SIBO (small intestine bacteria overgrowth)

oak

Member
Messages
12
Type of diabetes
Type 2
Treatment type
Non-insulin injectable medication (incretin mimetics)
Dislikes
being told what to do without the full picture
Hi

In my case, SIBO is a long term side effect of abdominal surgery for cancer and was diagnosed by The Royal Marsden after extensive tests early 2014.
I understand that diabetics are at a higher risk of developing SIBO.
It presents similar to IBS,
Malabsorbtion is a primary problem, especially fats and I also have Vitamin D deficiancy.
Struggling to get SIBO under control as the prescribed antibiotic is not a frontline drug and repeats are not available from my GP.
With so much going on in my digestive system my diabetes has gradually deteriorated and HbA1c has crept upto 11.
My nutritional knowledge is sound, I used to teach Food Studies. I currently weigh the major carb groups for my meals and will only have one at a meal time, treating most root vegetables as a major carb as well as aubergines.
Anyone with any thoughts or similar experiences
 

Indy51

Expert
Messages
5,540
Type of diabetes
Type 2
Treatment type
Diet only
Hi and welcome to the forum, @oak

Have you seen Dr Siebecker's site? http://www.siboinfo.com/

Fairly sure I have recurrent SIBO as well, especially badly prior to diagnosis with Type 2. Also had Vitamin D3 deficiency diagnosed at the same tiime. Whenever I have to take an antibiotic for other reasons, my symptoms go away for a while, but gradually creep back and my fasting BG goes up as a result of the occult infection. It's very frustrating, I know.

Another resource that may help is the FODMAPS diet: http://www.med.monash.edu/cecs/gastro/fodmap/
 
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oak

Member
Messages
12
Type of diabetes
Type 2
Treatment type
Non-insulin injectable medication (incretin mimetics)
Dislikes
being told what to do without the full picture
Thanks @Indy51 A lot of this is just thinking out loud.

I had seen similar sites to above and Dr Siebecker's concurs with my specialist at The Royal Marsden, which is a cancer specialist hospital in London. (i see you are in Australia) I am under a multidisciplinary team for long term side effects of cancer treatment, in addition to diabetes and arthritus. (I find it curious that all three have links to viral infections)

I was prescribed the Rifaxamin by the hospital and it was working well but in the UK your GP are limited as to the drugs the can prescribe. Rifaxamin is one of those restricted drugs, The trials I was put on by the hospital worked well and all the rest have messed things up immensely. from light sensativity, sending me to sleep and raising my BG levels. So now we are at the appeal stage.

Rifaxamin is great for me as it is not absorbed into the blood stream and works before it hits the large bowel which the cancer messed up. It does need to be repeated one week a month long term, but after a while you reduce the amount of days eg from 7 days a month to 5 days.
Many antibiotics are known to destroy the bacteria in the gut, hence the diarrhea, I recently had a dose of amoxyllan for something else the scoured me.
All this and my blood sugar levels are as you describe, up and down, and once I start the day with a high fasting BG level I seem doomed to get it down to a reasonable level before bed. I have a combined form of SIBO, constipation followed by diarrhea, usually on a 3 day cycle.

I am wondering if the exenatide I take is appropriate as I was advised that I had to eat some carbs with it. Not sure if this is the same advice for everyone, but then we are all unique.

Because of the reduced carb diet and as a consequence reduced fibre I am also prescribed Normacol which is a plant based non digestible carb used to replace the fibre in my diet.

All gets a bit messy with different contradictorary diets for different conditions. I am now on a reduced fibre (due to abdominal surgery) high fibre (diabetes) low fermentable carbs (SIBO) diet. What I do is eat a high unprocessed protein diet, with leafy vegetables, raspberries and cooking apples, plain unsweetened youghurt, butter. and as few carbs as I think is safe. I cook from scratch.

The full tests for SIBO are quite extensive. The breath test, not great for diabetics as it involves drinking a high glucose concentrate drink, is not conclusive. I also had a colonoscopy and and gastrocopy (endoscopy) as well as x-rays, scans, a multitude of blood tests, stool tests and questionnaires. If you can find a solution without the tests I would reccommend it.

I see you are active in the forum and a long time member, so if you remember anyone who has any experience of this type of thing I would appreciate being pointed in their direction.

best wishes
 
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Indy51

Expert
Messages
5,540
Type of diabetes
Type 2
Treatment type
Diet only
Hi again @oak.

Sorry, off the top of my head, I can't recall anyone having a similar mix of medical issues as yours - though there are certainly many with other complex histories.

I've not gone through the testing route but I suspect my SIBO may be connected to a large periampullary diverticulum next to my pancreas that was discovered via a scan a while back. I have such little faith in the two gastroenterology specialists I've seen that I'm hesitant to pursue it further. I guess that's something I'll face when/if it becomes unmanageable. I also have gallstones and hiatal hernia issues that add to my upper GI picture.

You certainly seem to have been through the mill with your cancer treatments - hope it all works out for you.

Have you ever tried acacia fibre? It's a soluble fibre that is recommended for IBS and it certainly works well for me without any fermentation issues.
 
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oak

Member
Messages
12
Type of diabetes
Type 2
Treatment type
Non-insulin injectable medication (incretin mimetics)
Dislikes
being told what to do without the full picture
I've just looked at acacia fibre and I think it works in a similar way to Normacol which is a trade name, also a plant fibre from the sterculia plant, so am on a similar track, Normacol comes on prescription in UK, one contains a laxative and the one I take doesn't,
Not sure if Acacia is prescribable here, but will ask.
Thanks