The SIBO Struggle: Treatment, Part 2

Last month I posted about my SIBO diagnosis as well as the first phase of my treatment. In case you don't feel like reading either of those posts (and to be honest I don't blame you if you don't!), the TL;DR recap is that after nearly 8 years of stomach issues I finally received a diagnosis of SIBO, which is a fancy way of saying there was too much bacteria in my small intestine and it was causing a whole bunch of health problems. My naturopath and I crafted a treatment plan to repair and restore good gut bacteria. The treatment has three stages:

1. Antibiotic treatment (2 weeks)
2. Low-FODMAP elimination diet and supplements (8 weeks)
3. Low-FODMAP reintroduction diet (indeterminate)

I completed phase one in early June and have been slogging through phase two for the past seven weeks.  

Photo courtesy of The Commons.

Before we talk about the diet, we need to talk about FODMAPs. I've been following this diet for seven weeks and I'm still a little fuzzy on the science, so I'm going to let my good friend Wikipedia explain: FODMAPs are short chain carbohydrates (oligosaccharides), disaccharides, monosaccharides and related alcohols that are poorly absorbed in the small intestine. These include short chain (oligo-) saccharide polymers of fructose (fructans) and galactose (galactans), disaccharides (lactose), monosaccharides (fructose), and sugar alcohols (polyols) such as sorbitol, mannitol, xylitol and maltitol.

I've actually been following a modified version of the low-FODMAP diet, but for the sake of simplicity I tell people I follow the low-FODMAP diet because it's just not worth explaining the fine print. But there are a few key differences between the two. For starters, I can't eat any grains whatsoever, including rice and oats, which are usually allowed on the low-FODMAP diet. I also can't have sugar or corn syrup, which cuts out a huge number of foods (take a look at the nutrition information the next time you eat just about anything, there's a 90% chance it's got sugar or corn syrup in it for ABSOLUTELY NO REASON). I also can't have lactose, which means most dairy is off-limits (except for most cheeses, thank goodness!). I'm also not allowed to have garlic and onion, which, like sugar and corn syrup, are in just about everything. There are also a whole host of fruits and vegetables that I can't have, including apples, cherries, watermelon, avocados, potatoes, and corn, just to name a few.  Most condiments, sauces, and marinades are out of the question. Oh, and beans! I can't do beans. Also: chocolate.

If that sounds extremely limiting, it's because it is. I said in my first post that this experience has been one of the most physically and psychologically challenging experiences of my life, and while I cringe now at how melodramatic that sounds, it still rings true. This diet has not only completely changed the way I eat, but it has also dramatically changed how I think about food and health. Some days I feel like I am eating constantly, while other days I feel like I've barely eaten anything. Some days I feel ravenously hungry and unsatisfied no matter how much I eat, while other days I feel completely disinterested or repulsed by food. Large meals have become a thing of the past, instead I graze all day long, mostly on fruits, vegetables, and cheese. I lug a huge bag of food with me everywhere I go, but if I run out of food or things come up unexpectedly I end up eating some pretty pathetic "meals", the worst being the time I ate 80 almonds in my car on the way to Zumba so that I would have something in my stomach before working out for an hour.

Perhaps the most difficult thing, aside from longing for things like pizza and french fries, is the amount of time and effort I have to invest in eating this way. Eating lots of fresh fruits and vegetables means more frequent trips to the grocery store (or old, sad, wilted produce). It has also meant that I devote a huge chunk of every day to preparing food, whether to be consumed immediately or to take to work the next day. I work full-time and commute about an hour each way, which means I'm devoting ten hours a day to work. Sometimes I just don't have the energy to pack a lunch for the following day, but I have to suck it up and do it anyway because I can't stop to pick something up, because restaurants are definitely not an option on this diet. The kitchen is always a mess and I just can't seem to stay on top of the dishes, which also means that I'm neglecting other housework. I resent that I have to spend so much time planning and preparing meals, and I resent that I don't have more variety in my diet. At times it feels as though I've been eating the same meals for seven weeks straight, probably because that's mostly true.

But it's not all bad. Thankfully I can still have my daily cup of coffee, but since half and half is out of the question, I've been alternating between hot bulletproof coffee and iced coffee with almond milk and honey. I've effectively curbed the sugar addiction I didn't even know I had (try going cold turkey and you'll learn just how much sugar you've been eating!), and to my surprise I don't really miss grains or any of the other "illegal" foods. I've lost at least ten pounds and have more energy. But most importantly, I feel better. Most of my SIBO symptoms have all but disappeared, but when I do have the occasional flare-up I can usually pinpoint what caused it thanks to this diet. I'm so glad I did this, and I'm so proud of myself and impressed with my discipline, but I also hope I never have to do it again. In one week I start in on the third phase of treatment: reintroducing foods one by one. I've accepted the fact that my diet is never going to be the same as it was before and that there are going to be some foods that I just can't eat, but I simply can't wait for the next stage of treatment, because there's only so many salads a girl can eat.