It’s the season 3 finale Q&A episode! And I have a dream guest here with me to answer all your lingering SIBO queries: the king of SIBO himself, Dr. Mark Pimentel.
If you’ve already been down the SIBO rabbit hole, Dr. Pimentel likely needs no introduction. He’s the director of The Pimentel Lab at Cedars-Sinai in Los Angeles, where he researches many pieces of the IBS puzzle, including gastrointestinal motility and bacterial overgrowths. He’s published dozens of studies on these subjects, and it’s fair to say that much of the data-backed information we’ve covered in the first 3 seasons of this podcast, has been discovered through Dr. Pimentel’s work.
There were a few recurring macro themes to your questions, so in today’s episode, we’re going to focus on Post-Infectious IBS, Methane overgrowth, and Hydrogen Sulfide SIBO.
If you don’t hear your question, don’t stress—there’s a big possibility I’ve covered it in a past episode already. Those who are new here might want to backtrack and listen to season 1, where we cover a lot of SIBO 101 topics related to the aftermath of a diagnosis.
The podcast will be on hiatus until the fall while I focus on putting the finishing touches on the SIBO Made Simple book (!!). In the meantime, stay in touch via instagram (I’m @phoebelapine) and by subscribing to my newsletter. Of course, subscribing to the podcast is the best way to be sure you’ll know when new episode start airing again.
A quick taste of what we’ll cover:
- The proper definition of IBS, Post-Infectious IBS and SIBO
- Why the IBS Smart Test is useful and how to decide when to use it versus a lactulose SIBO breath test
- How long it takes for Post-Infectious IBS antibodies to be cleared from the body
- Precautions those diagnosed need to take when traveling abroad
- Advice for methane SIBO and constipation sufferers and the latest research about what a different beast it is
- Atrantil as a treatment for methane SIBO
- What percentage of people with SIBO have Hydrogen Sulfide and treatment plans
- And so much more…
Resources, mentions and notes:
- Dr. Pimentel’s website
- EP 27 | Bad Bacteria: Food Poisoning and Post-Infectious IBS
- Talley Meta-Analysis on SIBO in IBS
- Dr. Pimentel’s new paper on IMO: Intestinal Methanogen Overgrowth
- Atrantil – Digestive Support for Methane SIBO
- Phoebe’s book, The Wellness Project, on her journey with Hashimoto’s
- Join the SIBO Made Simple Facebook Community Page
- Subscribe to the newsletter (and receive a free low FODMAP cookbook)
This episode is brought to you by 4 Weeks to Wellness, my online program for finding the sweet spot between health and hedonism. Need 4-weeks worth of easy low FODMAP recipes with a step-by-step meal plan laid out for you? You’ll receive a 20-recipe cookbook, complete with shopping lists, elimination diet guidance and reintroduction worksheets, in addition to the many other program resources like my symptom and activity tracker, lymphatic massage videos, doable desk stretches, and so much more. The 300+ people who have joined the tribe have reported clearer skin, calmer tummies, less bloat, tamer food cravings, and a general ease over their newfound habits. To find out more details about when the next session starts, click here. Use the code SIBOMADESIMPLE at checkout for $40 off!
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.
Is it possible to get transcripts of the latest episodes? I love the material but with a newborn at home, the time needed to listen is just not happening right now. Thanks
Great interview, though as always I end up with more questions. LOL
Was hoping for a few answers from Dr Pimentel if you could get them.
1) Is the study mentioned on treating the autoimmune aspect coming out soon or is that a year or more off?
2) Can you get an elaboration on what information is given patients with regards to food poisoning? As the comments on how to best avoid it or any other information you can give there.
Related to 2, it’d be great if this sort of information was available in what is given to Drs and Patients as part of the results for the ibssmart test. There were a lot of other things that were mentioned in the interview but aren’t in what is sent with the results.
Also related to 2 I have, in the little research I’ve done, found that I may have been food poisoning myself for a while now as I didn’t realize the expiration dates of some foods in the refrigerator. I’m A LOT more vigilant now that I found out about the autoimmunity I have to vinculin.
Paul Schleuniger says
Great podcast. That was major league information. I am new to this IBS syndrome. Since Oct 11th, 2019 I’ve had constant gas & diarrhea. No pain or cramping. It all started after we went out to eat and the very next day everything changed thinking these symptoms would be gone in a few days. It was like a night and day difference. Was hospitalized twice due to rushing to the bathroom 15 to 25 times a day, losing 40 lbs in just 5-6 weeks. Before Oct 11th my weight was 210 lbs on a 6′ 5″ frame. Saw 2 different GI doctors and had all the normal tests they perform which all came up negative. So the final outcome was labeled IBS. I was put on steroids, antibiotics, opioids, etc to which none of these were working. About a month ago, I started doing my own research and came across the word SIBO. Read quite a few other people’s problems that make mine seem like I shouldn’t even be complaining. Coming across your website has helped us to understand a little more about what might be the underlying problem. Just changing to more of a paleo type of diet has helped to cut down the number of trips to the bathroom. Listening to this podcast has led to scheduling a hydrogen breath test next week, which the GI docs never even mentioned. Hopefully, this will lead to some sort of procedure that I know now is going to take some time & patience.
Thanks again for this website! – Paul
Phoebe Lapine says
so happy to help Paul! good luck on your gut journey xo
Thanks a lot for interveiw.
what do you think about long term of low dose of herbal antibiotics as maintentance for SIBO symptoms? i can not get rid of SIBO. it allways come back. And i though to try low dose of herbals to make my life less misserable. Many thanks.
Jane Doey says
Great information! Regarding Sugar. For Hydrogen dominant SIBO (level 82) can one have any sugar to better question what is best type of sugar to consume if tolerated?
Kristen Park says
Thanks for this interview! I’d love to get an update on the IBS Smart test, and what they now know about PI-IBS. Phoebe asked all the right questions. I’m wondering what has changed since February 2020, as I know this is a fast evolving field due to Dr. Pimentel’s efforts. I have the Anti-CdtB Ab antibody with IBS symptoms (just cleared long term SIBO), but not the Anti-Vinculin Ab antibody.
Phoebe Lapine says
shhhhh – he’s coming back on for an update in Jan! Feel free to drop any questions here.
Kristen Park says
Awesome, thank you! Here are some questions:
-Is there an update on the food poisoning antibodies? Are there any out of the box suggestions or hints on how to lower those? The last we heard from Dr. Pimentel is that 50% of those with just the anti cdtb get better in 4-8 years. Other than that we don’t seem to know how to lower the antibodies.
-Is Rifaximin helpful if you have the food poisoning antibodies BUT no longer have SIBO? I know he said no previously but just double checking!
-What does a prokinetic do for those with the food poisoning antibodies? It may stop you from getting SIBO by keeping the MMC working, but you will still have gut dysbiosis – or does it help in another way?
-One of Dr. Pimentel’s presentations shows that rats injected with cdtb have gut inflammation/damage. Should we be trying to reduce gut inflammation rather than treating gut dysbiosis if we have the anti cdtb antibodies?