Diets for Digestive Health

cycle of SIBOSince releasing Fast Tract Digestion Heartburn, I have received several inquiries about using the Fast Tract Diet program to treat other SIBO-related conditions.  The answer is yes! That’s the reason Fast Tract Digestion is a book series. More books are coming. In the meantime, the diet can be used for all SIBO-related health problems. This article also reviews several other diets reported to improve SIBO along with the Fast Tract Diet.

What is SIBO?

In healthy people, the small intestine contains low levels of friendly bacteria such as Lactobacillus acidophilus, especially in the upper part of the small intestine where our own critical digestion takes place. SIBO involves the invasion of the small intestine with much greater numbers of bacteria from the large intestine. The official definition of SIBO is “the presence of an abnormally high number of bacteria (more than 100,000 bacteria per milliliter) in the upper part of the small intestine”. At this level, the normally harmless bacteria that live in our gut can become harmful. They produce toxins, enzymes, and intestinal gases, including hydrogen, methane, and carbon dioxide that can disrupt digestion, cause intense physical discomfort and even damage the small intestine.

The symptoms of SIBO include abdominal pain or cramps, diarrhea, constipation, gas, bloating, acid reflux, flatulence, nausea, dehydration and fatigue. More severe symptoms related to SIBO can include weight loss and “failure to thrive,” steatorrhea (the body’s failure to digest fats), anemia, bleeding or bruising, night blindness, bone pain and fractures, leaky gut syndrome, and autoimmune reactions, among others.

There is an abundance of scientific research linking SIBO to a growing number of digestive (and even systemic) conditions. The list continues to grow but already includes:

  • IBS
  • Diverticulosis,
  • Celiac disease
  • Crohns disease
  • Chronic acid reflux
  • Asthma
  • Fibromyalgia
  • Rosacea
  • Autoimmune disorders
  • Cystic fibrosis

SIBO has many underlying causes, but here some that stand out:

  • Slowed peristalsis – how well food moves through the intestine
  • Low stomach acidity
  • Immune deficiency
  • Antibiotic usage
  • Food poisoning
  • Carbohydrate malabsorption (key for dietary control)

Though each of these issues could increase your chances of having SIBO, the driving force behind SIBO is always poorly absorbed carbohydrates. That’s because gut bacteria consume mostly carbs for energy. For this reason, the best way to control SIBO is to deny gut bacteria the fuel they need to overrun the small intestine by limiting the consumption of certain carbohydrates. The worst offenders are the hard-to-digest carbohydrates including lactose, fructose, resistant starch, fiber and sugar alcohols (while sugar alcohols are not carbs, they can be fermented by bacteria). Fast Tract Digestion considers these hard-to-digest carbs as having “fermentation potential” or FP. Limiting FP, as opposed to overall carbs, is the secret of lasting symptoms relief.

SIBO Diets

Back to the question, “Can the Fast Tract Diet be used to treat other SIBO-related conditions?” The answer is yes, although specific conditions may have additional requirements. For instance, any diet for celiac disease would require all gluten (even small amounts) to be removed. With this in mind, the Fast Tract Diet is specifically designed to treat SIBO by limiting the carbohydrates (listed above) that drive bacterial overgrowth.  The idea is not new. Other diets have been used to treat SIBO-related conditions. These include the Paleo Diet, Elemental Diet, Specific Carbohydrate Diet (and the related GAPS Diet), Low Starch Diet, Low Carb Diet and the FODMAP approach. These diets all limit carbohydrate malabsorption to varying degrees. Let’s take a closer look at each.

The Paleo Diet – Did Cavemen get Heartburn?

Paleo diet experts make a rational case that eating like our ancestors ate is healthier.  The reason is, our bodies evolved in balance with the foods that were available before we learned to cultivate grains.

You hear different opinions on the details as no one knows for sure what paleolithic humans ate or what their diets were like locally. More fruits would be available in tropical areas. People near lakes, rivers or the ocean relied more heavily on aquatic foods. Hunting was a common thread as supported by fossil records. Foods tended to be uncooked and many foods we tend to dismiss in the modern Western world (i.e. insects) were likely part of the caveman diet.

I have gained a general view of paleo diet foods from reading two great books, The Paleo Solution, by Rob Wolf and The Primal Blueprint by Mark Sisson.  Another excellent source of information on paleo eating is the web site, Paleohacks. com. I also attended the Ancestral Health Symposium in Cambridge Massachusetts last August. My take away message is this.

”Modern paleo diets are based on a relatively short list of food types because that’s what was available during our evolution.”

Included:

  • Fish, meats; including organs, fowl and eggs
  • Green vegetables, fruits, nuts, seeds and herbs
  • Insects

Off limits:

  • Grains including rice (though Mark’s plan allows some wild rice)
  • Beans and pulses
  • Dairy and foods containing dairy
  • PUFA-containing oils except olive and coconut oil
  • Processed foods containing sugars and trans fats, nitrates and other additives.

Clearly, this diet is a big step in the right direction for gut health! The paleo diet removes or limits many difficult-to-digest carbohydrates that are tied to SIBO.

Let’s take a closer look at paleo diet foods to see if some might give Mark’s caveman, Grok, a little indigestion.

Removing the grains beans, pulses, dairy, and processes sugars should make a big improvement in reducing SIBO-related symptoms. But, I would advise caution on some of the other “acceptable” food choices when experiencing symptoms.

Wild rice likely has a relatively low glycemic index and high fermentation potential (FP) due to resistant starch.  Unfortunately, I can’t confirm this fact without a GI  value and I don’t believe wild rice has been tested. I would recommend jasmine rice with an FP value of zero. But, don’t eat too much if you have high blood sugar or insulin resistance.

How about fruit? Many fruits contain high amounts of fructose. Because fructose is a single sugar, it requires no digestion, but it’s absorbed slowly into the bloodstream. This makes it more available for excessive fermentation in the gut. There are many studies liking fructose consumption to gut problems, especially IBS symptoms. Apples, pears, cherries, grapes, plums, are examples of fruits containing a lot of fructose.

Another fruit that can create issues is bananas. Bananas have a lot of resistant starch, especially under-ripe bananas. Resistant starch, like all difficult to digest carbs, hangs around providing gas-producing bacteria fuel.

What about dairy? Dairy is restricted on the paleo diet because it wasn’t available throughout our evolution. For gut health, the major issue is lactose. I agree that high lactose dairy such as milk and ice cream (there is lactose-free ice cream available) should be avoided. I don’t see the benefit of excluding heavy and light cream, lactose-free milk, cheeses, plain yogurt and other fermented dairy. I personally can’t imagine life without them.

Of particular interest are tubers, which are allowed on many paleo diets. Tubers include potatoes, sweet potatoes, parsnips, celery root, carrots, beets, daikon, yams, and turnip. Some tubers contain significant amounts of resistant starch and need to be avoided.  See my recommendations at the end of the article for safe tubers.

The Elemental Diet

The Elemental diet consists of foods that are essentially “predigested.” The foods contain fatty acids rather than fats, amino acids rather than proteins, and glucose instead of carbohydrates. The diet formula also includes water and micronutrients — vitamins and minerals. Elemental diet product such as Nestle’s Vivonex can be delivered orally or enterally (by tube). Elemental diets are designed to ensure full absorption and have been used to treat a broad range of digestive conditions including: Crohn’s and celiac disease, lactose intolerance, malabsorption, diarrhea, constipation, diabetes, cystic fibrosis, abdominal distention, and short bowel syndrome. Note that all of these conditions have some connection to SIBO. Some of the drawbacks of the elemental diet approach include high cost, unappealing (predigested!) food products, and the need for medical supervision.

The Specific Carbohydrate Diet

The book Breaking the Vicious Cycle by Elaine Gottschall describes her experiences with Drs. Sidney and Merrill Haas, who successfully treated celiac disease with a diet that allowed only specific sugars and starches. The Specific Carbohydrate Diet limits disaccharide or double sugars as well as grains and starch, but allows simple sugars like glucose.

In general, this dietary approach is on the right track, but it fails to limit a number of known contributors to SIBO-related illness. For example, honey is used extensively in the recipes even though honey has just as much fructose as table sugar (sucrose is made of equal parts glucose and fructose). And the diet also allows a large variety of fruits and fruit juices that also contain large quantities of fructose, which is now recognized as a major contributor to the development of SIBO.

Finally, the SCD does not allow any grains or foods containing starch. It wrongly identifies amylose starch as easy to digest and amylopectin starch as difficult to digest, suggesting that amylopectin and not amylose is more likely to cause problems. The reverse is actually true.

Note: The GAPS Diet (Gut and Psychology Syndrome) created by Dr. Natasha Campbell-McBride is based on the Specific Carbohydrate Diet but also includes detoxification, and supplementation.

The Low Starch Diet

Carol Sinclair popularized the Low Starch Diet in her book The IBS Low-Starch Diet. Sinclair discovered that reducing starch in her diet improved her IBS symptoms. She also collaborated with Dr. Alan Ebringer, a professor of immunology at Kings College in London, UK, who found that the diet could improve painful symptoms of ankylosing spondylitis (AS). Dr. Ebringer has made the connection between the autoimmune disease AS, intestinal overgrowth of the bacterium Klebsiella pneumonia, and controlling the bacteria’s growth through a low-starch diet. Sinclair’s book limits all starches as well as sucrose, lactose and maltose.

Unfortunately, like the Specific Carbohydrate Diet, the Low Starch Diet unnecessarily limits all starch, yet does not limit fructose, and will not be completely effective in treating SIBO.

The Low Carb Diet

The book Protein Power by Drs. Mike and Mary Dan Eades documented how low-carb dieting helped people with heartburn. Clinical studies have also shown that strict (ketogenic) low-carb dieting can improve IBS and GERD, two conditions associated with SIBO.[i] Despite impressive results (as documented in my first book, Heartburn Cured), not everyone gets complete symptom relief from a low carb diet. One possible explanation for the variations in results is that the low-carb diets don’t restrict fiber — another well-known contributor to SIBO-related digestive illness. Another reason might be a simple failure to stick with the diet.

The FODMAP Approach

Susan Shepherd and Peter Gibson developed the FODMAP diet at Monash University in Victoria, Australia.[ii] The acronym FODMAP represents four classes of fermentable sugars/sugar alcohols:  Fermentable Oligo-, Di-, and Monosaccharides, And Polyols.[iii] The FODMAP approach limits fructose, fructans, lactose, galactans and sugar alcohols.

One flaw in the FODMAP approach is that it fails to limit resistant starch, a significant contributor to malabsorption and excessive fermentation. In fact, the FODMAP diet calls for adding more resistant starch. As a recent article on the diet stated, “Part of dietary counseling is to ensure continuing adequate intake of resistant starch.”[iv] Another drawback of the FODMAP system is that a trained dietitian must deliver it.[v]

The Fast Tract Diet – New Way to Treat SIBO

The Fast Tract Diet limits all difficult-to-digest carbohydrates including fructose, lactose, fiber, resistant starch and sugar alcohols. But the diet uses a special method called Fermentation Potential (FP) to calculate the potential for any food containing carbohydrates to cause symptoms. Mathematically derived FP values (they are listed in tables but can also be calculated) for each food help identify and restrict difficult-to-digest carbohydrates without having to know what carbs are in each food. So you don’t need the help of a medical professional or dietician.

Unlike a strictly low-carb diet, the Fast Tract Diet limits fiber, but can include some higher-carb foods as long as they don’t contain too many difficult-to-digest carbohydrates. For instance, sushi rice, which contains little resistant starch, is acceptable, but basmati rice, which contains more resistant starch, is not. The Fast Tract Digestion book series also explains and addresses the other underlying problems listed above that can contribute to SIBO.

Here are four recommendations to control SIBO and limit symptoms:

  1. Limit rice containing amylose starch – high FP. Low amylose rices (such as Asian glutinous or sticky rice) are safe for gut issues.
  2. Limit tubers containing amylose starch – high FP. There are other low FP tubers such as parsnips, Pontiac potatoes, celery root and daikon.
  3. Limit high fructose fruits – high FP. Low FP fruits include watermelon, strawberries, blueberries, etc. Consume other fruits, such as melon, pineapple, pears, peaches, apples, lemon, lime and oranges as single slices or small wedges.
  4. Limit dairy with lactose – high FP. Acceptable are heavy and light cream, fermented dairy products including plain yogurt and cheeses.

Note: Some low FP vegetables, while gut friendly, are high carb. Use your judgment to avoid metabolic complications from high blood sugar, such as diabetes, obesity and cardiovascular health.

Question: What foods cause you digestive problems?

Fast Tract Digestion

References


[i]Yancy WS Jr, Provenzale D, Westman EC. Improvement of gastroesophageal reflux disease after initiation of a low-carbohydrate diet: five brief cased reports. Altern Ther health med. 2001. Nov-Dec; 7(6):120,116-119. Austin GL, Thiny MT, Westman EC, Yancy WS Jr, Shaheen NJ. A very low-carbohydrate diet improves gastroesophageal reflux and its symptoms. Dig Dis Sci. 2006 Aug;51(8):1307-12. Austin GL, Dalton CB, Hu Y, Morris CB, Hankins J, Weinland SR, Westman EC, Yancy WS Jr, Drossman DA. A very low-carbohydrate diet improves symptoms and quality of life in diarrhea-predominant irritable bowel syndrome. Clin Gastroenterol Hepatol. 2009 Jun;7(6):706-708.

[ii] Shepherd S, Gibson P. Fructose malabsorption and symptoms of irritable bowel syndrome: guidelines for effective dietary management.  J Am Diet Assoc. 2006 Oct ;106 (10):1631-9.

[iii] Gibson, P, Shepherd, S. Evidence-based dietary management of functional gastrointestinal symptoms: The FODMAP approach.  J Gastroenterol Hepatol. 2010 Feb ;25 (2):252-8  20136989.

[iv] Peter R Gibson, Susan J Shepherd. Evidence-based Dietary Management of Functional Gastrointestinal Symptoms: The FODMAP Approach. J Gastroenterol Hepatol. 2010;25(2):252-258.

[v] Gibson, P, Shepherd, S. Evidence-based dietary management of functional gastrointestinal symptoms: The FODMAP approach.  J Gastroenterol Hepatol. 2010 Feb ;25 (2):252-8, 20136989f.

 

About Norm Robillard

Norman Robillard, Ph.D., is a microbiologist and former researcher who spent 20 years in the pharmaceutical industry before founding the Digestive Health Institute. His goal is to develop holistic treatments for digestive illnesses based on a clear understanding of the underlying causes of disease. Norm was the first to recognize a connection between bacteria in our intestines, nutritional malabsorption and the symptoms of acid reflux. Based on his extensive research, he created the clinically proven Fast Tract Diet System (Fast Tract Digestion Heartburn), a safe and effective alternative to proton pump inhibitor (PPI) and H2 blocking drugs. Bacterial overgrowth fueled by nutritional malabsorption is a factor in several other digestive health conditions. Research in this area is the main focus of the DHI. Norm received his Ph.D. at the University of Massachusetts, Amherst and completed post-doctoral training at Tufts University in Boston.
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26 Responses to Diets for Digestive Health

  1. Dvora Citron says:

    I just bought the book and read it. I have been following FODMAP, which I’d like to continue doing, along with this program. I figure if I can cut out resistant starches, that would qualify. But the Fast Tract Diet is really hard to follow because there is SUCH a limited list of foods available, and no where to check what the fermentation values are (the information you need for the computation is rarely available). Like how about all the nuts, seeds and peanut butter? Is there a resource with more food values available?

    • Hi Dvora,
      Following both FDMAP and Fast Tract Diet would be limiting because FDMAP eliminates any foods that contain any FODMAPs. The Fast Tract Program, on the other hand, limits FP so many foods that may contain some FODMAPs are still acceptable within the daily FP limits. A good example is garlic. Even though garlic contains FODMAPs, the actual amount in grams is very low and likely not to cause any problems in typical amounts used in cooking.

      The 15 – 16 FP tables in the appendices of Fast Tract Digestion heartburn and the new IBS volume list approximately 300 foods with up to 2000 possible foods based on the glycemic index data base. While I continue to expand the tables in new books or book revisions, many people create an excel table with the formula so they can just plug in new foods that have a glycemic index available.
      This is a new ground-breaking idea for controlling SIBO-related conditions. I recently presented the concept and clinical study at the Digestive Disease Week meeting and more doctors are beginning to recommend this approach to their patients. I expect as more patients and readers start using the approach, this collaborative effort will help expand the FP values in the tables.

      The book explains why many foods do not have a glycemic index value assigned. For instance the carb levels are so low in some foods, that they can’t be tested, but also so low as not to be a threat. The book also discusses ways to estimate FP based on similar foods. For instance you can assume that the glycemic index of nuts are likely on the low side, similar to peanuts. And when in doubt, you can also experiment with new foods after your symptoms are under control. I hope this helps.

  2. Melissa Coleman says:

    How can you say sugar and brown sugar (sucrose) are ok and low FP when articles like this say they are the primary choice of food for bacteria? This seems counter intuitive to the entire basis of a SIBO Diet?

    http://www.geekosystem.com/sugar-persistant-bacteria/

    • Hi Melissa,
      The fermentation potential for sucrose is calculated the same way as any other food based on the carb count, glycemic index and any sugar alcohol or fiber. But I can see how you might think I advocate sucrose because the FP in the tables is 6 grams considered to be “low”. But keep in mind, that value is only for a 0.5 ounce (14 gram) serving size. If you added it up for many sugar laced foods like soda pop, etc, the FP would obviously be much higher. The recipes in the Fast Tract books don’t used sucrose (except for a small amount of brown sugar in the ribs recipe) and I don’t advocate using sucrose. The option is there for people who do want to use it and include the the FP value for the serving used to calculate the daily FP amount.

      By the way, thanks for the link to the interesting article on sugar making “persistent” bacteria more susceptible to antibiotics. I had not seen that work before. Very interesting.

  3. Sarah Massello says:

    I have not been officially diagnosed with SIBO, however I have had stomach problems for about a year and half now, with the main symptom being extreme bloating and sometimes a general lack of appetite. Despite this, I have gained weight around my stomach (or at least it looks like I have because of the bloating. I had to take antibiotics at two points over the past year, once because of a spider bite and another time because of a do g bite (bad luck with animals, I know!) Both times (and especially the first) I noticed huge improvements in my digestion, with my appetite increasing, the bloating decreasing and the extra weight (or appearance of weight) around my stomach just falling off. This led me to believe that for some reason the antibiotics were helping whatever it is that is wrong with me, but I was not sure of the mechanism behind it.

    After going to the doctor for help, I went through some standard tests and tested positive for h pylori. I underwent a round of treatment for that (including two antibiotics and a PPI), but I didn’t notice much improvement in my symptoms. I just returned from a very frustrating first-visit with a gastroentology specialist, who told me h pylori may or not actually be an issue (as I guess a lot of people test positive but it’s not a problem), and that I likely have IBS that I will just have to manage through diet. This was really heartbreaking for me as I always thought of IBS as one of those things that doctors just tell you when they don’t really know what’s wrong with you.

    After I did some research and found out about SIBO, it made me feel a little better as at least it puts forth a reason as to why I am experience the symptoms I am, as well as why antibiotics would have temporarily made me feel better.

    So that was all a very long precursor to my main question – I am ready to try the fast track diet and see if that can help reduce my symptoms. I downloaded the ebook Fast Tract diet for IBS, however it is much easier for me to have a printed out book (especially for the charts and recipes). My question is – is the ‘Fast Tract Digestion – Heartburn’ book still relevant for me as someone who has more issues with bloating and IBS than Heartburn? And does it offer the same diet plan/recipes for me to follow?

    Thank you!

    • Hi Sarah,
      As you might imagine, I talk to many people in your exact situation. Keep our counseling program in mind if needed. In the mean time, I think you pretty much answered your own question on antibiotics. They help initially at the cost of wiping out a lot of other “good” bacteria. Also, survivors gain resistance to the antibiotics which limits the effectiveness of subsequent treatments. You may have already read this post on antibiotics for IBS. As for the IBS print book, we just went to print. It will be available in about three weeks. If you’re in a hurry, the Heartburn book uses the same FP approach though the recipes are different. It will also work fine for IBS.

  4. Sue Rapp says:

    Just dx’ed via endoscopy with small bleeding ulcers in the stomach. I take hcl as well as other enzymes to make sure no undigested food is getting into the small intestine. I also follow strict diet, and after 6 months treatment I am finally clear of sibo. Doctor recommended Prilosec to treat the ulcers but if I diminish stomach acid, I can’t digest my food and sibo sx return. What to do? Any other tx out there for ulcers? (official dx was acute gastritis, pin point bleeding ulcers).

    • Hi Sue,
      If you had an endoscopy, you likely are seeing a doctor which is key in your case to diagnose and treat not only the ulcer itself and any bleeding, but potentially other complications as well. Treating any possible underlying factors (most importantly, H. pylori, but also anti-inflammatories such as ibuprofen, as well as alcohol, smoking, etc.) will be required and stomach acid needs to be controlled to allow healing. I would think that your doctor will recommend not taking HCl as this is one case where too much acid is a bad thing. The Prilosec also makes sense in your situation and I would not be surprised if antibiotics are added if H. pylori positive. The Fast Tract approach will provide protection against SIBO during your ulcer treatment by limiting fermentable carbs. Even if stomach acid is low, the diet will limit overgrowth by denying gut bacteria excess fuel. Best of luck and speedy recovery.

      • Sue Rapp says:

        Thanks so much for your thoughts. In fact, I take a physiologic dose of hydrocortisone for low adrenals. I can’t go off this. This may be how I got into trouble to begin with, as there were many, many days where I took hydrocortisone on a very empty stomach. H. pylori was ruled out from the endoscopy. I did find that in the 3 days on the Prilosec, I had delayed gastric emptying, diarrhea, and nauseau. I’m not sure if this experience rules out the entire class of drug or just this particular drug. I appreciate your thoughts on the HCl. Jonathan Wright makes claims for DGL and mastic gum to heal ulcers, but I believe these are off limits due to their fermentable aspect, would you agree?

        • I’m not a big fan of PPIs, but in your case and given some complicating factors I can only suggest you confer with your doctor on whether or not to continue taking the Prilosec, adjusting the dosage or changing the type.

          DGL may be an option, but be sure to find a product (they exist, but not sure where) that is free of sugar alcohols. Also, use some caution with mastic gum as it has some potential side effects including diarrhea, cramping, belching.

          • Sue Rapp says:

            So you think that dgl and mastic gum won’t feed the bad guys in the gut? I believe they both are on the SCD “illegal” list. I plan on consulting with my doc on Monday, just looking around in the mean time. I may consider a different PPI, but not happily. Thank you again!

          • Should be OK so as long as the DGL has no sugar alcohols in it.

  5. Sue Rapp says:

    Thank you so much. I just purchased your IBS book, I really appreciate your thoughtful replies and am enjoying your book, especially as it relates to sibo. As you suspected, I cannot find a DGL w/o sugar alcohols. I read a very helpful suggestion from an Amazon reviewer who recommended powdered DGL. I’m passing that along in case it’s helpful. The powdered DGL has no sugar alcohol. Based on your above comment, I am assuming it is very low FP.

    • My pleasure. Thanks for reading the book. Someone posted on Digestivehealthinstitute.org about the sugar alcohol-free DGL. If I find the comment, I will repost here. It might be the same as what you found. If so, that DGL has less than one gram of carbs.

  6. Michelle Metz says:

    Hi Dr. Robillard,
    My son has recently been diagnosed with SIBO. He is ten years old. Prior to his diagnosis of SIBO, I had him on a gluten free diet because I suspected Celiacs as a cause of his stomach aches, bloating, constipation and acid reflux. He did much better on gluten free for about a year but still had frequent constipation and had occasional reflux and stomach aches. I took him to our Gastroenterologist and they said he should be formally tested for celiacs and needed to eat gluten for 6 weeks prior to having his endoscopy. Well it has been 2 months since his endoscopy results which showed no celiacs, mild reflux and lactase deficiency. He gained 11 pounds in the 6 weeks of eating gluten, felt horrible every day with severe stomach pains, vomiting, nausea, acid reflux. I have him back on gluten free again but this time he has not gotten any better. I convinced the doc to test him for bacterial overgrowth and it came back positive. He started Flagyl 500 2x a day and was supposed to be on it for 14 days but had terrible side effects after 4 days. We were told by the Doc to discontinue it and that the bacteria should be killed off already. He is in agony still, cant eat, cant sleep, dizzy, nausea, feels like knives are stabbing him in his stomach and we are not getting anywhere with his Doctor. They just want to treat his constipation and put him on PPI’s. I am wondering if he could be experiencing “die-off” symptoms or could the bacteria not be killed off yet and still be making him sick. I ordered your book Fast Tract Digestion for GERD and am waiting for it to arrive. He has been sick for 3 months now and I am hardpressed to find any answers from local doctors. Thank you for any information you are able to give.

    Reply

    • Hi Michelle,
      I know we have been in correspondence off line, but just wanted to mention one more thing. If your son continues to have constipation, Fast Tract Digestion IBS contains a more extensive section on constipation. I hope your son is doing better. Also, to be on the safe side, I would avoid any gluten-containing foods in case he has non-celiac gluten sensitivity.

  7. Michelle Metz says:

    forgot to mention he is also sick with a sinus infection now too and is on Augmentin for that. Could a sinus infection be connected with SIBO as well. It seems coincidental that as soon as he started Flagyl he came down with that as well.

    • Michelle,
      Sinus infections can be connected to SIBO and acid reflux likely because reflux can bring intestinal bacteria into contact with the sinuses. The connection with Flagyl is likely a coincidence. Getting the SIBO under control with diet should help prevent future occurrences.

  8. M C says:

    How bad is maltodextrin? All I know about it is that it’s an oligosaccharide.

  9. Emily says:

    Hi Dr. Norm,
    Just reading through the blogs to get any new info. Thought I’d chime in on the DGL issue since I’ve used quite a bit of the stuff and it has been very soothing. Here’s a non sugar alcohol version:

    https://www.swansonvitamins.com/swanson-superior-herbs-high-potency-dgl-
    licorice-750-mg-90-caps

    It does contain a small amt of brown rice powder, but I’m assuming not enough to cause problems.

    I’ll also mention a couple of stevia products I like that have no sugar alcohols:

    https://www.swansonvitamins.com/now-foods-better-stevia-extract-powder-1-oz-pwdr

    https://www.swansonvitamins.com/wisdom-natural-sweetleaf-sweet-drops-vanilla-creme-liquid-stevia-2-fl-oz-liquid

    Thanks for your great work!

    • Awesome Emily. Thanks for sharing the product links! I just bought all three. I almost never have heartburn these days, but who knows around the holidays. I have never tried either Stevia or DGL. I’m curious about both.

  10. Emily says:

    Glad I could help! There are very few sources of DGL without sugar or sugar alcohols of some kind. Another good one (but more expensive) is below. It’s a powder that’s good for soothing the throat. Actually I used the capsules from Swanson by breaking them open and dousing my throat (I’ve had some LPR).

    http://www.amazon.com/gp/product/B000KYMBT4/ref=ox_sc_act_title_2?ie=UTF8&psc=1&smid=A2XIEOBVGWFUKX

    Stevia is interesting. Not as “sugar-like” in taste as Splenda. Brands vary in “after-taste” and IMO next to impossible to use as the only sweetener in dessert recipes. I’ve tried a combo of stevia and just a little honey. I’m just glad that dates have a low FP :-)

  11. Peter says:

    Dr. Norm,
    I came across your book and website. There is much interest in this subject!
    My mother has had stomach problems and diarrhea for the past 7 months. When she visited, at 4 AM I could hear her stomach bubble from the next room
    She went to a gastroenterologist and he determined that she had H. Pylori.
    The treatment was 3 different antibiotics. She felt better, however it does not appear to be gone.
    How long should one go on your diet in order to eliminate H Pylori?
    And, I read that Cranberries kill H. pylori. Where do they fit in your recommendations.
    Thank You,
    Peter C.

    • Hi Peter,
      Sorry to hear about your mom. If she completed the antibiotics as prescribed, the H. pylori, that lives in the stomach, should be gone. The Fast Tract Diet is not aimed at H pylori, but your mom may have gut disturbances from the effects of the antibiotics on gut microbes in her intestines (nothing to do with H pylori). I have no information about how effective Cranberries would be in this situation. If you mom continues to have GI symptoms after she is done with the antibiotics, the Fast Tract Diet will likely be helpful in that regard.

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