I am feeling kind of snarky this morning and almost named this post, “Get out your fat pants! It’s digestive reset time!”
But I didn’t, so that you might decide to read it. You’re welcome.
Beware – like usual, I’m going to get real in this post and talk about the things that happen in a body going through digestive reset. Things my mother might wash my mouth out for saying. Things that non-SIBO sufferers would probably judge me for. Things “ladies” are not supposed to say. I say it here because, first, F that crap, and second, I value honesty and authenticity, which means I put myself out on a limb sometimes. It’s a precarious vantage point.
Life During Antibiotics
About four weeks ago now, I started down the synthetic antibiotic route for SIBO. You can read about the theory behind this protocol here, in my last update, but basically, the idea behind using this antibiotic is to kill all the bacteria in the gut as a way to gain traction and clear the slate so that healthy digestion can be restored.
Imagine for a moment a new born baby. What do they do? They eat, they burp, they spit up and they squirt out poop in a variety of colors and consistencies. Depending on what’s in momma’s milk, they may experience gas or bloating and go between crying and laughing between bouts of gas pain. Their digestive system is learning how to function and their gut biome is developing, which is a process. Some days better than others. This is about how I’ve felt for the past few weeks. Minus the spit up.
For the first two days or so on the Xifaxan, I felt a bit more tired than normal and developed the headaches and mild mood swings that I have come to associate with a die-off effect. By the end of week one, I felt pretty good. The main things that got me through these weeks were very good hydration (water and warm herbal tea), stocking up on low-fodmap meals for the week so I always had something to eat, and reducing my stress levels as much as possible. While on the antibiotics, things weren’t too bad.
Life After Antibiotics
When I finished the two week course of Xifaxan, I started taking 50mg (a very, very low dose, just 1/4 of a pill) of Erythromycin, another antibiotic that is supposed to act as a motility agent. I take this 1/4 pill at bed time, along with 2 caps (600mg) of my Tri-Magnesium supplement. Before the antibiotics, I was down to just one Tri-Mag as a way to help keep my bowels moving. Once the antibiotics ended, so did my ability to digest just about everything, and I had to increase my dose of magnesium to make sure I was eliminating daily. Constipation has been a problem for me since the antibiotics ended, along with other things that come from constipation. Ouchy things, like stomach aches and hemorrhoids.
About two days after I finished the Xifaxan, I started getting really bloated again, about 1 or 2 hours after a meal, with lots of annoying burping. I scheduled a visit with my naturopath, who assured me I was right to come in. She reminded me that this is a process, that it’s fine for me to check in. After a quick work-up, she concluded that my stomach and upper small intestine were not producing the enzymes needed to digest my meals, so my food was probably sitting in my stomach causing upper belly gas because it was fermenting (I didn’t have flatulence, just burping and bloating). She gave me a digestive enzyme from Thorne Research called Bio-Gest. It includes all kinds of interesting ingredients, including Betaine Hydrochloride, L-Glutamic Acid Hydrochloride, Pancreatin (pancreatic enzymes from animal sources), Ox Bile Concentrate and Pepsin.
Apparently, this is the mack truck of digestive enzyme supplements. She prescribed one before a meal. I was still having a LOT of trouble digesting, though. Four days later, with no relief, I emailed her and she upped my dose to two caps before a meal. Now I can finally digest things! Well, low-fodmap things, anyway.
The email I received from my ND reassured me again – this is process, it takes lots of management to reset digestion, we need frequent visits to make the next steps. So far, the two caps of digestive enzymes combined with the erythromycin and magnesium have made things better. The goal now is to restore each section of digestion – the digestive enzymes of each organ in the system in order – as well as restore motility. I have another appointment in about four weeks to reassess how I’m doing.
Thoughts, Feelings and Reeling in the Mind
Although this process is uncomfortable, I feel confident about my recovery. When I think about the major changes that my GI tract is going through it allows me to be gentle with myself through the process. In two weeks, I sent in an army to kill off everything – good guy and bad guys. Now I’m dealing with the aftermath of that battle. This is what antibiotics do, both the synthetic and the herbal. The herbal route may be easier on the body, as it takes longer to kill the bacteria. It also takes longer to kill the bacteria. There is no smoking gun root cause with SIBO – it’s a chicken and egg scenario whether digestive enzymes and motility were reduced first, or too many bad bacteria moved in. In order to start over, the bacteria need to go. This provides a clean slate for restarting digestion and repopulating the gut with good bacteria.
This is a big process. I have a physical heaviness in my stomach. I feel heavy. Digestion takes up about 20% of our body’s energy and I’m restarting the whole system – so when I feel tired, or moody, or that I don’t have the amount of energy that I want, I remember that. I’m resetting the system that turns food into tissue, the system that provides nourishment.
Although I’m not gaining weight, feeling fat or even pregnant has become part of my daily again. It brings back uncomfortable memories of my past, when I suffered an eating disorder and punished myself for being fat. I gently remind myself that those feelings are in the past and I look at the evidence in front of me to find peace. Evidence – I enjoy two or three kickboxing classes a week, one or two walks in the woods, and daily yoga/somatics practice. I eat three, small (because I can’t eat much at once) low-fodmap meals a day. I sleep 8-9 hours a night. I practice constructive rest pose to relieve stress and tension. I meditate. I am healing.
Some days are better than others depending on what I eat, how well I take my enzymes, and how well I handle stress. I’ve put away my skinniest jeans for now and packed up my belts. I’ve pulled out my wide-legged pants, baggy tunics and splurged on a new shirt from my favorite company to reward myself for my efforts.
The whole process reminds me of when I deep cleaned my house about a month ago. When I was in the thick of cleaning, my house was a mess – the appliances were pulled out into the middle of the kitchen and bathroom so I could get into the corners, the couch cushions were bare with their covers in the wash, piles of crap moved from their corners to create newer, sorted piles. But I kept scrubbing, working diligently from one end of the house to another. This is how deep cleaning is. We might feel worse before we feel better, but that doesn’t mean it’s not working. My self-awareness practice has helped me learn to realize the difference between healing and hurting, and I really feel, as uncomfortable as it is, that I am healing.
Thanks for all your comments on this journey – I will keep posting updates!