How did I get here? I took two 1-month courses of Xifaxan and Neomycin, which improved symptoms but did not eliminate them. After that treatment, I took a regimen of herbal SIBO treatments recommended by my doctor (Dr. M), but I eventually stopped because those treatments seemed to be causing more GI distress, not less. I have been taking digestive enzymes and an Allimax (a garlic extract) tablet with each meal since about January. That, combined with sticking to an anti-FODMAPS diet, and not snacking between meals (waiting at least 4 hours between meals), seems to have returned some of my quality of life to me. I also use LDN for motility, and a soil-based probiotic. If I stray from the anti-FODMAPS diet, I can usually tell immediately. The connection is very clear.
|Anti-FODMAPS diets allows most vegetables, about half of all fruits and nuts, and nearly all meats, oils, and fats.|
I went back to the GI specialist yesterday (Dr. L) and reported everything above and asked if there was anything else to test to make sure we aren't missing anything -- any other explanation (that could hopefully be treated more easily.) He said he was very confident that we haven't missed anything. He stated that if my symptoms worsened again, I could come back again in a few months and ask for one of three additional options:
1. CT Scan (I'm NOT doing this)
2. Scope of the stomach, intestines and colon. He said this is a significant procedure because the doctors need to send the scope in through both ends, under sedation.
3. SSRIs. Dr. L said that for unknown reasons, people who have inflammed and sensitive bowels, show improvement on SSRI drugs (a class of anti-depressants.) Dr. L stated that a side effect of SSRI drugs is that they calm the nerves in the gut. When these nerves are overactive, people experience pain and discomfort in the gut, and SSRIs calm them. (I'm not too keen on this idea either.)
The plan for now is to wait a few months and determine if I can simply manage my symptoms with diet, enzymes, Allimax, LDN, and probiotics. It seems to be a livable solution at this time. If symptoms worsen again, I'll go back to Dr. L for #2 above, and consider (but not likely try) #3.