Is that IBS? Is that SIBO? Is that SIFO?

[maxandco]

Hi there,

For the past 3 months I have been having strange gut behaviour very similar to what an IBS is:
– 1-2 stools a day not really formed or very “pasty” that smell bad
– It seems I am feeling well 1 day over 2 (like 1 day I am OK, the next one very bloated, the day after ok…)
– I started to have face pimple more regularly
– When I feel weaker/bloated I have weird sensation to legs and arms like joint pains? Is that leaky gut?
– More intolerance to food (milk, eggs, soya, some grains...)
- Recently during the night or late evening I got a belly pain like intoxication and need to poo quick but it's just gas and so i stay in my bed. It lasts around 15mins max and then it's fine (VERY WEIRD! it's like my body telling me: sorry you can just eat vegetables to be OK )

In overall, I don’t feel especially “bad” as I don’t want to go poop every hours but I know something is wrong. I have IBD (UC) and got a flare in December, I’ve been switched to anti-tnf and everything is OK, no inflammation at all, no side effect so far. Also no parasites nor pathogens as per recent analysis. NOTE: I started to feel this before the UC flare so it might have triggered it, but stool appearance was still OK at that time (before inflammatory diarrheas kick off of course).

I did a microbiota test in December showing low diversity so I also tried to improve my gut since it started: I sometimes drink water and milk kefir, eating more fermented food in general. I also eat any kind of fiber (starchy, legumes, vegetables, fruits) as I hate restriction. I wonder if my diet of fermented stuff messed things off? It seems sugar containing food is what triggers it so I’d go for SIFO but I know it’s very difficult to know exactly when it’s IBS related.
NOTE: I am taking anti histaminic for 2-3 weeks now (ebastin) and it's been amazing like 50% issues disappeared, but still I am concerned that if something is wrong with histamin there is a broader issue.

Any tests that have been showing proof? any similar stories or experiences? I think my gastro won’t be able to help and so I was ready to check medical functional practitioner to find the root if it’s the only solution but it’s long, painful and can cost a lot.
I was thinking about biofilm and wanted to give a try to NAC supplement. I do have caprylic acid but does not seem to have helped much.

Thank you!

 

[Michael Harrop]

Only your doctor can tell you if you have IBS. "SIBO" and "SIFO" are largely not real diagnoses. They're incorrect notions spread like wildfire on the internet for some reason... Perhaps they're easier for laypeople to grasp the notion of, and perhaps there are people profiting off of "solutions" for them.

Read this: https://humanmicrobiome.info/sibo/

Anything you eat could be a trigger, including fermented foods. https://humanmicrobiome.info/probiotic-guide/

The FAQ is a good place to start: https://humanmicrobiome.info/faq/

Don't depend on those microbiome tests: https://humanmicrobiome.info/testing/

I think my gastro won’t be able to help and so I was ready to check medical functional practitioner to find the root if it’s the only solution but it’s long, painful and can cost a lot.

Click to shrink...

Indeed. Which is why many people resort to DIY FMT. My knowledge and experience with alternative medicine practitioners is that they're a waste of time and money and may make things worse.

 

[maxandco]

Merci (from France) about all your information and this website. I will read cautiously about everything. It seems I am back to normal when I eat a lot of vegetables and low sugar diet so I will try to maintain something very healthy hoping my gut microbiota will be strong enough in some weeks.

I agree with you about SIBO and SIFO: that internet made these conditions like something terrible you need to get rid, but I don't know if that stupid of me, I have faith on natural recovery and I am sure if you treat well your organs (intestines-gut here), things will go back to normal some day.

 

[microbiome]

The condition I know about is TRPV1 related infections. This is the pathology which is researched to be "the" IBS-D. Though, of course IBS-D is a syndrome, which by definition has no cause, but that is what they call it trying to find a single pathology which most represents what the syndrome is as described as a specific type of irritation.

There is a lot of interesting research research. First on the SIBO/SIFO. There was a recent paper saying that the SIBO thing was wrong. I think the point is that it you may have these breath test gasses positive or negative and it is not the same as IBS-D, which is a TRPV1 pathological infection.
Critical appraisal of the SIBO hypothesis and breath testing: A clinical practice update endorsed by the European society of neurogastroenterology and motility (ESNM) and the American neurogastroenterology and motility society (ANMS)
https://onlinelibrary.wiley.com/doi/10.1111/nmo.14817

Next, if what happens is you eat spicy food or a fatty meal and that causes diarrhea, then that suggests a TRPV1 sensitizing infection. If this does not describe your illness, then there is no point into going into that pathology further and the research on that condition. However, if it does describe your condition then there is a paliative treatment which can also work as a test and that is the IBGard product which is a pellet encapsulated peppermint oil. Don't use regular peppermint because that will just cause reflux due to being released in the stomach.

A bacterial infection called Klebsiella Aerogenes was found to cause hyper-algeia through histamine 4 receptor (H4 recruits mast cells), those mast cells then release more histamine, among other immune factors. Histamine 1 sensitizes the TRPV1.

Histamine production by the gut microbiota induces visceral hyperalgesia through histamine 4 receptor signaling in mice
https://www.science.org/doi/10.1126/scitranslmed.abj1895

Microbiome, neuro-immune interactions, and the gut-brain. What is new?
https://www.youtube.com/watch?v=4n-YamO9kIE
[from American Neuro-Gastroenterology and Motility Society]
It discusses TRPV1 and klebsiella aerogenes

Also, there is fungal infection which induces visceral hypersensitivity

Fungal feelings in the irritable bowel syndrome: the intestinal mycobiome and abdominal pain
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9897793/
This is the study that says peppermint oil works as a paliative, which supports the use of IBGard. They also say that in their previous paper they show that classical anti-fungal treatment reverses the visceral hypersensitivity. Tghat is the paper "Intestinal Fungal Dysbiosis Is Associated With Visceral Hypersensitivity in Patients With Irritable Bowel Syndrome and Rats" below. Soluble beta-glucans also worked (sympomatically I believe). They are a dectin-1 antagonist. However, it is not clear how a consumer would get soluble beta-glucans. Many available beta-glucans are a mixture or insoluble/particulate. That will agonize dectin-1 instead which will cause diarrhea. From my investigation I suspect that algae created beta-glucans are soluble due to smaller size and linear structure. There is an ingredient product in some algae beta-glucans called "BetaVia" by Kemin, which may fulfill this soluble beta-glucan description, but I'm not sure. I did read one review of another algae beta-glucan and the person said it gave them diarrhea, and it was very similar product.

The Potential Role of Gut Mycobiome in Irritable Bowel Syndrome [2019] [mycobiome means fungal]
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6712173/

The Potential Role of Gut Mycobiome in Irritable Bowel Syndrome [2019] [mycobiome means fungal]
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6712173/

Intestinal Fungal Dysbiosis Is Associated With Visceral Hypersensitivity in Patients With Irritable Bowel Syndrome and Rats [2017]
https://pubmed.ncbi.nlm.nih.gov/28624575/
(fluconazole and nystatin reversed the condition) Other fungidies like Itraconazole are more broad spectrum and function against molds, not just yeast.