Dr. Allison Siebecker: Understanding SIBO & Cultivating A Healthy Gut

Watch the full interview below or listen to the full episode on your iPhone HERE.

Guy:  This week welcome to the show Dr. Allison Siebecker. Allison Siebecker, ND, MSOM, LAc, has worked in the nutritional field since 1988 and is a 2005 graduate of The National University of Natural Medicine (NUNM), where she earned her Doctorate in Naturopathic Medicine and her Masters in Oriental Medicine. She was the co-founder and former medical director of the SIBO Center for Digestive Health at NUNM Clinic and has specialized in the treatment of SIBO since 2010.

Dr. Siebecker is passionate about education- she is Instructor of Advanced Gastroenterology at NUNM, IBS Board of Advisor & Faculty for the GI Health Foundation, Co-Founder & Curriculum Coordinator of the 2014-2016 SIBO Symposiums, teaches continuing education classes for physicians, and is the author of the free educational website siboinfo.com.

In 2005, 2013 and 2015 she received the Best in Naturopathy award from the Townsend Letter, for her articles: “Traditional Bone Broth in Modern Health and Disease”, “Small Intestine Bacterial Overgrowth: Often Overlooked Cause of IBS” and “SIBO: Dysbiosis Has A New Name”. Dr. Siebecker is currently writing a book synthesizing the SIBO data into one source.

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Full Transcript

Guy
00:00:30] [00:01:00] Hey, this is Guy of 180 Nutrition and of course welcome to another stellar episode of The Health Sessions, where we are connecting with leading global health and wellness experts to share the best and the latest science and thinking, empowering us all, to turn our health and lives around. And this week our wonderful guest is Dr. Allison Siebecker. Now Allison has worked in the nutritional field since 1988, and is a 2005 graduate of the National University of Natural Medicine, where she got earned her doctorate in Naturopathic Medicine, and her Masters in Oriental Medicine. Boy, is Allison a wealth of information. I, again, biasedly, love this episode. This topic is actually a bit close to my heart, and after listening to what Allison had to say, today, I’ll be going to get a SIBO Test. If you have no idea what SIBO is, don’t worry about it. I still think it’s a really relevant topic for us all, to at least be aware of, and especially if you’re having symptoms of bloating, in the gut, all the time. Symptoms of IBS, and things like anxiety, as well, and depression, can even stem from SIBO, which is just fascinating. It is Small Intestinal Bacterial Overgrowth. [00:01:30] Anyway, we cover all areas today. We wanted to make this episode relevant for the listener, as well as maybe, the practitioner, that wants to learn more about SIBO, as well. I’m going to get a test and if you do fancy getting a test done, yourself, on SIBO, just drop us an email through 180, and we can help direct you in the right direction, if you choose to do so. And you probably will. [00:02:00] Anyway, the other thing I wanted to mention, as well: You might’ve heard me talking about giving away free samples of our 180 Superfood. Where you can just have a smoothie in the morning, get a complete natural protein, wholefood hit. Replaces poor meal choices, it’s a really quick and convenient way of doing so, which we love. With the free samples, plus shipping, I’m trying something different today, so what I didn’t realize, after podcasting for 4 and a half years, is that, if you’re actually listening to this podcast right now, on your phone, you can actually go to where it’s playing. Just below the play button, on the podcast app, there’s a ‘Show Notes’ button. If you click that, you can, within 3 seconds, click the link that directs you to free samples, and, like I said, all you have to do is pay a small shipping and handling fee. If you want to try them, and you haven’t yet, I suggest you do so. That is the easiest way to do it. Well there you go, eh. You learn something new every day. [00:02:30] Anyway, lets go over to Allison. I love this episode. Enjoy. Hi, this Guy, I’m joined with Stu, as always. Good morning, Stewart.
Stu
Ow’ yah goin’? How are you?
Guy
And our lovely guest, today, is Dr. Allison Siebecker. Allison, welcome to the show.
Dr. Allison
Thank you.
Guy
Well, what a topic. This is a topic, we’ve not covered in depth before. I tell you what, I am pumped for this episode, today. I truly am.
Dr. Allison
(laughs)
Guy
[00:03:00] Now, we ask a question to every guest that comes on the show. That is, “If a complete stranger stopped you on the street, and asked you what you did for a living, what would you say?”
Dr. Allison
I’d probably say, “I’m a doctor.” But you know, that’s a very simple answer, but these days I do a lot more teaching. So maybe I should say I’m a teacher. Or maybe I should say, “I’m a doctor that teaches.” (laughing)
Stu
(laughing)
Guy
[00:03:30] (laughing) Yeah, because, it normally strings a lot of questions. Now, we’re going to get into the topic of SIBO today and before we do, though, I’m interested to what drew you to this whole world in the first place. Would you mind filling in a bit of a backstory for us?
Dr. Allison
[00:04:00] I bet it’s the same as what you hear from so many people. It’s because I have it, so it’s enlightened self-interest. (laughing) It’s selfishness, ultimately. I wanted to understand what was wrong with me, better. I obviously went to naturopathic medical school, and it wasn’t in our curriculum, and I wasn’t getting the help I needed, and yet, I was seeing my own teachers – and they are brilliant – I knew how brilliant they were, well educated, and caring. So it was not their fault, you know?
Stu
Yeah.
Dr. Allison
[00:04:30] So what that showed me, was that there’s some information, that is missing, so I went searching around, like a lot of people do when they have a mysterious health circumstance. I was diagnosed as IBS, like many people are, irritable bowel syndrome. We can talk about that in a minute, but that’s an unsatisfactory diagnosis for most people, because it just really means “we don’t know” and “we don’t really know what to do.” [00:05:00] [00:05:30] So, that wasn’t acceptable. So, I went looking around, and I found it. I found the condition and how it’s related to IBS, and when I began one of the diets, that’s used to treat it, I got a lot better, really fast. So, what happened for me, then, is I felt sort of a double compulsion. Which was, first of all, to help people who had it, feel better, because, gosh, if I suffered for that long. I’ve had it since I was about 5. I wasn’t born with it, and I can explain to you, how I got it, and how many people get it. I’m close to 50 now. My birthday is in a couple weeks, I’ll be turning 48. So a long time, I had it. If I could feel better in a day, I wanted to share that. The second thing was, myself, as a physician. I was like well ” Myself and all my colleagues don’t know about this.” Then I felt compelled to teach people about it. Doctors.
Stu
So, for everybody that hasn’t heard the term, and I’m sure there are quite a few people out there, what exactly is SIBO? Dr. Allison: [00:06:00] [00:06:30] It stands for small intestine bacterial overgrowth. What it is, is when normal intestine bacteria, that are not – like they’re just normal. They congregate in the small intestine. Basically, they accumulate there. We use the term ‘overgrow’, but they’re just in the wrong place. It’s not that it’s a condition where there’s bad bacteria, per se, because that’s how most of us think about troubling bacterial digestive conditions. So bad bacteria. They’re not bad, they’re just in the wrong place. I think the concept to understand here, underlying it, is that bacteria are normally in abundance, in the large intestine, not the small intestine. So when they come in abundance, in the small intestine, it’s a problem. It causes a disorder.
Guy
Yeah, right. When did SIBO first come on the radar, for you? Were you aware of it when you became a naturopath, and everything, and then you started having all sorts of symptoms?

Dr. Allison
[00:07:00] [00:07:30] No, I found out about it, after I graduated from doing research. The term had only solidified – so the condition has probably been known, to humanity throughout all of time, but probably known by different names. But the name small intestinal bacterial overgrowth, only solidified around the year 2000. I graduated in 2005. I was supposed to graduate in 2003, but I tacked on another degree. So I was in there longer. But, that was barely – once something gets coined, and studies come out, it takes a while, for people to catch on. That’s what I’ve devoted myself to, is raising awareness. I found out about it, after. I actually found out about it from my gastroenterology professor. He was writing a book, and he did some research and found the term. He still didn’t fully know what it was, and then I went and researched it, and honestly, I stopped practicing to research full time, this condition. Then I spent about a year and a half researching it, doing nothing else. Then I came out and started teaching about it, and of course, practicing for it.
Guy
Got it, so why does it matter? Sorry, Stew. [00:08:00]
Stu
That’s okay. Guy: Yeah, why does SIBO matter in the first place?
Dr. Allison
Yeah, why do we care, right? Why are we even talking about it? It’s because it’s actually really common. That is the thing. Here it is, this term that probably a lot of people don’t even know what this term is, and it’s common. So here’s the deal: SIBO has been shown to be an underlying cause of IBS, irritable bowel syndrome, which is what I was diagnosed with, and most people are, who just have digestive symptoms and they don’t know why. [00:08:30] In one study, it was found to be up to 84% of people with IBS, actually, was SIBO. There’s a lot of studies that have been done, and the average prevalence is about 60%, so the majority of people with IBS have been shown to actually have SIBO. That’s what’s causing their IBS. [00:09:00] [00:09:30] Here’s the thing. IBS is the most common gastrointestinal disorder in the entire world. It doesn’t matter what country we look at, it’s number one. It effects up to, in some countries, 25% of the population. When we really hone in on that, sometimes those rates come down to 10%, but just in comparison, still, 10%, anywhere from 10-20% is a whopping amount of the population, because, just in comparison, celiac disease effects anywhere from 1-3%, depending upon what statistics we’re looking at. Diabetes up to maybe 8%. We’re talking IBS 10-25%, so that gives you a sense. Now, not all IBS is SIBO. Not all IBS is caused by SIBO, but still, it gives you a sense of why this matters. So many people are suffering with this condition, and maybe, have never heard the name of it, and don’t know what to do.
Guy
Yeah.
Stu
What symptoms would we experience if we thought SIBO was an issue for us?
Dr. Allison
[00:10:00] So, probably most common, would be abdominal bloating. That’s where the belly swells out, like a balloon, or something.
Guy
Yeah.
Dr. Allison
And it could be a little bit, or a lot. Along with, would come, maybe pain or sometimes just discomfort as it swells out. And then there can either be constipation, or diarrhea or a mixture of the two, and what I’ve just described is the symptoms of IBS-
Guy
Right.
Dr. Allison
[00:10:30] [00:11:00] It causes it. What comes along, with, probably second most common. Just about everybody who has SIBO is food sensitivity. What I mean by that, is those digestive symptoms that I just described come on from food. Sometimes people really can’t figure out what food it is. They go dairy free, and gluten free, two of the most common things people do, and they’re like “It kind of helped, maybe, but not enough,” so that is a real big thing. Additionally, you could have fatigue, that’s common. You could have anxiety or depression. In fact anxiety is quite common in SIBO, more common than depression. Then you could have acid reflux, and all the other digestive symptoms. Like nausea, just a general ill feeling after you eat. Things like that. So what’s interesting, first off, people might not know about SIBO. Second of all, if they do, they’re probably not thinking “Oh, this person has anxiety. It could actually be due to SIBO.” Who thinks that? You know.
Guy
Yeah.
Dr. Allison
[00:11:30] I mean, they think a lot of other things first. The same thing with acid reflux. It’s like, ” I have acid reflux”. They’re not thinking that this could be overgrowth of bacterial in the small intestine. So it can really effect a lot of people in a lot of ways. Knowing about it can be very helpful.
Guy
Yeah, massively. The thing I’m thinking is, how do we get it in the first place?
Dr. Allison
[00:12:00] There is a very large amount of ways you could get it. That would make sense, for something that is so prevalent, that could affect so many people all over the world. So, there’s a bunch of ways. There’s diseases that could give it to us, there’s drugs that could give it to us, or lifestyle factors. Surgery, or injuries, and maybe even genetics. [00:12:30] [00:13:00] So, probably the most common way that people get it, is actually from food poisoning, which is also known as stomach flu, and traveler’s diarrhea. People interchangeably call those things. This, to me, is one of the most incredibly interesting, and kind of shocking things. Because everybody has, pretty much, had food poisoning. You know, you run to the bathroom, and it’s coming out both ends. Most people have that at least once in their life, if not multiple times. In fact children get it a lot, and we don’t even remember, or record it. Not everybody who has food poisoning will get SIBO. I think it’s somewhere around 10%, the studies are now showing. But people get it – everybody gets it, and most people get it multiple times, so you can see where. I mean that, in and of itself, could explain a lot of the reasons why people do have SIBO. The pathophysiology, or the sequence of what actually happens in the body, has been figured out now. Maybe I’ll tell you, if you want to hear, because it’s really interesting.
Stu
Yes.
Guy
Please yeah.
Dr. Allison
[00:13:30] It’s just fascinating. So, what happens, is, first of all, people can get food poisoning from viruses, bacteria, parasites, all sorts of things, and what we’re talking about here, is predominately bacterial. Anyway, when the bacteria, come in – these are pathogenic bacteria, meaning they cause this acute illness. They’re pathogenic, they don’t normally live in us. They all have the same toxin. That toxin is called cyto-lethal distending toxin. For short, it’s called CDT. The portion that’s the problem is CDT-B. So this toxin actually looks similar to a protein that’s on one of our small intestine nerves, and these nerves are throughout our small intestine. [00:14:00] So what happens, is an autoimmune process occurs. It’s called cross- reactivity or molecular mimicry, where our body is trying to fight the toxin, but at the same time, damages our own nerve cells, because they look the same. Really similar anyway. So we damage our own nerve cells, and the nerve cells that we damage are these ones that are responsible for this particular form of movement or peristalsis, called the migrating motor complex, in the small intestine. [00:14:30] I know I’m throwing out all of these big words, but just follow me through here. The migrating motor complex is called a cleansing wave. It’s actually responsible for clearing the small intestine of bacteria. Kind of like washing the dishes after you eat. You have a meal, and then you’re not eating for a little while, and then this movement comes out and cleans out whatever is in there, including whatever bacteria is there. We actually think this is one of the main reasons why people get SIBO, is that migrating motor complex is not working very well. [00:15:00] [00:15:30] When these nerves get damaged, there’s not enough of them to create this movement. So you get a sort of stasis, or stagnation, in the small intestine, and bacteria just normally accumulate. Because bacteria are moving through us, at all time. Every time we swallow, or eat, or drink, they just are in our environment. They come down, and should move down, and through, or they can accumulate in the large intestine, which is fine. Also, we have all these ones in the large intestine. They could come backward if there isn’t this downward pressure. So that’s what we think happens. It’s just crazy that this has been identified. We actually know, it’s an autoimmune situation, and that’s the #1 cause, anyways. There’s other causes, but I’ll pause here to let you comment.
Stu
[00:16:00] I was intrigued as you were explaining that, and it, right now, in my mind’s eye, there seems to be a little bit of a shift in medical practitioners, from doctors, to then, functional practitioners. I’m wondering, if I went into the doctor’s tomorrow, or say the functional practitioner, who might talk about SIBO, leaking gut, microbiome, mitochondria, heavy metal toxicity, all of those things that are very impactful right now, versus a doctor who might say “Well, you know, lets just see how you go, I’ll give you some antibiotics.” If I went into the doctor tomorrow, would they be aware of SIBO? Would they question – [00:16:30]
Dr. Allison
It’s such an interesting question. It’s new knowledge in the medical field. Like I was saying, I graduated in 2005, it wasn’t in the curriculum. Myself, and my own gastroenterology professor, who I learned that first term SIBO, we combined together, to put it in our naturopathic college curriculum. But I think we’re one of the first schools that has it in their curriculum. I’m not sure it’s being taught in medical school. So, where people have to learn about it, is continuing education. [00:17:00] [00:17:30] There’s tons and tons of articles that are published, but lots of doctors don’t read articles. What they do, is they go to their continuing education conference, but lets just hope they hear a class on it. So, anyways, to answer your question, there are doctors that do know about it, and would be completely open and receptive, and if you went in tomorrow, depending on who your doctor was. Then there are doctors who’ve never heard of it, at all. Then there are doctors that have heard of it, and have just decided that they don’t even believe in it, probably without actually having been educated on it. Usually when people are just – it’s because they haven’t yet learned about it. It’s one thing if you make a decision thumbs-down, after you learn, but –
Stu
Yeah.

Dr. Allison
So anyways, the point is, you’d see a spectrum. Because we’re still in the process of teaching this, and bringing the awareness out. It’s still pretty new.
Stu
Okay, alright. Just one more question. How would we treat it? What would we do? [00:18:00]
Dr. Allison
[00:18:30] Yeah, so this interesting. The way you treat just the bacterial overgrowth, itself, is with antimicrobials, and then usually a combination of antimicrobials, and diet. So, for antimicrobials, we have three options. We have pharmaceutical antibiotics, and there’s one very special one that is used. We have herbal antibiotics, and then we have elemental diet, which is not actually a food diet. It’s a powdered product that winds up starving bacteria. I can describe it later, but it’s in our anti-microbial treatments. Then, we pick one of those. Along with that, we usually combine it with some form of a low carb diet. The reason for that is because, bacteria’s number one food is carbohydrates. The main reason we use diet is to reduce symptoms, and also help the prevention of relapse. [00:19:00] [00:19:30] This is the second thing I wanted to say about how we treat it. SIBO is a condition that has a very high relapse rate. The reason why, is because something else is causing it. So what we need to do, if we can, is to identify what is causing it. Like I just mentioned the food poisoning situation. I didn’t mention, there’s a lot of diseases. It can be caused by diabetes, by hypothyroid, but systemic sclerosis. It can be caused by medicines like proton pump inhibitors, which are so common, or opiate narcotics, which many people are on. They have chronic pain issues, chronic back pain injuries. There’s other things like physical, structural things in the body, that you might not even know, you have. Like a volvulus, or adhesions. Somethings that’s causing an obstruction. [00:20:00] The point is, we have to find what is going on, that’s allowing this to happen. What is the actual cause of the SIBO, and then we have to treat that, if we can. This is difficult. A lot of the situations that cause SIBO, don’t actually have a cure. Like diabetes or systemic sclerosis, or this food poisoning thing that I’ve mentioned. Then, if we are in a situation like that, we get into a chronic situation, where we have to, then manage relapses. It doesn’t mean a person can’t feel really, really, a lot better. 80, 90%, even 100% better. It just means that we haven’t cured it. We have to continue to put our attention to it. [00:20:30]
Guy
Got it. My next question was going to be, if I’m diagnosed with SIBO tomorrow, does that mean I’m cursed, or does that actually mean it is reversible, long term?
Dr. Allison
[00:21:00] I’ve seen it both, and you know what, we don’t have good statistics on it. But the statistics we have show about two thirds of patients deal with it chronically, and one third don’t. So about one third, they get one round of treatment, and that’s it. They’re good. They don’t relapse again, they’re done. But two thirds, it’s an ongoing thing, where they have remissions, but there are relapses.
Guy
Got it, and how long would a treatment protocol normally take?
Dr. Allison
[00:21:30] That’s a great question. For antibiotics, it’s usually two weeks, is one course. For herbal antibiotics, it’s between four and six weeks, for one course. Elemental diet is anywhere from two or three weeks, for one course. What we find, though, with a lot of patients, when we run their tests – I know we haven’t talked about diagnosis yet, but we can tell by their tests, that they have a more – we can sort of see the severity. That gives us a sense of the prognosis, and very often people will have a more severe situation, where one round won’t clear it. So, very often, we have to do more than one round. It might be two or three. It might switch between those antimicrobials, and that’s a really important thing to know, going in, if someone is diagnosed. [00:22:00] It’s not that common to only need one round. Because people think of antibiotics, whether you’re using herbal, or whatever, but people think of them like “Oh, I’ve got a urinary tract infection, I’ll take this for three to five days, or something, and I’ll be all better.” This is a little bit longer than that. Usually, it’s these courses, and then another course, maybe even a third, and then we get it gone.
Stu
Okay, and what treatment method, have you seen, to be the most effective? [00:22:30]
Dr. Allison
[00:23:00] I see, that all three of those antimicrobial methods are absolutely equal in effectiveness. So that’s really great news, because it means we’ve got a lot to choose from. Now, what we always see, is that a certain method might be better for that person, and then this one wasn’t as good. So that’s always the case, with all sort of medicine, but across the board, after years and years, I can say they’re equally effective. There is a little caveat, which is that, the elemental diet is able to reduce a more severe situation, in a shorter time. So, that one maybe gives it a slight edge, but here’s the rub, is that it’s the most onerous, and undesirable treatment that most people want to do. Most people save that for last, and yet, it has the best-
Guy
Yeah.
Dr. Allison
Because it’s a difficult treatment, but it can get rid of a severe situation in two weeks. [00:23:30]
Stu
Okay.
Guy
Yeah, I’m interested, as well. I’m just thinking about diagnosis and things like that, and SIBO; Other terms people might be familiar with, is leaky gut, and dysbiosis. Could you get some clarity around those things, because in my mind, at the moment, I’m seeing those two things as completely separate things, that would probably need to be looked after separately. Am I correct in thinking that?
Dr. Allison
Yeah, you mean dysbiosis, leaky gut, and then SIBO?
Guy
Yes. [00:24:00]
Dr. Allison
Yeah, so, dysbiosis is a rather – and by the way, I don’t see your picture right now, is that okay?
Guy
Yeah, that’s fine, my cameras just turned off for some reason, so, it’s still recording. So, yah –
Dr. Allison
[00:24:30] Okay, dysbiosis is a general term that just means, somethings not in quite the right balance, and it doesn’t even necessarily say what organ. Although, we think of it as generally intestinal. So certainly SIBO is a form of dysbiosis. There can be plenty of other forms. There can be dysbiosis of the large intestine, and this is a form of dysbiosis in the small intestine. Now, when we come to the leaky gut, SIBO can cause leaky gut. It’s one of the causes of leaky gut, along with so many other causes, there can be for leaky gut. Also, it doesn’t cause leaky gut in everybody. We’ve got two studies on this so far, and it shows about a 50% rate, which is very interesting. You would think, it would just cause it in everybody, but it doesn’t. [00:25:00] [00:25:30] Anyway, with leaky gut, that is when, as most people know, it’s when the cells in either the small or the large intestine, actually, you can have leaky gut of the esophagus, or the stomach. Once again, we would probably want to think, which organ do we think it’s effecting? Or do we think it’s effecting the entire GI tract? Anyways, it’s when the cells are not knit together tightly, and they’re a little bit loose, and things are able to move through, between them. That can cause a lot of food allergies, and inflammation. [00:26:00] So anyways, it is its own situation, and it could be caused by leaky gut, or maybe it’s not. So, a person could have SIBO and not have leaky gut, or they could have leaky gut. You would normally think you’d need to separately, but it’s interesting. In the two studies that we have on SIBO and leaky gut, in both studies, a large percentage of people’s leaky gut cleared, once they cleared the SIBO. That must have meant, that the SIBO was causing the leaky gut. [00:26:30] The intestines have a fast ability to heal themselves. I would say one or two weeks, in a lot of situations, they could heal themselves, because those cells turn over rapidly. Unless, of course, you have another condition, causing inflammation, or a reason why you couldn’t heal. So it was 75%, and 100% in the other study. Their leaky gut was gone within a month after the SIBO was eradicated, so that’s encouraging.
Guy
Great.

Stu
It is. Absolutely. So, it would be great to talk about treatment. So, what do we currently have, on offer, today, to be able to effectively, I guess, diagnose, first up, and then treat.
Dr. Allison
[00:27:00] Okay, so diagnosis is typically done with a breath test, and there are two types of breath tests we can use to diagnose it, officially. One is a lactulose breath test, and the other is a glucose breath test. The difference, is you can see what sugar we are consuming. The way the breath test is done, it’s like a lactose breath test, or a fructose breath test. You take in a sugar, you do a preparatory diet, for a day or two. You take in a sugar, usually in the morning, because you have to fast overnight. Then, you sample your breath, you blow into a collection implement thing, and then you sample your breath. [00:27:30] What we want to do is see- because bacteria eat carbohydrates, we want to see, “Well, did they make gas?” When they eat carbohydrates, they make gas. It’s actually the gas that causes most of the symptoms of SIBO, believe it or not. We want to measure this gas, because some of it will diffuse into our lungs, and out. [00:28:00] It’s the timing that really matters. We do the test for three hours. The research standard is three hours, and so we want to see. For about the first two hours, represents the small intestine. The last hour, the third, the large intestine. We expect to see the presence of bacteria indicated by gas rising, in the large intestine, we expect that. [00:28:30] Now we want to see, “Well, what happened in the first two hours, in particular?” That’s how we diagnose it, and some key things to know here, is that glucose can only diagnose SIBO in the top of the intestine. About the first two or three feet. The small intestine is about 20 feet long, so most physicians will do lactulose, iF they’re choosing one, because it can tell the whole small intestine. So that’s important to know, just in reading tests, because a lot of people will do a glucose test, and it will come back negative. Then they’ll think, “I don’t have SIBO.” In fact, if you get a negative glucose test, you then, need to go on, and do a lactulose, to be sure you’ve checked for that 18 other feet.
Stu
Yeah.
Dr. Allison
[00:29:00] That’s important to know. Now, in terms of treatments, the antibiotics that we have – there’s a very special antibiotic that’s used for SIBO and it’s called Rifaximin. It’s usually sold under the brand name of Xifaxan, but it’s name is actually Rifaximin. It’s very special. I almost wish it wasn’t called an antibiotic, because here are some of its properties: It doesn’t cause yeast overgrowth, it’s anti-inflammatory, it’s not absorbed systemically. [00:29:30] That means it stays in the intestines, and really actually, it has most of its effect, just in the small intestine. Right where we want, which means it doesn’t “carpet bomb” the large intestine, microflora. In fact, it raises bifidus, and it raises lactobacilli. So you can see, as I go on, it can decrease lipopolysaccharides. As I go on, it’s like, “Really?” So it’s actually called an antibiotic with U-biotic properties. It’s extremely unique. That’s important, because so many patients, in particular, are quite afraid of taking antibiotics.
Guy
Mm-hmm (affirmative)
Stu
Yeah. [00:30:00]
Dr. Allison
This is not one that’s in the same class as other antibiotics. It’s very special. So the reason it’s used here, is because it has this targeted effect, right in the small intestine. That’s why we use it for SIBO. Now, if you have – before I go on to the herbals – there are two main types, there’s actually three, but two main types of SIBO. One is with hydrogen gas, predominating, and the other is with methane gas predominating. You can also have a mixture of the two gasses. The hydrogen gas is associated more so with diarrhea. [00:30:30] The methane gas is associated with constipation, and in fact, we know methane gas causes constipation. That’s one of the things that’s come out in a lot of this research. Fascinating, but the point is, the treatment is different, depending upon which gas you have, and, which symptom you have, so we use Rifaximin, in all cases, if you’re using pharmaceutical antibiotics, in all cases. [00:31:00] [00:31:30] If you have the methane, that’s harder to treat. Then we need double anti-biotic therapy. Then we would add, either neomycin, or metronidazole, which is also called Flatule. Neomycin, and metronidazole are your typical antibiotics, so they could run the risks of all the problems antibiotics could run. So because of that, people with methane, often want to choose herbal antibiotics. They don’t want to deal with those. For herbal antibiotics, we typically use Berberine containing herbs, like golden seal, or oregano – I’m sorry – Oregon grape. You can also just buy formulas that are called Berberine. Berberine complex, or something. We use oregano. We use meem. M-E-E-M. Then, we use an extract that comes from garlic, that is the antibacterial portion of garlic. The product that we typically use, is called Allimed, simply because it has the highest amount, to our knowledge, of allicin, which is the extract that comes from the garlic. That is the one that is very helpful for methane. [00:32:00] So just like I was saying with the pharmaceuticals, if you have methane dominant SIBO, you would be sure to use that Allimed, along with one or maybe two of the other herbs. However, if you don’t have the methane, you don’t need the Allimed. So the Allimed is kind of like the neomycin, and the metronidazole. [00:32:30] [00:33:00] There are plenty of other herbs too. People use big combination formulas, and there’s other antibacterials. Now, third would be elemental diet, and what this is, is it’s basically your nutrients you need for survival, digested down into their most elemental form. So, proteins and amino acid. That’s really the crux of it. The fat is still just fat, and then the carbohydrates are simple. That’s usually glucose. Then you have your vitamins and minerals in there, and some salt. Then, what a person does, instead of eating their regular meals, they drink this substance that can absorb very quickly into the body, without needing digestion. So it just absorbs fast, before it has a chance to be feeding the bacteria. What winds up happening, is the bacteria starve, because you’re eating something that they don’t even get a chance at. So, it’s a different method of killing. It’s also very effective. So those are our three antimicrobial treatments. I’ll pause here, because I just talked a lot.
Guy
No, that’s fascinating. [00:33:30]
Stu
No, that’s great. I was interested, as well, in what you said about drinking the solution, because it takes less digestion, and it doesn’t feed these issues. I’ve never actually thought about it that way, in terms of liquid meals.
Dr. Allison
Well, it’s not that it’s liquid. It’s that it’s been pre-digested. It’s like you’re taking the amino acids instead of a protein, so it wouldn’t be the same thing. If you took a chicken breast, and pureed it, that wouldn’t work. It wouldn’t work for this purpose.
Stu
Right. [00:34:00]
Dr. Allison
So it’s like a space age product. It’s very lab-engineered, and it does not taste good. That’s the other thing, it tasses very bad, and the reason why, is because amino acids are very bitter and gag-y. Then you can buy versions that are flavored, and that really helps.
Stu
Right. Fantastic.
Guy
[00:34:30] So, just to recap everything we’ve covered so far, because it’s gotten quite complex. I’m thinking, for our listeners, that they could be going “Oh my god, I might have SIBO. I’ve been diagnosed with IBS,” or they’re not happy. What would your first recommendation be to them? Do all naturopaths- are they aware of SIBO? “I just want to go get a SIBO test.” Are they in good hands?
Dr. Allison
[00:35:00] I mean, that’s what I would say, is “go and get a SIBO test,” and no, not all naturopaths are aware. Although, because I’m a naturopath, and I’ve been actively, intensely teaching SIBO to my community, many naturopaths know. I think more naturopaths than MDs know, however, that is your first step. The first step is to go get the test, and hopefully you can find someone that is knowledgeable. There are certainly lots of doctors that work online, that you know you can Skype, but usually you need someone local to order a test for you. You might need some help interpreting, but I don’t want to make it seem more difficult than it is. I would say, just go to your doc, and say “I want a SIBO test.” If they don’t know about it, start looking around.
Guy
Got it. It sounds like we should all just go and get one anyways.

Dr. Allison
(laughing) No, I don’t think so.
Guy
(laughing) [00:35:30]
Dr. Allison
[00:36:00] I think the reason to get it, is if you really have those symptoms. If you’ve been struggling with digestive symptoms, and haven’t figured out what it is. There’s one other case where you might think about it, when you don’t have those symptoms. That’s if you have one of the associated diseases. There are a lot of associated conditions with SIBO. I’ll just use an example, like rosacea. If you have one of those conditions that’s associated, and you’ve tried the standard treatment for that condition, and you haven’t gotten anywhere with that, then you can think about SIBO. We do see that helping a lot. If somebody with rosacea has failed standard treatment, we run a SIBO test, and then we say “Yep, you have SIBO.” There are studies showing that then if you treat the SIBO, the rosacea gets better. Very good percentages of that. For anyone who wants to see the list of associated conditions, you can look on my website. It’s just a free, educational website on SIBO. It’s called SIBOinfo, S-I-B-O info. And you can go under the heading of “About” and you will go to “Associated Diseases” and you will see the list. [00:36:30]
Guy
Beautiful.
Stu
Fantastic.
Guy
I have another question for you, then – sorry Stew. I’m assuming you must have treated so many people with SIBO. What kind of effect has it had on their lives, once it’s been reversed? Are we seeing a huge, dramatic impact in their lives, or is it just a subtle thing?
Dr. Allison
[00:37:00] It’s not subtle for the patients that I see, because, being a specialist, I see people in a more severe circumstance, and more challenging cases, so what I have seen, is that it’s a life changer. I think the impact on someone’s life will depend on the severity of the disease, of how badly it was effecting them. [00:37:30] What I see, is, it gives people their lives back. Imagine it. People with diarrhea, they’re running to the bathroom throughout the day. They can’t go anywhere without knowing where a bathroom is. Imagine trying to take a flight. The bloating, it just affects the self esteem. They have to change pants throughout the day, or wear pregnancy pants, or something, if they’re female. Every food they eat might cause them pain. They’re up at night, can’t sleep, with pain. So you can see where, bringing these symptoms down, it gives people their life back. Often they’re too fatigued to exercise. Some people have to leave work. That’s on the severe end. If it was mild, then you know, okay, then it’s a mild result, but I see it giving people their lives back. [00:38:00]
Guy
Yeah, it’s massive. I’m suspicious, I’ve got to be honest.
Dr. Allison
(laughing)
Guy
Honestly (laughing)
Stu
Yeah, and I’ll put my hand up. I did actually have the SIBO test last year, and I don’t have it. Dr. Allison: Yay! Stu: [00:38:30] Yeah, which was good. So that was all good, but I can see how there are certainly so many different issues that could be interconnected, that could lead you to think “Oh, I’ve got this, I’ve got that.” Certainly, diet, lifestyle, sleep, stress, all of the above. It’s a really tricky one to pin down, but yeah. Had the test. Dr. Allison: [00:39:00] I’m so glad you had the test, and the reason why I said peoples’ first step is that, is because the symptoms, the digestive symptoms, the fatigue, the things you were just saying, they can be caused by like 40 or 50 different things, so you can’t just say “Oh, I think I have this.” Why wouldn’t it be the 40 or 50 other things? Stu: That’s right. Dr. Allison: You have to have a test, and I’m so glad you did. Then, you know that’s off the table. Then, in that case, it’s like “Great, lets go down the other 40 things. (laughing) You’ve got to figure it out, you know.
Guy
(laughing)
Stu
Yeah exactly, right.
Guy
That’s so funny.
Stu
[00:39:30] So we’ve spoken about a lot of things, and I can see how, as a concerned patient, you might think “Well I don’t know where to start.” Now, I understand that you’ve got a course, or you’re about to launch a course for SIBO patients. I just wondered if you could tell us a little bit about that.
Dr. Allison
That’s true, I haven’t even filmed it yet, but I’m just about to, in a week.
Stu
Okay.
Dr. Allison
A friend of mine, who is a SIBO patient, she asked me to do it, she sort of gave me her perspective of what is it she wanted to hear. I have an algorithm that just describes that sort of treatment. It’s like a map. You know “get tested, here are your treatment options, when you retest” that sort of thing. [00:40:00] It’s basically a course, bringing people through that. Just talking them through that. “Okay, I’m at this juncture, what do I do next?” so, I think we’re going to call it a road map course. Sort of like a road map for SIBO. It should be out in November. End of October, early November. I hope it’ll help patients. Just like you said, it might seem overwhelming, and I’d like to make it not so overwhelming.
Stu
Absolutely, fantastic.
Guy
[00:40:30] Fantastic. And for any practitioners, that are listening to this, that want to educate themselves more, on SIBO, you’ve got resources there, I’m guessing, for that too.
Dr. Allison
[00:41:00] A good place would be to just go to my free site. That’s good for patients and doctors. I actually originally wrote it for doctors, but it’s patients that wind up using it so much. There’s a tab called “Learning More” on the heading. Certainly, just reading the site is helpful. It’s got a lot of information there, but under “Learning More” you can see, there’s been a lot of different SIBO conferences, and webinars, and continuing education, so that would be a great place for physicians to look, If they want to learn more than just the basics.
Guy
Brilliant. Do you have a book on this as well?
Dr. Allison
I’ve been writing a book for seven years. (laughing)
Guy
(laughing)

Stu
(laughing)
Dr. Allison
[00:41:30] In my defense, I’ll say why it’s taken so long, it’s because I do so many jobs. I’ve had multiple practices, and often times close to full, and then writing a book, I teach at the university, I teach tons of continuing education, I’ve created a diet for SIBO, and I’m updating that. The list goes on, so I try to partition my time effectively. Anyway, it will be coming out, hopefully within a year.
Guy
Yeah, brilliant.
Stu
Fantastic.
Guy
It sounds like it’s very much needed, to get a book out there on that. Totally, totally. Now Allison, we’ve got certain questions we ask everyone one the show. The first one is: What are your non-negotiables, to be the best version of yourself each day? [00:42:00]
Dr. Allison
I saw these questions, you sent me. I just looked at them today, I thought they were great!
Guy
(laughing)
Dr. Allison
So something popped into my head, when I read that question, and it was: My schedule. I guess my non-negotiable, is to not over work. I think it’s something that a lot of people don’t pay enough attention to, certainly in western society. I care very much about not over scheduling myself. [00:42:30] I know other people thrive on a crazy, busy schedule, but I really like to make sure there’s enough time to rest, and I don’t schedule too many things. Here, I just said, that I’m doing all these projects (laughing). So you can see why. That’s part of the reason it’s taking me so long. I am not willing to work all the time. I want to enjoy my life, while I’m living it, so-
Stu
Yeah. [00:43:00]
Dr. Allison
[00:43:30] You say “to be your best you.” How could I be the best me, if I’m so tired? I’ve done it before, I’m sure we all have. There was a time when I just worked so hard for patients, and the schedule, and what winds up happening, no matter what your circumstance, when you over work, is that you wind up feeling sort of like a slave. IT’s not even your life. Then you’re not even you, and so what are you giving? To give, you have to have something to give. You have to balance. For me, that’s my non-negotiable. Taking an eye, on my schedule and making sure I’m not over-working, and I’m resting.
Guy
Absolutely love it. The last questions is: What’s the best piece of advice you’ve ever been given?
Dr. Allison
[00:44:00] This one flashed into my mind immediately, too. It’s: “trust your intuition.” That was from my mom. She used to say that right when I was growing up. Here’s a caveat. When I was younger, I think she meant trust her intuition. (laughing) “Do what I say.” But she really did mean it. I don’t mean, intuition, like you’re walking down a dark alley, and you get prickles on your neck, or something. I don’t mean it, like instinct. I mean like, intuition. [00:44:30] I guess what I really mean, is, where I’ve come to understand it as, because it can be hard to know, what is the voice of intuition, what voice are you hearing, you know? In whatever way we hear that voice, that you really trust yourself. Do what really seems right for you, within the bounds of being a good person, and morality, and not excessively harming anyone else with those choices, but you know what I mean. [00:45:00] I think that has steered me well, and I find so often, my intuition tells me to be patient, and to wait. The reason I say that, is, so many of us live in cultures that are very fast, and people want everything fast. Everybody wants it yesterday, and maybe even ourselves, but that’s something that a lot of the times, my intuition says is “wait”. That’s always steered me well – it doesn’t always- sometimes I get the intuition to go – but anyways, in whatever way we can really listen to ourselves, and do what is really right for us, I think is very good.
Guy
Fantastic. Absolutely, I couldn’t agree more.
Stu
That’s good advice.
Guy
[00:45:30] So, could you repeat the website URL for everyone? Where we can send everyone that wants to learn more about this absolutely fascinating topic?
Dr. Allison
Yeah, it’s www.S-I-B-O – for SIBO – info – I-N-F-O -.com
Guy
Beautiful, beautiful. We will spread this message, as much as we can, Allison. That is just an amazing topic. I’ve learned so much today. I truly have.
Dr. Allison
Well good.
Guy
Yeah, yeah, yeah.
Stu
Got it. My question, to you, Guy, is “will you get the test?”
Guy
I will, 100%.
Stu
Fantastic. [00:46:00]
Dr. Allison
Definitely. He got the test. I run the test on myself, like every other month. (laughing)
Stu
(laughing)
Guy
(laughing)
Stu
Join the club guy.
Guy
No, Linda’s on to me. My wife, she’s saying she wants to run the test on me. Totally.
Dr. Allison
I would just say that for someone like yourself, or anyone who’s going into it – of course it’s going to seem overwhelming – but just get the test, and then you just do an antimicrobial treatment, combine it with diet. It’s not that big of a deal.
Guy
Totally. I’m done. I’m in.
Dr. Allison
Okay! [00:46:30]
Stu
Love it, fantastic.
Guy
Thank you so much, for coming on the show today, Allison. That was a true pleasure. I really, really enjoyed it. I’ve no doubt, everyone is going to get so much out of it.
Dr. Allison
Thank you.
Stu
Absolutely. And, let us know when your program is up and running, as well. We’ll share that across our audience, and look forward to the book, hopefully next year.
Dr. Allison
Me too!
Guy
Thank you guys.
Stu
Fantastic. Thanks very much. Bye-bye. Guy: Bye.