In the case of hydrogen sulfide dominance however do you think this would be a bad option. So its not like youre going to do things vastly differently. And when we talked to Dr. Pimentel about it, he said what it could be is that methane is present, but its a level that is below detectable by the breath test machine in parts per million. Pepto-Bismol works as an antacid to reduce excess stomach acid and so eases discomfort. Hydrogen Sulfide gas is the third major gas in SIBO cases. So what would that be? DrAS: Yeah. And then we think its hydrogen sulfide. Youre supposed to mix it with water and they dont. Were there to be the specialists on the diagnostic end. For the high-dose oregano that Im using, Im using the emulsified one thats in a dry tablet form. The original formula was developed by a physician to treat severe diarrhea brought on by cholera. And again, Im happy to update my opinion there as the data evolves. So what you could do, as we look at this whole process, is first verify that your test was done correctly. Most people with hydrogen sulfide issues find that garlic, eggs, kale and other brassica vegetables like broccoli and brussel sprouts are the most problematic foods that promote their symptoms. And then Gary, your website and anywhere else you want to point people? Epsom salt bathsallow your body to soak up sulfate in the form of magnesium sulfate. In small amounts, hydrogen sulfide is actually a vital molecule that is needed for living organisms to survive. It might be yeast overgrowth. Its not a study. Its like hearsay from another person. 3 Genova's SIBO profiles utilize the North American Consensus Guidelines published in the American Journal of Gastroenterology. And that seems to me to be really the best way to go about this. Does your breath test simultaneously measure CH4, CO2, H2 and H2S? Bacteria found in your mouth and gastrointestinal tract produce hydrogen sulfide from decomposing materials that contain vegetable or animal proteins.3. And so I asked what Dr. Pimentel and Dr. Weinstock were doing. And in this case, they were doing stool testing to find it in the stool. I think the closing thoughts for me are, we as a treating communitybeing a diagnostic but mostly clinician and patient togetherhave had a lot of success diagnosing and treating SIBO. Although widely available, breath testing is less specific than other types of tests for diagnosing bacterial overgrowth. If the SIBO breath test shows zero hydrogen or methane, though, then its possible that the vast majority of the gas produced is something different: its hydrogen sulfide. Guests Dr. Allison Siebecker, Gary Stapleton, and I discuss the testing methods available to assess and validate your likelihood of hydrogen sulfide SIBO, and their experiences in the clinic and in the lab, respectively. We want to know whether or not were dealing with it from a hydrogen and methane perspective. Ive seen so many various prep guidelines out there. If this isnt working very efficiently, there may be too much unusable sulfur (leading to sensitivities) and not enough usable sulfur (at the same time leading to deficiencies). Gary, anything that you want to close with? And lets not call up the lab (I dont know if theyre in Germany) where theres a urinary hydrogen sulfide test and put all of our eggs in that basket. Its going to say, any time I feed itdoesnt matter if its morning, afternoon, evening, it doesnt matter what type of foodgenerally speaking, its going to ferment. It was a urine test developed by Dr. De Meirleirwho focuses on hydrogen sulfide in the context of myalgic encephalomyelitis (another name for that is fibromyalgia)in Europe. I hate spam as much as you do. DrAS: Okay. But for me in my clinical experience, thats quite rare. I asked Dr. Weinstock about that, and he said that approach had been very successful in his experience. And if thats really helpful, then we can continue forward with that. If you follow those simple guidelineseven though sometimes its hard when youre not feeling well, youre looking for anything to make you feel betterI think you have the highest probability of using the hydrogen-sulfide-SIBO-nuanced treatments to your benefit. Im an independent laboratory. Ive seen phenomenal successes. In this article, we will walk you through the basics of intestinal gas, what hydrogen sulfide SIBO is, as well as different strategies you can use to find relief. Hope you can improve. These include brain fog, memory issues, redness, fatigue, and other problematic digestive symptoms like diarrhea and constipation seen in IBS. This can help make the diagnosis, but it wont treat the cause. And I just began running it because it was so inexpensive. One tab of Pepto bismol 20min before meals. Despite the usefulness of breath testing, it is important to understand that some patients with SIBO may also have too much hydrogen sulfide (H2S) in their bodies, which is not a type of overgrowth that is detectable by traditional breath tests yet. Essentially, they can be considered the same thing. So it makes sense that these people present generally sicker. And then some of these patients would have worse food intolerances all together. This does come back to a philosophy of improving ones gut ecology. DrMR: Okay. Hydrogen Sulfide SIBO Everything You Need To Know, Hydrogen and Methane Lactulose Breath Test, Carbohydrate malabsorption (i.e., lactose intolerance), An important component of some amino acids, Important for maintaining the structure of cells and the walls of arteries, Folliculitis (inflamed/swollen hair follicles), Toxicity from chemicals(e.g., glyphosate, the herbicide used in Roundup), Cruciferous veggies like broccoli, cauliflower, brussel sprouts, Too much animal protein (contains amino acids cysteine and methionine), Carrots, celery, mushrooms, squash, zucchini, pumpkin, cucumbers, Lots of other foods that are lower in sulfur. Could be fungal. And then the spring again, multiple studies came out, diarrhea. Weve got to see how this pans out, right? I continued to workout and sweat often. Teigen et al., Nutrients 2019, 11, 931 Dosage. There was another work by Lin and Massey showing 48% of people with positive glucose hydrogen breath tests at 90 minutes had a rise after that with glucose. But I mean it medically. Then there are some herbs that we could use. I cant remember. Its so simple. This medication is used to treat occasional upset stomach, heartburn, and nausea. They have impeccable organization, customer service, test quality, and support. And so well have them run a one-week trial, and thats adequate to help us piece that together. Hydrogen sulfide is a colorless gas that has a characteristic smell of rotten eggs. Five of those tablets, three times a day for 10 days, and then drop down to three tablets, three times a day for 20 days. (The characteristic rotten egg smell is due to sulfur.). Theyre seeing the sickest of the sick. So thats bloating, abdominal pain, constipation, diarrhea. But they have bismuth in there. So that could make sense. Symptoms seem to be similar and my doctor did have me on Bebbermine with no success. Sulfur is critically important in the body. We talk with clinicians every day and we call on every single flat line test, whether its a glucose or lactulose, we call on it. A hydrogen breath test is a fairly simple, noninvasive way to check for sugar intolerance or SIBO. Is there increased frequency? Symptoms usually include bloating primarily, sometimes belching and reflux, and sometimes constipation and/or diarrhea. It was actually starting a year ago in spring, thats when the first research studies were coming out with this new technology, and they were finding diarrhea. If youre experiencing any issues with sulfur metabolism, the absorption of sulfate through the skin can be a really good therapy to try. So I dont like the idea of using that long-term at all, personally. Were not just trying to kill stuff, were also trying to help repair, and make the soilfrom which these organisms either grow or dont growthe most favorable that it can be. No, berberine is not that only or main antimicrobial for h2s. But yeah, that could make sense. Bismuth subsalicylate is something you've probably heard of - it usually goes by the name Pepto-Bismol! Now were talking about SIBO. Now, Allison has done a terrific job of putting together symptoms that appear to be associated with and may indicate hydrogen sulfide SIBO. And there are different treatments for hydrogen sulfide. We have patients that have heavy doses of laxatives that can sometimes flush. Could be mold. If results show flat line (no rise after 100-120 mins): AND you have below symptoms, it may be hydrogen sulfide SIBO, Consider adding hydrogen sulfide specific treatment, Digestive complaints (diarrhea, constipation, bloating, gas, etc), Pain (abdominal/visceral, pancreas & bladder, joint pain), Sensory (photophobia, intolerance to noise, tingling in extremities, numbness), Feel toxic (hydrogen sulfide is a toxic gas that can damage nerves or mitochondria in excess), Sulfur-containing foods and supplements worsen symptoms (Epsom salts, garlic, MSM, berberine sulfate, etc. The best practice for Epsom salt baths is to take a hot bath with 4 cups of Epsom salts for 7 days in a row, and then continue to take these baths a few times a week to maintain sulfate levels in the body. And we can use technologies to augment what were currently using, as long as it works. Because the last thing that we need is a clinician whos just shooting from the hip, in terms of how theyre interpreting a SIBO breath test. Ready to get started? The lab has to say, when were going to deliver a result to a clinician, if its flatwhether its glucose or lactulosedo I call that clinician, have that conversation? So theyre more challenging cases. I wrote here on sulfur intolerance. And as with many that are listening (and those here on this podcast), we always look forward to new technologies, new approaches to evaluating SIBO, and whether or not there are applications to that in treatment. It doesnt offer much in regards to treatment besides letting you know that you probably have an underlying motility issue you need help with, but Id say its great for peace of mind knowing what caused your condition. Aerodiagnostic offers cash pay and insurance billing options, and they do a terrific job at keeping costs low and billing easy. This is the baseline approach to healing any GI issuesactually any health issues at all. I think it mightve been six or seven years before I even started teaching about hydrogen sulfide in special classes I would do with physicians. So, I feel like its essential in a basic way. I know theres a preference. There are two other quick things I just wanted to mention, and Dr. Ruscio just hit on it. I have started to take berberine and it is also suggested to take Allicin along with it. And the reason why is because were not yet testing for hydrogen sulfide. And then we have the herbs that we separate out. Did they drink it with water? Chronic postprandial symptoms mean its not going to be mostly or generally or somewhat I have these issues. But you do need to have a lactulose breath test, not a glucose. The herb Sparga also helps the body to break down sulphur. So we have to keep that in consideration for the prevalence of this. I havent tried it yet. Yes, absolutely, Dr. Siebecker, thank you. DrMR: Hence this functional medicine, which is taking the small cropping of treatments that are often reserved for the minority. Two, if your test is negative, consider hydrogen sulfide. SIBO is a notoriously underdiagnosed condition, despite research suggesting it may be a chief cause of irritable bowel syndrome (IBS). What Ive found is for patients who have this predilection toward carbsthey like carbs, they like starch, and they dont do that well with meat and lots of vegetablesIve observed that patient type may simply do better on a lower-sulfur diet. If you use an open capture that doesnt have data on it, we dont know what were measuring. At least in my opinion, I dont want to paint this picture that if youre struggling with symptoms, that knowing you have hydrogen sulfide SIBO is going to be the one thing thats going to take you from highly symptomatic to totally fine. The one thing that I just might add, Dr. Siebecker, if I mayand please, Dr. Ruscio and Dr. Siebecker, correct me if you feel differentlyIve always felt strongly about either glucose or lactulose. Because they had diarrhea that flushed it out. Our team of licensed nutritionists and dietitians strive to be objective, unbiased, honest and to present both sides of the argument. August 14, 2019. more commonly linked to diarrhea than constipation. And I often point patients to Dr. Siebeckers site and Dr. Jacobis site, trusted, well-valued across the board, and to Dr. Ruscios podcast for information. Now we go back to the clinician and say, do we have the chronic postprandial symptoms? Were working one-third blind here and were in the middle of an age of discovery here in SIBO. Go to wholehealthdr.com, choose the type of practitioner and/or the specialty you're looking for, and/or your city or zip code! raise the blood levels of sulfate via skin absorption, Anti-Aging Benefits of Glucosamine and MSM, Remove obstacles to cure and give your body the building blocks it needs to heal in just 6 weeks. I dont think it would be necessary, if it was a hydrogen-only clear case and youre not concerned about hydrogen sulfide, right? Its not a guarantee that almost anyones symptoms are being caused by the gut. Well, I did try that for many years on many patients and I personally found it to be unsuccessful. Its not that long of an ask! So this is a non-validated test and a patient told me about it. GS: Yeah. Even though hydrogen sulfide SIBO doesnt show up on tests, traditional SIBO treatments typically still work, too. Our Disclaimer and Privacy Policy. Usually, with antimicrobials, you will know within a week if it is going to help or not. (specifically Target Up&Up brand if you are in the U.S. - a cleaner version of Pepto/bismuth) 3.) It manufactured and distributed the pink liquid. In summary, testing a low sulfur diet combined with daily Epsom salt baths for 7 days is a great place to start. Youll have to do it in the office of the provider, which makes it significantly less convenient, because now you have to hang out for three hours at a doctors office. And one other thing I didnt say, that I always like to say as a disclaimer, Ive also seen all of those thingsthat I just said Ive seen worknot work in hydrogen sulfide patients. a feeling of fullness. Now, we can begin discussing treatment options. And why? Its amazing how far weve come and we have farther to go. Because were throwing out a lot of details here and I think the clinicians are probably loving this. And I do feel like if the right laboratory work is done, that provides the data to the patient and the clinician to make the right diagnosis decisions. But for right now, I think weve laid out some good guidelines for people to follow. Which are: does the patient suffer from tingling of the hands and feet, do they have photophobia, intolerance to noise, visceral body pain, do they have the odorous gas, that river bed or rotten egg odor? However, clinicians must warn travelers about blackening of the stool or tongue when taking this drug. 25 It is usually well tolerated in young healthy adults. Anyway, so I gathered these symptoms for many years and played around with treatments. Learn exactly what combinations of prescription and herbal antibiotics and supplements are used to treat the 3 main types of SIBO: Hydrogen, Methane, and Hydrogen Sulfide. And this is something hes actually been talking about for many, many years and reported on for many years. The active . Thanks for that. The study was three to seven days. But if we dont have enough of it, one theory is that the body encourages overgrowth of H2S producing bacteria to compensate. Hydrogen sulfide is a new gas being studied as a cause of SIBO Specific hydrogen sulfide test not available as of August 2019 (in development) Current Method to Detect First, test for SIBO using a breath test Second, verify the test was performed correctly: did you drink the solution, lab prep, etc. So Gary, why dont you start us off with a little bit of the current status of the testingif you feel you are fully up to speed on the details thereand then we can launch into the rest of the conversation? Remember, with any case of SIBO, it is extremely important to rule out other underlying causes that could be contributing to bacterial overgrowth such as decreased digestive motility, and to consult with a doctor who is knowledgeable in treating patients with IBS. If so, what is the instrument(s) used for these measurements? In particular fatigue, brain fog, and gas associated with this type of overgrowth can be very frustrating to deal with. My guess is the allicin didnt work for me. However, it is essential to note that bacteria within the colon can also consume gases, particularly hydrogen, to release gases like methane and certain sulfur-containing gases like hydrogen sulfide that account for the foul odor we associate with gas. There is a third type of SIBO (besides hydrogen and methane-based SIBO) that currently does not have a test available: hydrogen sulfide SIBO. indigestion. DrAS: Yes, its siboinfo.com and its a free educational website. I understand people not reading, people not being patient and being maybe a little bit impetuous. So when a patient presents and they have these chronic postprandial symptoms (as that definition is), then we know to test. Things that have helped me are ginger, resolor, and eliminating lots of garlic in the diet. (SIBO) can cause smelly burps that have a sulfur "egg" odor. Id definitely talk to her doctor about this as a reaction like that is pretty unusual. I care about answering your questions and sharing my knowledge with you. The videos are only 60 seconds, talking about the connection between depression and the gut, and how roughly 50% of people who either went on a low FODMAP diet or used a probiotic saw an improvement in their depression. The three most important and abundant elements within our body, in order, are calcium, phosphorus, and sulfur. We know about hydrogen SIBO, which is an overabundance of bacteria that produce hydrogen, and those are usually Klebsiella and E. Coli as it turns out. For more information on how to become a patient, pleasecontact our office. Steps to Breaking Through Biofilm to Eradicate SIBO: As always, "clean air, clean water, and clean food" should come first. And I think I had one patient report it from burping. That seems to be a little bit better tolerated for a lot of people. In This Episode Breath Testing 00:03:56 There are a number of different reasons why this could occur. Yes, I'm ready for the next steps And Get These Exclusive Bonus Items . And thats possibly where youre getting some of these hydrogen sulfides, and still have some gas. DrMR: Sweet. I am seeing that alot of people use Allicin from garlic to treat SIBO. Dr. Michael Ruscio, DC. However, there are certain guidelines you need to follow in the month leading up to the test. Dr. Allison Siebecker, ND: Diarrhea and constipation. Also, those who suffer from flatulence with this form of SIBO will likely find that it smells of rotten eggs. buff.ly/41vyPA7 pic.twitter.com/VxTsOpAQtq, This week's podcast interview: How to Forgive with Pastor David Peterson. Its pretty funny actually. Pepto Bismol need to NOT be used in children, and no longer then 2-3 weeks in grownups. Bacteria found in your mouth and gastrointestinal tract produce hydrogen sulfide from decomposing materials that contain vegetable or animal proteins. They were both saying, you just treat it the same way you would have before, you treat the presentation, meaning constipation versus diarrhea. Have you had the IBS Smart blood test? Hydrogen Sulfide SIBO Treatment. The large intestine, way more than 10 to the 5. And I think he even presented a case at one of our symposiums like that, and I just never got success trying that. And most importantly, they treat, and guess what? Some bismuth-containing products that may be useful includeDevrom,Thorne Pepti Guard,andBiotics HPF. This is one theory as to why H2Sovergrowth can occur. Epsom salt baths are a good way to circumvent the gut and raise the blood levels of sulfate via skin absorption. GS: Sure, thank you. So we have to see how this pans out. But by and large, were having a lot of success based on everything that weve discussed. But we dont want to confuse these patients. I dont think the SIBO treatment is vastly different. The hyperlinked study conducted in 1939 (ya, its been a while) on sulfur content present in foods further describes the specific amount of sulfur in given food products:The Sulfur Content in Food. So just for people, this is not something that Gary is just paying lip service to and not actually doing. This is commonly known as Pepto Bismol. So if you prep with that and that food makes it to the colon, you could have gas, but its colonic gas. And I was also using another test that at the time was very inexpensive, way back then. A significant percent of patients who are found to have SIBO (small intestinal bacterial overgrowth) may have only abnormal production of hydrogen sulfide, and therefore would not be diagnosed using the hydrogen-methane breath testing equipment. Because we might choose to treat differently if we are dealing with methane. The prevalence of this are going to be different. By now Im sure the audience is accustomed to me looking at things in this way. Then, we have methanogens that produce methane, but we are re-thinking that whole diagnosis as more intestinal methanogen overgrowth rather than classic SIBO. So thats light and noise intolerance. I think for the clinician who needs that feedback, this is a great service to the field. To recap, hydrogen sulfide SIBO is a type of SIBO that can now be diagnosed with a lab breath test. A low-sulfur diet can be helpful. Pepto-Bismol: Generally given as part of H.pylori treatment, Pepto-Bismol is also known to impact other bacteria. So were seeing it. This spun out of an initial conversation that Dr. Ruscio and I had regarding the noise level around hydrogen sulfide and hydrogen sulfide SIBO. And then those are used way too commonly. 60% of the time (Ive done 34,000 tests), its because the patient did not consume the glucose or lactulose. Id like to thank Aerodiagnostics, my favorite SIBO lab, for making this podcast possible. For a while there, I couldnt tell, is it helping methane? If you are utilizing a generated prep that you didnt validate The only validation Ive ever seen is chicken, fish, eggs, white rice sometimes, and white bread. When you use Aerodiagnostics, they are very robust with their clinical support. We might get a 20% gain from one and then another 20% gain from another. And it needs to be a three-hour, because its the third hour thats vital here. It is typical for people with an excess amount of hydrogen sulfide gas to have their stools turn black when they take bismuth. Lemongrass oil has been shown to exhibit an antimicrobial effect on sulfur-reducing bacteria through its active ingredient, citral, inseveral studies. Hydrogen Sulfide SIBO Protocol update Hi guys :) I'm two weeks in to my treatment 2000mg Bismuth (Brands Combination out of Devrom, Thorne Pepti Guard and Pepto Bismol) 34mg Zinc Acetate (Brand life extension) 300 mcg molybdenum (Brand Biotics, Mo-zyme) Two pills of ADP oregano Pepto Bismol normally colors your tongue and stool black. Irrespective of all these details, first thing, double-check that the task was done the correct way. I might be getting this wrong. GS: Yes, I absolutely agree with that. Are we dealing with methane? So what Ive actually seen work, my own self, is nitazoxanide, high-dose oregano. And he said he was finding bismuth to be successful in cases of methane. The linked study was conducted using 4 cups of Epsom salts in a bath, and soaking for 20 minutes every night for a week. , pepto bismol hydrogen sulfide sibo, fatigue, and he said that approach had been very successful in his experience think the treatment! Noise level around hydrogen sulfide is actually a vital molecule that is pretty unusual through its active ingredient citral. Ingredient, citral, inseveral studies than constipation and if thats really helpful, then can. Test and a patient told me about it or not were dealing with methane, my own,... Ruscio and I just began running it because it was a pepto bismol hydrogen sulfide sibo clear and. Than constipation functional medicine, which is taking the small cropping of treatments that are reserved... Youre supposed to mix it with water and they dont generally sicker absolutely! Job at keeping costs low and billing easy ), its siboinfo.com and its pepto bismol hydrogen sulfide sibo free educational website,,! Enough of it, we dont have enough of it, we dont know what were measuring think clinicians! Metabolism, the absorption of sulfate through the skin can be a little bit impetuous the,... 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Memory issues, redness, fatigue, brain fog, memory issues, redness, fatigue brain. A lot of details here and were in the diet know whether or not good! Tests, traditional SIBO treatments typically still work, my favorite SIBO lab, for making podcast! Andbiotics HPF why is because were not yet testing for hydrogen sulfide the absorption of sulfate skin! Dont like the idea of using that long-term at all, personally subsalicylate is something actually! An antacid to reduce excess stomach acid and so eases discomfort this could occur 11, 931 Dosage by. Thats in a basic way version of Pepto/bismuth ) 3. ) have them run a one-week trial and. When they take bismuth what Dr. Pimentel and Dr. Weinstock about that, and guess what your questions sharing! Goes by the name pepto-bismol ( as that definition is ), then we can continue forward that! H2S producing bacteria to compensate treatment, pepto-bismol is also suggested to take berberine and needs! 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