I only recommend re-test if patient is symptomatic.

Tiffany–villi would be found in your small intestine. Have you been ruled out for small intestinal bacterial overgrowth and/or celiac? Your doctor should be able to discuss this further with you.

It would be good to have a review about small gut dysmotility, type-3 Ehlers-Danlos syndrome (hypermobile EDS) & SIBO.

I probably have this, as does one of my daughters.

ME: (aged 72y) – regular, sometimes quite severe IBS-type symptoms for several years before. Have had endoscopies and colonoscopies, and capsule endoscopy. Jujunal diverticulosis and colonic diverticulosis. Also developed acute inflammatory arthritis –onset age 55y. Treated with analgesics, some steroid injections, then plus NSAIDs of increasing potency, then plus hydroxychloroquine, then plus methotrexate p.o. , then plus methotrexate sc up to max dose of 25mg weekly. My joint problems were progressively getting slowly worse.
I was anaemic (Fe and B12 deficiency – so mixed aetiology), and Vit D deficient. Have had occasional Fe infusions, regular B12 injections and oral Vit D replacement therapy.

Finally on my own initiative about 3 years ago (and advice from my other daughter who happens to be a FODMAP-trained dietician) I started on a low-FODMAP diet. Hey presto! I can report now that my gut symptoms have slowly improved to date, and I have progressively reduced my anti-arthritis medication one-by-one and finally (and on the advice of my rheumatologist) I have now stopped ALL all my arthritis drugs and my joints are fine!
As long as I keep to the low FODMAP diet my gut is pretty much fine as well!

I have never had joint hypermobility, but did have POTS-like symptoms when younger. So perhaps a “form-fruste” of EDS type-3?

YOUNGER DAUGHTER – (aged 44y) – has obvious type-3 EDS with multi-system involvement. Over many year she has seen numerous specialists in many disciplines – finally she now has a firm diagnosis. Much of her symptomatology has also dramatically improved on a low-FODMAP diet.

– Oh! – I forgot to say that I am a retired medic and my younger daughter is a paediatrician (her 2 daughters also have type-3 EDS). There is a lesson there – all of this is complex, and no wonder it is poorly recognised by most medics!

Much of our sufferings then have been enormously helped by a low-FODMAP diet – it has probably enabled my daughter to keep going as a busy Dr in acute paediatrics. We are truly amazed by the help that our diets have been to our well-being!
We assume that we have SIBO due to gut hypomobility/paresis and deficient GI neuroregulation, and that the FODMAP-induced changes in the gut microbiome have had a major effect on our multi-symptomatology. Many of our medical advisors/colleagues (but not all!) agree.

A piece about EDS / gut dysmotility / SIBO / low-FODMAP from you would help spread thoughts about the inter-relationships of these issues, and perhaps stimulate more research which is sorely needed!

Sorry this is such a complex story, & perhaps rather boring to many!!

A big question for us now is concern about the effects of a very long-term, even life-long, low FODMAP diet. I must add we both take supplements (B-100, Vitamin C, Chelated Mg, and Bio-Kult).

Best Wishes
John Harrop.

Have you found any reliable research to support the notion of drinking sixteen pounces of celery juice every morning to rebalance the hydrochloric acid in the stomach is helpful in controlling SIBO? There are some who say this is crucial for those who have not had any success with xifaxin or the xifaxin and neomycin regimens even when they adhere strictly to the low FODMAP diet….

Would you please address this?

Thanks in advance…

Some people are intolerant to the type of protein in milk. Learn more here: https://blog.katescarlata.com/2016/09/01/got-cows-milk-intolerance-lets-learn/
Probiotic and prebiotic post is being worked on! Stay tuned.

I look forward to reading the post !
Cheers, Joy