Fast Tract Diet for SIBO Forum Heartburn and GERD Fats causing Heartburn

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  • robray
    Participant
    Post count: 10

    I read Fast Track over a year ago, but I just found this forum. I really appreciated the book and I am grateful that this forum exists.

    This is my first post so I will introduce myself a little. I am 40 years old and live in Vancouver, Canada. I am not over weight and I exercise by biking to work every day and do lots of other sports sporadically. In addition to suffering from GERD my whole life, I was diagnosed with Ulcerative Colitis in 1991, Osteoporosis in 2008 and rosacea in my cheeks in 2009. The rosacea showed up shortly after starting PPIs, which I stopped in 2012 after starting the paleo diet.

    I have tested barely positive for SIBO on the hydrogen breath test. I also did the Heidelberg test for low stomach acid and I failed on the second baking soda challenge. I think it is very likely that I have SIBO and I know from experimenting with my diet that generally the principles of the Fast Track diet works for me, but I have a burning (yup its a pun) question that didn’t seem to get addressed in the book.

    I know from reading the book that fats are not the culprit when it comes to SIBO causing gas, bloating and heartburn, but this is exactly the effect when I eat fatty cuts of meat.

    I was wondering if there are any papers or thoughts on what could be going on in my guts. You might be wondering how I know it is the fats and maybe not just other foods I am eating with the fats. To answer this question for myself I went on an elimination diet where I ate only grass fed beef bone broth soup for 3 days. I cooked the bones in a crockpot by adding only water and the juice from half a lemon and let it go for 24 hrs. After it was cooked I cooled it and took of the top layer of fat. I then filter and separate the bones and sludge and discard it. I then separate and discard most of the fat from the meat and I store the meat separately from the broth. Note that the meat is still quite fatty.

    When I drink the soup with meat I will begin to bloat, burp and belch within a half an hour. Then within an hour or two I will start feeling the reflux happening where it is almost like a weak form of regurgitation and the acid comes up my throat. If I eliminate the meat and just drink the broth I still get a slight bit of reflux, but it is greatly reduced.

    I know I am not the only one who responds this way to fats because I have seen many posts on other forums where people say fats cause them problems. I have tried taking HCL betaine, enzymes, ox bile, porcine based enzymes, but nothing seems to help with the fats. I am also not digesting the fats as they are coming out in my stool (I know TMI!).

    I know nothing about microbiology, so here comes the dumb questions. Are there microbes in my gut that could be digesting the fats and producing gas? When I add fibre in to my diet by eating lots of plants like lettuce and cucumbers I can greatly reduce and even eliminate the heartburn. I stumbled on this way of eating after reading Loren Cordain’s Paleo book.

    Any insight in to the fats would be greatly appreciated.

    Pompadur
    Participant
    Post count: 39

    Hello robray!
    Your sitautaion reminds my own… Did you ever check your gallbladder function?
    Mine is lazy and that is why (my gasto doc believes) i have so many problems with GERD and gastritis. But with gallbladder issues the situation doesn;t become more clear because it is still unknown how to treat it and to make it work better 🙁

    robray
    Participant
    Post count: 10

    Pompadur, Do you respond positively to ox bile or enzymes? I keep on trying enzymes with bile, but they seem to make me worse. My digestion seems worse and I even get pain in my gut.

    I did a second test after the SIBO breath test that is supposed to measure how my bile function is. I swallowed a radioactive pill and it’s progress through my system and in to my bile gets measured with a sensor. I will let you know if anything positive comes out of it. What test did they do to test your gallbladder?

    Pompadur
    Participant
    Post count: 39

    I am taking Ursodeoxycholic acid now – to make bile less concentrated. It seems that i don;t need more bile if i need to dilute it. Everything cholagogue makes my symptoms worse (and fats are highly cholagogue).
    Enzymes seems to be useless…i still take them occasionally but i don;t find any relief from them.

    To check my gallbladder function the ultrasound was performed twice. The first time it was on empty stomach, then i drank something cholagogue and the ultrasound had been repeated in 30 minutes. It showed that gallbladder contracts only by 30%. Also i have “cloudy bile” in gallbladder wich predispose me to the stones formation.

    robray
    Participant
    Post count: 10

    So I got some more info on my situation. I did a SECHAT test that checks bile re absorption. It turns out that I am not re absorbing my bile. It was a nuclear medicine test. The measurement said my re absorption was 14% and should be > 19%.

    Just before I got those results I listened to a talk by Dr. Allison Siebecker about SIBO. She mentioned something interesting in her talk. She mentioned that SIBO can deconjugate bile acids and that the deconjugated bile acids are caustic and can cause gut damage.

    This seems like a good theory on what’s going on in my gut. It seems to coincide with my experience of increasing bile acids by taking ox bile, enzymes, HCL, bitters and getting a sore gut. I think it also explains that why I get so much gas and bloating when I eat a high fat diet.

    I am really interested in this idea. I did some googling and the idea is not new. There are lots of studies going back to the 70’s. It is tough to find any study where this problem existed and was resolved by treating SIBO.

    Right now, my plan is to have a consultation with Dr. Siebecker and see what protocol she recommends for treating SIBO and preventing recurrence. My appointment is not until Aug 14, but I am not sure if I can wait that long before trying to kill the SIBO. My doc is willing to prescribe the antibiotic to kill the SIBO now if I am willing to take it. Not sure what I want to do. I would sure love to be rid of this problem.

    Any experience or good info on the deconjugation of bile acids by SIBO? What do you think of this as a reason why fats cause us heartburn?

    JI
    Participant
    Post count: 180

    Robray, I do not have experience with the deconjugation of bile acids by SIBO. I did have SIBO which was eradicated by taking a 10 day course of the antibiotic Rifaximin. I decided on the antibiotic therapy because the SIBO caused me a lot of discomfort. A caveat…I am very careful about antibiotic use as I know that overuse can really mess up the digestive system. I think that taking a good probiotic during and after antibiotic treatment helps to regulate your gut flora. I believe that Nexium made me contract SIBO. My lowered stomach acid could not fight off the infection. In conjunction with the antibiotic treatment and probiotics, I weaned myself off Nexium by stepping down to lower and lower doses of Zantac until I was on no heartburn medication. I also started the Fast Tract diet at the same time. I think the combination of all of these things rid me of SIBO. Good luck on your wellness journey. Everyone is different, but I am just relaying my story and what worked for me.

    saffyhoward
    Participant
    Post count: 15

    Hello everybody, 7am here in Australia and I have another bad uncomfortable and mostly sleepless night. I am just feeling so desperate.
    Started fast tract diet over a month ago and get some relief but only if the fp is below 20 or so per day. Too much carbohydrate and bloat, get reflux and some regurgitation of food.
    In addition I am also having problem with fats. It’s a different sensation to my reaction to carbs. I get a very uncomfortable feeling like really bad indigestion and and very painful sensation at the bottom of my oesophugus. I also experience a pounding heart sensation and sometime even get a bit short of breath.
    This has all lead to an extreme weight loss, sky high anxiety, and a feeling of total despair.
    Have been to a couple of doctors who seem to think I’m just being neurotic. I have started on Zoloft(a type of ssri)Had gastroscopy which was all clear. Am about to have investigations into my gallbladder but I think I have both sibo and gallbladder issues. However apart from being a bit constipated my bowl motions ( sorry!)are ok…brown in colour and not fatty.
    I have tried every remedy under the sun, betaine Hcl, digestive enzymes, ox bile and they all seem to make me feel worse.
    To complicate matters even more I have started getting ectopic heart beats when I eat certain foods so am unable to tolerate bone broth, aged cheeses and avocado. ( seems a reaction to tyramine containing foods) I think probably caused by damaged gut lining.
    Am very nervous about trying antibiotics, either the natural ones or riflixin as I don’t want to make matters any worse than they already are.
    Sorry for the long post but I just am feeling so desperate I am hoping someone will have some advice for me as to how to deal with my predicament and find my way back to the life I was enjoying only six months ago.
    Many thanks
    Saffy.

    robray
    Participant
    Post count: 10

    Saffy, sorry you are going through hell right now. I really don’t have any suggestions for you other than to share my own experiences. I know they won’t be a great help, but here it goes.

    I think I may have blamed fat a little prematurely. I have been doing lots of experimenting with my diet and I think the problem for me was really the BONE BROTH! I was listening to a talk by Dr. Siebecker on SIBO and she mentioned there are GAGs in the cartilage around the meat and bones and the GAGs can be consumed by the bacteria. The bacteria then produces gas and voila heartburn.

    So now I cut out all the fruit and I am slowly ramping up the meat, but I avoid cartilage and really any meat around the bones.

    I still wonder if there is not something to the deconjugated bile by SIBO. When I was eating lots of fruit, low fat meat and lots of non starchy veggies I had a lot of heartburn. I am sure the fruit fed the SIBO. I also tried just fruit and lettuce for a day and was in total hell by the end of it. Could the combo of well fed SIBO and some fatty meat, which causes lots of bile to be released be a double whammy for the SIBO? This idea would coincide with the trouble I have eating bone broth with the meat. It seems worse for sure. Although, it could also be that there is still a lot of cartilage in that meat because it came directly off the bone and so it is just a double dose of GAGs.

    Does the heartburn calm down for you at all? For me it was not too bad in the morning and it would get worse as the day went by depending on what I ate. I did try fasting and I would get heartburn by the afternoon even if I ate nothing, but I guess that could have been the deconjugation of bile by the SIBO.

    Could you try some chicken breast and well cooked spinach or lettuce? Check out Dr. Siebecker’s site. One of the treatments is the elemental diet. I have never tried that, but maybe you could go that route and let the SIBO die off.

    saffyhoward
    Participant
    Post count: 15

    Hello robray thankyou so much for your reply. Glad to hear that you have worked out the problem with the bone broth.
    Yes I do get relief from my symptoms at times briefly and like you it does get worse as the day goes on. I seem to cycle between reflux and regurgitation, then indigestion and pain in oesophugus then times of high anxiety when I get very restless and agitated which I realise is not conducive to good digestion!
    And I can eat certain things ok such as lean meat, small amount of cheese, jasmine rice and some low fp vegies, strawbs and cantaloupe but main concern at the moment is my weight loss which has been extreme. I need more food!
    I have read about the elemental diet but I doubt that I could do it due to the ectopic heartbeats I get in response to certain foods.
    Anyway thankyou once again for your kind response. Kind regards saffy

    Jaeme
    Participant
    Post count: 348

    Hi Saffy- Ask your doctor about Remeron instead of Zoloft. A similar medicine, but it helps with weight gain, sleep, and calms the GI tract. I was having weight-loss issues, and after a week on Remeron, I am putting on weight and sleeping at night. My LPR symptoms have gotten better as well. Remeron has some aantihistamine properties at low dose (7.5mg-15mg), so I think it has anti-inflammatory effect on the GI tract. It was suggested to me by another forum member.

    saffyhoward
    Participant
    Post count: 15

    Hi Jaeme, thankyou for your reply. I think Zoloft has a similar effect on appetite as remeron and hopefully it will help with the anxiety. However I don’t know that it has any effect on inflammation of the gi tract so was very interested to read that remeron might help with healing that. Will talk to my doc about the possibility of changing. Did you have any start up side effects when starting on the remeron and are you still following the fast tract diet?
    Many thanks
    Saffy

    JI
    Participant
    Post count: 180

    Hi Saffy, one thing to consider is that SIBO can cause a lot of damage to the gut. I debated about taking the antibiotic, but decided that I wanted to eradicate the SIBO. In my case, the SIBO was very advanced. As I mentioned before, I weaned off of Nexium and started the Fast Tract diet. I also took a probiotic. If you are on any acid reducing medications, try to wean yourself off of them as lowered stomach acid allows opportunistic infections to grow.
    Jaeme, I am so glad the Remeron is working so well for you. I hope it also works for you, Saffy. Forum members can learn a lot from each other!

    saffyhoward
    Participant
    Post count: 15

    Hi JI, thankyou for your reply. No not on any ppi. Had a mild bout of reflux some years ago and found them not to be not all that helpful and after some research on the negative consequences of taking them I have decided not to go down that path again. I think I might ask my doc if he will write a prescription for the antibiotics and give it a go, as it seems to have worked for you and I was reading on dr siebecker web site that the success rate is very high.
    So trip to doc( again!) this week to ask about 2 new medications. Unfortunately I live in a small country town and the mds here are not all that up to date with the latest thinking on gut issues which is making things more difficult for me.
    Thankyou for your advice. It is very reassuring to hear that some of you have found a way forward!
    Kind regards
    Saffy

    saffyhoward
    Participant
    Post count: 15

    Just another thought. I have read on Chris Kressers blog that he uses monolaurin to great sibo. It’s a mono fatty acid extracted front coconut oil. I have purchased some but nervous about trying. Has anyone used it all or heard of any positive results from using natural antibiotics?

    Jaeme
    Participant
    Post count: 348

    Saffy- Remeron is a unique creature, as it has different effects at different strengths. Originally prescribed as an antidepressant, but the lower the dose the more it acts like an antihistamine (so more effect on sleep, etc.) It is now prescribed “off label” for other conditions than depression. My Dr. started me at 15mg, but I was very drowsy the next day until 3pm. I cut the dose to 7.5mg (another forum member had success with that) which has been perfect for me. Good sleep, no drowsy next day, LPR improved. It can cause constipation, but I take Magnesium Citrate for that due to the FT diet anyway.

    Yes, I am still on the FT diet. It greatly improved my LPR, but I originally erred by not eating any of the white carbs and went into ketosis and lost 30 lbs. & 3 bra sizes in a month (TMI, sorry). It was a big struggle to get out of ketosis, but had to up my FP points to get enough carbs to start putting on weght. So my LPR flared up again (not as bad as before FT). That’s dhere the Remeron had been a big help so far.

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