Methane dominant SIBO
While not widespread, more doctors are starting to test for SIBO and offer dietary guidance by suggesting the low FODMAP diet.
But because Western medicine is more than 15 years behind in the latest developments in gut health research, medical knowledge about SIBO is still lacking.
Many of my clients have been misinformed about SIBO by their physicians. Many people have been told that it can’t be SIBO if there is no diarrhea present.
Others shortfalls are only testing for hydrogen gas, while ignoring methane gas levels.
Other doctors prescribe antibiotics based on symptoms without doing any testing. Not an efficient approach if you treat SIBO by guessing which gases are present and at what levels. This approach is basically a guessing game, like blindly throwing a dart and hoping you hit.
I believe in the power of testing to shed light on what actually is going on because symptoms tell us nothing. Don’t settle for treatment that is based on conjecture or misinformation. My intention is to educate you so you can effectively lobby your doctor or find a practitioner who will work better for you.
Methane dominant SIBO (small intestinal bacterial overgrowth)
SIBO is caused by one or two gasses in the small intestine, methane and/or hydrogen.
There is a third less common gas that you can read about here.
The rule of thumb is that hydrogen is typically associated with diarrhea and methane with constipation, but this is not always the case. I’ve seen it vary with many clients.
The diet is the same for hydrogen and methane dominant SIBO.
Today we are going to discuss methane dominant SIBO. Hydrogen gas is the one that is more commonly addresses with antibiotics or natural antimicrobials but methane requires its own unique approach to fix.
Methane SIBO is the harder of the two gases to address.
First, some quick background on SIBO or small intestinal bacterial overgrowth. When motility is slowed or damaged, bacteria collects and overgrows in the small intestine where it’s not supposed to be. Bacteria primarily reside in the large intestine.
SIBO causes bloating, gas, pain, and inflammation in the gut. It can also lead to food allergies, nausea, reflux/GERD and weight gain/weight loss.
SIBO is diagnosed with a breath test. A lactulose substrate is ingested and it measure for both hydrogen and methane gases. Any level above a 20 is a positive for hydrogen dominant SIBO. A reading higher than 10 is a positive for methane, especially if constipation is also present.
Hydrogen dominant SIBO is usually preceded by a food poisoning incident or the flu. Methane overgrowth is not.
How to approach methane SIBO
SIBO is typically treated with the antibiotic Rifaxomin, which is only effective on hydrogen dominant SIBO and does little to address methane. A second antibiotic, Neomycin, is required for methane.
As a health coach I don’t work with prescription anti-biotics, rather working with antimicrobial herbs that are gentler on the system and aimed at bringing balance to the biome.
Allicin extract is an additional supplement that works to reduce methane.
Allimax pro is my favorite product to use. But make sure to work with a practitioner to provide proper dosing and testing. You can buy it here. I use this online dispensary to prevent the supplement fraud that happens on Amazon.
Another interesting thing to note about a positive methane result is if methane is very high, it could be hiding a hydrogen overgrowth. It takes 4 hydrogen molecules to produce a methane molecule, so if there is a lot of methane present it could be consuming the hydrogen gases to full its growth.
If a large methane overgrowth is addressed and a SIBO retest is done, hydrogen can finally show up on the test.
When Methane levels are particularly high (anything over 50 is considered a severe overgrowth) they can most easily be addressed with an elemental diet.
An elemental diet will starve the bacteria that produce these gases, while feeding and nourishing you. It’s a powdered whole food that contains carbs, fat and protein, along with vitamins and minerals. It’s mixed with water, and dosed one scoop at a time at 150 calorie increments. This is a great way to absorb nutrition with a reactive gut.
You can do either a full or half elemental diet. You can replace one, two or all meals with the elemental powder.
You can order an elemental diet here.
Despite the antimicrobial approach for methane-dominant SIBO, there’s additional support to speed things up.
Prokinetics are an important part of addressing SIBO as they support the migrating motor complex, which rules and regulates motility.
Slow motility is one of the main reasons bacteria overgrows in small intestine.
It’s not known why motility slows downs but some of the hypothetical reasons are chronic or acute stress, adhesions from an accident or surgery, a pathogen or parasite, a dose of antibiotics or pain meds (or both), a slow thyroid or a high sugar, high carb, processed food diet.
Eating a diet very high in fatty protein and fat can make an methanogenic overgrowth worse. It’s important to practice moderation in eating fat and fatty meat with a methane overgrowth.
Probiotics
Probiotics are an important part of bringing balance back to the biome. While the antimicrobial reduce overgrowth in the small intestine, probiotics support the biome in the large intestine.
People with bacterial overgrowth can react to many probiotics. The two probiotics below are safe for SIBO and work particularly well at addressing methane overgrowth.
Take 1 or 2 a day of Jarrow probiotic on an empty stomach
Megasporbiotic (you can buy this at the bottom of the page here) 1 a day on an empty stomach away from other herbs.
Bio gaia is a probiotic that also serves as a motility agent.
Other helpful herbs
Partially hydrolyzed guar gum can lower methane and feed beneficial bifido species. Start with just a pinch or a 1/4 teaspoon in water.
Atrantil is a mix of three herbs (that are also polyphenols) that disrupt the cell wall of the archaebacteria, which are the specific bugs responsible for producing methane gas.
Approaching methane the smart way
Even if it’s harder to address, methane dominant SIBO is fixable. Knowing what to do and having the right tools and help will greatly increase your chances. SIBO is complicated to deal with.
After clearing methane, a a SIBO retest must be done. The SIBO diet must be followed up to 2 to 3 months after clearing it to prevent relapse.
For vegetarians, soy can help address a methane overgrowth. I don’t suggest soy for meat eaters but vegetarians should try sprouted tempeh, as this can help reduce methane.
The bi phasic diet has a lot of vegetarian substitutions for those who don’t eat meat.
Lastly, improving digestion is an important part of addressing SIBO. Taking digestive enzymes, bitters, HCL, apple cider vinegar or ginger before a meal can help stimulate stomach acid.
Also avoid raw veggies and cook your meals well. Stews, pureed soups and blended fruits and veggies are easier to digest.
Angela Privin is proof that IBS is NOT an incurable disease or a disease at all. IBS is a body out of balance. It’s an invitation for change. After solving her own IBS mystery more than a decade ago Angela trained as a health coach to help others.
Angela uses both science and intuition to help people figure out what’s out of balance in their body. She works with lab tests, dietary changes, supplementation and nervous system rebalancing. Get help rebalancing your digestive system and solving your IBS mystery here.
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