This week we are hanging in Nantucket. Not a bad gig. I love this island.
We left our car and our stress on the mainland. Got some bikes, a beach blanket and pretty much that is all we need for the week.
Love the old-fashioned feel of this island.
Love biking in a dress, do you?
So, if I don’t answer your comment immediately….it might mean I am away from my computer and chilling with my family.
Today, was a bit of biking, beaching, and a cold beer at Cisco brewery. Not too shabby!
Hope you all enjoy the week!
Marcy
I just found your site! I was recently DX with SIBO (small intestine bacterial overgrowth). Do you have special diet for this? I know carbs can keep the overgrowth well fed! I’m overwhelmed and don’t know what to eat. Waiting Ins to approve expensive strong antibiotics, then do probiotic. Want to follow with diet so doesn’t return. Have read it returns quickly… So many diets on line for IBS, but SIBO is different. Thanks!
katescarlata
The low FODMAP diet can be helpful in SIBO-one recent study noted this. Overall, there is little data on diet for SIBO in the medical literature…this is a problem 🙁 ….and there are many sites that suggest other diets may be helpful but they have little research to support their claims. I wish the medical community would do more research on diet and SIBO as there are many people out there that could benefit. I think Mark Pimentel’s book, The New IBS solution (some info in it is antiquated) is a good general book to read on SIBO. I personally have had SIBO–I have found meal spacing (eating every 3-4 hours vs. grazing), low FODMAPs and a diet that focuses on real foods vs packaged can be a good start. Magnesium rich foods may also help with inflammation. Some individuals find going grain free helpful too but until we get better research in this area…it’s a bit of a trial and error.
Marcy
Thanks for the info! How did you treat your SIBO and what did you eat? I have cut fruits down to 2 servings a day, few grains (Gluten free cereal, GF pretzels, Jasmine Rice, Russet potatoes), almond milk and Greek Yogurt/Cheddar & Mozzerella cheese, no artificial sweetners or caffeine, decaf tea, lean meats, All natural Peanut Butter. Problem is VERY Constipated – always my main issue (IBS-C – SIBO). I also do salads with EVOO/Bal. Vinegar and cooked and fresh veggies/tomatoes etc. Afraid if eat too much fiber or grains the SIBO will just keep GROWING! Any further suggestions much appreciated. Any SIBO RD here in St. Louis MO area? Waiting now to get into specialist in SIBO (Late October UGH). Wanted to switch Dr’s due to current GI not up on diet to prevent SIBO returning etc. Thanks again!
katescarlata
Hey Marcy!
Perhaps you need a different treatment for SIBO. I did rifaximin–did best after a full month of treatment. Some individuals with IBS-C and SIBO benefit from adding neomycin to their rifaximin treatment –better efficacy in this treatment for some. Also, some of my clients have done best with following up their antibiotic treatment with low dose erthryomycin (50 mg) at night to help with small intestinal cleansing waves. Make sure the GI specialist you are working with is well aware of research with SIBO or is willing to look at the research and get acquainted with it–this is SO important–sounds like you have made the right steps and advocated for yourself!! Good for you!
An important part of SIBO management is meal spacing–allowing 3-4 hours between meals is ideal. Your small intestine initiates a cleansing wave ONLY when you are fasting (not eating) so if you are constantly grazing…this can impact SIBO risk.
Perhaps adding a little caffeine may give your sluggish intestine a little get up and go? Fiber needs to be carefully balanced and titrated individually–some of my clients have done best with low fiber but MOST need a little extra or at least around 25 g /day–and chia seeds seem to be the best tolerated!
As for your diet, would suggest you limit the almond milk –may have FODMAPs. Another potential issue for some of my clients is dairy–not just the lactose but dairy altogether. Not that you want to add another restriction to your diet–but you might give dairy free a try for a week and see if you note any improvement in your constipation symptoms. Of course, work all these diet changes with your health care provider. I don’t know of an St. Louis area SIBO RD–perhaps reach out to the local dietetic association to see if they can assist you.
Hope that helps a bit. Best to you!
Beth
Kate, can I ask you a general nutrition question? Do either eggs or bananas or both make constipation worse? Or is this a myth? Thank you for your help.
katescarlata
I don’t think bananas contribute to constipation. They may not be the biggest source of fiber so other fruit choices may be better for constipation. Eggs are a source of sulfur (not FODMAPs) and this perhaps can contribute to constipation in some individuals.
Jacqueline
Just found your blog and wanted to say you are adorable!! I have IBS C and figuring out how to eat is pretty challenging. I’m looking forward to stalking er reading your blog. 🙂 Enjoy your time in Nantucket – it looks like an incredible place to visit.
Marcy
Thanks for the additional info, Kate! I have Xifaxan RX for 2 wks from “old GI Dr.”. I read that many do Neomycin with this antibiotic. I’m allergic to Pencillin, so probably wouldn’t be able to do Erthryomycin. Dr. advised taking Align after the 2 wks of Antibiotics (guessing similar to Erthryomycin. I have been doing pretty good at not snacking – HUNGRY! Feel like missing so many nutrients. Multivitamins? Many contain Iron didn’t know if ok?
I’ve tried Lactose Free milk – so sweet! Thought Soy milk was a no no. So, do almond milk when have gluten free cereal (probably not good have grain with SIBO though?)Don’t do the almond milk often. Will try cutting out cheese (although don’t have much at all)I was tested for Lactose, Fructose, Gluten Intolerance – all negative. Although was before the SIBO Dx. (if makes difference)Added another fruit to diet today (3 total) and more raw veggies. Guessing best way to add fiber, since SIBO doesn’t like other fiber choices. I added Chia seeds to grocery list!
Have you heard of Fast Tract Diet? Thinking of trying that. It seems to include a lot of the Low FODMAP diet ideas. I need something to try, till see new GI Dr. in October.
One last question…What diet if any is best while taking the antibiotics? Do you want to limit sugar/carbs while on RX OR eat those carbs etc. during the treatment to kill more off?
Thanks much! Hoping the GI Dr. will know of SIBO RD – Low FODMAP RD in STL. I’ve worn the pages off of your blog!
katescarlata
Marcy-I don’t know much about the Fast Tract diet but doesn’t it advertise that you can lose 8 lbs. OVERNIGHT??! If so, sounds unhealthy.
As for what diet is best while on antibiotics—I don’t believe there is research on that…but per discussions I have had with SIBO MD experts, the diet should not be super strict when you are on antibiotics as the bacteria tend to hibernate and the antibiotic may be less effective….so you want to draw them out like “cheese to a mouse”. So I recommend a moderately low FODMAP diet–a BUT more liberal–allow some FODMAPs but not enough to make you miserable.
Marcy
Thanks for your time and expertise! Will continue to watch FODMAP’s and SIBO sugars until get into GI Dr. in late Oct.Taking a meal/day at a time! Had cramping after dinner last night: Brown rice pasta, lil lean ground beef, infused olive oil, small salad with few carrots/tomatoes (with olive oil and Balsamic Vinegar). Is it the dinner OR something ate earlier or day before? How do you pinpoint what caused pain. Also, not for sure what “milk” to use. Lactose Free has a lot of sugar for SIBO as well as Rice Milk. Using Almond milk(only when have cereal) but you mentioned may have FODMAPs…I purchased the Ebook of Fast Tract Diet. It didn’t mention losing 8 lbs day. I am losing wt due to not eating snacks(waiting 3 – 5 hrs between meals for cleansing wave) etc. Fast Tract seems LOW FODMAP in many ways. It goes by Fermentation rate of foods in body and Glycemic Index etc. It limits more carbs (Dairy – greek yogurt ok; allows fewer grains and starchy veg and some fruits due to sugar that keeps SIBO around). Guess Trail and error is best bet for me at this point while waiting to see GI Dr. Thanks for your posts and wealth of info! Wishing could do Low FODMAP, but feel with SIBO need watch many items(Carbs etc). Maybe a combination of both diets…
dkaj
Hi Kate,
When you use chia seeds to add fiber, are you soaking them first in water before baking with them so they get the moisture they need to soften up? I tried putting some in a granola bar recipe I made, and they pretty much stayed hard. Thus, the texture wasn’t good and it was somewhat annoying as the hard seeds kept sticking to my teeth and getting in between the teeth. I’m thinking the recipe I used didn’t have enough liquid in it. Any suggestions would be appreciated.
katescarlata
I add the chia seeds dry to recipes or top on my yogurt or oats. If you soak them–the soluble fiber on the outside of the seed will take in the water and become a little gel like ball….so it all depends on your texture preference. They can be blended into a smoothie as another alternative –making the smoothie thicker as they attract the water and thicken it up. I have also used chia in jam–very easy to do. Here is the link: http://blog.katescarlata.com/2013/06/04/berry-chia-jam/
dkaj
Thanks!! I’m going to try your tips!
Ron
I am also a big fan of the island of Nantucket.
Is the alcohol content of pure vanilla extract a problem on a low FODMAP diet?
Also, Is it possible to determine whether it is fructans or gluten in wheat and rye products that is the source of my food sensitivity?
Thanks so much.
katescarlata
Ron–the alcohol in vanilla extract should be okay–used in small amounts of course. Yes, a dietitian should be able to set up a challenge for you to test your tolerance to gluten or wheat. I would recommend you find a dietitian knowledgable in the low FODMAP diet.