Nourishment

Microbiome Back in Balance

Dr. Rose’s Perspective

The idea behind the SCD is that we want to eliminate the foods that the bacteria thrive on which consist of carbohydrates including starch (grains, beans, starchy vegetables), soluble fiber (grains, beans, vegetables, fruit), prebiotics (often added to your probiotic supplements as “food for the bacteria”, look for inulin, FOS), sugars (fruit, all added sweeteners).  While this list may seem prohibitively restrictive, as Kristy has shared it IS possible to eat beautiful, delicious, fulfilling meals with COMPANY!  Possibly 80% of IBS sufferers really have SIBO. Read more research HERE. Wouldn’t you rather know what you can do about it?  In my experience if you have SIBO you will need antibiotics or herbs to eradicate the problem bacteria along with modifying your diet.  Also important is looking to find the cause of the imbalance to begin with:  motility problems related to nerve damage or medications, gastroenteritis, diabetes.  We are learning more every day about the connection between our micro-biome and our health:  immune health, mental health, digestive health.  Using food to influence the balance of bacteria in our system is one way that we can influence every cell in our body!

Where I am Now (Kristy's update)

I am now SIBO free!  While I’m extremely grateful and excited about this, I also realize there’s continual work and maintenance to be done.  I receive weekly hydrotherapy sessions from Dr. Rose that will have a positive effect on my general gut motility and the vagus nerve specifically (instrumental in gut health).  I’m follow a loose SCD, which means I generally avoid grains, heavy starches, lactose and sugar but can still go to a restaurant and not ask a waiter a million questions - fantastic!   I’ve begun to add a bigger repetoire of fruits and vegetables back into my diet.  Some of this is trial and error and I’m trying to balance my new found freedom with the knowledge that I am still healing and may always have a somewhat sensitive system.  My journey has been a mixture of learning, healing, and becoming a key advocate of my health.  I am grateful to be on this journey with several brilliant and caring doctors, Louise Rose being one of the most instrumental.  Her natural curiosity and scientific knowledge mixed with empathy and compassion have supported me in both my physical and emotional well being.  And lucky for me, she isn’t just a SIBO specialist but she also focuses on general health so we’ll be able to continue to work on my wellness together.  

Thank you Kristy, for introducing my patients to this area of new research and sharing your personal story.  I'm sure so many people can relate to your experiences!

Specific Carbohydrate Diet for SIBO

The Specific Carbohydrate Diet & a Major Lifestyle Change

More by Guest Blogger Kristy Regan, candidate for Masters of Science in Nutrition.

I was highly motivated to begin the new diet (SCD) immediately as I hated being sick.  My friends were surprised that I would so easily give up the foods I loved.  I can’t tell you how many times people have said to me, “Oh, I would just die if I couldn’t eat croissants/ice cream/insert favorite food here.”  But for me, it was part of choosing health and wanting to feel whole again.  And even though I found SCD very challenging it taught me immense amounts about food related symptoms and how I process specific foods.  Over time, I learned that I can still prepare beautiful meals for family and friends that are also healthy and extremely enjoyable for me.  

Here’s my list of SCD Frequently Asked Questions:

I’ve never been good at diets.  How do I know this will work for me?  

For most people, SCD becomes less of a short-term diet and more of a life style change.  It can be an integral part of the healing process, easing IBS and inflammatory symptoms.  Many people who have been on SCD long term say they feel much better and have more energy.  

Which individual foods can I eat on the SCD Intro diet?  

Homemade chicken broth, beef broth, carrots, roasted chicken, roasted turkey (no additives/no lunch meat), roasted lean pork (such as tenderloin), broiled fish, 

beef broth, broiled hamburger, eggs, dry curd cottage cheese, 24 hour homemade yogurt, honey (small amounts), gelatin/homemade jello made with Welch's grape juice

(100% grape in a jar, any color, not frozen, not with calcium) or apple cider (cider only; commercial apple juice is not legal).  

My symptoms aren’t out of control  - can I skip the intro diet and just go to the regular diet?

No, for the diet to work, the introduction diet must be followed for two days minimum and five days maximum.  

How do I know when I can add new foods and at what intervals? 

After the introduction diet, and when cramping or diarrhea aren’t present, peeled and cooked fruit, ripe spotted bananas and peeled and cooked vegetables can be added to the diet.  

Foods should be introduced one at a time, with a two to four day interval between new foods.  

An entire list of legal/illegal founds can be found here  

I don’t have time to make coconut milk, yogurt, etc. – why can’t I just buy them at the grocery store?

You must make or buy food where ALL ingredients are listed.  Labeling in the US dictates that if less than 2% of an ingredient is included, it doesn’t need to be listed.  Often unlisted ingredients include sugar or starch that isn’t allowed on SCD.  Most commercial brands of coconut or almond milk contain starches and sugars.  Label reading is particularly important because products may include sugar or starch products that you’re unfamiliar with.  Refer to the legal/illegal list

Cooking becomes easier once you get used to making specific items.  If you don’t have time to cook, it’s possible to buy some SCD legal foods.  

Some SCD legal food websites:  Wellbees SCD Bakery JK Gourmet 

Is it ok if I cheat once a week or with just one food?

No, SCD isn’t like other diets where a little cheating is ok.  Since bacteria are so small, a little bit of the wrong food will allow them to thrive and multiply.  

That said it’s important to talk to your doctor about the diet in conjunction with antibiotics or other methods of healing.  Most doctors believe the diet is meant to control the symptoms of SIBO but that it won’t necessarily “starve” the bacteria.  

After two years of following the SCD fanatically, one of my doctors recommended I try following a “loose” SCD, so it really depends on your specific situation.

My family is worried about me because I’m rapidly losing weight and they think the diet is crazy.  

Some people will lose weight because they have malabsorption or other issues.  Some may initially lose weight because SCD entails a way of eating is very different than their previous lifestyle.  SCD should be undertaken under the guidance of a doctor and/or a nutritionist.  A medical professional will be able to recommend high calorie and/or high fat items that can be added to the diet to maintain weight.  

I’m on the diet but I’m still having IBS symptoms.  Should I give up?

No!  It’s very helpful to keep a food and symptoms diary while you’re on the diet.  There may be foods that were introduced too quickly or that are not tolerable.  Keeping a food and symptom diary can help you and your doctor see trends in what you’re eating and your symptoms.  If food isn’t tolerated, it can be removed and reintroduced after a month.  

High FODMAPs foods are sometimes an issue for people.  FODMAPs information can be found here:

I’m so frustrated about not going out with my friends/family to restaurants and parties. 

 

Parties:  If you know the host/hostess, it can be helpful to bring some of your own food and put it on a plate or out to share so you don’t have to feel like you’re not eating at all.  It’s ok to drink small amounts of dry wine (no dessert wines).  It’s good to eat before going to a party so you don’t feel deprived once you’re there.  If you can afford the time and money, it’s often the most fun to have a party at your house.  That way you can control the menu and serve only SCD friendly food.  You can give friends SCD recipes to prepare or hire a caterer if possible so you don’t have to make everything by yourself.  

Restaurants:  It’s helpful to have a couple restaurants where you can develop relationships with the Chef and wait staff and feel respected and safe.  Most chefs are used to dealing with special diets and would much rather get a phone call before a meal than to receive many special requests when they are in the middle of a busy service.  If it’s a new restaurant, you can bring your own salad dressing or request lemon and olive oil.  At most restaurants you will be able to order a basic protein and cooked vegetable side but be clear about no seasoning other than salt and pepper, no marinades, etc.  Some people print out a laminated card that they can carry to restaurants that says what they can/can’t eat.  

I’m torn between making traditional food for my family and staying on the diet for myself.  

It’s challenging to be eating a different diet than the rest of your family.  As you become more familiar with SCD recipes and your food variety increases, it becomes easier to make SCD legal food that everyone likes.  Your health practitioner should be able to help you give family favorite recipes a “makeover” or introduce new recipes that can become traditional favorites.  

It’s also important for your entire family to understand how very crucial it is for you to stay on the SCD diet.  If you’re not well, you won’t be able to support your family and your current medical issues may become much more serious.  

Stay tuned to hear more from Kristy about how she is doing!

Small Intestinal Bacterial Overgrowth-What is it?

Hi, I’m Kristy, a 45-year-old back-to-school student, earning my Master’s of Science in Nutrition.  Dr. Rose has been kind enough to invite me to write a series of guest blog posts, talking about SIBO from a patient perspective.  Dr. Rose will chime in with more information and her thoughts.

What is SIBO?

images-of-human-digestive-system

SIBO stands for small intestine bacterial overgrowth.  Bacteria from the large intestine can migrate to the small intestine where it wreaks havoc on the overall system.  Some signs of SIBO can include bloating, gassiness, constipation, diarrhea, fat malabsorption, abdominal cramping, fatigue, anxiety, leaky gut/food intolerances and acid reflux.   My symptoms of gas, constipation, and eventually diarrhea started out as minor inconveniences and worsened over a couple of years before I understood I needed to see a doctor.  I was covered by Kaiser but was worried that a MD would only prescribe medication to cover up my symptoms, or give me a diagnosis of IBS with no real solution.  I decided to see a Naturopathic Doctor (ND) as NDs are trained to treat the whole person and to ascertain the root cause of symptoms.  The ND I initially saw in Northern California first advised me to remove gluten and dairy from my diet as these are common food allergens which can cause IBS symptoms.  When my symptoms continued to get worse, she tested me for SIBO.  The SIBO test checks for hydrogen and methane gas that are specifically produced by an overgrowth of bacteria.  I tested positive for SIBO. Upon hearing my diagnosis and the prescribed diet, I was angry, frustrated and sad.  I considered myself a gourmand, the person who loves beautiful food, adores cooking with and for other people and cherishes communities who come together to share food around a table.  The trial of giving up dairy and gluten had been very challenging for me but it was only a taste of was yet to come.  

My ND recommended that I immediately start the introduction portion of the Specific Carbohydrate Diet (SCD).  As a student on a very limited budget, I kept in contact with my doctor via email but didn’t have regular appointments until I moved to Portland for graduate school and found Dr. Rose and my GI doctor.  Looking back, I wish I had done more research on SIBO treatments and also seen a ND or nutrition counselor regularly in the beginning as having SIBO had many physical, social and mental implications for me. (Click HERE to learn more about associated symptoms)  I got frustrated navigating my symptoms, cried at more than one restaurant when I couldn’t find anything to eat or was served something other than what I had specifically asked for, worried about malabsorption, had issues concentrating and experienced anxiety and isolation.  I now understand these are all SIBO related but I wish I had found Dr. Rose sooner as she’s played an integral role in educating and supporting me on the road to healing.  

Stay tuned for another blog post by Kristy Regan about her path to wellness!

Open House June 21st 11-5

DSCN2535Celebrate the abundance of Summer! Come join the community that has become Rose Cabinet Medicine!  Saturday June 21st 2014 from 11-5 drop in to visit, eat delicious food, relax with a foot bath, mix your own custom flower essence, and receive a shiatsu massage!  Learn about my passions: Nutrition, Brain Health, and Stress Management!  Visit, relax, and enjoy the company of others who share your interest in health and wellness.