It’s the first thing I thought when I felt the familiar bloating patterns start again.

Fuck. Not again!?!

I started feeling them sometime last April (it’s June now). The bloating never lasted for three days in a row, however, so I chalked it up to inflammation and crossed my fingers and toes and cast spells and prayed to the good gods that it just be inflammation.

Spoiler alert – it wasn’t.

(Not caught up on round one? Start here.)

Last November, I woke up the day after thanksgiving to a breakfast of leftovers. I ate, then sat down in the living room to play with my son. Somewhere between stack the blocks and the third reading of “Little Blue Truck,” I swiftly threw my son into someone else’s arms and sprinted to the bathroom. Food poisoning.

I was the first, but I wasn’t the only – it’s how I knew it wasn’t just a stomach bug.

I have Variable Type IBS, or IBS type D. This type of IBS contains a genetic, autoimmune component that is activated through food-borne illness. Lucky, lucky me.

After this episode, I went to my doctor. She told me that a recurrence of SIBO was likely, and gave me a low-dose drug to help reduce my body’s autoimmune response. Usually, after exposure to food-borne illness, it takes about three months for SIBO to re-appear. With the medication, it took six (lucky me!?).

About a month ago, I started getting the consistent, heavy bloating patterns that worsened as the day went on. I knew it was SIBO, because – for me – the bloating makes me feel incredibly fat and uncomfortable if anything touches my waist. Pre-baby, I had all kinds of energy to spend on being uncomfortable, and continued to wear regular clothes while I went through the healing process.

This round, I went to Target and bought a $25 pair of maternity jeans and headed to my doctor for testing.

Here are my results.

As you can see, they’re not bad. The infection is rather low in my small intestine. My amazing doctor thinks I might get away with a normal, two-week kill phase, followed by a month of low-fodmap foods, digestive enzymes and erythromycin for motility. Cross all your digits that I only spend a month on this diet (instead of a year, like last time). I already did my year of zucchini and eggs, thankyouverymuch, I’d like to eat tacos and drink tequila for most of my life.


I started my two week round of Xifaxan 13 days ago, so I’m finishing up today. I was expecting it to be easy.


Last time, I had very few die off symptoms (at least that I can remember). This time, I was nauseas and had accident-producing diarrhea. So that was fun, particularly because I was in a two-day mountain bike clinic at the time. I couldn’t eat, I was afraid of squirting into my bike shorts, and oh, then I had to teach the entire day after. Four days of icky tummy and carrying extra undies in my purse, and then things finally settled down.

The rest of the two weeks has been rather uneventful (thankfully), except that as I get close to winding down the course, I feel worse. Which is exactly what I was expecting and exactly what happened last time.

Also, from last time, I know that I’ll need those digestive enzymes to help my belly remember how to digest food. So I’ll take those.

A few things I’m doing differently this time:

  • COMFORT FUCKING MATTERS. I’m a mom. And I work. I don’t have time or energy to spend on trying to staying comfortable when I’m not. I’m wearing maternity pants, comfy stretch cotton and if I could find overalls like I wore in 1995, BY GOD I’D WEAR THEM.
  • Bone broth. ALL THE BONE BROTH. I wasn’t making bone broth last time. I bought the bone-broth recipe book Brodo and it’s changed my life. I’ve got a new grass fed beef broth in the fridge and I can’t wait to drink it down each day. So yummy.

Remember dear reader – I am not an expert on SIBO. But my doctor is. I interviewed her on my podcast, and you can listen to the knowledge download that happened right here. I’ll be keeping you updated, just like last time, so be sure to share your updates in the comments!


anna holden



  1. Ilona Salminen June 19, 2018 at 9:52 pm #

    Hi Anna,

    Thank you for sharing about this SIBO story of yours. It sounds like my adventure with my digestive track system. Exept the doctor part.
    I’m living in Finland and here the SIBO understanding is very different. We don’t have any tests for it exept gastroscopia. So if symptoms are not severe (bloating, diarrhea…) they treat you as IBS patient.
    But. Luckily my super sensors can find ways to heal myself but that’s not an easy road either.
    Hope that little SIBO darling won’t show up again in your life in a vary looong time!

    Best wishes,

    Ilona ❤

  2. Cindi Madsen July 3, 2018 at 4:38 am #

    This is my life. Constant bloating. Thinking I know all the right things to eat & then getting a flare up. I’m glad ya found a good doctor as mine still don’t seem to be that concerned I go from pants falling off to I can’t button them & look 5 months pregnant in a day. I guess it’s iist nice to know I’m not alone.

  3. Chris July 21, 2018 at 11:49 am #

    Dang! I get stomach cramps with bone broth.

    • anna July 23, 2018 at 12:39 pm #

      Hi Chris – bummer! Do you get stomach cramps with bone broth that you make with low-fodmap ingredients, or those made by others? I ask because bone broth almost always has onions and/or garlic cooked into it, which would be a devastating combination for a sibo sufferer. I can only drink the broth I make myself.

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