SIBO on top of collagenous colitis

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SunHiker
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SIBO on top of collagenous colitis

Post by SunHiker »

Hydrogen breath test with lactulose came back positive, so I've been madly researching how to treat SIBO, and preparing to go on the Diet from Hell while taking the antibiotic. I have avoided dairy in all forms since I was diagnosed with collagenous colitis six years ago. But many of the dietary recommendations for SIBO include homemade 24-hr yogurt; apparently incubating for that long is supposed to get rid of the lactose. So I made some, and it was delicious, and I had it for breakfast three days this week. The result? D again, though I had been D-free for months except when stressed. So I guess something in milk products other than lactose is problematic for the colitis. Maybe casein?
SunHiker

Collagenous colitis since 2011, managed with diet.
SIBO now, too. )-:
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tex
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Post by tex »

Hi Hiker,

Welcome aboard. Yes, most MC patients are also intolerant of casein, the main protein in all dairy products, including yogurt of course. Your SIBO (as shown by a lactulose test) will probably soon return if it hasn't already. This is because our gut bacteria profile is determined by our diet or our digestive efficiency. And MC prevents digestive efficiency as long as it is active. It can only be temporarily altered by antibiotics, and then it will return to whatever our diet and digestion efficiency determine. All MC patients have "SIBO". It resolves automatically as we resolve the MC.

Again, welcome. Hopefully casein will be the last of your undiscovered food sensitivities. Happy healing.

Tex
:cowboy:

It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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SunHiker
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Post by SunHiker »

Thanks! Casein in butter also? In ghee? In kefir?
SunHiker

Collagenous colitis since 2011, managed with diet.
SIBO now, too. )-:
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tex
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Post by tex »

Butter is loaded with it. Ghee may or may not contain it, depending on the efficiency of the separation process. Kefir — if it's made from milk, it contains casein.

Tex
:cowboy:

It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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SunHiker
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Post by SunHiker »

Ah well. A Venn diagram showing foods allowable for combating SIBO and foods allowable for combating MC would have a pretty small overlap. Thus the Diet from Hell: meat or fish freshly cooked (except those kinds found intolerable via Alcat), cooked non-starchy low-fodmap vegetables (only those OK by Alcat), a very few low-fodmap fruits (cooked), a few low-fodmap nuts, a few oils, and that's it. No grains, no legumes, no dairy, no gluten, no additives. No soluble fiber (SIBO). No insoluble fiber (MC). My Dr. says let her know if I start losing weight...
SunHiker

Collagenous colitis since 2011, managed with diet.
SIBO now, too. )-:
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tex
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Post by tex »

It's not necessarily that restrictive, but it might be, depending on your actual food sensitivities. ALCAT is a blood test isn't it? It doesn't work particularly well for MC. No blood test does. We use the stool tests (testing for IgA antibldies) at EnteroLab to get much more reliable results. The antibodies are produced in the intestines, not in the blood. Only a small percentage ever reach the blood. That's why the celiac screening tests have such poor sensitivity that they miss about 95 % of cases.

Or, in lieu of the Enterolab tests, you can look for IgA antibodies in biopsy samples taken from the colon, but it's much easier and cheaper to use the EnteroLab tests. Or you can simply follow the restrictive diet that you outlined and avoid all those foods. But that's pretty tough.

Tex
:cowboy:

It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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SunHiker
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Post by SunHiker »

Yes, ALCAT is a blood test. I'm interested in what you say about Enterolab, and plan to look them up. Both a colonoscopy and a stool sample processed by a lab somewhere in the Southeast US confirmed collagenous colitis, six years ago. Now it appears that after six years of a moderately restricted diet (no dairy, no gluten, no sugar in any form, minimal grains and legumes) the MC hasn't budged an inch. All I have accomplished is to reduce the symptoms. It's discouraging! Now I have to also cope with a new set of symptoms brought on by SIBO, without disturbing the slumbering MC any more than I can help. Is it even possible to resolve MC?
SunHiker

Collagenous colitis since 2011, managed with diet.
SIBO now, too. )-:
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tex
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Post by tex »

You can control it, and resolve all the clinical symptoms, and heal (which will restore the original cellular histology in your colon). But there is no cure ,unfortunately. It's always waiting for us to lower our guard.

There may be an undetected food issue, or a medication, or something else in your environment. Or your diet might somehow be getting cross-contaminated. Tracking down the last problem trigger can be tough, but it can surely be done.

Tex
:cowboy:

It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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SunHiker
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Post by SunHiker »

I guess healing did not occur, despite appropriate dietary measures (I also excluded nearly all processed foods). The naturopath who treated me at the time recommended atractylodes before every meal (she was into TCM), which I still use, and digestive enzymes plus betaine hydrochloride, which I still use. But I take no prescription meds for MC or anything else.

My success at managing symptoms with diet went out the window when SIBO apparently became active right after a series of stressful eye surgeries. SIBO could have been there all along, and perhaps my restricted diet plus a purposely low-stress life style kept it from becoming a full-blown menace. Which it is now. So I am off to the kitchen to see if I can concoct crackers and breads and soups with only ingredients not known to be associated with flare-ups of either SIBO or MC. Sigh.
SunHiker

Collagenous colitis since 2011, managed with diet.
SIBO now, too. )-:
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tex
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Post by tex »

Naturopaths have the right idea, but many of them are unable to treat MC successfully because they push too many "supplements" on the patient. When treating an MC flare, less is more. The fewer foods, medications, supplements, herbs, etc we put into our bodies, the faster we are likely to recover. Too many things are an irritant when we are flaring and ingesting them can be counterproductive.

One day when I was recovering someone suggested digestive enzymes. I thought, "Sure — why not? I'll recover faster." I learned the hard way that digestive enzymes were not for me after I took one pill and was sick for 4 or 5 days. YMMV.

Tex
:cowboy:

It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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