Hompes Method. Practitioner Training Level II. Lesson Eight Part 1C SIBO Protocols

Transcription

1 Hompes Method Practitioner Training Level II Lesson Eight Part 1C SIBO Protocols Health for the People Ltd not for reuse without expressed permission Hompes Method is a trading name of Health For The People Ltt Registered in England & Wales Company # VAT #

2 SIBO Protocols - Intro SIBO is associated with pretty much all the common digestive symptoms. According to Pimentel et al, it s also associated with chronic fatigue syndrome and fibromaylgia. These are conditions I d put at about a 4 on the Vitality Scale.

3 SIBO Protocols - Intro If SIBO could lead to conditions labeled 4 on the VS, then do you think it s feasible that SIBO could also create symptoms experienced by people at a 5, 6, or 7 on the scale? Of course it could!

4 SIBO Protocols - Intro It s associated with: Bloating (fermentation gas - wind) GERD (CHO malabsorption, IAP) Constipation and diarrhoea Steatorrhoea all the stuff people are walking round with!

5 SIBO Protocols - Intro Endotoxin / LPS leaking through the gut wall may trigger or contribute to a variety of other conditions: Reproduction (possibly- very little data) Energy (definitely) Aches and pains (definitely) Mood (definitely) Sleep (probably no data) Skin (likely some data, but not enough) Diabetes, obesity, cardiovascular disease, cancer?

6 SIBO Protocols - Intro

7 SIBO Protocols - Options Q: How do you deal with SIBO? A: It s not easy. Antibiotics Prokinetic agents Herbs Probiotics Diet Stomach, pancreatic and gallbladder function

8 SIBO Protocols - Options Therapy for SIBO must be complex, addressing all causes, symptoms and complications, and fully individualised. It should include treatment of the underlying disease, nutritional support and cyclical gastro-intestinal selective antibiotics. Prognosis is usually serious, determined mostly by the underlying disease that led to SIBO. Bures J, et al. Small intestinal bacterial overgrowth syndrome. World J Gastroenterol Jun 28;16(24):

9 SIBO Protocols - Meds Diagnosing and Treating Small Intestinal Bacterial Overgrowth (SIBO) Gerard E. Mullin MD; IFM 2011 Symposium.

10 SIBO Protocols - Meds Diagnosing and Treating Small Intestinal Bacterial Overgrowth (SIBO) Gerard E. Mullin MD; IFM 2011 Symposium.

11 SIBO Protocols - Meds Of course, when using antibiotics, you run the risk of causing further problems: Candida Further bacterial overgrowth Side effects Drug resistance BUT they do work well for some people!

12 SIBO Protocols - Meds GBT positivity recurrence rate was high after antibiotic treatment. Older age, history of appendectomy, and chronic use of PPIs were associated with GBT positivity recurrence. Patients with evidence of GBT positivity recurrence showed gastrointestinal symptoms relapse thus suggesting SIBO recurrence. Lauritano EC. Small intestinal bacterial overgrowth recurrence after antibiotic therapy. Am J Gastroenterol Aug;103(8):

13 SIBO Protocols - Nutrition Nutrition: FODMAPS remove fermentable CHO (see handout) Remove all the main players in food sensitivity (gluten, milk, soy, corn, etc.) Low CHO diet for a period of time may help

14 SIBO Protocols - Foods The acronym FODMAP Fermentable Oligo-, Diand Monosaccharides and Polyols was coined to describe a previously unrelated group of short-chain carbohydrates and sugar alcohols (polyols).

15 SIBO Protocols - Foods They comprise fructose, lactose, fructo- and galactooligosaccharides (fructans, and galactans), and polyols (such as sorbitol, mannitol, xylitol and maltitol) all of which putatively have three common functional properties.

16 SIBO Protocols - Nutrition Fermentation by bacteria is dictated by the chain length of the carbohydrate; oligosaccharides and sugars are very rapidly fermented compared with polysaccharides such as soluble dietary fiber. Get people on a low FODMAP diet Diagnosing and Treating Small Intestinal Bacterial Overgrowth (SIBO) Gerard E. Mullin MD; IFM 2011 Symposium.

17 SIBO Protocols - Botanicals Herbal therapies are at least as effective as rifaximin for resolution of SIBO by LBT. Herbals also appear to be as effective as triple antibiotic therapy for SIBO rescue therapy for rifaximin non-responders. Further, prospective studies are needed to validate these findings and explore additional alternative therapies in patients with refractory SIBO. Chedid V, Dhalla S, Clarke JO, et al. Herbal therapy is equivalent to rifaximin for the treatment of small intestinal bacterial overgrowth. Global Adv Health Med. 2014;3(3):

18 SIBO Protocols - Botanicals

19 SIBO Protocols - Botanicals

20 SIBO Protocols - Botanicals Iberogast (STW5): Developed in Germany Several herbal ingredients Chamomile Candytuft Angelica root Milk thistle Celandine root Caraway fruit Liquorice root Peppermint Balm leaf

21 SIBO Protocols - Motility Improve Motility (prokinetic): If client/patient is constipated Remove dietary agents gluten, soy, milk, sugar, coffee Eat in a relaxed state at same time of day each day - chew food 30 times minimum Magnesium (citrate or oxide) Triphala D-limonene Digestive enzymes

22 SIBO Protocols Stomach Support If H. pylori is not detected, you may seek to improve stomach acid levels. Betaine HCL 1-2 caps per meal Look for other signs of stomach acid deficiency age, mineral deficiencies, etc. Read, Why Stomach Acid Is Good For You by Wright & Lenard.

23 SIBO Protocols Pancreatic Support Adding a high quality pancreatic enzyme support product can be very beneficial for helping clients a) digest food and b) make the duodenum and ileum less hospitable to SIBO and others.

24 SIBO Protocols - Probiotics Attempts at treating SIBO with probiotics (nonpathogenic strains of bacteria) have shown mixed results. A placebo-controlled trial of Lactobacillus showed an improvement in diarrhea and a reduction in hydrogen breath levels that was sustained for 21 days after completing treatment. Other trials have not shown such encouraging results, and further studies are needed to define the role of probiotic therapy in SIBO.

25 SIBO Protocols - Probiotics Probiotics appear to be efficacious in IBS, but the magnitude of benefit and the most effective species and strain are uncertain. Gut Mar;59(3): Epub 2008 Dec 17

26 SIBO Protocols - Probiotics Much of the research focuses on probiotics being beneficial in IBS, but not specifically in SIBO. SIBO is strongly associated with IBS, but can we say for sure that probiotics are resolving SIBO issues, or is something else involved?

27 SIBO Protocols - Probiotics Diagnosing and Treating Small Intestinal Bacterial Overgrowth (SIBO) Gerard E. Mullin MD; IFM 2011 Symposium.

28 SIBO Protocols - Probiotics Probiotics are going to be effective for some people you ll need to experiment and you may need to avoid giving Lactobacillus, as it can actually be one of the bacterial types causing the SIBO (run an Organix to determine the type of overgrowth).

29 SIBO Protocols - Sequence You ll often see SIBO alongside H. pylori (low stomach acid), Candida, etc. What to treat first? As always, it depends on the person.

30 SIBO Protocols - Sequence As a general rule, I d run with a top-down approach: Remove common trigger foods + FODMAPS Eating patterns / chewing / cephalic response Motility HCL (if no H. pylori), digestive enzymes H. pylori Candida / parasites Herbs / meds Probiotics

31 Summary By working with clients on all parameters education, food, eating habits, HCL/enzymes, motility, meds/herbs, probiotics you re giving yourself the best chance of success.

32 Thank You! As always, thanks a million for tuning in and consuming this info. In the next lesson we ll explore the protocols used for supporting detoxification before and during the gut cleansing protocols.