hopefully help with movement in the morning...

just a note: I do not recommend any one takes that much Miralax. There are some worries that it may contain chemicals that can severely damage the kidneys, or other parts.

But at this point - nothing else works for me...and i mean - really nothing else works.. And I tried it all..

Miralax + lots of liquids... between 6 am and noon...

I tried to take more magnesium - but magnesium is also muscle relaxer - and the colon needs working muscles... so for me - too much magnesium made me bloated, retaining a lot of water- yet nothing would come out...

Thanks for the responses and thank you very much H.A.L.A B. for sharing your personal experience with SiBO. I'm so sorry you have to go through this every day. You have given me very good information, and hope that I can make it through this too. I was afraid of what you said that once SiBO takes hold it's very difficult to get rid of. I'm definitely going to work on my diet to help control the symptoms. I have found a Functional Medicine Practitioner but he is very expensive. I'm hoping to be able to save up enough to see him for help. I feel like every doctor I have seen regarding this just wants to treat with antibiotics and pain meds. It's interesting that probiotics can actually worsen the issue.

H.A.L.A B....Do you think the SiBO was a result of the RNY or we're just unlucky enough to have gotten it? I don't regret having the surgery because it gave me my life back, but I would really like to figure out the connection between the two.

Thanks.