And the clinician is diagnosing hydrogen sulfide SIBO, regardless of glucose or lactulose. There are also studies of using bismuth with antibiotics of your choice, really. Then we have chronic postprandial symptoms. Sulfur is also part of the cellular stress response, improving ATP (energy) productionso that cells can carry on normal functions even when under stress. Again, Aerodiagnostics is the SIBO lab I use in my clinic. Are we dealing with methane? Today Im here with Dr. Allison Siebecker, and Gary Stapleton from Aerodiagnostics. For more information on how to become a patient, pleasecontact our office. However, it is essential to note that bacteria within the colon can also consume gases, particularly hydrogen, to release gases like methane and certain sulfur-containing gases like hydrogen sulfide that account for the foul odor we associate with gas. August 14, 2019. And now the exciting opportunity iswhen the technology becomes available and when its not in research mode, when its actually been a large-scale study across multiple geographies and anatomies across the globeis it standard? So were seeing it. GS: Well, I think Ive talked quite a bit. Also, those who suffer from flatulence with this form of SIBO will likely find that it smells of rotten eggs. So what Ive actually seen work, my own self, is nitazoxanide, high-dose oregano. I asked Dr. Weinstock about that, and he said that approach had been very successful in his experience. Now, I think what that would mean is were missing some people who maybe are showing a negative and they really do have hydrogen sulfide, because theyre not showing a flat line. Thanks for that. But from what Ive been told it will not be available for a distance test or a mail kit or do-it-at-home kit. I would start it slow, be careful. This isnt a long-term solution, but if you do have hydrogen sulfide-producing SIBO, it, Another diagnostic: while traditional SIBO typically responds well to a low FODMAP diet, those with hydrogen sulfide SIBO will likely respond better to a, Epsom salt baths are a good way to circumvent the gut and, Its most important, of course, to find the root cause. Its by Priority One, I think. This was really more like muscle pain, like that idea of fibromyalgia, and not as much joint pain, but more muscle kind of pain. We might get a 20% gain from one and then another 20% gain from another. In This Episode Breath Testing 00:03:56 I believe we discussed this on the podcast a while ago, that for suspected hydrogen sulfide SIBO, you could add in bismuth to synergize with antimicrobials. So thats Alinia. Its not going to be effective until its just as widespread as hydrogen and methane testing. If you use an open capture that doesnt have data on it, we dont know what were measuring. Symptoms of hydrogen sulfide SIBO are similar to those of regular SIBO, except that they also are more commonly linked to diarrhea than constipation. We dont have that technology. Allison, anything that you want to add there? I see people after theyve seen other doctors. So I cant report. But it is tenable to say that almost any symptom could be driven by a problem in the gut. So it could be that theres methane present at the same time, and methane is usually more dominant than hydrogen sulfide. And one lady said, What probiotics do you recommend?. Second, verify the test was performed correctly: did you drink the solution, lab prep, etc. Background & Aims: Hydrogen sulfide is one of the main malodorous compounds in human flatus.This toxic gas also has been implicated in the pathogenesis of ulcerative colitis.Therefore, a treatment that reduces colonic H 2 S levels could be clinically useful in the treatment of flatus odor and of ulcerative colitis. It seems like a lot of the things that can work on hydrogen sulfide can work on methanogen. So this really confused both of us. Hydrogen Sulfide SIBO Protocol update Hi guys :) I'm two weeks in to my treatment 2000mg Bismuth (Brands Combination out of Devrom, Thorne Pepti Guard and Pepto Bismol) 34mg Zinc Acetate (Brand life extension) 300 mcg molybdenum (Brand Biotics, Mo-zyme) Two pills of ADP oregano So theyre not so much chronic because they need some new novel treatment, but theyre chronic because the level of precision the clinician has had hasnt been up to snuff to help them get over this. People with SIBO or dysbiosis will produce even more gas than average. This is what we do. Three of the livers Phase II Detoxification processes (rendering a toxic molecule less harmful) require sulfur: sulfation, glucoronidation, and glutathione-S-transferase. A multi-focused approach works best to treat SIBO and biofilm. Pepto Bismol is an antacid . So I just dont want someone to be like, But she said this works for hydrogen sulfide. Its always hit or miss. Unfortunately, there are no clear SIBO treatment guidelines, and more research on the use of antibiotics for SIBO is still needed. But usually its more like I asked, Do you have irritation when youre urinating? Then we do this right and we get enough of these therapies integrated in sequence together. Yes, it is possible to overdo exercise. EXCESS HYDROGEN SULFIDE . By the way, one other theory could be that when hydrogen sulfide is in the large intestine, it causes constipation. First thing we do is validate via the questions. So I dont like the idea of using that long-term at all, personally. So thats bloating, abdominal pain, constipation, diarrhea. Most people with hydrogen sulfide issues find that garlic, eggs, kale and other brassica vegetables like broccoli and brussel sprouts are the most problematic foods that promote their symptoms. Is it the air from the mouth? Keep your gut in balance by choosing the right supplements for your gut microbiome. Another diagnostic: while traditional SIBO typically responds well to a low FODMAP diet, those with hydrogen sulfide SIBO will likely respond better to a low sulfur diet. If you are someone who has always had a mysterious case of SIBO or dysbiosis, your tests are inconclusive and/or show a flat line, or you know that you have recognized that your symptoms or the smell of your gas are linked to sulfur, then hydrogen sulfide overgrowth might be an issue. Then there are some herbs that we could use. I usually use two herbs at once when Im treating SIBO. Did they drink it with water? We respect your privacy. Pepto-Bismol can be taken as a tablet or liquid, depending on . Its a hydrogen sulfide. In particular, you want to reduce your intake of sulfur-containing foods to help your bodys sulfur metabolism and detoxification pathways. In any case. DrAS: Okay. Green tea is well documented with research showing it reduces hydrogen sulfide gas by 30%. However, that comes with salicylic acid, which can be damaging to the stomach lining. In small amounts, hydrogen sulfide is actually a vital molecule that is needed for living organisms to survive. Its going to say, any time I feed itdoesnt matter if its morning, afternoon, evening, it doesnt matter what type of foodgenerally speaking, its going to ferment. So yes, there are things that may be more active against hydrogen sulfide. Thats what Ive seen work. But they only did it for like seven days. Every product is science-based, validated by real-world use, and personally vetted by Dr. Ruscio, DC. What did you specifically do? You see, your digestive tract is designed to house a host of different microbes that make up what is collectively known as your gut microbiome. And I think he even presented a case at one of our symposiums like that, and I just never got success trying that. And particularly for hydrogen in the third hour, thats sort of the keynote: we should see the hydrogen rising because theres bacteria in the large intestine. When we consume food products that contain sulfur, they go through a series of steps where they react with the oxygen that is naturally present in our body to form sulfate (SO2-). This seems contradictory if the whole issue is low sulfur levels, but again, the problem may be that the body is unable to use the sulfur it receives from food. It works by helping to slow the . belching. Is it colonic gas? Ready to get started? It could be so many different things. If this isnt working very efficiently, there may be too much unusable sulfur (leading to sensitivities) and not enough usable sulfur (at the same time leading to deficiencies). The videos are only 60 seconds, talking about the connection between depression and the gut, and how roughly 50% of people who either went on a low FODMAP diet or used a probiotic saw an improvement in their depression. So we need to validate a flat line first, then go to the secondary questions. And this was not my dosing regimen. Some bismuth-containing products that may be useful includeDevrom,Thorne Pepti Guard,andBiotics HPF. We know about hydrogen SIBO, which is an overabundance of bacteria that produce hydrogen, and those are usually Klebsiella and E. Coli as it turns out. If the SIBO breath test shows zero hydrogen or methane, though, then its possible that the vast majority of the gas produced is something different: its hydrogen sulfide. Although widely available, breath testing is less specific than other types of tests for diagnosing bacterial overgrowth. A new SIBO breath test assesses hydrogen sulfide, which is directly related to diarrhea and abdominal pain. It has nothing to do with flat line. So if you have bacteria where it doesnt belong and you eat something, the bacteria isnt going to say, On Monday Im going to eat it and Im going to ferment that and produce gas, and thats whats going to result in symptoms.. It can be compounded, but you could also buy it over the counter. Not digesting proteins and fats very well based on testing, low stomach acid, inflammation, and gas build up in my gut. Studies show that a large percentage of Irritable Bowel Syndrome (IBS) is actually Small Intestinal Bacterial Overgrowth (SIBO). buff.ly/41vyPA7 pic.twitter.com/VxTsOpAQtq, This week's podcast interview: How to Forgive with Pastor David Peterson. Because you will most likely need an experienced clinician or a good program to work through to rebuild your gut health, which would include things other than just, Okay, were going to use bismuth plus high-dose oregano.. Mike. If you are utilizing a generated prep that you didnt validate The only validation Ive ever seen is chicken, fish, eggs, white rice sometimes, and white bread. It depends on if the prep was done right, the appropriate laboratory work was done right, the right devices. And it doesnt matter if you eat a hamburger or if you eat a pancake or if you eat something else. 2: Laxatives, stool softeners, stool bulking agents (Ex-Lax, Colace, Metamucil, Fibercon) . This can help make the diagnosis, but it won't treat the cause. As a doctor treating SIBO, I feel that we absolutely need all three gases. So if you prep with that and that food makes it to the colon, you could have gas, but its colonic gas. You can see a good list of low thiol foods to stick tohere. But as an example, just looking at the SIBO biofilm data that we collected, yes, we did show a measurable benefit that was statistically significantwhere the people who are treated with SIBO herbs plus antibiofilm agents had a greater reduction in hydrogen than did patients treated with SIBO herbsbut it didnt really seem to be clinically meaningful. (SIBO) can cause smelly burps that have a sulfur "egg" odor. Were not just trying to kill stuff, were also trying to help repair, and make the soilfrom which these organisms either grow or dont growthe most favorable that it can be. Theres a study that used it and it had a very successful rate of treating it. . Do I take my time to do that or take the easy way out and just send the results? DrMR: Hence this functional medicine, which is taking the small cropping of treatments that are often reserved for the minority. Things that have helped me are ginger, resolor, and eliminating lots of garlic in the diet. Sulfate plays an important role in a number of daily processes that occur within our body, such as maintaining the viscosity of the blood and lining our connective tissues. And they often actually say, I feel toxic. Its really interesting. But yeah, that could make sense. Symptoms seem to be similar and my doctor did have me on Bebbermine with no success. So this is a non-validated test and a patient told me about it. Learn more about breath testing here. So if youre going to treat SIBO more empirically, then you consider adding these in. Can a fecal transplant cure the dysbiosis imbalance causing hydrogen sulfide SIBO that causes debilitating diarrhea? By reducing your intake of sulfur for an extended period of time, youll give your body the break it needs to get back on track. Bismuth is also effective at reducing symptoms of Hydrogen Sulfide SIBO. Learn exactly what combinations of prescription and herbal antibiotics and supplements are used to treat the 3 main types of SIBO: Hydrogen, Methane, and Hydrogen Sulfide. So thats just something that you can look at, some early dietary clues. Well, first off, I didnt know what to do all those years ago. Its important to remember that taking Pepto Bismol for extended periods is not advised. However, the testing for this is not yet available. Lets say the technology does come out, but its only in office and its not something that offices want to buy because of the cost of the technology. Could be mold. Different underlying hydrogen sulfide issues (SIBO, LIBO, and sulfur-sensitivity) Different diagnostics (flat line, Trio Smart, or symptoms) Different symptoms (headaches, brain fog, sulfur gas, etc), and . Dr. Mark Pimentel tells us more about this new test and how it can help to personalize SIBO treatment. It also works to protect the stomach and lower part of your food pipe (esophagus) from stomach acid. GS: Sure, thank you. And I have some patients report to me some very good results from doctors who had prescribed them Clindamycin. And most importantly, they treat, and guess what? But I mean it medically. 34:42 Treatment for hydrogen sulfide SIBO. So all those things. Aerodiagnostic offers cash pay and insurance billing options, and they do a terrific job at keeping costs low and billing easy. Im trying to help patients and providers make as much sense out of this as possible. They have found that patients who perhaps may otherwise be negative for SIBO may be positive for hydrogen sulfide. However, there are certain guidelines you need to follow in the month leading up to the test. I know theres a preference. So thats light and noise intolerance. a feeling of fullness. Hi.My friend with severe constipation tested negative for SIBO ( breath test) but I suspect hydrogen sulfide, particularly because she reacted to her Espom salts ( Her legs swelled up). This can help make the diagnosis, but it wont treat the cause. If they do, then we yield to Dr. Siebeckers work here, and weve been validating that they are hitting on one or more of these. So we just see nothing or close to nothing. So we get a flat line hydrogen methane breath test. Im resigned to using fresh ginger at night due to its cost-effectiveness. encourages overgrowth of H2S producing bacteria to compensate. But my point with this is, flat is flat, and I would not disagree whatsoever with Dr. Siebecker that its highlighted in lactulose tests. And this is something hes actually been talking about for many, many years and reported on for many years. Third hour represents the large intestine generally. Allison, why dont we go into the symptoms that one may want to be on the lookout for, that indicate that hydrogen sulfide SIBO may be present? Bismuth subsalicyclate (BSS) has been shown to provide up to 65% protection against TD when taken as 2 tablets 4 times per day for a maximum of 3 weeks. Personalizing SIBO treatment by assessing hydrogen sulfide with Dr. Mark Pimentel. And then number two, do they have chronic postprandial symptoms? If there is a deficiency of molybdenum in the body, this can further contribute to ineffective sulfur metabolism. This spun out of an initial conversation that Dr. Ruscio and I had regarding the noise level around hydrogen sulfide and hydrogen sulfide SIBO. And what wed like to do is level set what we know today. GS: Right. And the reason why is because were not yet testing for hydrogen sulfide. Also, a pain in the area of the bladder. And in terms of sulfur types of foods or supplements, a lot of them are worse from an Epsom salt bath, because thats magnesium sulfate. I understand people not reading, people not being patient and being maybe a little bit impetuous. Then the hands and feet and fingers and toes can have tingling or numbness. In H2S SIBO, the hydrogen sulfide-producing bacteria compete with the methane-producing bacteria in consuming hydrogen gas. Im an independent laboratory. I havent prescribed it, but Ive had patients report to me multiple cases of success with hydrogen sulfide SIBO and that antibiotic. But you do need to have a lactulose breath test, not a glucose. However, you can consider treating for SIBO or presume SIBO, and potentially add some nuance to that treatment that is hydrogen-sulfide-specific. We might not have a rise in the colon with lactulose because they were on elemental diet. Aerodiagnostics, check them out. Its pretty funny actually. I could sit here and name 25 agents: rifaximin, and go down the line. And they have been exciting. However, when there is an excessive amount of H2S produced by the body, as in the case of H2S SIBO, a number of issues can occur. And at the end of the 60-second video, we provide a link with the specific probiotic recommendations based upon this gut-brain connection. DrMR: Awesome. I havent tried it yet. Then the other thing would be, there are people who have positive hydrogen or methane, but they also have hydrogen sulfide, and were not seeing that. Were working one-third blind here and were in the middle of an age of discovery here in SIBO. I also have H2S. Go to wholehealthdr.com, choose the type of practitioner and/or the specialty you're looking for, and/or your city or zip code! But the other thing that Ive seen is body pain. Weve got to see how this pans out, right? 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