Digestive issues

[Colin of Kent]

Hello folks,

Before I get into the main topic, it may help to let you know that I'm 38, diagnosed Type 1 aged 10, and have always found it difficult to control my BG. I've always been lucky enough to have a healthy, stable weight, don't drink much and don't smoke. I've been on a pump for about ten years now.

I have had intermittent digestive problems since around 2010 or 2011, which began with about three episodes of violent vomiting and diarrhoea in the space of three months. I was referred via my GP to a gastro consultant, under whom I had two endoscopies, an MRI and a barium x-ray. Alas she was unable to diagnose anything more than reduced digestive motility.

Following that, I changed jobs and was able to cycle to work (yay!), so managed a good three hours proper exercise a week, started meditating regularly and made an effort to cut out processed foods almost entirely. My digestive problems vanished entirely.

Then in about 2014, I had to change jobs again and the cycling fell by the wayside, so the symptoms gradually started returning. Never quite as bad as those first three times, but it's now something fairly frequent. The vomiting is always accompanied by sulphur smell and gas. Most days I feel a bit funny inside, never quite sure what's going on. I've noticed certain foods repeat on me several hours after eating them (such as cucumber, lettuce, peppers).

I have taken up running in the last two years (now doing 5k three times a week), walk the dog for an hour on the days when I don't run, and have recently got a standing desk at work (was sitting for 90% of my day). Also got a folding bike, so I can snatch a bit of pedal action ad hoc.

More recently I was re-referred to another gastro consultant who has said it's not gastroparesis, and confirmed 'reduced digestive motility'. In the last month, he has suggested 'bacterial overgrowth' as the most likely situation, but has yet to confirm this formally, and is suggesting a rolling programme of intermittent antibiotics as a method of treatment. He sent me for a hydrogen breath test last week. Nothing happened -- no side effects, no results of note on the meter. I'm currently awaiting the consultant's opinion on what that means.

In the meantime, I searched for 'bacterial overgrowth' and came across lots of results for SIBO. In particular, I was interested to discover that several other of my symptoms could potentially be explained by this condition, such as chronic tiredness and what I call 'brain fog'. I'm reluctant to use antibiotics, really, and would much prefer to treat the problem without them if I can. Many strategies seem to involve an elimination diet to begin with, combined with natural antibiotics such as oregano oil or peppermint oil, followed by slow reintroduction of various food types to work out what's okay and what's not.

Low-carb seems to be a good approach, and it makes sense to me, as the bacteria feed on the sugars. What I'm puzzling over is how to implement a low-carb diet. I can't imagine that it's possible to eliminate carbs altogether, especially when exercise and frequent hypos are factored in!

I've done some searching on this forum and have read about a few of your experiences (many far worse than mine), but I'd be very grateful if anyone would like to share any more anecdotes and/or advice, please.

Thank you for taking the time to read this!

 

[EllieM]

There seem to be quite a few T1s on here who are low carb, have a look at the threads and hopefully some will post. I'm moderately low carb, 3 lots of 30 carb per day, but obviously I use glucose when hypo. The trick is to minimise the hypos, which seems to depend on reducing insulin appropriately. Good luck, hopefully some of the serious low carbers will post. I've found that my basal insulin has reduced after going lower carb....

 

[NoCrbs4Me]

I used to have gastrointestinal issues for many years. The issues went away when I stopped eating anything from the plant kingdom and only ate from the animal kingdom (aka "zero carb"). What I did was a bit drastic, but it worked. Certainly eliminating refined carbs/sugar is a good start. The elimination diet is a good idea as well if you don't want to cut out fruits and veg completely.

 

[Fairygodmother]

Personally I’d choose to go with the specific antibiotic for it, after all it’s said to be effective, and wouldn’t be being given to you irresponsibly.

I’d then acquire some kefir - not the ready-bottled stuff from the shop shelf but a live culture from somewhere like kumbucha - and use it along with things like sauerkraut to reintroduce ‘good’ bacteria. I’d work hard to keep bs as good as I could and cut right down on processed and high-sugar food. However, I’d continue to eat some low GI carb, a good range of veg, limiting or eliminating some of the more sugar packed root veg such as carrot and swede, and the higher-sugar fruits.
Good luck.

 

[Donna1]

I have had similar gastric issues for about 7 years only been diabetic for 4. Type 1. Doc kept sayin it was IBS i wasnt having the vomiting but would get a very uncomfortable stomach for 2/3 days so swollen i looked pregnant.
Went to my doc with a pic of my stomach the day before and on the day at the docs it was flat again i said this is not IBS. She sent me for an endoscopy and diagnosed me with gastritis, duodenitis. I sometimes wonder if its related and maybe brought on my diabetes as i was 33 when diagnosed. I feel its when i eat red meat like steak it causes a flare up and think i cant digest large pieces of red meat. As i had steak last night and been so uncomfortable in work today. X

 

[Colin of Kent]

Personally I’d choose to go with the specific antibiotic for it, after all it’s said to be effective, and wouldn’t be being given to you irresponsibly.

I’d then acquire some kefir - not the ready-bottled stuff from the shop shelf but a live culture from somewhere like kumbucha - and use it along with things like sauerkraut to reintroduce ‘good’ bacteria. I’d work hard to keep bs as good as I could and cut right down on processed and high-sugar food. However, I’d continue to eat some low GI carb, a good range of veg, limiting or eliminating some of the more sugar packed root veg such as carrot and swede, and the higher-sugar fruits.
Good luck.

Thank you for this. It's not that I'm averse to antibiotics altogether, but I'd prefer not to be on them indefinitely, which seems to be what is proposed.

 

[Colin of Kent]

I also forgot to mention that my symptoms always get worse in the winter months. I'm sure there's a psychological aspect to it somewhere, too.

Does anyone else have this pattern?

 

[Kristin251]

I’m sure I have SIBO. Before you get the antibiotics, do some research. They only help for a few months and then you need them again. Also probiotics are contraindicated as the bad bacteria feed on them as well

For me, vlc ( keto) is the only way to manage it. Google keto diet food lists. You’ll get a good idea of what you can and can’t eat. That wasn’t enough for me. I need to stay in ketosis and mainly eat protein and fats. No dairy, sugar, grains, fruit ( except avocado) , keep veggie portions small etc and I also need to keep fiber low.
I take very small doses of insulin doing this but I don’t work out so I can’t help you on the exercise front.

It is hard managing SIBO and exercise.

 

[Kristin251]

I should have mentioned as well the elimination diet is very helpful. People with SIBO generally have lots of food intolerances.
Grains of all kinds, dairy of all kinds, peanuts, tree nuts, eggs, shellfish and fish are on the top of the list

 

[Colin of Kent]

Good advice, thank you.

 

[Kristin251]

Good advice, thank you.

I meant google SIBO diet food list. Not keto.

Another thing to look into that helped me a lot was the FODMAPS diet.

This can be very restrictive and overwhelming at first. The first things to ditch are all grains and dairy. That should help a bunch. But please be aware that you’ll probably feel worse before better. It’s your body purging the toxins. It can feel like the flu. It can last about a week. The worse you feel, the more you need it.

Again, be careful with insulin.

 

[lindijanice]

I meant google SIBO diet food list. Not keto.

Another thing to look into that helped me a lot was the FODMAPS diet.

This can be very restrictive and overwhelming at first. The first things to ditch are all grains and dairy. That should help a bunch. But please be aware that you’ll probably feel worse before better. It’s your body purging the toxins. It can feel like the flu. It can last about a week. The worse you feel, the more you need it.

Again, be careful with insulin.

Hi Colin of Kent, I would agree wholeheartedly with Kristin re: SIBO diet and/or FODMAPS diet....have severe IBS, but have improved using a combination of these diets - not the same as yourself, but with gut issues, it is certainly worth the effort - and discomfort for a while - to eliminate, eliminate, eliminate food groups and then slowly reintroduce one food at a time to see how it goes....you will have to go cold turkey in the elimination process though if you want to see results of any one particular food group being eliminated and how it affects you.

I also don't think it would be hurtful to try one or two cycles of antibiotics specific for SIBO and see if there is any improvement....sometimes medical intervention can be a good thing, kick start healing...along with natural helps/food....oil of oregano is a daily go to for me and it has been helpful in overall support for immune system. Hope you can come up with a plan that works for you/Blessings/L

 

[Kristin251]

Hi Colin of Kent, I would agree wholeheartedly with Kristin re: SIBO diet and/or FODMAPS diet....have severe IBS, but have improved using a combination of these diets - not the same as yourself, but with gut issues, it is certainly worth the effort - and discomfort for a while - to eliminate, eliminate, eliminate food groups and then slowly reintroduce one food at a time to see how it goes....you will have to go cold turkey in the elimination process though if you want to see results of any one particular food group being eliminated and how it affects you.

I also don't think it would be hurtful to try one or two cycles of antibiotics specific for SIBO and see if there is any improvement....sometimes medical intervention can be a good thing, kick start healing...along with natural helps/food....oil of oregano is a daily go to for me and it has been helpful in overall support for immune system. Hope you can come up with a plan that works for you/Blessings/L

I’ve read o er answers over again the abx are a revolving door. And they are not a cure. Most likely what got us here in the first place. There is no cure for SIBO, only managed by diet

My diet is very basic. Protein, healthy fats like avocado, olive oil, olives, mayo and some green veggies in moderation. Small meals more frequent.
The only processed food I have is mayo for the most part. Limited but simple.

 

[Colin of Kent]

Thanks, @lindijanice

I think maybe you're right. Like I said, I'm not totally against antibiotics per se, just don't fancy long-term use of them. I need to do some more reading around treatment options, and then discuss it all with doctors before proceeding.

My biggest concerns are treating hypos, of which I have many, and exercise. Exercise improves my gut motility, mental health and BG control, so it's vital I keep it up. But it's hard to imagine how one could do so without a reasonable level of carb intake.

 

[Tophat1900]

You could google info about Biotin or Vit B7 as it is also known as.

I started taking it about 3 weeks ago for digestive issues, in particular, digesting fat. Things have significantly improved. Biotin is particularly important in the digestion of fatty acids, but plays a role in all foods. Part of the reason I take it is I also take R-alpha lipoic acid. Taking it can reduce biotin levels and vice versa I believe.

I'm NOT saying drop everything, rush out the door and buy it or take it, but it might be worth reading about. Take into account possible interactions with any meds you take etc.

 

[Kristin251]

Have you played around with insulin timing? I bolus 20 min before a low carb meal but if you have slow gut motility you might need to bolus just before you eat or after you eat. Are your hypos early after you eat or later ?
Exercise has always been a wild czars for me. I can’t control bs so I keep it to slow walks when the weather is nice and a little yoga stretching through the day. Even this gives different results.

Just thoughts...

 

[Colin of Kent]

You could google info about Biotin or Vit B7 as it is also known as.

I started taking it about 3 weeks ago for digestive issues, in particular, digesting fat. Things have significantly improved. Biotin is particularly important in the digestion of fatty acids, but plays a role in all foods. Part of the reason I take it is I also take R-alpha lipoic acid. Taking it can reduce biotin levels and vice versa I believe.

I'm NOT saying drop everything, rush out the door and buy it or take it, but it might be worth reading about. Take into account possible interactions with any meds you take etc.

Thanks, I will consider it.

 

[Colin of Kent]

Have you played around with insulin timing? I bolus 20 min before a low carb meal but if you have slow gut motility you might need to bolus just before you eat or after you eat. Are your hypos early after you eat or later ?
Exercise has always been a wild czars for me. I can’t control bs so I keep it to slow walks when the weather is nice and a little yoga stretching through the day. Even this gives different results.

Just thoughts...

Thanks for your thoughts!

I think my hypos are mainly due to the after-effects of exercise, as the body is replenishing its liver stores. I run 5k before my evening meal, three or four times a week, and nocturnal hypos are not uncommon. So I need to do some work around night-time basal rates, certainly. Things have always been difficult, as I am very insulin-sensitive, so getting doses right has always been a bit of a guessing game. I'm currently in the throes of doing some fasting basal tests, to make sure they're right. Once they're tweaked accordingly, I'll probably start journaling again. Tedious, but necessary every now and then, to build up a picture of what's going on.