HEALTH: SIBO Protocol + Resources

Treatment Protocol, 5R’s:

1. Remove
2. Replace
3. Rebalance
4. Repair
5. Reinoculate

REMOVE – Eliminate unhealthy bacteria and avoid any foods that may be contributing to the imbalance in your microbiome. Remove stress!

Anti-Microbial Protocol: To remove unhealthy bacteria, you need herbal anti-microbial supplements and dietary changes. Popular Herbs: Berberine, Oregano, Allicin.
(Consider alternating herbs, take 2 types for 4 days, then switch to 2 more, then back again, etc.)

Diet Protocol (Minimum 3 months): Low FODMAP (PDF) / List of foods to avoid and eat (website)
AVOID: Garlic, Onions, Mushrooms, Cauliflower, Cashews
Grocery List, Whole30 Low FODMAP Modification

REPLACE – Add in digestive support.

• Take Digestive Enzymes before each meal to help break down food and absorb nutrients, take HCL stomach acid after each meal.
• Each evening, take Magnesium Citrate (osmotic laxative- draws water into intestine) 500-2000 mg/night, start lower, (1000 is a common effective dose)
• Increase Insoluble Fiber Intake (less likely to cause gas) (i.e., nuts, green beans)

REBALANCE – Rest. Relax. Restore. Lifestyle improvements and self-care such as good sleep, mindful, relaxed eating (with lots of chewing), meditation, yoga, or other relaxation practices, acupuncture.

REPAIR – Restore optimal digestive function and heal the lining of your intestinal walls.

• Take L-glutamine supplement to help seal leaky gut as it’s a primary nutrient source for the mucosal lining of our GI tract.
• Take prokinetics to help to propel the GI tract and stimulate the migrating motor complex (MMC). Popular suggestions: Triphala, Ginger, and Iberogast.

REINOCULATE – Replenish the gut with healthy probiotics, and incorporate prebiotics and fiber. (IMPORTANT: Timing of reintroducing probiotics and fermented foods will vary by individual. Specifically, some do not do well with lactobacillus species until gut problems are resolved.)

Useful SIBO Resources/Websites:

• Dr. Westin Childs: https://www.restartmed.com/sibo/
• Dr.Dr. Allison Siebecker: http://www.siboinfo.com/
• Dr. Mark Pimentel: http://www.anewibssolution.com/
• Dr. Melanie Keller: http://www.sibosolution.com/
• Beyond MTHFR: http://www.beyondmthfr.com/
• Dr. Jockers: https://drjockers.com/
• Dr. Jill Carnahan: https://www.jillcarnahan.com/
• Amy Evans: https://www.theroutinefix.com/
• Bella Lindemann: http://bellalindemann.com/
• Low FODMAP Guide
• Dr. Seibecker’s SCD/FODMAP Food Guide

Other Supplements Commonly Recommended:

• Bile salts and bitter extracts to help break down fats.
• Medical Futures ‘Iberogast’- 20 drops with meals as needed and at bedtime.
• Bone Broth