Thanks for joining us for episode 83 of The Ancestral RD podcast. If you want to keep up with our podcasts, subscribe in iTunes and never miss an episode! Remember, please send us your question if you’d like us to answer it on the show.

Today we are answering the following question from a listener:

“I have finished my kill phase for treated diagnosed SIBO with Lauricidin, NAC, and low dose Naltrexone and I’m now in the rebuild phase. Should I be taking probiotics and prebiotics Prescript-Assist, or just probiotics? I have rosacea on my face and both seem to be making it worse. Is that from the histamine or FODMAPS? I’m following a low FODMAP and Specific Carbohydrate Diet, but I’m slowly adding more carbs in. What do you recommend for this gut healing stage? Thanks.”

After finishing a SIBO treatment protocol, it’s tempting to expect your gut to be completely back to normal. But there’s more to healing from SIBO than antimicrobial treatment. The time period after treatment is crucial for healing from the effects of SIBO.

Tune in today for an important discussion about the gut healing stage after SIBO treatment. We discuss why time is a significant factor in gut healing, recommend helpful supplements, and explain why symptoms can still be present when trying to reintroduce foods and repopulate the gut with good bacteria.

Whether you are currently dealing with SIBO or have already nipped it in the bud, you won’t want to miss today’s podcast!

Here’s what Laura and Kelsey will be discussing in this episode:

• The relationship between skin conditions and gut bacteria imbalance
• The importance of retesting for SIBO after treatment if you still have symptoms
• Recommendations for prebiotic supplements
• Why it’s a good idea to take a prebiotic during the treatment phase for SIBO as well as in the gut healing phase
• How probiotics have more of an effect on the immune system than the gut bacteria
• What to do if probiotics and/or prebiotics are causing symptoms
• The strains of probiotics we recommended for those sensitive to probiotic supplementation
• The importance of giving your gut time to heal to see improvement after SIBO treatment
• Supplement recommendations for the gut healing phase after successful SIBO treatment
• SIBO treatment and healing is a very individualized process
• Experimentation is key when in the gut healing phase
• The significant role stress management plays in gut healing

Links Discussed:

• This episode is sponsored by SunBasket.com. Receive $30 off your first order here!

TRANSCRIPT:

Kelsey: Hi everyone. Welcome to episode 83 of The Ancestral RDs. I’m Kelsey Kinney and with me as always is Laura Schoenfeld.

Laura: Hi everybody.

Kelsey: Hey, Laura. How are you doing today?

Laura: Not bad, just had my first full weekend home in about 6 weeks. It was almost like a little break from all the traveling, and I got a lot of work done, and had my first cake tasting experience yesterday which is somewhat relevant to just the overall week I had since we’re about to go into Thanksgiving. I have 3 cake tastings scheduled at this point during this week.

Kelsey: Yum!

Laura: Yeah, it’s a little ridiculous. I don’t really particularly like cake and neither does my fiancé, so it’s kind of an interesting experience and one of the reasons why I may drop that scheduling down to 2 because it’s already enough as is, and then having Thanksgiving coming up with all of the deserts that I’m going to be being around that day, I’m like do we really need to have 3 days’ worth of cake eating?

Kelsey: Right, especially if you don’t even like cake that much.

Laura: I know. I mean I don’t hate it. It’s just like I’m not that into it and so choosing a wedding cake I’m just kind of like I don’t really care that much. Last night I did it by myself and took a decent amount home to share with my parents and my aunt and uncle who are in town visiting. They were super happy about that.

It was interesting because last week when I was at the Weston Price Conference, there was a lot of wheat products as part of the meal as like bread primarily, which I ate some of. And I felt okay, I didn’t feel awesome on the bread. It’s not something that usually makes me feel as good. If it’s a typical wheat bread, I tend to get a little digestive discomfort from wheat products and mostly like breads, pastas, that kind of thing. As we’ve talked about before, neither of us are like strict gluten free all the time at this point.

Kelsey: Yeah.

Laura: I tend to buy gluten free as much as possible because it just makes me feel better, but I don’t freak out if I’m going to have a little bit of wheat here and there. But last night I decided…well I didn’t really decide, I kind of didn’t anticipate the cake tasting to go as long as it did. It’s a 30 minute drive each way and then a 2 hour appointment.

Kelsey: Wow.

Laura: It was like a 3 hour evening spent doing this which because of that, I didn’t eat dinner and I was like well, I guess I’ll just have cake for dinner, whatever. Honestly, as a dietician I generally eat pretty well, but there are times when I’m just like screw it, I don’t have time to make a real meal and I’ll just get the calories in. But the weird thing was, and I don’t remember the last time I had a whole piece of cake, and this was a pretty big portion because I was tasting 2 different flavors, I got the worst stomach cramps a couple hours later and then even in the morning I feel like I’m just now recovered from it and it’s about lunch time at this point.

Kelsey: Mm hmm.

Laura: It was just really weird because I’m trying to think the last time I had that experience with a wheat product. Honestly, I was trying to figure out what about the cake might have been different. It’s white flour, lots of sugar, I assume that she used butter. I feel like most good bakers use butter and not vegetables oil to make their products.

Kelsey: Right.

Laura: But you never know. It was just a kind of interesting experience because for a lot of people when they have that kind of thing happen where they eat something that’s probably not optimal…For sure, obviously having wedding cake for dinner is not an optimal choice. But a lot of times people will do that and if they have any sort of negative reaction to it they will feel really bad emotionally afterwards.

Kelsey: Mm hmm.

Laura: They’ll feel like they made a mistake, or they’ll get angry with themselves, or it might spiral them into this bad choice after bad choice kind of situation where they’re like well I screwed up last night, so I might as well just keep going on eating crap or whatever.

Kelsey: Right.

Laura: Which none of that really happens to me anymore now that I’m kind of less restrictive in the dieting choices that I make. I don’t hold back from eating what I want to eat in general, but I also don’t eat just whatever because I also value how I feel, and my health, and all that.

This experience is interesting because I haven’t felt that immediately sick after eating in a while and it was one of those things where I’m like I guess maybe I shouldn’t do that again. I didn’t feel guilty about it or like I had made a bad choice because honestly I didn’t think I was going to have a reaction. Now that I did, I’m like alright, well maybe that means I should only have one cake tasting for the rest of the week.

Kelsey: Right.

Laura: And maybe I should just try a couple bites of it and not eat a whole slice. It’s just one of those experiences where I could have gotten upset or mad at myself for doing that, or feeling like I screwed up, or I fell off the wagon, or whatever you want to call it. But honestly, I didn’t really see it as being that big of a deal and physically I recovered from it. I feel fine now, so I’m like okay, clearly it wasn’t the end of the world.

Kelsey: Mm hmm.

Laura: I didn’t cause any irreparable damage by eating that. But yeah, I didn’t feel good and maybe that means for the next one I should eat less or maybe over Thanksgiving this week I should just be moderate or mindful about the amount of the desserts that I eat. It was just kind of an interesting experience because I don’t often have that severe of a reaction to things that I eat.

Kelsey: Yeah.

Laura: And it wasn’t like horrible, it was just something that I haven’t had in a while so I was like that’s not fun.

Kelsey: Yeah, this is different in a bad way. That’s interesting because I think working with a lot of digestive clients, I kind of…not experience this with them, but they go this sort of thing where we are trying to add things in and sometimes it is stuff like cake, maybe it’s gluten free cake if they’re really sensitive. But they want to feel like they can eat a little bit more normally at some point in their journey. They try something, maybe it doesn’t go well. That happens, obviously. But I think there’s a lot of fear that can come in after an experience like that sometimes, which is normal. Obviously if you have a bad reaction, your brain is like okay, maybe I shouldn’t do that again, which totally makes sense. But sometimes with how I work with my clients, I do tell them that if you’re going to strictly avoid something especially if it’s an otherwise healthy food, so I guess cake doesn’t apply in this scenario.

Laura: What? Come on.

Kelsey: But let’s say it’s onions or something, and they tried a meal with onions in it, it didn’t go well, and now they want to never eat onions again. The next step for me is always to have them replicate that, which as you can imagine most people don’t want to do because when you’re sitting down to a meal full of onions and the last time you ate onions it went horribly, you don’t really want to do that. But I think it’s actually really important to do that because sometimes it’s just a fluke or there was something in there, maybe in that particular bakery for example, they were using some weird thing that you wouldn’t have in a lot of other cakes. That can kind of confuse you and think that whatever food you tried, you just don’t tolerate when it may not actually be true. That’s sort of how I walk my clients through that process. And it’s not necessarily a fun process of course, but I would much rather them try things again and make sure that something’s causing a problem before writing it off for basically the rest of their life.

My husband, I just tested him for SIBO a while back at this point, maybe like a month ago. He came back positive on SIBO because he was having all these weird reactions to foods that we couldn’t quite figure out an underlying issue with the foods necessarily. Some things would cross over but then there would be another food that didn’t really fit the pattern. I was like okay, let’s test you for SIBO, see if there’s anything going on because I think that’s another thing that can potentially play into this sort of thing where you have these kind of strange reactions to foods and they don’t really necessarily follow a pattern either.

That’s especially true if you try a food and then you’re going to go to re test it because you had a bad reaction the first time, but then you don’t have a bad reaction. A lot of times I find that that is due to some sort of gut issue like SIBO, or having some sort of pathogen, or something like that because it just kind of messes with the gut. At least that’s my really unscientific theory there that there’s a lot of strange things going on in the gut when you’re dealing with a pathogen or overgrowth of some kind. This can generally cause different sort of reactions to foods depending on what’s going on in your gut that day, like how much inflammation there is or other things like that that can kind affect how your body is going to respond to a food coming in.

I’m not saying that you, Laura, have anything like that going on. But I just wanted to throw that out there for people who maybe are having some kind of strange reactions to foods that don’t really make sense necessarily either. It might be worth thinking about testing for a few different things.

Laura: For sure. Well, I think for me, the context was important. When I say context, I mean the fact that I didn’t have dinner. I didn’t really have anything in my stomach.

Kelsey: Right.

Laura: Because normally if I’m going to have desert, it’s after dinner or after I’ve already had a meal. I ate a lot of it so the portion size that I ate was lot more than I would have normally eaten. I think those two things were probably big contributing factors. I’m trying to think of the last time I just ate something like that without having it come after a meal.

Kelsey: Mm hmm.

Laura: I don’t know how much of a difference that would make, but I can imagine if let’s say It’s a lot higher sugar than what I might normally eat, that could have affected the water balance in my gut.

Kelsey: Right.

Laura: And then could affect some symptoms, or just the total amount of sugar and wheat was something my gut bacteria haven’t experienced in a long time.

Kelsey: Mm hmm.

Laura: So they might have just been, like you said, triggered in a weird way. I would be interested to see what happens in a couple days when we have our next tasting if I do a smaller amount, like just a couple bites of each flavor that we’re trying, and then I also have a meal before I go and see if I have the same reaction. Because if I’m going to react that way to cake, I’m like maybe I won’t have cake on my wedding.

Kelsey: Right.

Laura: Maybe that’s not that big of a deal. But if it’s kind of a fluke that happened because I had nothing in my stomach and I just had like a big wheat and sugar bomb come in, I think that’s relevant. Even if somebody has a certain experience with a certain type of food once and then they don’t have it again, thinking about what the context around that food was is really important too. Because like you said, if you react to a huge pile of onions or you eat a bunch of onion rings and have a reaction, then maybe it was more the way the onions were prepared or the volume of onions.

Kelsey: Mm hmm.

Laura: I have some clients that raw onions really bother them, but cooked onions don’t. Or just the sheer amount could be an issue. If you had a couple of onions on a salad versus a whole pile of onions on top of some kind of meal, that can definitely make a difference. So just keeping in mind that just because you react to something the first time, doesn’t mean that you’re always going to react that way to that food no matter what the context or preparation method is.

Kelsey: Exactly.

Laura: Like you said, it’s good to try it out. I mean there’s certain things that if you know you’re really sensitive to, like if you have like gluten sensitivity and you have really severe reactions that last for days after you eat that, I wouldn’t say try oh it again, try it a couple times.

Kelsey: Right.

Laura: But if it’s some more normal food that you had a short term reaction to and you’re not really sure if it’s an issue, then definitely testing it out a couple times is a good idea.

Kelsey: Yeah, exactly. Alright. This kind of feeds in a little bit into our question for today, so we’ll jump in now. But before we do that, here is a word from our sponsor:

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Kelsey: Okay. Our question for today is:

“I have finished my kill phase for treated diagnosed SIBO with Lauricidin, NAC, and low dose Naltrexone and I’m now in the rebuild phase. Should I be taking probiotics and prebiotics Prescript-Assist, or just probiotics? I have rosacea on my face and both seem to be making it worse. Is that from the histamine or FODMAPS? I’m following a low FODMAP and Specific Carbohydrate Diet, but I’m slowly adding more carbs in. What do you recommend for this gut healing stage? Thanks.”

Kelsey: Okay. This is a good question. I think I’ll try to generalize it a little bit just so it’s applicable to more than just this one person. I will basically go through what I do as the gut healing stage. First, one thing to consider just in particular with this person’s case because she’s still getting a lot of rosacea on the face, definitely skin issues can be related to having SIBO or some other kind of gut microbial imbalance. The first thing I would check actually is to see if she actually got rid of the SIBO. A lot of practitioners will not tend to test again once you do the antimicrobial phase, whatever that may be for you. But I think especially if you’re having some significant symptoms and they don’t want to just continue you on a longer antimicrobial phase to see if that helps even more, I would definitely retest and see if it’s still there.

Because first of all, what this particular person is on as their treatment for SIBO is just a little bit different than the kind of stuff that I tend to see, Lauricidin being really the only antimicrobial that this person is taking. The NAC typically that’s used as more of a biofilm disruptor in the context of SIBO, so that makes sense, but again, not really an antimicrobial. And then the low dose Naltrexone I assume is more for the rosacea, but I guess I really don’t know. This person is saying that it was used to treat the SIBO.

Laura: It could actually be for gut motility.

Kelsey: Yeah, oh that’s true.

Laura: It depends on if she has constipation or diarrhea.

Kelsey: Right, like what kind of SIBO.

Laura: Yeah.

Laura: If she had either of those, she might have been using that to help promote better motility.

Kelsey: That’s true. Good point. It all makes sense as treatment for SIBO, but typically there’s some extra antimicrobials thrown in. Lauricidin would be one of a few different kinds of antimicrobials used. She doesn’t mention any kind of antibiotics that go along with this either.

My first thought is that potentially the SIBO wasn’t totally dealt with. And again, we don’t know how long this went on for either, like how long she was on this protocol, so a lot of questions up in the air there. But in general, I would say if you have gone through a SIBO protocol, and you’re still having a lot of symptoms, and your practitioner doesn’t want to either change up the type of antimicrobials that you’re on, or maybe you want to try antibiotics because your symptoms aren’t improving at a certain point, or if they don’t want to just continue you on a longer protocol, definitely worth retesting. Because a lot of times the SIBO can still be there, and of course if the SIBO is still there, you’re generally going to have symptoms. That’s my first thought, just make sure you actually got rid of the SIBO.

And then from there, the question is should I be taking probiotics and prebiotics, or just probiotics? I just wanted to mention because this person in their question says that they’re taking Prescript-Assist as their prebiotic. This is something I hear from a lot of clients too actually that they think they’re taking a prebiotic because they’re taking Prescript-Assist. Prescript-Assist has a little bit of prebiotic in there basically to just help the probiotics survive a little bit better as a supplement and when you take it as a supplement. But I would not consider the amount of prebiotic in Prescript-Assist as a therapeutic amount of prebiotic. What that means is essentially yes, you’re taking a little bit of prebiotic, but it’s really just feeding the probiotics in Prescript-Assist rather than feeding the good bacteria in your gut because there’s just simply not enough for it to kind of get there and make a significant impact on your own gut bacteria.

If this person wanted to actually take a therapeutic dose of prebiotics, the two that I like the most are, one is called Galactomune which has beta-glucan and galactooligosaccharides. It’s just a mix of the two. And then I also like FOS powder which is fructooligosaccharides. Both of those things are prebiotics. I usually recommend that my clients get them in powdered form and you just can either mix them in water or a lot of my clients just throw it right on their tongue and kind of use their saliva to mix it up and then just swallow it because it kind of gums up essentially. That works really well.

I have a lot of SIBO clients on prebiotics because I do think that it’s helpful. Honestly, I actually would have recommended it while you were doing your treatment for SIBO as well. We’ve talked about that in a couple other podcasts I think at this point that you generally want to be feeding your gut bacteria when you’re treating for SIBO because really it just brings those bacteria out of hiding. They’re kind of really active, and when they’re very active it’s easier for your antimicrobials or your antibiotics to kill them. It’s a good idea to take prebiotics while you are on a SIBO protocol.

Basically I would say prebiotics, if you can tolerate them, are a really great thing to take not only during that treatment phase, but also in the gut healing stage. Because when you’ve taken an antimicrobial protocol, depending on what it is and what kind of bacteria it affects, it is going to affect your large intestine to a degree. Just to play it safe really, I like to have people on prebiotics after they’ve gone through that protocol to make sure that the large intestine bacteria is back up to speed. You don’t want to kind of not have a lot of bacteria at all there. Not that it would kill off all of your bacteria or anything, but you just want to make sure that you’re good bacteria is in a good place so that it could kind of kill off or push out any bad bacteria or enough so that balance is correct in the large intestine. Definitely a good idea if you can tolerate it.

I’ve certainly had people even after SIBO treatment who have somewhat of a difficult time with prebiotics. Again, you want to check and make sure the SIBO is actually gone because that can be an indicator that potentially you haven’t gotten rid of the SIBO. But if you have and you’re still having problems with prebiotics, don’t worry about it if you can’t include them or feel free to lower the dose on that if you can’t take the full therapeutic amount for whichever supplement you’re choosing. But if you can, it’s a good idea to include at whatever level that you can tolerate it.

And then as for probiotics, really I would say if you can, it’s great. It doesn’t have as much of an effect on your actual gut bacteria as it does really on the immune system. When you take probiotics they don’t really stay in your gut. They essential pass through and have much more of an effect on your immune system so that you are making more, for example, T regulatory cells which are going to regulate the immune system essentially so that you’re not going more into autoimmune type reactions or things like that.

Especially for somebody with rosacea, I’d say that the probiotics are probably a good idea, but you may be taking one that doesn’t work for you. If this person seems to say that if the rosacea is getting worse because of the probiotics and the prebiotics that they’re taking, and if that’s actually true, which it may not be. First of all they may have SIBO still which is making the rosacea bad. They could be eating some foods that they’re sensitive to that could be making the rosacea bad. But let’s say they’ve kind of gone through all of those possibilities, everything’s all good, but the rosacea is still bad and it seems to be related to taking probiotics and prebiotics. First of all, you can take both things out just for a little while. See what happens. If it gets better, you’ve kind of confirmed that those two things, or at least one of those things was the culprit. At that point you can add whichever one you think may not have been the culprit back in and see if your better rosacea stays the same. And then depending on which one was causing it, or if they both were causing it, you can especially for prebiotics you can try a different type of prebiotic. Sometimes people just have bad reactions to particular probiotics. Laura, have you seen that in some of your clients?

Laura: Yeah. It’s sometimes hard to figure out exactly what they’re reacting to. I’m a little surprised that this person is reacting the same way to Prescript-Assist that she might be reacting to normal probiotics because they tend to be very different products. But there are some strains that tend to be a little bit better tolerated by people that if I have someone who’s super sensitive, I’ll limit the types that they’re on.

Kelsey: Yeah.

Laura: I find that bifido probiotics tend to be well tolerated. I haven’t known a lot of people react strongly to those. I don’t know if you have a similar or different experience.

Kelsey: Honestly I don’t have that same experience because I find that it’s just so specific to the person. I haven’t seen any actual trends I guess I should say.

Laura: Okay. Yeah, I mean it might depend on like you were saying, the specific type of product so Prescript-Assist is more of a soil based organism where other probiotics tend to be more of that lactobacillus and bifido bacteria blend usually. I mean there’s usually other things in there as well. Maybe it’s because some of the bifido products are just less strains.

Kelsey: Mm hmm.

Laura: So maybe they have like one or maybe up to like three or four strains in there. It might be a little bit more easier for the body to deal with then some of those super diverse combo supplements. I just find that the bifido ones tend to not cause as many symptoms.

Kelsey: Yeah.

Laura: But it could just be complete correlation and not actually a legitimate thing.  And then also the single strain products I do find those to be a little less reactive.

Kelsey: Yeah, I agree with that. Definitely. Who knows what it is really, but anytime you can cut down on the amount of variables, I think that’s typically a good idea if somebody’s reacting to something. I tend to do that too, like just kind of get them on a single strain of probiotic rather than giving them a product that has 12 different kinds of probiotics in it because you just don’t know which one they’re responding to. You just cut down or your variables, that helps a little bit.

If you’ve been taking the same probiotic for a long time, or even if you just started on it and you’ve notice that your rosacea has been getting worse, it’s a good idea to just try out a different probiotic if you want to do that. Because I think probiotics for this person would be a good idea if they could tolerate one, but it’s just a matter of finding one that works for them. If you can’t find one that works for you right now, again, like not the end of the world. Don’t worry about it.

When you’re trying to heal the gut, sometimes a lot of different inputs coming in can be overwhelming because just because you’ve gotten rid of the SIBO doesn’t mean that your gut is totally back to normal right that second. There’s a lot of catching up that has to be done because really the gut has been infiltrated by bacteria, it’s been inflamed, it’s been irritated, you have leaky gut to a degree probably right after you finish treating SIBO. There’s a lot of stuff that needs to get back up to speed and that just takes time really. You can try to speed some of that along with some particular supplements which I’ll talk about in a second. But in general, it’s just going to take time.

When you overload your gut with lots of different things and lots of different supplements to try to do that, for some people that backfires a little bit. And it’s really dependent on the person, how long they’ve had SIBO or if they’re stressed out in their day to day life, that can have a negative impact on the healing process.

You just have to try it really. Try the probiotics, try the prebiotics, try some other supplements that I’ll talk about in the second. If they don’t go well for you, just take everything out and just give your body some time because time is also a healer in and of itself especially when it comes to the gut once you’ve gotten rid of whatever invading pathogen or overgrowth was there to begin with. You can kind of consider time a supplement as well. Feel free to just take all your supplements out, just give your body a rest.

Chances are you’ll notice like in a month or two you’re starting to feel a little better, your gut isn’t as sensitive. At that point, you could certainly try again. Try the prebiotics, try the probiotics, see if anything works better for you because both of those things are great to have just as kind of maintenance supplements especially if you have a condition like rosacea. But at the end of the day, you have to listen to your body and if it is not wanting this stuff, you just have to take it out.

Laura: Yeah, I mean for me, I feel like with this particular person my biggest concern is that the kill phase wasn’t adequate.

Kelsey: Yeah.

Laura: Again, maybe she just didn’t write all the different things that she was taking, but I’m a little surprised that that was the extent of her SIBO protocol.

Kelsey: Mm hmm.

Laura: I mean I’m not saying the items were bad. Like you said, they do have good reason to use those products. But it didn’t seem complete. I normally would see at least some kind of antimicrobial herb in there as another treatment protocol.

Kelsey: Right.

Laura: For this person I think is the main question is did the SIBO actually get treated? Is it gone? Or is it still there and some of these prebiotic/probiotic combos are actually just exacerbating the overgrowth still? That’s a big one for this person.

But let’s just say hypothetically the SIBO is gone, then I agree that sometimes supplements can be, I don’t want to say that they do more harm than good, but sometimes they can be a little premature. In this person’s case, like you said if she’s experiencing symptoms from taking those products, I would really just focus on the diet and reintroducing some of those carbs, and starches, and prebiotic containing foods.

Kelsey: Mm hmm.

Laura: Maybe branching out from the low FODMAP diet looking at little bits of FODMAPs to start including in the diet and seeing how they are tolerated. Because in that situation, if she can kind of sneak higher prebiotic rich into her diet and increase the volume of those foods overtime, she may find that down the road she tolerates those supplements better.

Kelsey: Right.

Laura: It’s one of those things that it’s definitely going to depend on the individual, and what her symptoms are, and what her ability to reintroduce foods is, and what this probiotic that she was taking was, and maybe there will be a single strain product that she would tolerate and she could that one out.

There’s lots of different potential pieces of the puzzle that we don’t really have answers to from this description of the question, but I do think that ensuring that the SIBO has been fully treated before trying to do this rebuild phase is important. Whether that’s retesting or looking at the symptoms and seeing if what symptoms led to the SIBO diagnosis are, if they’re still there, then I think we should assume that the SIBO is not fully dealt with.

Kelsey: Right, exactly. Yeah, I think that’s a huge, huge part of this question. But let’s say that the SIBO is gone and let’s say this person wants to try some supplements to help the gut healing stage because part of this question was “What do you recommend for this gut healing stage?” In general I think from where this person started, which is on a low FODMAP and a Specific Carbohydrate Diet, it sounds like they’re doing the right thing by adding some more carbs in. Like Laura just mentioned, I would probably try adding in some FODMAP foods, see how they do with that. Provided that you have killed off the SIBO, you could do pretty well with those foods right off the bat. For other people, again, it takes that time to get the gut back up to speed so that’s it’s able digest those of food properly.

I’d say it’s worth trying, but if you find that you can’t tolerate some of those foods quite yet, don’t worry about it. It doesn’t necessarily mean that there’s anything wrong or that your SIBO treatment didn’t work, provided of course that you tested and saw that it was gone. You just may need some extra time to let your gut heal a little bit on its own.

Some of the things that you can do to help that healing process, one of my favorite supplements to add after this whole thing, the whole SIBO treatment protocol is something like GI Revive, which just has a bunch of different demulcent herbs in it. Essentially what demulcent herbs do is kind of coat and heal inflamed tissue. You can imagine that like we were talking about, SIBO kind of wrecks your gut a bit. It inflames it, it irritates it, and so you want to soothe that essentially once you’ve gotten rid of that bacterial overgrowth. Demulcent herbs are a great, great way to do that. That includes things like DGL, slippery elm root, marshmallow root, aloe, all those kinds of things that generally are just really, really soothing. That can help reduce a lot of that inflammation that is left over from a SIBO infection. And for a lot of people, it’s the inflammation I find, or at least that I think, that tends to still be causing some food reactions afterwards. Either that or just that they’re not creating enough digestive enzymes still.

So try some demulcent herbs, see if that helps anything in terms of food reactions, like if you’re having trouble adding some stuff back in. See if that helps the situation. It may even help you tolerate the probiotics and the prebiotics a little bit better. But if you can tolerate some demulcent herbs, that’s a great way to kind of speed up that healing process.

Then the other thing to think about of course, I just mentioned that sometimes some people after they killed off their SIBO infection, they have trouble creating enough digestive enzymes. For a lot of people, I find that adding digestive enzymes or digestive bitters for a little while can really help to basically allow them to eat some of the foods that maybe without that digestive enzyme right now they wouldn’t be able digest and break down easily.

Usually that’s a short term thing. Hopefully they can start to make their own digestive enzyme eventually. But if you’re having a lot of trouble eating any sort of food and you’ve been restricted for a really long time because you had SIBO and maybe didn’t know it, and know that you’ve finally gotten rid of it, of course you just want to start eating some of these things as soon as possible so you can get your calories up, you can get enough food. Just getting enough food in general is going to help that healing process as well. Whatever you can do to help that goal along is a really good idea. I find that the digestive enzymes or digestive bitters are great things to add in that can kind of help speed up that getting back to normal feeling where you can eat more foods, you can tolerate more stuff.  It just kind of helps that whole process.

Laura: Yeah, I mean SIBO is one of those situations that I feel like every person has their own little factors that make the treatment different. There’s general recommendations that can definitely help, but a lot of this is going to be an experimentation and that stuff that you just recommended is helpful for I’d say the majority of people. Trying that stuff out and being willing to experiment is really important because it may be something that doesn’t work right now, or maybe it works down the road, or it might just require a little bit of a slower ramp up period of gut healing.

Kelsey: Mm hmm.

Laura: Gosh, I’ve had so many different experience with SIBO, some clients where they got better really fast and it was kind of like amazing how much better they got from the treatment.

Kelsey: Yep.

Laura: And then other people that it just took I mean honestly years for them to really see the results. Just keep that mind that it’s not always like a straightforward follow these five steps and you’ll be healed kind of process. It’s rarely like that, but everyone’s going to have their own experience with even the best recommendations. Just remembering that individualization is really important and not being afraid to take time to implement these things and not do everything all at once.

Kelsey: Yeah. I agree and I would also just say that time aspect really can’t be overstated. I feel like people always think that they need to add all of these different supplements in after they’ve treated their SIBO. While I think that can help some people a lot, and it can speed up that healing process, there are just people that’s not right for. If you are finding that that is you, like you’re just not tolerating a lot of this stuff, like I said before, just take everything out, chill out.

I would say focusing on stress relief as kind of your gut healing stage rather than all these different kinds of supplements can go a really, really long way because the gut and the brain are so closely connected that if you’re really stressed out about the whole process or if you just have a lot of stress going on in your life, that’s going to make it a lot harder for your gut to heal and it might make it a lot harder for you to tolerate some of the supplements that you’re trying to desperately work into your protocol.

If you’re somebody who even after treating your SIBO is having a lot of trouble, I think there’s a lot to be said for just giving your body a 30 day break and focusing on stress relief, not introducing tons of different supplements, potentially not even introducing tons of different foods at that point either, just giving your body that time to chill out, get back to normal at least just a little bit and then trying to add some stuff in I would say probably starting with food rather than supplementation.

Laura: Yeah, I agree. I’m on board with all those recommendations.

Kelsey: Yay!

Laura: I think we talk a lot about this stuff and I’m looking forward to you creating your online program to help with this very issue.

Kelsey: Yeah, me too.

Laura: Because like we were saying, there’s lots of things that you can try and different approaches you can take, and it is helpful to have general recommendations, but you also do need have some level of individualization which can be difficult if you’re not working with someone.

Kelsey: Yeah. I hope to give a little bit of guidance in that area because it can be confusing, but it think there’s also a lot of stuff that if people knew that they could kind of make their own little guide map and if this happens, then do this, and if this doesn’t happen, do this. Just kind of giving people a road map and guiding them in the right direction when if you’re on your own, all this stuff just seems really, really complicated.

Laura: Definitely. Well I think that should hopefully be helpful for this person. If you guys have follow up questions or more information you want to learn about SIBO and how to deal with that since Kelsey’s definitely the gut expert of the team. If you guys want to get more information, feel free to submit your questions to the podcast through TheAncestralRDs.com. If you go to the contact tab you can submit a question that way. But even if it’s not on SIBO, if you have questions of any type regarding nutrition, lifestyle changes, anything that Kelsey and I can help you with, we’re happy to answer your questions. But otherwise, we will catch you guys next week and hope everyone’s having a happy holiday season.

Kelsey: Alright. Take care, Laura.

Laura: You too, Kelsey.