SIBO Made Simple | EP 10 | A Patient’s Guide to Ridding Your Life of SIBO Without SIBO Taking Over Your Life with Rebecca Coomes

For the season 1 finale, I wanted to get the perspective of someone who has stood in these SIBO shoes many times and found a silver (intestinal) lining. In today’s episode, Rebecca Coomes is sharing her powerful patient story, from getting through cervical cancer, to managing endometriosis, to finding balance despite a chronic case of SIBO.

Rebecca is a fellow podcaster (go listen to her show, The Healthy Gut!), cookbook author, and coach. She has dealt with more than her fair share of health issues, and has learned a lot in the process about what it takes to tackle chronic illness without it taking over your life. We talk a lot about mindset in this episode, learning to tune into your body, focusing on what matters most, and maintaining a generous spirit when everything feels like it’s being taken away from you.

For those of you who have been asking for a patients’ perspective, more information on endometriosis, and living with chronic SIBO, this episode is for you.

A quick taste of what we’ll cover:

• Rebecca’s health history from birth as a C-section baby to today and everything gut-related in between
• Why lesions caused by endometriosis can lead to SIBO
• How to prevent surgical adhesions from messing with your organs
• Diet and lifestyle choices that can help combat the autoimmune component of endo
• Rebecca’s experience with hormonal birth control and and what she wish she’d known when she was 23 about endometriosis
• Lifestyle and mindset and stress reduction strategies for the chronic SIBO case
• The biggest mistakes people make when trying to get rid of SIBO
• How to find your joy when dealing with chronic illness
• And so much more…

Resources, mentions and notes:

• Rebecca’s podcast and website, The Healthy Gut
• Rebecca’s interview with Alyssa Tait on visceral mobilization 
• More on the bi-phasic diet
• More on hormonal birth control and SIBO
• Rebecca’s SIBO meal planner download
• Phoebe’s Meal Prep Like a Pro E-book
• Join the SIBO Made Simple Facebook Community Page
• Subscribe to receive a free download of the episode transcript

This episode is brought to you by Fody Foods, my favorite resource for condiments, sauces and spice blends that are low FODMAP and use real ingredients to promote digestive health. Everything is Gluten-Free, Dairy-Free, non-GMO, and most importantly, delicious. The garlic-infused oil and tomato-basil sauce are my personal favorites. Use code SIBOMADESIMPLE at checkout for 15 percent off your order!

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 SIBO AND ENDOMETRIOSIS + MINDSET HEALING

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PHOEBE: Dr. Coomes, thank you so much for coming on the SIBO Made Simple podcast. You are a total pro, and I’m a little starstruck, I guess, to be talking to you, not face-to-face, but interweb-to-interweb.

REBECCA:  It’s a pleasure to be on the show, and it’s really nice that there is a new SIBO podcast out there for people to learn more about this condition, because it can be really quite overwhelming, frustrating, a little bit scary at time. The more people can learn, the better it is for them. Congratulations on launching your podcast.

PHOEBE:  Thank you so much. I feel like you guys in Australia are just always ten steps ahead on – certainly in SIBO but in a lot of things in the wellness space. Thank you for blazing the trail. It’s been really inspiring to see what you’ve done with your platforms and really excited to share your story with our listeners. As I mentioned before we started recording, I’ve had a lot of doctors on but very few people who’ve been sitting in the same place as me, someone who’s maybe started as a layman and who’s a patient yourself developing your own expertise. I’m a big believer that we have so much more to learn from other people’s stories and just simply sticking our nose in a dense health book. I’d love to just begin by having you tell everyone your health journey, which I know started a bit before you were ever diagnosed with SIBO, and then how you found yourself. It’s the struggles of [0:01:31] SIBO.

REBECCA:  I really started my health journey from day one. I was a premature baby; I was born two months early and right from the get-go, things were a little bit challenging for me. My mom was incredibly unwell when I was born. She wasn’t able to breastfeed me, which is unfortunate. I was born in 1978, and the doctors just didn’t know what they know how. They didn’t realize the importance of breast milk. I was put on formula, dairy formula, and I reacted really strongly to it. I have never been great with dairy, and so I was a really colicky baby. I was also phlegm-y and quite sick. Mom felt that there was issues with myself and dairy, but doctors back in those days were like, what would you know? You’re just some silly little woman. It wasn’t until I was about four or five that Mom found a doctor, and she said to him, “I just don’t think my daughter’s very good with dairy,” and he said, “Well, if you think that, take her off it.” She said within hours of coming off dairy, my symptoms had improve enormously. That was really the commencement of me and food intolerance

As I went through my childhood, I was the sick kid. When I got chickenpox, I got one of the worst cases of chickenpox my doctor had ever seen, to the point where he was considering getting me photographed for medical journals. If I got the common cold and my sister got it as well, I would be in bed for two weeks. She’d be in bed for a day. My immune system was highly compromised and I was just constantly sick. Every single winter, I would spend a good couple of weeks in bed. I’d generally get some really nasty illness, as well, during the year. I ended up with hepatitis when I was a kid, and my liver really stopped working. As I said, chickenpox to the extreme. I got glandular fever several times, which wiped me out for months at a time.

As I went into my 20s, I then – my reproductive issues started to become really apparent. I started getting my periods when I was 11, and my period pain was extreme. I would have a 15-minute window in order to take painkillers and if I missed that because, let’s say, my period started in the middle of the night, I would then be vomiting for the first two days of my period. What I didn’t know then that I know now is that I had endometriosis, so I had extremely heavy periods, incredibly painful periods that would leave me vomiting and just racked with these waves of cramping. I used to think if this is less than childbirth, I never want to have a baby because this pain is extreme.

As I went into my 20s, I then was diagnosed with a precancerous cervix, so that was the first round of some treatment on my reproductive system. That really didn’t heal and six months later, they went in for exploratory surgery and realized I had endometriosis. Then I had a couple of surgeries for my endometriosis. It was at that time I was living in the UK, and I had been to very traditional male doctors. In fact, one male doctor who was an endometriosis specialist, when asking me what my symptoms were like and I told him it was like the worst period pain you could ever imagine, like aliens were ripping your insides out, he said to me, “I don’t know what that means. Tell me in a way that I will understand” I remember thinking, why on earth are you dealing with women with reproductive disorders? This is so wrong.

I, luckily, was put into the care of a female endometriosis doctor, and she said to me, “Many of my ladies have issues with gluten and dairy. I don’t know why,” bearing in mind this is in the early 2000s, so the link between inflammation and food really wasn’t as known as it is now. She said, “I can’t tell you why it is, but I know that they do significantly better. I don’t want to operate on you until we’ve put you on a three-month restriction on gluten and dairy. Come back and see me in three months and we’ll assess how your symptoms are.” I would have said at that time there is no way I have an issue with gluten and dairy, even though I’d forgotten as a kid I was so sick with it, but my symptoms, all symptoms, improved significantly within a matter of days of coming off gluten and dairy. My symptoms in those days were bloating, brain fog, extreme fatigue in the afternoon, so I’d do the classic thing. At 3 o’clock when I’d feel like crawling under my desk at work and going for a nap, I would then go and have sugar and caffeine to try and keep myself awake through that afternoon slump. I lost some weight, and I’ve always really struggled with losing weight. I was vegetarian in those days, and I was eating a very healthy diet with lots of plant-based foods, but the weight just stuck on me.

When the gluten and dairy came out of my diet, I felt like a new person. Those symptoms, my digestive symptoms, really went on hiatus for probably about two or three years. What I noticed was everything started to come back. I was eating a lot of legumes, a lot of tofu, fermented foods because I was in that vegetarian world. My protein intake was very low. My carbohydrate intake was very high. My fat intake was low because I was terrified of fat because I’d been told fat makes you fat. I was indoctrinated in that awful ’80s messaging, so I was totally eating the wrong foods What I didn’t know was that I had SIBO.

When I returned to live in Australia, I really commenced searching for the right solutions. This lead me to multiple doctors, dietitians, nutritionists. Every time I’d go in, I’d say, “I just don’t feel good. I feel unwell. My tummy feels funny. I feel quite sick a lot of the time. I don’t think this is how I should be feeling.” Every time, they would run blood tests. The blood tests would come back and they’d be like, “But you’re in perfect health. There’s nothing wrong with you.” the dietitians would put me on exclusion diets, which would often made me worse because I’d often be eating foods that I now know feed the SIBO. I’d be, “But I feel so sick now,” and they’d be like, “Just keep going. It will resolve,” and it wouldn’t. It would make me worse.

In desperation one night, I was on good ol’ Google and I was getting to the point where I thought if this is life, I don’t want to keep living it. I’m so sick and no one believes me. I know I’m not supposed to feel like this. Surely there’s somebody in the world that can help me. I can’t remember what I was googling, but this woman’s name kept appearing, and I looked her up. She’s a naturopath here in Melbourne, Australia. She was nearby; she was close to where my office at the time was. I thought well, I’m just going to call her and see if she can help me. I walked into her clinic, sat down, burst into tears, and said, “I don’t know what’s wrong with me, but I feel really sick and no one believes me. I’m at my wit’s end, and I’m hoping you can help me.”

The most important thing that happened to me at that time was she said, “I believe you.” Those words were just so profound because nobody had said they’d believed me before that when I said I was sick. She said, “We can do some tests. I have some suspicions on what’s going on, but we’ll uncover was it is.” Very quickly, she’d organized a SIBO breath test for me. She could see that I was highly depleted in key vitamins and nutrients, so she put me on some amazing naturopathic herbs that literally overnight, I felt like I had an energy plug plugged into me, and suddenly I felt amazing just from getting my balances in a better order. Then we discovered that I had SIBO, and that diagnosis was so exciting initially because I finally knew what was going on in my gut and that I wasn’t a crazy lady. It wasn’t all in my head, and there was something actually causing the bloating and the constipation, the weight gain, and it was a real hallelujah moment.

PHOEBE:  How long do you suspect you had it before you ended up in tears at this naturopath’s office?

REBECCA:  I think I’ve had SIBO my whole life given my symptoms. Given that we know the classic SIBO symptoms are often changed bowel habits, I’ve had chronic constipation my entire life. I didn’t actually know you were supposed to open your bowels every day, and I remember as a kid thinking doing a poo was really boring because it was such a time-waster. I was happier when I only went once or twice a week if I was lucky. I’ve always had food sensitivities, and I remember foods as a little kid making me feel really sick and saying to my mom, “Mommy, I feel really yucky,” and she’d say, “What does that mean?” I’m like, “I don’t know. I just feel really yucky,” and I would imagine that was foods reacting in my gut. I often had quite a bloated little tummy. I suspect that SIBO has been present all along with my life.

PHOEBE:  I’m curious because we haven’t really gotten into endometriosis so much. I have Hashimoto’s, which is another big risk factor for SIBO, but I’m curious. Besides the surgical interventions, are there any other aspects of endo that can contribute to SIBO, anything going on with the hormonal balances?

REBECCA:  Well, endometriosis is an autoimmune condition. The immune system is attacking itself, and we know there is also an autoimmune component for SIBO for some people. Endometriosis really throws your hormones out, and we know that there’s a link between hormone imbalance and SIBO. Is there a direct correlation between endo and SIBO? Possibly, so endometriosis causes lesions. The lesions can become quite bad scarring, and if those lesions form on the outside wall of the small intestine, they can then create little pockets where bacteria can live and reside. What I know for me is that my endometriosis was causing lesions all around my abdominal cavity, so I suspect that that was contributing to this inflammation and potentially restrictions in my small intestine.

The other thing is that endometriosis – at this point in time, they say there is no known cure for it. A common treatment is surgery where they go in generally via a little incision in your bellybutton and they laser off the adhesions. What that then does, and no one told me this for all of the surgeries that I had, was that that creates scar tissue, and that can create adhesions, which can then constrict the small intestine even further. Without realizing it, my surgeries for my endometriosis inadvertently made my abdominal structure worse, and I now have significant adhesions and scar tissue wrapping all of my organs in my abdominal cavity, not just my small intestine, but my liver and stomach are compromised. My reproductive organs have wrapped up. I’ve got one scarring the size of a head of broccoli, which I’m currently having manual therapy of visceral mobilization treatment to try and stretch that out and resolve it.

Was it chicken and the egg? I can’t answer that, but I know that my surgery definitely made my SIBO worse. Also because there’s an autoimmune component to endometriosis and that we know that foods like dairy and gluten, which are quite inflammatory, also are problematic with women with endometriosis. We know they’re problematic for people with SIBO, so we can see that there’s this interwoven web around nutrition, adhesions, scarring, autoimmune componentries as well. A woman with endometriosis has a higher risk factor of developing SIBO than the average woman.

PHOEBE:  I was wondering if once you change your diet – obviously the gluten and the dairy, taking that out, made you feel better or I guess brought you to a higher plateau of normal. When you’ve noticed – and I know it’s a chronic condition for you – that you’ve eradicated SIBO, has that also helped the symptoms of endometriosis? I’m curious about how those two conditions have played that tango in your life.

REBECCA:  It has significantly improved my endometriosis. The first step for me in improving my endo symptoms was a nutritional change, taking out those inflammatory foods like gluten and dairy made a significant improvement to how I felt. I know now because that was in my early 20s when I did that, so I’ve played around with my food over the last 20-odd years and really been so much more in tune with my body. I know when I fall off the bandwagon and I end up eating gluten and dairy, I can guarantee that the next periods that I have will be way more painful than a period when I’m eating really good quality nutrition. It’s pretty immediate for me. It was a ramping up of symptoms.

Prior to discovering I had SIBO, I still needed to be on some form of contraception that prevented me from having periods. I did the Depo Provera injection for many years where I did not have a menstrual cycle at all, and that was done to prevent me going through that monthly pain. I then went onto the pill, the contraceptive pill, and because it’s not a true period, I found that I didn’t have symptoms as well. I did try the Mirena coil and that was a disaster for me. I got every single side effect that they have documented, and I got it extremely badly. It was hell on earth for me, and I would never do something like that again. I was still having to really manage my endo symptoms quite closely.

When I went into my SIBO treatment, I was talking to my naturopath around my concerns of being on pretty strong hormones or treatment for so long. She said to me, “Look, the way I look at it is when you’re on contraception, it’s like hitting your ovaries with a sledgehammer. Why don’t we take you off; let’s see how you do. You haven’t been off contraception since your early 20s. Let’s see how your symptoms are and as we treat your SIBO, I would anticipate your endo symptoms reduce and hopefully we can get them to a point where you can manage them just with painkillers.” My first round of SIBO treatment went for six months. I did the herbal protocol. We rotated herbs throughout that whole six-month period and then I combined that with following the bi-phasic diet. I was on a very restricted diet and very low FODMAP. I was strictly alcohol-free. I didn’t want to drink any alcohol at the same time, so very clean living.

What I discovered was very quickly as my SIBO numbers dropped, my endometriosis symptoms pretty much vanished to the point where today, I don’t need to take painkillers when I have my period. Going from a woman who vomited violently for two days, I now can manage my period with nothing, and that’s an amazing feeling. Admittedly, I am older, and I’m coming to the end of my reproductive cycle, so I’m turning 41 in February. My days – I’m not such a young, fertile woman anymore, and that generally does see the reduction in endo symptoms as well. It’s really nice to not even have to take a painkiller with my endometriosis.

I have relapsing SIBO because I have so many adhesions and scar tissue in my abdominal cavity that the structure of my small intestine is compromised. My small intestine is not able to work efficiently, so bacteria does keep reforming in the small intestine, which means I keep relapsing with SIBO. Even though that is occurring, my endometriosis symptoms are still kept at bay because I now follow a very healthy diet. I’ve done so much work around the lifestyle, the mindset, the stress reduction piece as well, and I’ve been healing the lining of my gut. All of that has combined to have a significant improvement in this other condition I have.

PHOEBE:  It’s incredibly inspiring, and I know I have a friend who’s an amazing advocate for endometriosis. She has a site called knowyourend.com and a course around it. It just feels like you’re between a rock and a hard place, especially when it comes to the surgeries. Also, I’m curious to get in a little bit to the pill as one of the root causes of gut issues in general and therefore, SIBO that we don’t talk about too much. I’m curious what your advice would be for some of the endo sisters out there who are now maybe worried about the fact that they are at risk for SIBO and also maybe considering using hormonal birth control to alleviate some of the symptoms or going off of it and forging a different path. I’m curious what advice you would give to them across the board in terms of having the surgeries, going on or off hormonal birth control, and just generally what to do to prevent SIBO when you have endometriosis.

REBECCA:  I’ve thought a lot about this because I often thing what would I go back and tell my 23 year old self now that I know so much. For me, one of the first things I would’ve done was the nutritional change. I would’ve done that earlier if I’d known how important my nutrition was. I didn’t appreciate how inflammatory some of the foods that I was eating were to my system and therefore triggering more of an immune reaction which then, obviously when your immune system is already over-active, when you’ve got a condition like endometriosis, when you’re putting foods in that your immune system is reacting to, you’re just putting fuel on the fire. I would have gone and done a food sensitivity test and seen if there are other foods that I’m inadvertently eating that are keeping that fuel on the fire.

I think it’s really important as a woman that you do what you need to do to put yourself in a position where you feel better. I’ve often thought, would I have done the surgeries now knowing that I could’ve ended up with a lot of scarring, which I did. I was in extreme pain, and I had pain in places where you don’t want. I think the surgeries were ultimately beneficial for me because I could get back to living a life, but what I wish I’d known was that they were putting me at risk of scarring. There are things you can do to help reduce the amount of scar tissue that occurs. There’s a great interview I did on my podcast, The Healthy Gut, with the therapist who now treats me, Alyssa Tate, and we talk about some of those manual therapies. It’s around moving the area where the incision are made so that those deep scars don’t form. Obviously you can contact Alyssa Tate if you want to know more about how you prevent scarring.

What I should have been doing back in my 20s with these surgeries was doing after-care and no surgeon ever told me that I would end up with scarring. That would be some advice to someone that’s considering having the surgery for endometriosis. Get really clear on what your after-care therapy needs to be. Look for a visceral mobilization therapist in your area who can support you in your recovery. If you can prevent scars from occurring, it’s so much easier than having to try to undo them like I am now. Only you can make that decision as to whether the operation is the right thing for you, and it’s really a case of what’s your quality of life and is it worthwhile going through the risks of surgeries for the outcomes. My surgeries did leave me feeling better for periods of time, so I felt that they were successful at that time. Unfortunately, I just didn’t know about the scarring.

Then the other component with endometriosis is this is an autoimmune condition, so you need to play private investigator and really understand why has your immune system gone crazy. Why is your immune system attacking itself? What can you do to help calm your immune system? Nutrition is such a big piece of that, but so is stress. If you’re living in a very stressful environment – I was. I thought I thrived on stress. I loved being stressed and in these high-powered jobs, and running around, and I thought it was so good, but it wasn’t. It was slowly destroying me. Had to look at relationships as well. Who was in my life that was causing stress? Who was helping me and hindering me on my journey to health? I had to do some culling with friends and people that I had relationships with.

Sleep is also a really big component. If you are not sleeping enough, if you’re not getting good quality sleep every night, how on earth can you expect your body to heal itself? Then you need to look at other conditions. SIBO is a – you’re at a much higher risk of developing SIBO with endometriosis, but what else is happening in your body? What’s happening with your microbiome? Look at getting a stool sample and seeing if you’ve got parasites, or if you’ve got an overgrowth or an undergrowth of certain bacteria. Take a very holistic 360 degree view of your body because the more you can treat the entire body rather than just one section of it, the greater chance you have at being able to return to a better level of health.

PHOEBE:  That’s such great advice. I’ll definitely link to your episode with Alyssa Tate, because I think that’s probably a decision that many, many people have had to face or will face in the future. It’s at least reassuring to know that there’s something you can do on the other end of it to ease the transition and help with prevention.

Yeah, the microbiome piece, obviously something we talk a lot about on this show and on your show. We had a whole episode, actually, about the pill and how it can affect your microbiome. It just always amazes me these downstream effects that people don’t think about, even medical professionals don’t think about. It pains me to think of so many women who are put on these hormones as pain management for endometriosis and maybe perpetuating one of the root causes of that issue, which is a gut imbalance as the years go on.

I personally was on birth control for ten-plus years as well, and I think I probably had Hashimoto’s wrapped up in there that I didn’t realize until it was too late and then experienced the whole fallout with my body when I went off and tried to normalize. That’s neither here nor there.

I would love to switch gears and talk a little bit about things that you’ve learned since you became a SIBO professional. You have a coaching practice, and you’ve helped people from all over the world. I know from listening to your podcast that you must be just the most incredible advocate for people. I’m curious what are some of the biggest mistakes you see people make in their attempts to eradicate SIBO and if you’ve experienced any of these stumbles personally.

REBECCA:  There’s quite a few things that people do, and I think I’ve experienced all of them myself. One of the first thing is when you get your initial diagnosis, there’s often the initial elation which immediately then turns into the oh, God, what am I going to do now? That can be wrapped up in a lot of fear, and anxiety, and trepidation. Many people like me think to themselves, I’m going to have this beaten within a matter of days or weeks, particularly those people that take the antibiotic route, the likes of Refraximine are often given as a 14-day course of treatment. Many people think well, I’ll just do this for 14 days and I’ll be good, and that’s not the case for the overwhelming majority of us. For many people with SIBO, this has been a long-term condition. We’ve only just discovered it, but our bodies have been dealing with this for months, if not for years, if not for decades like for me.

One of the mistakes we make as the SIBO patient is we think we can have this all healed, all resolved in two weeks. It really is a process of peeling back the layers of the onion. I’ve been dealing with SIBO and recurring SIBO now for – consciously knowing about it for three and a half years. Now, I still have SIBO today because it keeps relapsing because of all the structural issues, but I can tell you I feel a million times better than I did originally. That’s another mistake people make is they become terrified of relapse, and I was like that. I was so determined never to relapse I’m a Type A personality; I want to do things absolutely perfectly. I’ve seen through my coaching program and all of the thousands of people I have contact with through The Healthy Gut that we are traditionally more of a Type A personality than a Type B personality. We are really driven; we’re perfectionists; we’re often quite stressed. We often deal with anxiety. We really want to be the best that we can do, and we want to do things the quickest we can do them. We need to allow our bodies the time to heal.

A stat I heard from one of the doctors that I’ve interviewed is that for every one year of illness, you need to allow at least one month of healing. I was 37 when I discovered I had SIBO, so that’s 37 months of healing at a minimum that I needed to do, because I suspect I’ve had SIBO since infancy. Think about your own journey and where you are. How long have you been sick? Has it been years? Has it been decades? Don’t assume that you can be well again in a two-week course of antibiotics.

Another mistake that I see people make is that they look at the treatment of SIBO. They don’t then dig deeper and look for the underlying cause. SIBO is a symptom of something else going wrong in your body. For me, I did exactly that. I discovered I had SIBO, I found out what the treatment was, and I only fixated on that. I fixated on the diet, and I fixated on taking these herbal protocols. I did not spare a second to think about why was my small intestine not working. I only started to think about that once I was through the treatment and I was terrified of relapsing. I started to think well, what else do I have to do now? I learned about adhesions, and I went through this whole big journey. I was like, oh, my gosh, that’s me. That’s my picture.

My practitioner and I were not speaking about prevention, and I think that if you’re not speaking about that with your practitioner, you need to. If they’re not willing to talk to you about prevention, it’s time to find a new practitioner. Prevention is a really, really important piece of the puzzle when it comes to SIBO treatment.

Another mistake I see people making is they don’t do a thorough diagnosis with their practitioner. They might just do a SIBO diagnosis, but they might not be looking at what else is going on. I’m yet to meet a single person that just has SIBO. SIBO is a sign that the body is not working optimally There’s often other things that are not working optimally, so you need to look at what that is. It’s literally like when you see those entertainers and they’ve got those plates spinning on those spikey poles, and they’re trying to get all of them to keep going. That’s what it’s like when you’ve got SIBO and other conditions. You need to keep all your plates spinning, but sometimes you’ve got to spend more attention one of those plates than other of those plates. You might need to spend more attention on your SIBO for now, but it doesn’t mean you need to take your eye off the ball completely with your other conditions

Another issue I see – and this breaks my heart – is the fear of food. Because diet is something that we can control as a SIBO patient and for many of us, we have felt so out of control with these symptoms in our bodies that when we’re given a low FODMAP diet, the bi-phasic diet, the SIBO-specific diet, or one of the others that people are commonly given, we can become fixated, obsessive,k very controlling, and we can put ourselves into a distorted way of thinking about food. Food is our life force; it’s our nourishment. It’s what keeps us alive. It is not to be hated. It is not the enemy. Just because you can’t eat something today does not mean you won’t be able to eat it in the future. That’s been one of my greatest lessons. I was really, really reactive to foods three and a half years ago. I had this long list of foods I could no longer eat.

Today, I choose not to eat gluten. I’ve got my dairy at an absolute minimum. I have a little bit of butter; that’s it. I’m not even eating that much butter these days. I’ve made that conscious decision because I know that they’re quite inflammatory, and I’ve already got issue with my immune system. Everything else I’m focusing on is around color, and abundance, and diversity. I aim to eat 40 or more plant-based foods every week so that I can feed my microbiome. I don’t have to eat lots; sometimes it’s a tablespoon and I just start there, or even a teaspoon but building up diversity helps my microbiome, which ultimately helps my overall health, which ultimately helps me feel better. I see a lot of people, through my coaching and through people contacting me, who were down to five foods. They’re reacting those those foods, they’re miserable, and they just can’t live life. That is no way to live.  I think it’s really important if you find yourself there to work with a qualified and experienced nutritionist or dietitian, someone that deeply understands SIBO, someone that has a very good understanding of gut health, and that they can slowly work with you to build out the diversity in your foods because gosh, you feel so much better when you’re eating more foods.

A final thing is just around the mindset piece. When we first learn about SIBO, it’s very easy to fall into this research obsessive mode. I know it because I did it myself. You go onto every blog, every Facebook group You listen to every podcast. It’s overwhelming, particularly on some of those big online groups and the Facebook groups. People are very quick to share the negative; they’re not as quick to share the positive. I found myself spiraling into this depression where I thought oh, my gosh, no one gets better. No one gets out of this. I am doomed. My life is over. I actually needed to take a break. I needed to cut myself off from those platforms and tune into my body and learn what my body needed. What’s happening to me is very different to what’s happening to somebody else. I think it’s important that we’re empowered and we educate ourselves to a level that’s appropriate on this condition, but if we recognize that we are lying in bed at night dwelling on things we’ve read or heard, then perhaps it’s time to take a vacation and just be. Just be in your condition for the moment and come back to it when you feel stronger. The anxiety, the stress, the negativity you put your body through when you’re in that state is actually detrimental to healing, and it’s detrimental to your gut health, so you’re making it worse by being in that state.

I often say to my clients, let’s stop looking inward and let’s look outward. We have a practice where I call it my happiness jar. Some people like to do it as photos where every day, we need to focus on one thing that made us smile, that made us happy, that brought us joy that’s not about our gut, and put it in a jar. I use different colored Post-It notes. At the end of the year, you’ve got this really brightly colored jar of things that made you happy. For me, it’s things like seeing the first blossom as we come out of winter. It’s my dog being absolutely crazy and making me laugh because he’s done some stupid leap in the air It might be seeing the sun on a winter’s day and it’s been raining lots. It might be reading a good book. It might be waking up feeling refreshed. It can be anything. It can be having a really great conversation with a girlfriend or anything, anything really good but outside of the gut so you can lift your gaze outwards and you can focus on the fact that there are still good things happening in your life every day. Even if it feels really hard to see them initially, as you get into that habit and that routine, it really helps you to realize that life isn’t as bad as sometimes it feels, that we’ve got to look for the positive.

PHOEBE:  I love that. I mean, people talk all the time about gratitude journals, but so few people will look back on past entries. I know I certainly didn’t when I do a gratitude journal. I love the idea of being able to see a jar fill over time and then to look back over the landscape of what might feel like a really long span, like a year, and seeing how far you’ve come. I think that’s beautiful

REBECCA:  A jar is really easy to do as is a little Post-It note. A journal can feel overwhelming when you just think, I can’t even write. What am I supposed to write? If you just write down – I’ll write – today my happiness jar entry is it’s my dog’s second birthday today, and I gave him a new toy. He was so excited to get this new toy, so that’s my happiness entry. I literally just have to write, giving Basil a new fluffy toy for his birthday. It’s just a handful of words. It’s on a Post-It note; it goes straight into my jar. I will know what that means in a year’s time when I look back on it, so it doesn’t need to be this long, lengthy entry. I think that’s what makes it any more accessible than a gratitude journal, which can feel very overwhelming to get started.

PHOEBE:  Well, I feel like we could do a whole episode on animals as emotional support animals through various conditions and illnesses, so I love that example. I have a dog, as well. I feel like I had a million follow-up comments to all those fantastic mistakes and ways to avoid them that you just listed. I identified so much in my own journey, the first leg of which I really dealt with was my Hashimoto’s. I feel incredibly grateful because I feel like I did a lot of the work of overcoming the obsession side of things and realizing how much my own stress around the condition and also hopping down those internet rabbit holes and chat groups was doing more harm than good.

I’m just curious how you help people walk that tightrope with SIBO since it is such a strict protocol for people. I feel like my big question with my health with Hashimoto’s and also it’s the kind of question I asked again when I faced this long path of SIBO healing, but it’s like, how do you become more serious about your health but less obsessive at the same time?  How do you adopt new restrictions while learning to let go? I’m just curious what your advice is to people when facing their SIBO protocol in terms of the herbs and diet? How much wiggle room should people have to throw perfection out the window when in that intense phase of killing and healing?

REBECCA:  I think it comes down to your mindset. What I needed to change with my mindset was going from this really obsessive, I’m going to kill the critters; I’m going to get through this the fastest; my naturopath will be the most impressed with me out of all of her clients; she’ll have never seen anybody heal as fast as me. It was really about a competition, and it was coming from a very negative place. What I think recognized about four weeks into my treatment was that I needed to change the focus around killing and anger and competition to I am now walking towards health. With every meal, I used to be really angry and feel really deprived. I’d be like, this is so unfair. No one else has to eat like this. What about all the people eating burgers and fries? It sucks to be me. Instead, I think started sitting down to every plate of food and I was like, look at the abundance of food on my plate. I’m so grateful and thankful that I get to eat this meal today. Everything on this plate is nutritious and then I would visualize the food going into my mouth before I took even the first bite. I’d visualize it going into my mouth, and then going into my cells, and healing me in a way that I actually needed it.

Then I started focusing on I am taking baby steps every day towards a healthier Rebecca. I looked at what I wanted to achieve. I really want to be a healthy old lady. I don’t want to be a lady on [azimiframe]. I want to be a lady that is robust, and healthy, and fit, and people look at me and say gosh, she’s 85? That’s amazing! Look at how good she looks, because I’m still really active. I recognized that I needed to start taking those steps today to do that. To do that, I need to eat good, nutritious food. Rather than thinking about the food I couldn’t eat, I focused on the food I could eat, so focusing on the bright colors on my plate, or the foods that tasted delicious and discovering new herbs and spices that added new flavor combinations to my food. I really had to work hard at this, but I overcame my fear of fat, and I started to experiment with rendering down my own animal fat so that now at any one time in my fridge, I have rendered down tallow and lard. I make my own gee. I’ve got goose fat and duck fat. Then I have butter in my fridge. I started to experiment with different salts and peppers and those types of things. I really needed to shift the focus on what I can do rather than what I can’t do.

That’s what I do a lot of work with my coaching clients around because when we get given the SIBO diagnosis and the diet, our practitioners talk very much about the killing phase and what we can’t do. You can’t have gluten; you can’t have dairy; you can’t have sugar, whatever it is they’re telling you. I spent a lot of time with talking to practitioners about asking them or encouraging them to change their wording so that it’s more about what you can now eat rather than what you can’t now eat.

It’s very common for us to still have flares when we’re on our treatment. Every single person needs to find the treatment that works for them. What worked for me won’t work for the next person, and that can be disheartening. What I talk about with my clients is that it is all a science experiment of one, and let’s approach our treatment with interest and intrigue rather than fear and trepidation. When you do take a new herbal therapy or a new antibiotic, be interested in what it’s doing for your body. Is your body able to tolerate that now, or is it not the right time for it? Perhaps the dosage just isn’t correct and you need to drop down to a lower dose.

I’ve got a very sensitive system, so I can’t start at a full dose strength when it comes to my herbs. Every single herb I’ve ever had to take, I start at a very low dose and I slowly increase it up. When I’m doing that. I’m like, wow, isn’t this so interesting? Last week, I could only handle one tablet twice a day, and now I’m up to two tablets twice a day. Wow, body, you’re really interesting. I have these silly little conversations with myself, but it really helps me to stay positive about the experience rather than be focusing on the things that I can’t do.

PHOEBE:  That’s so important to think about. It’s a great segue because I know you have all these fantastic cookbooks, and I wanted to just ask to cap off our conversation if there’s a particular recipe of yours that you would recommend to those who were just diving into the weeds of a SIBO diet that they should have in their back pocket.

REBECCA:  I think when you first start, the key is simplicity because you can be very overwhelmed. I’ve got a heap of freely available recipes on my website, thehealthygut.com. I’m also the author of the world’s first SIBO cookbook that you can find on my website, and the world’s first SIBO meal plans. If you’re feeling really overwhelmed at what you can eat or – don’t focus on what you can’t but what you can eat, I’ve got some really great guides on my website that will help you. What I think is important when you first start is to actually sit down and do some meal planning. I would be happy to give as a free gift to all of your listeners my downloadable meal planner. It’s a blank document that you can then print out and you can fill in. It’s a way that you can plot out what you want to eat for the next few days, the next week, and it takes the fear and frustration around dinnertime or breakfast, whatever it is that you find is the most challenging meal. When you’ve planned it ahead of time, you don’t then have to spend any brain power on thinking about what to eat. You just then need to go and cook it.

The other tip I’ve got for – it’s not so much about a specific recipe but the thing that I did in the early days which really helped me be successful each week is that I would spend Sunday as my prep day. I’d head to my local market; I’d buy the best quality produce that I could afford. Then on Sunday, I would cook up several dishes. Then I would know that I would have dishes on hand so I could come home from work. I didn’t the have to cook anything. I could just reheat something on the stove. I always portion things up in single-serve portions so I’d have some containers in the freezer, some in the fridge. I’d prep my vegetables so I’d just have to steam them. Then it takes so much pressure off you to be organized. If you’re like me and you like to be organized, then it just takes so much stress away from you. Then you can focus on healing. You can focus on things like your mindset, and getting to be early, and how you can reduce your stress, and all these other really important factors to healing.

PHOEBE:  Absolutely. We are big fans of batch cooking and meal prep over on feedmephoebe.com. I also have a free ebook with a bunch of my strategies for that, so I’ll link to that in the show notes. Thank you so much for offering your free meal planner chart; that’ll be super helpful for people.

Well, Rebecca, we are at the end. I feel like this really flew by. Is there anything else from your many years of experience that you want to leave our listeners with before we take off?

REBECCA:  I think the key thing that I’ve learned over these last couple of years is that this is a process and that it does take time. I often use the analogy rather than looking at the top of Mt. Everest and seeing how far you’ve got to go to get to your goals, look down at your feet and enjoy the wildflowers that are in the meadow where you’re starting out. You can still find beauty, and happiness, and joy where you are today. Don’t put your life on hold waiting for tomorrow for a tomorrow that may take a many months or years to achieve. Just because we have SIBO does not mean that life needs to be over. We can still do things within perhaps some different parameters, but we can still do things that can still find us happiness and joy. You can plan for other things that you’d like to do in the future, but don’t let this condition stop you living your life. It does get better. I have relapse SIBO. I have SIBO today. I feel like a new woman. Just because you may not be able to get that all-important, for you, clear SIBO breath test does not mean your health won’t improve. You can totally live a much more improved and healthy life regardless of what a SIBO breath test says to you.

PHOEBE:  Such perfect words to end on. Thank you so much, Rebecca, for coming on the show. I know people are going to really love this episode.

REBECCA:  It’s been my pleasure. Thanks for having me.

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Disclaimer: The information in this podcast does not provide medical advice, professional diagnosis, opinion, or treatment. The information discussed is for educational purposes only and is not a substitute for medical or professional care.