Well - a lot for sure. My story shortened. Couple years ago it began with terrible gas and constipation/diarrhea cycle. Found that I has pancreatic insufficiency so started taking CREON. Symtptons continued. Breathe test showed high methane and low hydrogen. Started with Rifaxin & Neomycin. Two treatments and seemed good, for about 6 months and then the same again. Did this a couple times - back to gas and constipation. Did a lot of reading and research. My opinion (not a doctor) is that my problem was not the Archaea in my small intestine ( that is a symptom, not the problem), but that my digestive system is out of whack. More research and found that anti-microbials can work against the Archaea (Emulsified Oregano OIl, Atrantil, Berbedine, Allicin, NEEM, MCT Oil and a few more). But I also found that my motility was also an issue, so other supplements. Then I found through research that the gut gets irritated and thus supplements to help the gut health.
Then I found about the Migrating Motor Complex (MMC). When I eat in between meals, it messes with the MMC timing, which leads to incorrect digestion. We a get away with a-lot of things when we’re young and the body has excess capacity, but when it goes off of perfect (mine is low on digestive enzymes) then digestion is more difficult. Then I realized that my problem had to do with timing of eating, what I’m eating and supplements.
Abbreviated results: This is what I did and in 4 months, my gas is gone and daily BM without stress or difficulty (you may be different but this helped me).
1- 64 oz of water per day, Body needs it work correctly.
2- Three meals per day (5 hours apart) with no snacking (anything with calories - soda, coffee etc). Snacks stops the digestive process temporarily and get the digestive capacity out of whack.
3- Low FODMAP as much as possible but try to keep it balanced.
4- Anti-microbials to kill off the archaea in the small intestine (it shouldn’t be there).
5- Gut health ; Ginger, L-Glutamine, Iberogast, Artichoke/Ginger, Tributyrin, Tumeric/Curcumin, Coc-Q-10 and Zinc-Carnosine.
6- Motility help: Miralax and Sunfiber prebiotic, but be careful of anything with inulin (possibly problematic).
7- I had low B-12 and Iron due to the archaea (showed in my blood test) so I took liquid B12 and iron.
8- These helped a great deal but wasn’t perfect. I then had an Endoscopy and it turned out that I have multiple enzymes that are low ( not zero) but lactase and sucrase were both low enough that I need supplements to help. After learning about and taking a couple of low priced enzyme supplements, I have stopped all other pills (other than CREON) and life is good.
The digestive system is slow and it is difficult to correlate what we eat vs the results. A bit of patience is going to be required.
Now, my diet is :
Sardines a couple times per week, eggs, salmon a couple times per week, lean beef twice per week and mostly chicken other than those items. This gives me good Omega 3 and other beneficial amino acids, good protein. (Note: some sources of Omega 3 are not the best, it can be confusing). Stay with the 64 oz of water, 3 meals, and a diversified diet. I take an occasional probiotic, but not every day. I’m still working to see what works for me, so I’m diversifying my diet slowly. So far - so good.
Talk to your doctor / dietitian about these and see if any of them make sense for you. Hopefully you can get your body back in sync and happy again. One last note: some of the chatbots are good research tools to quickly give you an easy way to correlate opinions and data. I use a couple of chatbots to see if they agree. Good luck.
@marylandbob ~ nice writeup. Great job and congratulations. Not many grasp what you did or why. Your advise likely came from Naturopaths and/or Chiropactors, a solid percentage have taken professional coursework dedicated to SIBO/ IMO. These physicians grasp the medical , microbial and medicinal aspects clearly and know what they are doing. BTW> your low H2 and high CH4 "potentially" point to H2S issues, keep it mind and if so, consider adding bismuth to your protocol.