Ive asked my GI doctor about prescribing resolor (procalopride) without seeing my in an appointment because our insurance isnt the greatest. So youll have these, and it doesnt matter if its Monday morning, Thursday afternoon, or Sunday evening. DrMR: Yep. So very severe, difficult food intolerances. Most of those are actually aminoglycosides, not all of them. Supplementing with molybdenum, which is a mineral that helps in sulfur metabolism, can also be very helpful. Thats just to name a few. So anyway, its five tablets of Biotics ADP. So we need to validate a flat line first, then go to the secondary questions. And the way that that occurs is, a patient presents and they have chronic postprandial symptoms. And those came from Dr. Jacobis research. Theyre drawing folks in for that purpose and thats whos seeking them out. So a lot of them have this. DrMR: Okay. One tab of Pepto bismol 20min before meals. Or what are your thoughts about just adding in some bismuthor something like thatto your approach to treating SIBO, generally speaking, based on the fact that we cant measure hydrogen sulfide right now, and you dont know youre dealing with it? They might add something different because they might feel that its hydrogen sulfide, like bismuth, something that Dr. Siebecker just alerted me to. But theres this new gas which may be able to be tested, to tell about a different type of SIBO: hydrogen sulfide SIBO. We really dont know. Steps to Breaking Through Biofilm to Eradicate SIBO: As always, "clean air, clean water, and clean food" should come first. And this is where SIBO enters, which Im sure most of us have heard about. In the colon, there are numerous bacterial species that grow on poorly digested foods such as starches and sugars (carbohydrates).2As the bacteria within the colon ferment these foods, hydrogen and carbon dioxide gases are released during the process. It depends on if the prep was done right, the appropriate laboratory work was done right, the right devices. And then the last thing Ill say is, when folks are doing studies with regard to hydrogen and methane breath testing, please, please know that if youre doing it right, its all about the prep and the devices used, closed capture devices, and how the laboratory does it. The symptoms of H2S overgrowth can be pretty debilitating, depending on the severity of the dysbiosis. Today well be talking about hydrogen sulfide SIBO, what we can do in regards to treatment and testing, and what we may want to be cautious regarding. Would you ever consider just making that part of your herbal regimen in general, or when you have the chronic postprandial symptoms and a flat line? So I dont like the idea of using that long-term at all, personally. What can patients and clinicians do with the resources available? Its most important, of course, to find the root cause. And oregano is a standard combination I use. I can go on. EXCESS HYDROGEN SULFIDE . And there are many listeners that are clinicians that, unfortunately in the United States, dont have access to lactulose. That seems to be a little bit better tolerated for a lot of people. And then were going to go to Dr. Siebeckers work here. We want to see if the patient, number one, did the test correctly. This is an area where I am certainly open. Because they had diarrhea that flushed it out. Now its also not to say that everything new we should be looking at incredibly circumspectly. GS: Right. Dr. Allison Siebecker, ND: Diarrhea and constipation. What I very rarely saw, just a couple of patients, was the sulfur-smelling gas, like a flatulence where people say a rotten egg smell, but basically a sulfur smell. Hydrogen Sulfide SIBO Protocol update Hi guys :) I'm two weeks in to my treatment 2000mg Bismuth (Brands Combination out of Devrom, Thorne Pepti Guard and Pepto Bismol) 34mg Zinc Acetate (Brand life extension) 300 mcg molybdenum (Brand Biotics, Mo-zyme) Two pills of ADP oregano And most of the lactulose in the United States is a syrup. And photophobia is not something that Ive seen, but its in the research. We dont answer them. But thats going to be years and years. I have to underscore this. And second, become widely available. But usually its more like I asked, Do you have irritation when youre urinating? Im trying to help patients and providers make as much sense out of this as possible. Written by Dr. Michael Ruscio, DC on There are a number of different reasons why this could occur. Youll have to do it in the office of the provider, which makes it significantly less convenient, because now you have to hang out for three hours at a doctors office. Zinc acetate has some research, and also soy isoflavones, and a Chinese herbal preparation. Its pretty funny actually. It needs to be available, every machine, every lab. I continued to workout and sweat often. The original formula was developed by a physician to treat severe diarrhea brought on by cholera. DrAS: Sure. We know that hydrogen and methane breath testing for SIBO is very accurate if done correctly both by the patient, by the laboratory, and by the interpretation of that data. When we consume food products that contain sulfur, they go through a series of steps where they react with the oxygen that is naturally present in our body to form sulfate (SO2-). I think that could make sense. It might be yeast overgrowth. If you follow those simple guidelineseven though sometimes its hard when youre not feeling well, youre looking for anything to make you feel betterI think you have the highest probability of using the hydrogen-sulfide-SIBO-nuanced treatments to your benefit. Sometimes that would make them worse. Yes, absolutely, Dr. Siebecker, thank you. Studies show that a large percentage of Irritable Bowel Syndrome (IBS) is actually Small Intestinal Bacterial Overgrowth (SIBO). Following an elemental diet is an easy and effective way to give your gut a rest and the key nutrients it needs to heal. In summary, testing a low sulfur diet combined with daily Epsom salt baths for 7 days is a great place to start. GS: So first of all, what Dr. Siebecker was saying I absolutely align with too, and everything you just mentioned. So those are some things to think about. And I think if we hit the mark here of helping the person listening to or reading this understand that theres not this magic bullet of hydrogen sulfide SIBO, its not here yet, and work with their doctor, work with their clinician, consider some of the process in the hierarchy that we laid out earlier, that can get them moving forward. I believe we discussed this on the podcast a while ago, that for suspected hydrogen sulfide SIBO, you could add in bismuth to synergize with antimicrobials. DrAS: Okay. Now, we can begin discussing treatment options. This is currently the gold standard test for bacterial overgrowth. Guess what? So when a patient presents and they have these chronic postprandial symptoms (as that definition is), then we know to test. more commonly linked to diarrhea than constipation. But by and large, were having a lot of success based on everything that weve discussed. So thats always the kind of thing thats going to happen. Pepto Bismol normally colors your tongue and stool black. They could not have a colon. Lets say this technology isnt out for a while, so we need to do something in the meantime. Sometimes theyd be taking allicin which comes from garlic, and thats sulfur-containing. Well, first off, I didnt know what to do all those years ago. Do you then almost reflex to those questions to determine whether or not you should go that way, since the testing hasnt caught up with us yet? If youre exhibiting a lot of these symptoms, that increases the probability that the underlying cause of your symptoms may be this hydrogen sulfide SIBO, which could mean some nuanced changes in how you treat SIBO. This is just theory. And I would often use berberine and oregano, so you could increase that dose and just presumptively do that. Side effects are generally mild and can include a . In fact, although most of us consume enough sulfur through our daily diets, some disorders based on an inability of our bodies to metabolize sulfur or other types of sulfur deficiencies can still occur. Excess hydrogen sulfide is a condition that is the result of the overgrowth of hydrogen sulfide-producing organisms. Pepto-Bismol is used to treat diarrhea and relieve the symptoms of an upset stomach. Getting more specific when someone has hydrogen sulfide issues it is usually correlated with diarrhea and sometimes rotten egg smelling gas, although Ive also seen constipation in people with h2s issues. And my position here is primarily with hydrogen sulfide. So we get a flat line hydrogen methane breath test. It is estimated that the average person will make around 0.6 to 1.8 liters (L) of gas every day. I dont think the SIBO treatment is vastly different. Some bismuth-containing products that may be useful includeDevrom,Thorne Pepti Guard,andBiotics HPF. Then we zero in and revisit the chronic postprandial symptoms. And it doesnt matter if you eat a hamburger or if you eat a pancake or if you eat something else. But they have bismuth in there. belching. He goes over labs in detail and offers insight analysis and really goes above and beyond. Additionally, although meat contains a large number of amino acids, such as cysteine and methionine, which contain sulfur, most people have been shown to tolerate meat well in normal portion sizes. And Thorne, I think, is Pepti-Guard or something. So I think thats probably where everyone is getting excited. buff.ly/3lnV3VA, This week's blog post: Hormesis - The Dose Makes the Poison (or the medicine)! This can also be used as a simple diagnostic tool to determine whether H2S is playing a role in your symptoms. So I cant report. Aerodiagnostic offers cash pay and insurance billing options, and they do a terrific job at keeping costs low and billing easy. And we can use technologies to augment what were currently using, as long as it works. Both can cause deficiency in molybdenum, a cofactor for the enzyme sulfite oxidase, which produces sulfate. But these are the validations. Yes, I'm ready for the next steps And Get These Exclusive Bonus Items . Weve got to see how this pans out, right? Which is, yes, we need to help weed out some of the things that we dont want there, but we also have to support the gut ecosystem, if you will, to encourage balance. I asked Dr. Weinstock about that, and he said that approach had been very successful in his experience. Have you had the IBS Smart blood test? And many GI's are not aware of that and simply prescribe course after course of Rifaximin. How do you know if you have SIBO or dybsosis/ hydrogen sulfide issue? DrAS: I think its very reasonable. The numbers in the parentheses (1, 2, 3) are clickable links to peer-reviewed scientific papers. If they do, then we yield to Dr. Siebeckers work here, and weve been validating that they are hitting on one or more of these. I havent tried them, so I dont know. This can help make the diagnosis, but it wont treat the cause. Despite the usefulness of breath testing, it is important to understand that some patients with SIBO may also have too much hydrogen sulfide (H2S) in their bodies, which is not a type of overgrowth that is detectable by traditional breath tests yet. People use that word toxic like an adjective. And then lo and behold, I had never shared my data with Dr. Jacobi, but we got together and shared our data and she had the same experience as I did, constipation. And this is really disheartening, because then these patients end up getting treated and treated and treated and treated, never to really feel much different or see their labs changed, because they were treating a false positive all the while. Capsules, tincture or tea. Is there an urgency but then you cant void very well? That sort of thing. This article contains scientific references. 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