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Mysterious debilitating undiagnosable nausea.

That keeps getting worse.

Despite more than 16 months on the Autoimmune Protocol (AIP). That's what was happening to Matthew. Even though 15 of those months were low-FODMAP.

The AIP is working

All of Matthew's autoimmune symptoms are reversing on the AIP.

But the nausea has not been responding. It's been worsening. Slowly. For a year.

Until this April when he was hardly eating and was almost completely incapacitated.

We determined the nausea is NOT autoimmune and will require a different treatment. So we set out to hack that.

BE proactive

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All the specialists, including his functional medicine doctor, have poked, prodded, tested and hypothesized & come up with nothing. Then shrugged & left us alone with a deteriorating, undiagnosed, unresponsive health issue that has caused Matthew to be unable to work since December 2013.

We've suspected Small Intestinal Bacterial Overgrowth (SIBO) for a long time.

Despite the fact that Matthew's Gastroenterologist says SIBO doesn't exist.

Small Intestinal Bacterial Overgrowth (SIBO)

SIBO is a condition in which beneficial bacteria become displaced in the digestive tract.

They migrate from the colon, where they are supposed to be, into the small intestine. This results in fermentation of carbohydrates in a part of the gut where fermentation is not supposed to occur, causing gas, abdominal pain, constipation or diarrhea, heartburn &/or nausea. Symptoms range from mild to debilitating.

SIBO causes primary symptoms, but it also contributes to intestinal permeability ('leaky gut') which is implicated in autoimmune and other chronic health conditions.

Treatment

Treatment options include specific pharmaceutical antibiotics (such as Rifaximin), herbal antibiotics or a dietary protocol that makes a low-FODMAP AIP look like a cakewalk (at least at first).

Experts seem to disagree about whether it is possible to treat SIBO through diet alone.

Registered dietician in her book Digestive Health with Real Food, indicates that diet is a viable options for treatment of SIBO. Angie Alt of Autoimmune Paleo suggests that SIBO cannot be treated with diet alone. She references Dr. Alison Siebecker's research to support this view. 

As SIBO experts Allison Siebecker & Steven Sandberg-Lewis explain, "diet alone has proven successful for infants and children, but for adults one or more of the other three treatment options are often needed to reduce bacteria quickly, particularly in cases in which diet needs to be very restricted to obtain symptomatic relief."

After combing thorough the research it remains unclear to me whether it is truly impossible to cure SIBO through diet, or if maintaining the required protocol for a sufficient length of time is considered too difficult, or too risky from a nutritional standpoint.

We have learned that Matthew's diet definitely needs to be very restricted to obtain symptomatic relief, but nevertheless he is taking a dietary approach.

Partly because he tried to get a prescription for antibiotics to treat SIBO but was turned down by two different doctors, who cited their own ignorance about SIBO and the fact that he was in such rough shape. Neither was wiling to risk making him worse.

It can be extremely challenging to get a prescription for antibiotics to treat SIBO here in Canada.

So, as of a month ago, Matthew is following the elimination diet outlined by in Digestive Health with Real Food. Lots of bone broth (no surprise there!), no caffeine & the only carbohydrates he is eating currently are carrots & spinach.

This is meant to be a short-term elimination diet, until symptoms have been 'mostly absent' for at least five consecutive days. According to

We were pretty confident that Matthew's gut was the intransigent type, so from the beginning we figured he'd give it an 8 week trial.

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He is now 5 weeks in.

At the beginning he was almost completely disabled. Unable to care for himself.

Not only was he suffering excessively, I was drowning in stress. We were back where we'd been at the worst of his autoimmune crisis: I was caring for him; keeping the household running, including all the food prep & cooking that is required on the AIP; keeping up with a demanding career (currently our only option for income); parenting; and worrying constantly about our future.

That was our baseline.

The Results

Within 9 days on this new protocol his nausea had reduced from a 7-10 (on a scale of 0-10, in which '0' is no nausea and '10' is completely incapacitated) to a 4-6.

One month in, he is still in the 4-6 range. And as he says, the difference between  a 4 and a 6 is "at 6, I'm just tending to my immediate needs whereas when I'm a 4, I can be more thoughtful and proactive about life. Over 6 and I can't really take care of much".

As Matthew's spouse, I can vouch for that.

This post is part 1 of a 2-part series. Find part 2 here.

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