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Tootsie had her follow-up with the gastroenterologist and the naturopath today. The results of the SIBO breath test showed a strong positive, with a peak hydrogen of 136 ppm (the threshold his 20 ppm). It was also positive for methane producing bacteria. The blood test showed elevated levels for liver function, blood glucose, and white blood cell count. Doctor would like to repeat these tests to rule out diabetes. (I don't believe she has diabetes. I think he was assuming her fasting blood glucose was 153, but the nurse had sent us to eat lunch because she wasn't able to draw any blood after 15 hours of fasting). The celiac blood screening was negative, which means she can continue challenging gluten as long as it agrees with her.
Both the doctor and the naturopath thought they could get rid of SIBO once and for all. They also felt by doing so that Tootsie's fructose malabsorption will greatly improve...and possibly could cure it all together! Say what?! That was music to our ears. We will definitely be praying for that.
This is our plan of attack:
1. Treatment for SIBO
Augmentin 250mg twice per day for 2 weeks followed by Flagyl 125 mg twice per day for 2 weeks for SIBO.
Augmentin 250mg twice per day for 2 weeks followed by Flagyl 125 mg twice per day for 2 weeks for SIBO.
2. Supplements
L-glutamine - 2 tsp daily, mixed with a little non heated beverage - To help heal the GI tract.
LactoPrime Plus SCD Compliant - 1 capsule daily - To help support GI health, regular bowel function & immunity.
Cal Mag Liquid - 2 tsp daily - To support regular bowel function
Motil-Pro - 2 capsules twice daily - To support normal GI motility
Curcumin - 1 capsule twice daily - To reduce inflammation, and control die-off reaction. As needed.
Theanine - 1-2 capsules 1-2 times per day - To improve sleep & bedtime anxiety
L-glutamine - 2 tsp daily, mixed with a little non heated beverage - To help heal the GI tract.
LactoPrime Plus SCD Compliant - 1 capsule daily - To help support GI health, regular bowel function & immunity.
Cal Mag Liquid - 2 tsp daily - To support regular bowel function
Motil-Pro - 2 capsules twice daily - To support normal GI motility
Curcumin - 1 capsule twice daily - To reduce inflammation, and control die-off reaction. As needed.
Theanine - 1-2 capsules 1-2 times per day - To improve sleep & bedtime anxiety
3. Blood work
Hepatic Function Panel
Hepatic Function Panel
C-Reactive Protein
GGT
Glucose, serum
Hemoglobin A1c
Sed Rate
4. Follow-up Breath Test
Lactulose breath test 2 weeks after finishing antibiotics & probiotics with Zofran (to prevent vomiting)
Lactulose breath test 2 weeks after finishing antibiotics & probiotics with Zofran (to prevent vomiting)
5. Follow-up for results with GI and Naturopath
2 weeks after breath test.
6. Follow up with registered dietician to review diet log
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I would like to answer a few questions that have come up from friends in the Parents of FructMal Kids Facebook group...
Why did Doctor prescribe Augmentin instead of Xifaxan?
Tootsie has been on Xifaxan off-and-on for 6-1/2 years. Her previous GI called it "Vitamin X" and prescribed it monthly at one point. The new GI (Dr. A) believes she has become resistant to it. When she completes the Augmentin, she'll move to Flagyl. This will work on the methane producing bugs. Tootsie developed a bad case of yeast overgrowth in 2013 after a round of Flagyl so Dr. A is using 1/2 the recommended dose for a longer duration. The ND wants her to take Lactoprime probiotic during the course of antibiotics to also help prevent yeast overgrowth.
Did he say why she has SIBO to begin with?
He believes the underlying issue is related to abnormal motility. He believes if we treat SIBO while addressing motility we can keep it from returning. He believes she has never been truly SIBO free and has had chronic inflammation in her intestines resulting in fructose malabsorption.
How are you feeling about all of this?
I have hope again and I am excited! I was feeling defeated when our last round of Xifaxan didn't work (prescribed by the Naturopath at Bastyr Clinic in Seattle). I loved the ND there and she was studying up on SIBO and following the latest research, but it just felt like there was a missing link. The underlying cause was not being addressed properly. I hope to be able to share our success story with her someday.
_________________________________________________________________________________
I would like to answer a few questions that have come up from friends in the Parents of FructMal Kids Facebook group...
Why did Doctor prescribe Augmentin instead of Xifaxan?
Tootsie has been on Xifaxan off-and-on for 6-1/2 years. Her previous GI called it "Vitamin X" and prescribed it monthly at one point. The new GI (Dr. A) believes she has become resistant to it. When she completes the Augmentin, she'll move to Flagyl. This will work on the methane producing bugs. Tootsie developed a bad case of yeast overgrowth in 2013 after a round of Flagyl so Dr. A is using 1/2 the recommended dose for a longer duration. The ND wants her to take Lactoprime probiotic during the course of antibiotics to also help prevent yeast overgrowth.
Did he say why she has SIBO to begin with?
He believes the underlying issue is related to abnormal motility. He believes if we treat SIBO while addressing motility we can keep it from returning. He believes she has never been truly SIBO free and has had chronic inflammation in her intestines resulting in fructose malabsorption.
How are you feeling about all of this?
I have hope again and I am excited! I was feeling defeated when our last round of Xifaxan didn't work (prescribed by the Naturopath at Bastyr Clinic in Seattle). I loved the ND there and she was studying up on SIBO and following the latest research, but it just felt like there was a missing link. The underlying cause was not being addressed properly. I hope to be able to share our success story with her someday.
Greetings,
ReplyDeleteI hope things will be very well for you and your family. One question that many GIs do not clarify well, is: Why do they prescribe probiotics (flora/good bacts) with SIBO? SIBO results from overgrowth of bacteria (they call it bad ones, but no body knows for sure) in SI. But, some GIs think that SIBO occurs when good bacteria finds a shelter in the SI, because of one reason or another (bad motility, ibs...). If this is true, then adding more bacteria (be it good or bad) doesn't make any sense. Probably they are adding the same problematic strains even back? One does not know which strain specifically is turning to an opportunistic one. If you could do us a favor by asking your seemingly well experienced GI Dr. Abdullah, he might have a clue about it. Adding any feedback here and publicly would be greatly appreciated in advance by many people. I think we should collect the pieces of this puzzle.