This EndoLife podcast

My Small Intestine Fungal Overgrowth Protocol

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Okay, so a number of you have reached out to ask me whether I’m going to talk about my next steps for SIFO treatment, which I wasn’t originally going to do as I have an expert in mind to invite onto the show, but as a number of you asked, I hope that sharing my story will be somewhat helpful for you! 

So, unlike with SIBO where I had quite a long-term plan in mind, this I am more so feeling out my journey because as I discussed in my previous update, I’m not 100% sure if the issue is gut dysbiosis or SIFO.

So, to recap, let’s start with what SIFO is. SIFO stands for small intestine fungal overgrowth and it’s when fungus like yeast (or other fungi) grow in the small intestine. We do have some normal, non-harmful levels of fungus and yeast in the large intestine, but they become a problem either when they overgrow or when they’re found I the small intestine. 

Unfortunately, the symptoms of SIFO are exactly the same as SIBO, so it can be very tricky to identify between the two. What makes it harder is that testing for SIFO is unreliable. Often the fungus hides in biofilms, which are protective mucosal-like layers, so they don’t show up on tests and even if they do, there’s no way, without a very invasive biopsy, to tell whether the fungus is in the large intestine or small intestine. What we do know is that the organic acids test tends to be the most reliable test, at least according to the practitioners I’ve trained with.

We also know the candida tends to be the culprit behind SIFO in many cases, and just to be clear, that’s the type of yeast which causes thrush, and we also know that about xxx of SIBO cases. 

Now there are some extra tell-tale signs of candida specifically, if that’s the fungus behind the problem, and those are… 

·       Allergies

·       Yeast overgrowth (vaginal, oral or on the skin)

·       Nasal congestion and excess mucus or phlegm 

·       Rashes

·       Joint pain

·       Brain fog and chronic fatigue

·       Headaches

The difficulty is that unless you have the obvious thrush, whether oral, vaginal or on your skin, this symptoms are also typical of histamine intolerance, which you know if you listen to my podcast, is very common with our community and is also very common with SIBO, and hydrogen sulphide SIBO specifically. 

As I had suspected hydrogen sulphide and for sure, have histamine intolerance, any possible SIFO really wasn’t obvious. Until more recently.

As you may know, about two months ago, I cleared my SIBO! But unfortunately, I still had the majority of the SIBO symptoms. I also had an unusual test result, which showed no hydrogen gas in my large intestine, which is where it should be. In a healthy negative result, you should see little hydrogen gas in the small intestine and then a rise in the large intestine, but I had a flat line. So, this indicates two possible issues – either hydrogen sulphide or a bacterial imbalance in my large intestine, essentially, the bacteria in my gut having been wiped out.

Because I’d done so many treatment rounds and most of them would target all three types of SIBO, I felt it unlikely it was still hydrogen sulphide remaining, and my colleagues agreed. Secondly, I had done a round of antibiotics, and I react quite badly to them, having lots of diarrhoea, fatigue, and headaches, and after I finished the course, I got shingles, which you only get when you’re very immune compromised. And 70% of the immune system is in and around the gut. If your healthy microbiome in the large intestine is wiped out, you can bet your immune system will be too.

So, for sure, I was certain that there was some gut dysbiosis happening. But I didn’t believe it was enough to cause all my symptoms. 

And a few clues made me suspect SIFO. 

Firstly, I was doing pretty well with symptom reduction until the third week of the elemental diet, which is full of simple sugars. Suddenly, I began to bloat up again. I also had a strong white film throughout the entire elemental diet, which indicated the sugars were feeding bacteria or yeast in my mouth, and secondly, I started having thrush symptoms during the elemental diet.

Then, from the elemental diet, I went onto the antibiotics, and I got thrush symptoms again!

Now Dr Siebecker warns that the elemental diet may cause yeast or fungal overgrowth in people who already have it, in contrast, Dr Ruscio uses the elemental diet for candida overgrowth, because he says the simple sugars are absorbed too quickly for the yeast to eat it. I think it’s probably the case that both doctors are right, but that it depends on the individual and that they see different types of patients. Either way, it seemed quite clear to me that I had some yeast overgrowth as a result. 

I went to my doctor at Vala, and they agreed that it looked like candida overgrowth in my mouth. 

Additionally, I’ve always had a white film on my tongue, honestly ever since I could remember. I used to ask dentists about it, but they would shrug it off, and tell me it was down to what I had eaten, but I was waking up with it before I had eaten a thing. Back then I just took what they said as gospel. Then a few years ago, my boyfriend and I went through a real sweet tooth phase, long before I had gotten on top of my endo and eating an anti-inflammatory diet, and we were eating a lot of sugar. At that point, I got full on oral thrush, which thankfully was cleared with 24 hours of taking the medication – or so I thought!

I’ve only ever had vaginal thrush a handful times, so again, initially, I really didn’t think candida was an issue for me! However, the fact that I then started getting the symptoms from two things which we know may cause yeast overgrowth – the elemental diet and antibiotics – made me think that maybe I have had SIFO all along, but the white film never got out of control, and it wasn’t really affecting my vagina too much.

Now having said this, according to Dr Jacobi, candida can also cause a burning bladder pain, and for sure, that’s what my pain feels like inside my bladder. Like I have a fire going on in there, and there’s also a few rusty knitting needles sticking through it too! 

So, alongside my colleagues who I trained with in SIBO and my doctor, I concluded I do likely have SIFO and gut dysbiosis. 

The problem is, if you have SIFO, its usually quite hard to clear SIBO or to stay in remission, and even though I still had all the symptoms of SIBO, I felt like I relapsed about 2 weeks into my all clear. The changes were subtle, but they were there. I was still having bloating and loose stools, that hadn’t changed. But what had improved is I could no longer feel fermentation happening in my gut, like active bubbles forming and moving around in my gut, which I used to get all the time – and that returned. The second issue was that my stools changed, and I won’t go into the detail, but it was reminiscent of when my SIBO used to be really bad. Then I started getting the burping back, which was a new symptom originally, that started I think in 2019, but it went during treatment, and came back around the same time as these other symptoms.

So, this occurred whilst I was in my prevention of relapse phase. So, when you clear your SIBO, you move into a three-to-six-month period where you put in place meal spacing, prokinetics (which are supplements or drugs which stimulate your migrating motor complex in the small intestine overnight, to clear out bacteria) and some kind of SIBO diet. There are also some additional extras you can do, which I was doing. I was pretty much doing everything perfectly, but I relapsed. 

So, I was two weeks in, whilst deciding what treatment to start for SIFO. And at that point, sometime after my relapse, is when we decided to go to Greece. 

Now originally, you’ll know my plan was to do a very specific reintroduction of foods, following the usual elimination diet reintroduction phase, where you try one new food basically a week. But now I had relapsed, and I was at a point where I never didn’t have symptoms. I bloated after every meal, despite being on the SIBO bi-phasic, so I couldn’t get any more restrictive. So, trying to tell what I was specifically going to react to was going to be incredibly difficult and frustrating. 

Also, we have been wanting to travel for years, but in addition to COVID, we hadn’t because of my SIBO. I didn’t want to be in a position where I had to eat outside of a SIBO diet and ended up relapsing. But now I had relapsed.

And part of what may cause relapse is chronic stress and an elevated nervous system. I won’t go into it now, but many of you know that I have felt very, very stressed and unsafe in our current home in Margate, but we’ve had continual circumstances that have prevented us from moving – one of them being that we didn’t want to just move to a new flat, we really wanted to move overseas and roam around for a while. Additionally, we had mould, which we’ve cleared as much as we can, but there’s likely a lot of hidden mould as the entire flat was flooded not long after we first moved in, and it was after that that I got very sick with histamine intolerance, which can flare up from mould triggering the immune system. But this is a stressor on the body and nervous system, and additionally, can cause relapse if your immune system is being compromised by something like mould.

On top of that, I’d worked really hard, for really, really long and it had been a tough few years. So, we made quite an overnight decision to go to Greece for six week. You know, our original vision was to pack up, leave the flat entirely and just travel Europe for six months, because that’s all we’re allowed to do thanks to Brexit, but because of the restrictions with COVID, etc. it was just all so limited and so fingers crossed, we can do that this year. But we both decided enough was enough and we wanted a break from the house and a change of scenery, of course it was something we just wanted to do in life, but in a large part for me, my health was my motivation and my therapist even called it an intervention, and that’s for sure what it felt like.

So, I made the decision to go to Greece, knowing full well I wouldn’t have total control about the reintroduction of food, but by this point I was pretty certain I had relapsed and giving that I still had the SIFO road ahead of me, a break away seemed not just like it wouldn’t do much more damage, but that it would be good for me.

So, my plan for SIBO and SIFO basically revolved around Greece because I would have to take all my treatment with me. And I established three goals, I mean I didn’t, I’m not that organised, but that’s this is what I focused on –

·       Keeping SIBO at bay and continuing the prevention of relapse to the best of my ability so it didn’t progress rapidly.

·       Beginning to take on SIFO, but gently, to avoid any die off reactions whilst away.

·       And to rebuild my microbiome and improve my gut lining, which I was already working on anyway.

So as a result, here’s what my current protocol looks like:

 

Diet

Before we went away, I began expanding with one to three new foods a week. Just some of the key ones that I thought I should try before we went, that I would likely rely on in restaurants, like lentils and some nuts.

Then, as we planned for Greece, my aim was to eat as expanded as possible, so basically the more lenient end of a SIBO diet, which looks more like the expanded version of the low FODMAP diet and the paleo diet. This is fine by the way; you won’t relapse if you expand. The point of the prevention of relapse phase is to expand to tolerance as rapidly as possible. Of course, I had no bloody idea what I was and wasn’t tolerating, so I just decided to follow the low FODMAP serving guidance to help me to stay within some kind of relatively low carb (that’s the basis of a SIBO diet) protocol. So, before we went, I basically started transitioning from the bi-phasic, which is very, very restrictive, to low FODMAP.

Because we are here for six weeks, I had the advantage of not eating out all the time. So, I my plan was, and what I have implemented whilst here, was to eat low FODMAP during the week at home, and then at the weekend, to eat as low FODMAP or paleo friendly as I could manage whilst out and about, but also allowing for treats and just basically enjoying and appreciating a different cuisine.

Now my doctor, who is a functional medicine doctor, sent me a candida diet. There are a few different versions, but essentially, it’s a low carb diet to a degree, that removes yeasts and sugars. I had a look through it and because in terms of servings, it’s generally less restrictive than the low FODMAP, I was essentially doing it, other than when I have some bread or ice cream over the weekend. But I didn’t really want to go down a rabbit hole with that, especially as I’m not sure how suitable the candida diet is for SIBO and equally, some practitioners debate whether the candida diet is even necessary. So that’s going to be a bridge that I cross when I get home. But for the most part, I am naturally doing it anyway.

So, we’ve been here for about two weeks now and I’ve settled into a routine of this kind of pattern. The first weekend we were in Athens for 48 hours and were travelling and didn’t really have time to seek out gluten free and dairy free, etc. We did stumble across a few places, thankfully, so that was great. But I ended up eating quite a bit of gluten, and by the third day I felt really nauseas and started getting an upset stomach. I also had dairy too, once, or twice, because it turns out that in Greece, it’s really hard to eat vegan and gluten free in general restaurants. The protein options are mainly meat, fish or dairy and often the fish was things that I just wouldn’t be able to stomach, like octopus, and as you know, I was hoping to transition back off of meat after having to eat on the bi-phasic, so I had some cheese every now and then, as being a health coach, blood sugar is important to me and so you do need protein with every meal. Also, my blood sugar is very suspectable to lows, so just having a plate of carbs would really mess me up and ruin the rest of the day, so I had to make choices about having enough fat and protein and that sometimes looked like a little dairy. Now I know I’m intolerant to dairy, which actually might be due to having SIBO, because it causes temporary lactose intolerance until you clear it, so I wasn’t eating huge amounts and I tried to choose cheeses that I know I tolerate better, and I avoided cow’s dairy and milk for the most part – except for a scoop of ice cream here or there, but in Athens I could get vegan. 

So, because I was nervous about eating foods out, that I hadn’t eaten for a long time, I took with me betaine HCL, which is stomach acid support; digestive enzymes; FODMATE, which is digestive enzymes specifically for FODMAP foods and charcoal capsules, which absorb gas if you have bloating and can also be helpful with diarrhea, and all of these have been really handy when out. I’ve still not had the happiest bowel movements, but I wasn’t having sudden severe reactions whilst out and needing to dash to the loo, which is what I used to get and what I was scared of.

So that’s the diet side of things.

 

SIFO

For SIFO, I didn’t want to go in too hard core now and then have lots of die off reactions whilst away, which would leave me feeling really unwell.

So instead, I started subtle. I have a one-week course of an anti-fungal from my doctor, but I am also taking a high dose of saccharomyces boulardii, which is a healthy yeast probiotic that competes with candida for space in the gut and has been shown to be very effective.

I am also taking another probiotic called lactobacillus acidophilus NCFM, which creates candida antibodies to kill it off. 

I am also taking immunoglobulins, which are naturally a part of our immune system and line our gut, but I am very low on these. They bind to toxins and help expel them, and when they’re low, we’re more suspectable to infections, parasites, yeast, etc. So, I am taking them to help with both the SIBO and SIFO.

Additionally, I am taking glutathione, which is an antioxidant that’s absolutely essential to liver function, and so this is supporting my liver to clear out all the toxins as the candida, fungus, etc. clears, helping me by lessening the die off. 

 

SIBO

For SIBO, I am keeping it at bay with the strongest prokinetic, called prucalopride. This is a pharmaceutical drug, but unfortunately, the natural prokinetics aren’t normally strong enough and this was certainly the case for me. I tried them all, and they just didn’t do the job.

Whilst doing that, I am of course doing the diet 80% of the time, and then meal spacing as much as possible. So that’s 4 hours between meals and 12 hours overnight. Sometimes I can’t manage the 4 hours between meals because I’m hungry or I need to support my blood sugar, but at a minimum we’re required to do 12 hours over night. I think maybe three days I ended up doing less than that because of travelling, maybe 10 hours or something.

And alongside that I am taking low dose allicin, which is an extract from garlic, and I use multiple times in my SIBO treatment with success, and allicin also kills off fungus. It’s reportedly not strong enough alone to kill fungus and yeast, but it can help and in combination with the probiotics, I think it’s a nice combo to keep the SIFO at bay at least, if not begin killing it off. 

So, I am taking the allicin at a low dose to keep the SIBO at bay, and this is a common approach. Dr Siebecker doesn’t use it, but some other doctors do use it between treatment rounds instead of a prokinetic, and it does work. So, it may not be enough to kill the SIBO, in fact I know it’s not, but it just sort of keeps it from growing like crazy. 

Then of course, the immunoglobulins help too.

 

Microbiome and gut lining repair

So, I am taking high dose fish oil, about 2000mg, which helps to repair the gut lining.

 I am taking 2000mg of quercetin, which again helps to repair the gut lining, and also lowers inflammation in the body and gut and is a natural antihistamine. I was taking l-glutamine before I left, which is the best leaky gut healer, but the tub was huge and was open, and is a white powder, so I thought I might get arrested for that one!

Additionally, the saccharomyces boulardii also helps to repair the gut lining, and the lactobacillus acidophilus also contains two other strains which have been shown to repopulate the gut and increase levels of beneficial bacteria. Now normally, I wouldn’t take so many probiotics with SIBO, because taking too many can cause a flare up and even cause it to grow, but it’s about testing your tolerance. If you take a probiotic and you’re bloating or SIBO symptoms get worse, it’s probably not the best one for you because it’s feeding your SIBO. In contrast, certain single strains are better tolerated. I like to build people up to a few strains, and I was already on two, so with this combo I’m on four, and I tested them out before I left to make sure I wasn’t reacting. But essentially, I couldn’t find a single strain of lactobacillus acidophilus for the life of me, so this was the best I could find!

 And the immunoglobulins help to rebuild the gut lining and support the microbiome too. 

Additionally, in general, I have been supporting my gut by using the app. Nerva, which improves the gut-brain connection and using Arvigo massage at night to stimulate the migrating motor complex overnight. Both of these also help to lower stress, which damages the gut lining and microbiome, so addressing a stressed nervous system and an anxious gut is really important too – and I see Greece as part of that. I have to say, I haven’t been able to be consistent with the massage and the Nerva with all the travelling, but we’re a week into our new temporary home now and we’re here for another three weeks, so I can get back into my routine. 

So that’s my current protocol.

When I return to the UK, I am going to move into a high dose of oregano and another yeast antimicrobial, likely Candibactin AR, but continue with the probiotics, and I’ll of course retest for SIBO. If I am positive, I may do the elemental diet again, whilst taking anti-fungals, as that should kill it at the same time.

I may then need to continue with the candida treatment for several months, as it can take some time to clear. But I think that will be judged on whether I am seeing any improvements, because if it’s not candida, then I don’t want to waste time treating the wrong issue. I’m hoping to do an organic acids test too, to see if any candida shows up. What I’ll do is take an anti-biofilm for two weeks ahead of the test, and that will hopefully break up the biofilm so it can be detected. It doesn’t always work, but we’ll see. But there are plenty of natural anti-fungals to rotate through and I have all the doses from my course with Dr Jacobi, so I’ll let you know which ones I’m doing as I go through the treatments.

If it’s not candida, I may be still having symptoms because of possible Ehlers-Danlos syndrome, which I am being assessed for when I return, and I’ve been talking about that over on Instagram if you want to learn more about its connection to endo and SIBO. And it could also be that I am just rapidly relapsing and severely reacting because of an upregulated nervous system, in which case, there are two great courses for rewiring your brain if your body is very reactive, one is called DNRS and the other is the Gupta Programme, so I may consider those too. I see a lot of this with my clients, an upregulated nervous system from years of pain, inflammation, etc.

It’s really too early to say which route I’m going to go down until I see what my SIBO results say, and I see how I respond to the candida treatment that I try when I get back.

So that’s it. I hope that sharing my journey has given you some insight into your own, has maybe offered you some hope or some motivation to keep going. I know clearing these guys is tough, and I’m with you on that, but feeling well is possible. 

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Show Notes

Nerva

DNRS

Gupta Programme

Arvigo massage practitioner

 

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Now this tends to occur if the coeliac disease developed as a child (and just be mindful that coeliac disease can develop at any age!) due to the body being unable to absorb enough nutrients due to the damage in the intestines and from my understand, also as a result of the immune reactions. Dental problems can occur as issues with the enamel and can look like discolouration, patches on the teeth, translucent areas, grooves on the teeth and potentially increased cavities. Additionally, the growth of adult teeth can be delayed too.(12) 3) Number three is mouth ulcers(13), and these would be on the side of the mouth, on the cheeks and tongue, not on the lips – so we’re not talking about cold sores. These won’t occur in everyone, but if they do, they’ll usually be recurring and you may have a few at one time. Again, this is thought to be a result of the nutrient deficiencies and immune response to the gluten.  4) Number four is anaemia, either b12 or iron deficiency induced anaemia or both(14). And this is tricky, because this is also a sign of SIBO!(15) So again, it’s easy to dismiss coeliac disease here. B12 and iron deficiency anaemia will cause symptoms like tiredness, dizziness, shortness of breath, heart palpitations, numbness in the hands and feet, mouth ulcers, brain fog and irritability to name a few.(16,17) I’ve linked to the NHS page for symptoms in the show notes.  You can fairly easily get tested for these through your GP or online testing sites like Thriva in the UK, and I’ve linked to a few of them(18). If your levels are low but not deficient, it’s still worth ruling out coeliac disease, because they have to get low to get deficient and if you’ve only just recently developed coeliac disease, it may take some time for your levels to drop. And on top of that, if you have the presence of gut problems, endo belly or any of the other symptoms I’ve listed, and you have low levels of iron and B12, it’s safer just to rule it out. 5) Number five is infertility or reoccurring miscarriages, and I think this is an important one to raise because we often dismiss fertility problems as a symptom of endometriosis.  Now if coeliac disease is diagnosed and treated (as in, a person sticks to a strictly gluten free diet, which is the only form of treatment there is) then fertility rates return to normal and are equal to someone without coeliac disease. The problem is when it’s left undiagnosed, and in fact, the guidance in the UK is that people who have recurring miscarriages or fertility struggles should be tested. I mean I think they should be tested as soon as the difficulty begins, to save people all that heartache, but I guess it costs the NHS less this way. There are numerous reasons why coeliac disease will affect fertility, from disrupting hormones, causing inflammation in the body, nutrient deficiencies and so on. But the bottom line is, the only way to treat it would be with a diagnosis and an adherence to a gluten free diet.(19)  6) Number six is brain fog(20). Coeliac disease patients often report brain fog and fatigue and research confirming these reports, with MRI scans showing brain changes and damage in people with coeliac disease. This brain fog may be accompanied by memory loss, headaches, and even balance or speech problems.  One small study found a significant improvement in patients with CD and cognitive impairment after a year on a strict gluten free diet(21), so there is definitely hope if this is a symptom you have and you’re diagnosed!  And I thought I’d raise this one because so many of us report brain fog with endometriosis, and whilst there are many root causes behind this (in fact, I have a whole episode on them) often we just dismiss it as something we have to live with. So those are a few symptoms that you may not suspect would be behind coeliac disease – and these can all occur with or without gut problems and the endo belly. Some other signs to look out for include the development of autoimmune conditions like hashimoto's thyroiditis, type 1 diabetes (which my brother developed) and osteoporosis(22). So now let’s move onto testing. To accurately test for coeliac disease, you must be eating gluten daily, at least twice a day, for six weeks(23). This is because the immune system will create antibodies against gluten and that’s what’s being measured. If you’re not eating gluten at all or not regularly, you’ll get a false negative test, even if you have the disease. So, if my brother tested today, he would come up as negative, because he hasn’t eaten gluten for several years.  Once you’ve done the blood test, you’ll then also be sent for a biopsy.  If you’re still not sure whether it’s worth getting tested, I’ve linked to an online assessment in the show notes, which will literally create a letter to take to the doctor, if it advises you to get tested, based on your symptoms.(24)  So that’s it! If you have the endo belly, full stop, I advise you to get tested. And if any of these other symptoms sound familiar, I advise you to get tested too! Left undiagnosed, coeliac disease can cause serious health problems and increase your risk of multiple conditions and chronic diseases(24), and we’ve never lived in a better time to be gluten free, so even though it might be a hassle to get tested, it’ll be worth it in the long run.  I’ve also linked to some gluten free courses and cookbooks in the show notes.(25) Listen and subscribe on your favourite player or listen directly/download MP3 here or just listen below! Let's get social! Come say hello on Instagram or sign up to my newsletter. Sign up to my free workshop: Creating a Roadmap to Endo Belly Healing Sign up to the wait list for my course, Live and Thrive with Endo here. My cookbook This EndoLife, It Starts with Breakfast is out now! Get 28 anti-inflammatory, hormone friendly recipes for living and thriving with endometriosis. Order your copy here. If you feel like you need more support with managing endometriosis, you can join Your EndoLife Coaching Programme. A 1-to-1 three month health and life coaching programme to help you thrive with endometriosis. To find out more about the programme and to discuss whether it could be right for you, email me at hello@thisendolife.com or visit my website. This episode is sponsored by The Pod Farm. Learn all about how to start your own podcast with the complete course from The Pod Farm. Aimed at beginners, this course takes a simple and straightforward approach to planning, equipment buying, setting up, recording, editing and hosting your own podcast. With hours of audio and video materials, and downloadable guides and useful links, this multimedia approach aims to have something for every kind of learner. From now until April 15, newsletter subscribers get 20% off the course price. Visit www.thepodfarm.com to enroll or find out more This episode is sponsored by BeYou. Soothe period cramps the natural way with these 100% natural and discreet menthol and eucalyptus oil stick on patches and CBD range. Click here to find out more and to shop: https://beyouonline.co.uk  Show Notes 1.      https://farrp.unl.edu/resources/gi-fas/celiac-disease 2.     https://www.nhs.uk/conditions/coeliac-disease/symptoms/ 3.    https://www.coeliac.org.uk/information-and-support/coeliac-disease/coeliac-disease-faqs/ 4.      https://www.coeliac.org.uk/information-and-support/coeliac-disease/about-coeliac-disease/myths-about-coeliac-disease/?&&type=rfst&set=true#cookie-widget 5.      https://www.beyondceliac.org/fast-facts-about-celiac-disease-infographic/ 6.     https://pubmed.ncbi.nlm.nih.gov/21840904/ 7.     https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6601386/ 8.    https://www.siboinfo.com/associated-diseases.html 9.    https://pubmed.ncbi.nlm.nih.gov/9660426/ 10.  https://pubmed.ncbi.nlm.nih.gov/23334113/ 11.    https://celiac.org/about-celiac-disease/related-conditions/dermatitis-herpetiformis/ 12.   https://celiac.org/about-celiac-disease/related-conditions/oral-health/, https://jcda.ca/article/b39 13.  https://www.coeliac.org.uk/information-and-support/coeliac-disease/about-coeliac-disease/what-are-coeliac-disease-symptoms/ 14.   https://www.coeliac.org.uk/information-and-support/coeliac-disease/about-coeliac-disease/what-are-coeliac-disease-symptoms/ 15.   https://www.siboinfo.com/overview1.html 16.  https://www.nhs.uk/conditions/vitamin-b12-or-folate-deficiency-anaemia/symptoms/ 17.   https://www.nhs.uk/conditions/iron-deficiency-anaemia/ 18.  https://thriva.co, https://valahealth.com, https://www.letsgetchecked.com 19.  https://www.coeliac.org.uk/information-and-support/coeliac-disease/conditions-linked-to-coeliac-disease/infertility-and-coeliac-disease/ 20. https://www.coeliac.org.uk/information-and-support/coeliac-disease/conditions-linked-to-coeliac-disease/neurological-conditions/ 21.   https://celiac.org/about-the-foundation/featured-news/2014/07/brainfog/ 22.  https://www.coeliac.org.uk/information-and-support/coeliac-disease/conditions-linked-to-coeliac-disease/ 23.  https://www.coeliac.org.uk/information-and-support/coeliac-disease/getting-diagnosed/#glutenthroughout 24.  https://www.nhs.uk/conditions/coeliac-disease/complications/ 25.  https://www.penguinrandomhouse.com/books/665647/cannelle-et-vanille-bakes-simple-by-aran-goyoaga/, https://www.arangoyoaga.com/on-demand-videos,https://www.learningwithexperts.com/foodanddrink/courses/river-cottage-gluten-free?ref=naomidevlin, https://gluten-free-baking-school.thinkific.com/courses/gluten-free-sourdough-bread, https://gluten-free-baking-school.thinkific.com/courses/enriched-dough, https://gluten-free-baking-school.thinkific.com/courses/everyday-gluten-free, https://gluten-free-baking-school.thinkific.com/courses/bao-noodles-and-dumplings, https://sweetlaurel.com
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    How Do You Get Rid of Adhesions without Surgery, Advice on Exercising with Diaphragmatic Endo and Other Questions Answered!

    28:30

    Happy Monday everyone! As I mentioned, today is another live Q&A style episode, with Friday’s episode being one of my regular recorded episodes. This is a nice, short Q&A but I many of those who watched really appreciated the questions and found the answers useful! So hopefully, there’s something in this episode for you too! In this episode I answered… How do you test for SIBO and what do you ask for? Advice on exercising with diaphragmatic endometriosis? Can you get rid of scar tissue/adhesions with other methods other than more surgery (short answer: YES!) I really hope this short Q&A was helpful and gives you guys some info/inspiration for your own healing journey. Listen and subscribe on your favourite player or listen directly/download MP3 here or just listen below! Let's get social! Come say hello on Instagram or sign up to my newsletter. Sign up to my free workshop: Creating a Roadmap to Endo Belly Healing Sign up to the wait list for my course, Live and Thrive with Endo here. My cookbook This EndoLife, It Starts with Breakfast is out now! Get 28 anti-inflammatory, hormone friendly recipes for living and thriving with endometriosis. Order your copy here. If you feel like you need more support with managing endometriosis, you can join Your EndoLife Coaching Programme. A 1-to-1 three month health and life coaching programme to help you thrive with endometriosis. To find out more about the programme and to discuss whether it could be right for you, email me at hello@thisendolife.com or visit my website. This episode is sponsored by The Pod Farm. Learn all about how to start your own podcast with the complete course from The Pod Farm. Aimed at beginners, this course takes a simple and straightforward approach to planning, equipment buying, setting up, recording, editing and hosting your own podcast. With hours of audio and video materials, and downloadable guides and useful links, this multimedia approach aims to have something for every kind of learner. From now until April 15, newsletter subscribers get 20% off the course price. Visit www.thepodfarm.com to enroll or find out more This episode is sponsored by BeYou. Soothe period cramps the natural way with these 100% natural and discreet menthol and eucalyptus oil stick on patches and CBD range. Click here to find out more and to shop: https://beyouonline.co.uk
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    Nutrition for Endo 101

    44:00

    Today is another live Q&A from back in June, as due to being unwell and the passing of our cat, I have been unable to complete the planned episode for this week. But, this Q&A is chock full of the foundations of eating for endo, so I hope you find it useful. In this Q&A on nutrition for endometriosis, I cover… The research behind the anti-inflammatory diets and the most researched diets for pain. The key components of an anti-inflammatory diet. Why personalisation is so important. Deficiencies, absorption of nutrients and how to ensure variation. How to eat for blood sugar balance. I also answer some specific SIBO, gut questions and foodie questions. I really hope you find this episode helpful and it gives you some starters to support you with your own tailored endometriosis diet.  Listen and subscribe on your favourite player or listen directly/download MP3 here or just listen below! Let's get social! Come say hello on Instagram or sign up to my newsletter. Sign up to my free workshop: Creating a Roadmap to Endo Belly Healing Sign up to the wait list for my course, Live and Thrive with Endo here. My cookbook This EndoLife, It Starts with Breakfast is out now! Get 28 anti-inflammatory, hormone friendly recipes for living and thriving with endometriosis. Order your copy here. If you feel like you need more support with managing endometriosis, you can join Your EndoLife Coaching Programme. A 1-to-1 three month health and life coaching programme to help you thrive with endometriosis. To find out more about the programme and to discuss whether it could be right for you, email me at hello@thisendolife.com or visit my website. This episode is sponsored by The Pod Farm. Learn all about how to start your own podcast with the complete course from The Pod Farm. Aimed at beginners, this course takes a simple and straightforward approach to planning, equipment buying, setting up, recording, editing and hosting your own podcast. With hours of audio and video materials, and downloadable guides and useful links, this multimedia approach aims to have something for every kind of learner. From now until April 15, newsletter subscribers get 20% off the course price. Visit www.thepodfarm.com to enroll or find out more This episode is sponsored by BeYou. Soothe period cramps the natural way with these 100% natural and discreet menthol and eucalyptus oil stick on patches and CBD range. Click here to find out more and to shop: https://beyouonline.co.uk
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    Endo and Relationships Q&A with My Partner

    51:44

      This episode is another live Q&A and I managed to convince Chris (who hates public speaking, IG lives, etc.) to help me answer your questions about relationships and endo. I had so many questions submitted in the end that we answered the ones that were sort of directed to Chris and I/about romantic relationships and I’ll answer the remaining in another live soon! So in this Q&A we answer... Advice to a partner on how to support you when they say they feel “helpless”. Is Chris into holistic/naturopathic health and does he find what I do interesting. Suggestions for helping a partner understand endo. How to have fun with your partner again when endo gets in the way. Just to give a little bit of context, Chris and I have been together almost 8 years, and have been friends for I think 11 or years! He was my friend when I was first diagnosed with endo and we were literally a month into our relationship when my endo symptoms returned. We have a joint column together on Endometriosis Net and Chris has also written for Endometriosis News and still writes monthly for Endometriosis Net! We really hope you found this live helpful.  Listen and subscribe on your favourite player or listen directly/download MP3 here or just listen below! Let's get social! Come say hello on Instagram or sign up to my newsletter. Sign up to my free workshop: Creating a Roadmap to Endo Belly Healing To become a The Endo Belly Course Founding Member, email me at hello@thisendolife.com with ‘Yes’ in the subject line. Sign up to the wait list for my course, Live and Thrive with Endo here. My cookbook This EndoLife, It Starts with Breakfast is out now! Get 28 anti-inflammatory, hormone friendly recipes for living and thriving with endometriosis. Order your copy here. If you feel like you need more support with managing endometriosis, you can join Your EndoLife Coaching Programme. A 1-to-1 three month health and life coaching programme to help you thrive with endometriosis. To find out more about the programme and to discuss whether it could be right for you, email me at hello@thisendolife.com or visit my website. This episode is sponsored by The Pod Farm. Learn all about how to start your own podcast with the complete course from The Pod Farm. Aimed at beginners, this course takes a simple and straightforward approach to planning, equipment buying, setting up, recording, editing and hosting your own podcast. With hours of audio and video materials, and downloadable guides and useful links, this multimedia approach aims to have something for every kind of learner. From now until April 15, newsletter subscribers get 20% off the course price. Visit www.thepodfarm.com to enroll or find out more This episode is sponsored by BeYou. Soothe period cramps the natural way with these 100% natural and discreet menthol and eucalyptus oil stick on patches and CBD range. Click here to find out more and to shop: https://beyouonline.co.uk
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    How Endo Surgery Could Cause Endo Belly, Affect Your Digestion and Cause Gut Problems – and What to Do About It

    40:40

     So last week I did an episode on adhesion formation post-surgery and how that can affect or literally cause endo belly – and you guys loved it! And I’m glad that you did, because I had another linked episode to follow up with, a part two in a way… So today, aside from adhesions, I am talking about the ways in which endo surgery could have worsened or even caused your endo belly. Now of course, adhesions are included in that, but they’re a big topic hence the separate episode, so I encourage you to listen to that if you haven’t done so already! So, let’s dive in… 1)   Number one is constipation. The medications, like pain relief and some of the other medications they may use in surgery,  can be a cause of constipation following your laparoscopy. Even just having to water fast and not eat anything before surgery, can cause constipation.  There’s also the possibility that if you don’t feel like eating much post-surgery, or you’re stressed from surgery, your gut feels sore after surgery or you suddenly eat a lot more stodgy comfort foods post-surgery, that you may get constipation.  Now a lot of people think constipation is just a matter of discomfort and that it’s not a big deal, but actually, we eliminate oestrogen through daily bowel movements. You’ve heard me talk a lot about excess oestrogen and oestrogen dominance in the past, and how it can be a potential driver of endometriosis and endometriosis symptoms in some of us. However, for many, the symptoms of endo look very similar to the symptoms of oestrogen dominance or oestrogen excess. When we have too much oestrogen in our bodies or we have oestrogen levels that are too high in relation to progesterone, we get symptoms such as heavy periods, period pain, clotty periods, mood swings, breast tenderness and bloating in the lead up to our periods, post-ovulation. So, we may think that our endometriosis is out of hand and causing all of these problems, but if we spent even just a month balancing our hormones, we may see a dramatic reduction or even complete elimination of these symptoms. Now of course, you can have these symptoms of oestrogen dominance or excess AND the excess oestrogen may also be fuelling your endo or worsening your symptoms, that’s certainly a possibility, but for some of us, the cause of the symptoms is the hormone imbalance itself.  Regardless, we want to ensure we’re supporting your hormones, especially after surgery, because we want to build on the good work of the surgery, and we don’t want to have excess oestrogen circulating in our system and possibly feeding any future endo growth. It’s not that oestrogen is bad, it’s a wonderful and essential hormone, but we want to ensure it is in the correct levels and in its healthiest form, as high levels and unhealthier forms of oestrogen are behind issues like breast cancer, fibroids, and endo. So already, you can see that constipation can have a knock-on effect on our health with endo. But aside from this, constipation or sluggish bowels can cause bloating and discomfort in the abdomen, as waste and gases continue to build up, and this will of course mimic what we call the endo belly. Now as I’ve said before, I don’t believe the endo belly is just the endo belly and it’s one sole root cause is endometriosis. In fact, I usually see multiple causes behind the bloating and swelling my clients experience, and sluggish bowels is one of them.  So, if post-surgery you’re getting a lot of bloating and swelling (which you will of course, for the first few days, from the gases they use to inflate our bellies), just consider whether you’re having healthy bowel movements. You should be having at least one bowel movement a day, and it should be long, snake-like with a banana like consistency. If it’s hard, cracked, like pellets or stones of difficult to pass, that’s constipation. And if you’re not going daily, that’s constipation too. Often, we’re led to believe that we only have constipation if we’re not going as regularly as we normally would, but that’s not healthy! If you go once a week and then you start going every 10 days, that doesn’t mean your once a week was healthy. A healthy bowel habit for optimal health, hormones and waste elimination is at least once a day.  So, if you are constipated, what can you do about it? Firstly, don’t panic. You might be a little constipated for a few days post-surgery as your organs essentially get over the shock of going through surgery, it is after all, a trauma to the body. Even with the methods I’m going to suggest, it might take a few days to get things moving, so don’t worry, just get started with them and give yourself some time. Hopefully within two or three days we can get things moving again.   So, the first tip would be to move, gently. This is a basic first line therapy that we genuinely use with gut healing – simply to exercise. It’s low risk and is free. I’m not saying to jump on a trampoline, but your body requires movement to get things moving and constipation can often be aided by exercise. Now if we weren’t post-surgery, you could maybe do some yoga, go for a run, or do some Pilates, but clearly, we’re not going to do that post-surgery.  So, just like is suggested in the post-surgery recovery guidance, just ensure you’re getting up regularly and moving around gently for a couple of minutes.  I don’t mean a fast walk, I don’t mean standing up until you hurt, I literally mean every 30 minutes or an hour, or further apart if that’s all you can handle, just gently get up and walk slowly around your room or house, for a few minutes. It could even just be one minute to start with. But if you’re lying down for eight hours then things are not going to be moving well in your body.  Doing this is also going to speed up your recovery, because it ensures that blood is flowing to the area of your surgery and getting to work with healing the wounds.  Now, you’ve likely heard your doctors encourage you to move gently after surgery, but I do want you to check in with them on this, because of course, I don’t know the type of surgery you’re having or have had. If you had a six-hour surgery then they may give you different advice, so please do check in with them on this.  Next up is a very simple strategy and that’s warm or hot water, drunk slowly in the mornings. Yes, really! This actually triggers something called the gastrocolic reflex, which stimulates movement in the large intestine, creating the urge to have a bowel movement.   You can also try increasing your intake of healthy fats, like egg yolks, fish oil (so maybe you take an omega 3 rich oil), or full-fat yoghurt (dairy free if that’s better for you, and organic to avoid added hormones if you’re having animal-based yoghurt), ideally in the mornings, as this will increase motility (which basically means movement) in the large intestine, and generally, we’re more likely to have bowel movements in the morning because digestion has been working overnight and it should take between 12-24 hours to for the food we eat to form a bowel movement.  If none of these simple at home methods work for you, you can try magnesium citrate or oxide. This works by drawing water into the intestines, creating looser stools and encouraging a bowel movement. You can safely take between 500mg to 2000mg, at night, before bed, but normally 1000mg tends to work well for people. You’ll need to build up until you find the right dose for you, as going straight in at 1000mg or 2000mg may cause diarrhoea. So, start at 500mg and increase slightly every other night until you get a bowel movement, but keep in mind may take 2-3 days as it can take a little while to get going. If you get bloating or abdominal pain from the magnesium, you’ve probably taken too much, and you’ll need to reduce back down.  Of course, consult your doctor before starting any new supplement!    2)   Number 2 is that the stress from surgery, whether emotional or the physical stress of your body undergoing surgery, can turn off your digestion. Your digestion is controlled by a part of your nervous system called the ‘rest and digest response’, whereas your stress response, which helps us to power through stressful or genuinely life-threatening situations, is controlled by a part of the nervous system called the ‘flight or fight response’. The two cannot be operating at the same time and unfortunately or fortunately, depending on the situation, the stress response will always win, because it ensures our survival. This has allowed us to survive and evolve as humanity, but in modern times, even just a stressful email might trigger the flight or fight response, turning the rest and digest response off.  And the thing is, post-surgery we really want the rest and digest response to be operating well, because not only does it control digestion, but it also controls healing. So, when our body and mind is feeling stressed from having a surgery, our healing and recovery time is impaired. But back to digestion. When digestion shuts off, a few things happen. Firstly, our digestion and motility tend to slow down. Now for some people, you may get exaggerated and increased motility in the large intestine, resulting in diarrhoea, but that doesn’t mean things are moving well in the small intestines. So, if things have slowed down in the stomach and small intestine, this creates stagnation and a chance for bacteria to populate in the small intestines where they shouldn’t be. Now that of course, sounds like small intestine bacterial overgrowth, which is a condition many people with endometriosis have, where bacteria which should be in the large intestine, happily existing in the gut microbiome, are living in the small intestine. This creates a whole host of problems and symptoms like bloating (which we may think is the endo belly), gas, constipation, diarrhoea, and abdominal pain to name a few. Now this likely wouldn’t be enough to cause you to develop SIBO alone, because once the rest and digest mode is switched back on, hopefully your motility is working well enough that the bacteria are swept out of the small intestine and into the large intestine where it belongs. However, if you also have adhesions or low stomach acid, or other risk factors for SIBO, it might be enough if you keep returning to this state of fight or flight and you’re really chronically stressed.  So, if SIBO does happen to develop, that most certainly is going to cause what we see as the endo belly, which in my experience with my clients, is most of the time at least in part caused by SIBO, so that’s one possibility. However, even if you don’t have SIBO, that slowed down motility and digestion is going to leave food hanging out in your intestines, whether that’s the small or large, leaving lots of time for bacteria to have a good munch on that food, and in turn, they make gas as a result. That’s the process of fermentation.  Additionally, when digestion turns off, we also don’t get a release of gastric juices like stomach acid and digestive enzymes. These guys are absolutely vital for breaking down food and extracting nutrients, so without them, we’re going to have chunks of food in our intestines that can’t be broken down and that can result in pain, bloating, gas, constipation, or diarrhoea.  A side note here is that we really want to be absorbing our nutrients. Our body requires vitamins, minerals, amino acids, glucose, and fats to heal, not just for the energy but for the actual process of healing and repairing the tissue. If our digestion is shutting down and we’re not absorbing our nutrients properly, we’re going to have a harder time healing and are most likely going to experience more inflammation and more pain.  Lastly, stomach acid and digestive enzymes actually play a role in protecting us from SIBO and bad bacteria. They kill off bacteria as it enters the gut, and so if those levels are lowered, it’s like our first line of defence is lower and bad bacteria can more easily move in. Having low stomach acid is also a risk factor for developing SIBO, it’s not usually enough on its own, but coupled with another risk factor it could take us to the point where we do develop it So, what can we do about this?  So, the first thing, of course, is creating feelings of safety in the body and lowering our stress response. There are numerous ways to do this, but some proven effective strategies for turning off the flight or fight response include tapping (where you tap on different points of your body and repeat certain statements), meditation, deep breathing, and spending time in nature. There are other strategies like yoga and exercise, but I’m trying to only highlight the ones that you’ll be able to do post-surgery. So even though you may not be able to go for a run or something in nature, maybe you might be able to sit in your garden, or by a window, or when you get stronger, maybe you can manage a 10-minute walk in the park. Now of course, we can’t always live in a stress-free bubble, and you may have recurring feelings of stress about your surgery, so it’s not that we’re trying to totally remove you from the feeling of stress, because that could get pretty stressful in itself! But what we want to do, is a few times a day, take some time to lower our stress response, so the body gets these reminders that it’s safe, that you are safe. So perhaps you do some gentle breathing in the morning, maybe you do some tapping at lunch and some meditation before bed, for example.  In the show notes, I have linked to a few apps where you can learn these techniques. Next up is digestion support. Firstly, we want to ensure that when you’re eating, your rest and digest response is actually switched on. So, to do that, we want to be eating in a calm environment and taking time with our meal rather than rushing, if we’re rushing or eating when we’re tense, the flight or fight response will be switched on and digestion will be switched off! You can further encourage the rest and digest response to be on by taking a deep breath or a few deep breaths before eating – in through the nose, and out through the mouth, with your exhale longer than your inhale. This helps to turn the flight or fight response off and the rest and digest response on. Finally, we can further support your digestion by adding in stomach acid support and digestive enzyme support. You can stimulate the production of stomach acid by drinking one tablespoon of apple cider vinegar in 8 tablespoons of water 15 minutes before a meal. Drink through a straw to protect your enamel and don’t do this if you have a history of stomach ulcers or inflammatory bowel disease. If you have interstitial cystitis or histamine intolerance, the vinegar may not be the best option for you, so I recommend adding bitter foods with your meals, like rocket in your salad, as that can also help stimulate stomach acid – not dramatically, but somewhat. Of course, always consult a doctor before adding in supplements or digestive support.  You can also buy tinctures known as bitters, which are a blend of bitter herbs, and you can take a few drops of that before a meal instead of the vinegar. Again, these tinctures do tend to contain alcohol so people with IC may need to be careful. You can actually take a supplement called betaine HCL, that literally provides you with more stomach acid, but at first, it’s best to see how you respond to these options as it can be very strong and is not always suitable for some people. So, start here and if you don’t feel like it’s helping, I have a protocol for taking betaine HCL in my upcoming course The Endo Belly Course and I think it might be in my endo belly podcast series as well  For digestive enzymes, certain herbs and spices have actually been shown to stimulate the production of digestive enzymes! These are:  ·      Garlic ·      Mint ·      Onion ·      Turmeric ·      Ginger ·      Fenugreek ·      Caraway ·      Fennel ·      Coriander ·      Cumin So, adding a mix of these to dishes can help to increase your digestive enzyme levels. A mix is always best because they tend to increase different digestive enzymes and you need an array of them, so for example, don’t just rely on garlic in a meal, try to add one or two other herbs to get the best support.  You can also use digestive enzyme supplements, which you take with meals, as directed on the label. Unless you have a gut health condition, it’s best not to use these for more than a month so that your body doesn’t get too reliant on them, but I do use them longer term for people with SIBO and anyone with more extensive gut health issues.   3)   The last way endo surgery can cause endo belly and gut problems is by causing leaky gut. As you may know, the pain relief drugs known as NSAIDs can cause leaky gut, but so can stress as the chemicals released in the stress response actually directly damage the gut lining. If you’re not familiar with leaky gut, I have a whole episode on it which I’ve linked to in the show notes, but leaky gut or intestinal permeability occurs when tiny holes appear in the gut lining. Think of the gut lining as a sausage skin, it’s a tube from the mouth to the colon that separates what’s coming in and going out from the rest of the body. The lining is incredibly thin, just one cell thick and these cells are tightly packed together with only the tiniest gap between them, to allow for the absorption of nutrients. When the gut gets inflamed or damaged from chronic IBS reactions, chronic stress, NSAIDs, infections, SIBO, allergies, intolerances, an inflammatory microbiome, etc. the gaps begin to widen.   When this happens, food particles can pass through the gut lining alongside bacteria and toxins from bacteria, known as LPS. While some of the immune defences are inside the gut, there is also a large amount on the outside of the gut lining, waiting to attack anything that passes through which shouldn’t be there. It doesn’t matter if this is food or bacteria, inflammatory immune cells will be released and because the blood stream is also on the other side of the gut lining, the inflammatory cells can get swept along the blood stream, causing full body inflammation. If you have leaky gut, this is going to be happening every time you eat, putting you in a state of chronic inflammation. Additionally, leaky gut can cause gut irritation, creating reactions like bloating (or what we may see as the endo belly) and IBS issues. Over time, leaky gut can cause food intolerances as the immune system begins to create antibodies to the foods passes through.  Of course, we don’t want this to be happening whilst we’re trying to recover from surgery. We want a healthy level of inflammation to help us heal, not chronic inflammation, and we certainly don’t want swelling or abdominal distress putting pressure on our stitches or the internal sites which have been excised.  So, what can we do about it?  Well of course, firstly we want to try and lower stress as I mentioned before, so go back to those practices. Secondly, if we can, we want to lower our reliance on NSAIDS during this period. Now if you can’t, don’t worry – don’t feel guilty or pressured, just focus on the stress piece and maybe the next tip too. But if you can, there are supplements that have been shown to be just as effective as NSAIDs for reducing pain, in particular, ginger powder.  Ginger has been shown to be just as effective as ibuprofen and mefenamic acid for dysmenorrhea, it’s also been shown to be a wonderful pain reliever in numerous studies for migraines, arthritis pain, back pain and so on. Dose wise, ginger is safe to take at up to 2000mg a day, but it needs to be divided into doses rather than taken all in one go, as that can cause diarrhoea. You could start at 1000mg a day and take it four times a day, so 250mg per dose or some supplement brands are 500mg a dose, so you could start there and do two a day or four a day, depending on the level of pain you’re in. You could take it like this daily, to just keep pain down, or you can literally take it at the onset of pain, like a pain killer. Now ginger is a blood thinner, so if you decide to start taking it before surgery, to lower inflammation ahead of time, just consult with your surgeon as they may want you to stop taking it for a few days or a week before your surgery date. Curcumin has also been shown to be just as effective as ibuprofen for pain relief when taken daily for 4 weeks at 1,500mg. It was also shown to have less GI side effects than ibuprofen, which is great for the endo belly! And guess what else? Curcumin helps to heal leaky gut and reduce intestinal inflammation, so double bonus.  Now curcumin is also natural blood thinner, so what you could do is take it for four weeks prior to your surgery to gain the beneficial effects and build up that level of pain relief, and then stop before your surgery if instructed to by your surgeon, so check in with them ahead of the surgery in case they want you to stop, and then start again after your surgery to continue reaping the pain relieving effects. You’ll probably only be pausing your dose for a few days, two weeks at the maximum, but it’s likely they’ll only ask you to stop taking it for a week or even less before the surgery, especially if it’s only keyhole. Of course, you may need some more pain relief than these alone, but for some of us, they’re enough, and if you’re also using some of the supplements, I mentioned in my last episode on the endo belly and surgery, then you really may not need any additional pain relief. However, if you do, hopefully the addition of ginger and maybe curcumin, might lower your need for as many  Finally, I don’t want to throw too many supplements at you for this episode and so if you do want some specific supplements and strategies for leaky gut, head to my episode on leaky gut and endo belly healing, which are linked in the show notes. But for now, I want to give you a very simple at home method for calming the gut and healing leaky gut, and that’s bone broth. Bone broth contains amino acids and collagen, which help to heal leaky gut.  Now a few caveats to this, if you’re vegan or vegetarian, this is of course not the one for you, and so what I recommend is you just really focus on a diet rich in anti-inflammatory foods to lower intestinal inflammation, support your gut with curcumin and perhaps listen to my episode on leaky gut and try some of the other tips from there.  The other caveat is if you have SIBO, you might react to bone broth because the collagen in there actually can feed SIBO. Some people with SIBO do fine on bone broth, but others get bloated or get abdominal discomfort, so test how you feel on it. Finally, if you have histamine intolerance, bone broth is high in histamine, so this also may not be for you. You can make a low histamine bone broth by cooking it for much less time, but it won’t be as healing for leaky gut because it’s going to contain less of those amino acids, collagen, minerals, etc. from the bones.  So if for whatever reason, bone broth is not for you (and actually, even if it is) the foundational thing you can do to support your gut lining to heal, is to eat a nutrient dense diet full of anti-inflammatory foods, because if we just spend our time recovering eating sugar, alcohol and fast foods, the gut lining is going to become even more inflamed and any damage from NSAIDs or stress is just going to be exaggerated. But if you can add bone broth, it’ll be a wonderful healing addition to this protocol.  So that’s it! You have lots of options to choose from, and you certainly don’t have to try them all. Pick and choose what suits you, your values, and your lifestyle, and they will go a long way to helping your gut to recover and heal post-surgery and preventing recurrence or worsening of the endo belly.  Listen and subscribe on your favourite player or listen directly/download MP3 here or just listen below! Let's get social! Come say hello on Instagram or sign up to my newsletter. Sign up to my free workshop: Creating a Roadmap to Endo Belly Healing To become a The Endo Belly Course Founding Member, email me at hello@thisendolife.com with ‘Yes’ in the subject line. Sign up to the wait list for my course, Live and Thrive with Endo here. My cookbook This EndoLife, It Starts with Breakfast is out now! Get 28 anti-inflammatory, hormone friendly recipes for living and thriving with endometriosis. Order your copy here. If you feel like you need more support with managing endometriosis, you can join Your EndoLife Coaching Programme. A 1-to-1 three month health and life coaching programme to help you thrive with endometriosis. To find out more about the programme and to discuss whether it could be right for you, email me at hello@thisendolife.com or visit my website. This episode is sponsored by The Pod Farm. Learn all about how to start your own podcast with the complete course from The Pod Farm. Aimed at beginners, this course takes a simple and straightforward approach to planning, equipment buying, setting up, recording, editing and hosting your own podcast. With hours of audio and video materials, and downloadable guides and useful links, this multimedia approach aims to have something for every kind of learner. From now until April 15, newsletter subscribers get 20% off the course price. Visit www.thepodfarm.com to enroll or find out more This episode is sponsored by BeYou. Soothe period cramps the natural way with these 100% natural and discreet menthol and eucalyptus oil stick on patches and CBD range. Click here to find out more and to shop: https://beyouonline.co.uk  Show Notes Stress relief tools Headspace Calm Tapping Solution Frequency Mind   Ginger research  https://pubmed.ncbi.nlm.nih.gov/23865123/ https://pubmed.ncbi.nlm.nih.gov/26177393/ https://pubmed.ncbi.nlm.nih.gov/25912592/ https://onlinelibrary.wiley.com/doi/10.1002/ptr.6730 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7171779/ https://pubmed.ncbi.nlm.nih.gov/23657930/   Curcumin https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4533742/ https://www.karger.com/Article/FullText/491886 https://www.sciencedirect.com/science/article/abs/pii/S0753332217346838?via%3Dihub https://www.sciencedirect.com/science/article/pii/S1756464615000092 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5407015/ https://pubmed.ncbi.nlm.nih.gov/24672232/ https://pubmed.ncbi.nlm.nih.gov/25277322/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3476912/ Leaky gut episodes https://www.thisendolife.com/this-endolife-podcast-episodes/endometriosis-leaky-gut https://www.thisendolife.com/this-endolife-podcast-episodes/-the-endometriosis-belly https://www.thisendolife.com/this-endolife-podcast-episodes/understanding-the-endometriosis-belly-part-2
  • This EndoLife podcast

    Endo and Skin Conditions/Endo Friendly Skincare Q&A

    47:22

    Today’s episode is another bonus Q&A and this time it was more light-hearted and fun. This time I’m talking about endometriosis and the associated skin conditions, and I’m also sharing endo friendly skin care tips! In this episode I talk about... My personal experience with rosacea and eczema and how I healed those after over a decade of suffering with them. How treating SIBO improved my skin in so many ways but also dehydrated it and caused some surprising skin issues! My skin care routine, favourite products and gua sha technique that are all endometriosis friendly. The link between endometriosis, histamines and eczema. The link between SIBO and rosacea. Cystic acne, endometriosis and oestrogen and how to begin healing acne. Endocrine disrupting chemicals in skincare and how they affect endometriosis. I hope this Q&A is both fun and helpful! Listen and subscribe on your favourite player or listen directly/download MP3 here or just listen below! Let's get social! Come say hello on Instagram or sign up to my newsletter. Sign up to my free workshop: Creating a Roadmap to Endo Belly Healing To become a The Endo Belly Course Founding Member, email me at hello@thisendolife.com with ‘Yes’ in the subject line. Sign up to the wait list for my course, Live and Thrive with Endo here. My cookbook This EndoLife, It Starts with Breakfast is out now! Get 28 anti-inflammatory, hormone friendly recipes for living and thriving with endometriosis. Order your copy here. If you feel like you need more support with managing endometriosis, you can join Your EndoLife Coaching Programme. A 1-to-1 three month health and life coaching programme to help you thrive with endometriosis. To find out more about the programme and to discuss whether it could be right for you, email me at hello@thisendolife.com or visit my website. This episode is sponsored by The Pod Farm. Learn all about how to start your own podcast with the complete course from The Pod Farm. Aimed at beginners, this course takes a simple and straightforward approach to planning, equipment buying, setting up, recording, editing and hosting your own podcast. With hours of audio and video materials, and downloadable guides and useful links, this multimedia approach aims to have something for every kind of learner. From now until April 15, newsletter subscribers get 20% off the course price. Visit www.thepodfarm.com to enroll or find out more This episode is sponsored by BeYou. Soothe period cramps the natural way with these 100% natural and discreet menthol and eucalyptus oil stick on patches and CBD range. Click here to find out more and to shop: https://beyouonline.co.uk
  • This EndoLife podcast

    How Adhesions from Surgery Can Cause Endo Belly and Five Tips to Prevent Adhesion Formation Post-Surgery

    25:51

    So, you’ve had an endometriosis surgery and you’re really hopeful that’s this is it – you’re going to have some relief, for a while at the least. Maybe your periods are better, your chronic pelvis pain is better, things are improving. But after a few months, the endo belly comes back. Or maybe you get it for the first time ever. You’re bloated all the time or maybe you bloat badly after meals, or maybe it gets worse over the day? Perhaps it’s also accompanied by IBS issues like constipation, gas, or loose stools. If any of this sounds familiar, this episode is for you. Whilst surgery is essential for many people, it doesn’t come without its risks. And I honestly feel like it’s a disservice that these aren’t more talked about. So today, I’m talking about why you may get endo belly for the first time, a return of it or a worsening of it as a result of adhesions, and what you can do to prevent them.  If you haven’t heard me bang on about these guys before, adhesions are a form of scar tissue. They are web-like structures and bands of collagen that grow in response to injury and trauma, to ‘knit’ back together a wounded area and as part of the healing process from infection and inflammation. Collagen strands bond together to protect the damaged area to allow healing to occur in a safe and isolated environment, and if an infection is present, they protect the rest of the body by preventing the spread.  Adhesions occur in nearly all cases of abdominal surgery, the results vary from study to study, but one large and long study found that between 55% to 100% of women who had pelvic surgery developed adhesions, and up to 90% of people who had major abdominal surgery - so something like a caesarean - developed adhesions. So, if you’ve had even one or more surgeries for endo, it’s very likely that you have some adhesions. Now adhesions are a leading cause of the condition, small intestine bacterial overgrowth. This is another topic I bang on about all the time, but if you’re new here, I am specialised in endometriosis and SIBO, because SIBO is so prevalent in our community, the research at present is indicating that 80% of us have it. And SIBO is a condition where the normal bacteria which should be in our large intestine (this is referred to as our gut microbiome), starts accumulating in our small intestine, where it shouldn’t be. Normally, bacteria are moved through the small intestine into the large intestine with the help of something called the migrating motor complex, and this MMC is a wave like motion that sweeps the small intestine of any left-over food bits and bacteria, and it kicks in about two hours after meals and at night whilst we’re asleep. Now a number of things can damage the MMC or prevent it from doing its job. Food poisoning or gastroenteritis is the main cause of damage to the MMC, and that actually damages nerves and muscles that control it. But adhesions, even if the MMC is working well, they can stop it from doing its job properly. And they do this by pulling on our intestines. So, imagine you have an adhesion that is going from your pelvis to somewhere on your intestines, it’s going to be pulling down on your intestines and distorting the shape or the flow of the intestines. In fact, your intestines need to be able to slip and slide over each other, they need to be able to expand and accommodate food and waste, but if they’re being yanked in different directions and they’re being held in place by adhesions, the flow is going to disrupted. There may even be adhesions wrapped around the intestine, which would create an obstruction, or the adhesions may have caused the intestine to loop over itself, creating a pocket area that the bacteria can’t escape from. Whatever is happening, the result is the same. The small intestine can’t get clean, and bacteria builds up, causing SIBO. And the small intestine isn’t designed to house bacteria, so this causes all sorts of problems like bloating, which is a main cause of the endo belly and IBS issues. The gases that are released from the bacteria can also cause brain fog, fatigue, joint pain, and body pain to name a few symptoms. I’ve linked to a couple of episodes where I break down SIBO in more detail, so if you’re not familiar with it, have a listen to that. Now even if SIBO hasn’t developed yet, adhesions may still be a source of your bloating. If they’re not affecting your small intestine, they could still be affecting your large intestine and may be causing a build-up of waste or gas, you may not be able to have regular bowel movements or your intestines might be sluggish and slow, allowing for gases to accumulate, creating that swelling. So, what’s the solution? Prevent the adhesions from taking root in the first place, or if they have, start to break them down. So first up, just as a caveat, we want to be lowering inflammation levels before and after surgery with good anti-inflammatory nutrition. Now inflammation occurs during healing, it’s actually part of the healing process, but too much of it for too long will encourage adhesion formation. We want a healthy level of inflammation that aids in healing, not a chronic level that accelerates the growth of adhesions. So, before your surgery and during your healing phase, make sure you’re filling your diet with those anti-inflammatory foods I always harp on about: colourful vegetables and fruits; healthy fats like avocado, olive oil, nuts, seeds, and fatty fish; antioxidant packed herbs and spices; and organic lean protein sources beans and lentils, free range organic omega 3 rich eggs, wild caught fish and free range, organic, grass-fed meat. If you want to learn more, I’ve linked to a few of my podcast episodes on anti-inflammatory nutrition and a free copy of my cookbook in the show notes. I should also be bringing out a nutrition for endo workshop in the next few weeks too, so keep your eyes peeled for that. Okay, so now that’s cleared up, let’s dive into the extra strategies. I’m going to start with what you can do before and initially after the surgery, and then what you can do once the scars have healed. 1. Number one is supplementing with omega 3 fatty acids.  Fish oil was shown to reduce adhesion formation following surgery on mice with induced endometriosis, and reduced the inflammatory healing process post-surgery, which could reduce the chances of further endo development as inflammatory chemicals like prostaglandins fuel endometriosis. This led to the mice who were fed with fish oil to have fewer lesions than those who were fed a standard diet without fish oil supplementation, so even though we don’t have research specifically on adhesion formation and omega 3 on humans with endo,  this could be a potential helpful supplement before and after surgery (though I would argue it’s an essential daily supplement).  The therapeutic dose is between 1000mg to 3000mg a day. I personally find I get more pain relief from the higher doses, but it can be tricky to get hold of those levels without exceeding the dose recommendations on the bottle. I have linked to a few higher dose supplements in the show notes, but if you chose to exceed the dose recommendations on the label, obviously that’s your choice but you’ll need to consult with a practitioner to be on the safe side. However, omega 3 fatty acids are generally very safe at these doses.  If you’re vegan, look for an algae-based supplement that contains both DHA and EPA, because we need both. I’ve linked to a few in the handout.  The only risk is that they can sometimes thin blood, so speak to your surgeon ahead of surgery to see whether you need to stop taking them a few days beforehand, for keyhole surgery it’s unlikely, but just check.   2. Number 2 is proteolytic enzymes. Proteolytic enzymes are natural substances that break down protein, and of course, the building blocks of muscle and tissue are amino acids, which form protein. As a result, proteolytic enzymes help to reduce adhesion formation and they also reduce inflammation post-surgery and aid in clearing waste products from the wound site. The research is limited, with most of the research being in oral surgery or sports related injuries but there is one study on endometriosis.   So, the only study we have on enzymes for endo is the use of a brand we use commonly at IWHI and that’s Wobenzyme. In the study, Wobenzyme was shown to reduce pain and inflammation post-surgery, reducing the chances of adhesions growth and it also inhibited the formation of new blood vessels, reducing the chances of further endo development. The dose used in the study was the label dose for 40-60 days pre-op and then 60 days post op.  One thing to note is that because proteolytic enzymes reduce adhesion formation, there is the risk that if there is an infection at the site of the wound, that it could spread, as adhesions play a role in isolating infection sites from the rest of the body. This is rare but has been known to happen.    3.  Number three is home Arvigo Massage. Now, everyone is different, but my recommendation is as soon as your scars have healed and the therapist gives you the go ahead, learn Arvigo massage from a licensed therapists and start practising on yourself every day or a couple times a week. This really increases blood flow and helps to clear away scar tissue. It only takes 10 minutes and can be part of your evening routine, because if you do it at night, it actually helps to stimulate your MMC, so that will also help to reduce your chances of clearing SIBO. So that’s a great tool you can be trying at home and that’s like your daily maintenance. But we do want to go in with the bigger guns and that’s so that’s number four.    4.  Number four is having some form of professional abdominal massage known as manual therapy, which is designed to break up adhesions. Manual therapy is a form of organ massage and manipulation to break down and prevent adhesions from forming, unstick organs and release a frozen pelvis. Your main options are visceral manipulation or Clear Passage.  Visceral manipulation is a form of manual therapy which was designed by Jean-Pierre Barral. It’s generally the more affordable and accessible option and is very effective for treating adhesions. Not much research has been specifically done on its effects on endometriosis, but there is plenty of research on its effects for pain conditions and lots of clinical research with endo patients experiencing success from treatment. The holy grail of manual therapy is Clear Passage. This is a unique form of manual therapy which is designed for adhesions and is incredibly effective for SIBO and endometriosis. In fact, there is even amazing research behind it for these conditions, showing its effectiveness. If you’re contemplating a surgery but you’re not sure it’s necessary or the right path for you, for whatever reason, and you have the money to afford Clear Passage, you may want to look into it first because it can even prevent the need for surgery with endometriosis. Of course, if you have cysts that need removing or deep infiltrating endo that’s damaging your organs, I am not saying to ignore the advice of a surgeon and not have surgery, but in some cases, surgery isn’t the best option – especially if you’ve already had a few. Research has shown that the pain relief from Clear Passage is the same as surgery and is long lasting, and they all have remarkable results for endometriosis related infertility, pain during sex, and menstrual or ovulatory pain.  They also have wonderful results for SIBO and are endorsed by many of the world’s leading SIBO doctors. Honestly, I wish all of my clients with SIBO, and endo could have Clear Passage because the results from the studies are so positive. However, it’s very expensive so if you can’t afford it, honestly, don’t worry and try the Arvigo massage and visceral manipulation approach. 5. Lastly, you could also try regular castor oil packs. I know countless leading women’s health practitioners who use castor oil to soften and break down adhesions and who experience great success with it with their clients. However, it’s generally considered that more research needs to be done, though there is research on castor oil’s abilities to lower inflammation, reduce symptoms of constipation, improve circulation, and stimulate muscle relaxation.  I actually asked Arvigo Therapist Tara Ghosh about using castor oil packs for breaking down adhesions and she explained how it works. So, castor oil actually triggers the immune system, due to some of its chemical components, but once it responds to the call and finds no poison to clear, the immune system goes about utilising its tools on repairing and healing the pelvic area seeing as it’s already there, which in turn helps to break down and clear adhesions. She also emphasises that it lowers of inflammation and improves of blood flow to the area, and that this also helps to clear adhesions or prevent their formation. If you want to learn how to make your own castor oil pack and how and when to safely use them, I advise listening to my interview with Tara who has a really quick and easy method as opposed to the often messy and sticky traditional approach! You can try a castor oil pack alongside your Arvigo massage a couple of times a week once your scars have healed. And if you’re years past surgery, don’t worry – other than the proteolytic enzymes, you can use all of these strategies to break down any old adhesions that have formed! With the proteolytic enzymes, we only have research that focuses on pre- and post-surgery, so I really couldn’t say whether they would work years after surgery, you could try, but I just can’t make any guarantees! So that’s it! I hope that this episode provides you with a bit of a protocol for healing post-surgery and preventing adhesion formation. I think it’s actually appalling that we’re not told about them and how to manage them, given that they cause people with endometriosis so many problems, but hopefully this gives you some tools to get to work with.  Listen and subscribe on your favourite player or listen directly/download MP3 here or just listen below! Let's get social! Come say hello on Instagram or sign up to my newsletter. Sign up to my free Endo Belly Challenge here. To become a The Endo Belly Course Founding Member, email me at hello@thisendolife.com with ‘Yes’ in the subject line. Sign up to the wait list for my course, Live and Thrive with Endo here. My cookbook This EndoLife, It Starts with Breakfast is out now! Get 28 anti-inflammatory, hormone friendly recipes for living and thriving with endometriosis. Order your copy here. If you feel like you need more support with managing endometriosis, you can join Your EndoLife Coaching Programme. A 1-to-1 three month health and life coaching programme to help you thrive with endometriosis. To find out more about the programme and to discuss whether it could be right for you, email me at hello@thisendolife.com or visit my website. This episode is sponsored by The Pod Farm. Learn all about how to start your own podcast with the complete course from The Pod Farm. Aimed at beginners, this course takes a simple and straightforward approach to planning, equipment buying, setting up, recording, editing and hosting your own podcast. With hours of audio and video materials, and downloadable guides and useful links, this multimedia approach aims to have something for every kind of learner. From now until April 15, newsletter subscribers get 20% off the course price. Visit www.thepodfarm.com to enroll or find out more This episode is sponsored by BeYou. Soothe period cramps the natural way with these 100% natural and discreet menthol and eucalyptus oil stick on patches and CBD range. Click here to find out more and to shop: https://beyouonline.co.uk
  • This EndoLife podcast

    Endo Q&A: Will Endo Get Worse or Stay the Same and How Does Mould Affect Endo?

    52:47

    This episode is another endo Q&A and in this live I answer: Will endo get worse or stay the same? My personal experience with mould and how it affected my endo co-conditions. Will endo continue to cause issues even if you’re not having pain? Tips for managing the kind of pain flare that leaves you on the floor. Post-period pelvic pain and what to do about it. ...And more! I really hope you find this live helpful! We covered A LOT of super interesting topics in this one. Listen and subscribe on your favourite player or listen directly/download MP3 here or just listen below! Let's get social! Come say hello on Instagram or sign up to my newsletter. Sign up to my free Endo Belly Challenge here. To become a The Endo Belly Course Founding Member, email me at hello@thisendolife.com with ‘Yes’ in the subject line. Sign up to the wait list for my course, Live and Thrive with Endo here. My cookbook This EndoLife, It Starts with Breakfast is out now! Get 28 anti-inflammatory, hormone friendly recipes for living and thriving with endometriosis. Order your copy here. If you feel like you need more support with managing endometriosis, you can join Your EndoLife Coaching Programme. A 1-to-1 three month health and life coaching programme to help you thrive with endometriosis. To find out more about the programme and to discuss whether it could be right for you, email me at hello@thisendolife.com or visit my website. This episode is sponsored by The Pod Farm. Learn all about how to start your own podcast with the complete course from The Pod Farm. Aimed at beginners, this course takes a simple and straightforward approach to planning, equipment buying, setting up, recording, editing and hosting your own podcast. With hours of audio and video materials, and downloadable guides and useful links, this multimedia approach aims to have something for every kind of learner. From now until April 15, newsletter subscribers get 20% off the course price. Visit www.thepodfarm.com to enroll or find out more This episode is sponsored by BeYou. Soothe period cramps the natural way with these 100% natural and discreet menthol and eucalyptus oil stick on patches and CBD range. Click here to find out more and to shop: https://beyouonline.co.uk
  • This EndoLife podcast

    My Small Intestine Fungal Overgrowth Protocol

    49:39

    Okay, so a number of you have reached out to ask me whether I’m going to talk about my next steps for SIFO treatment, which I wasn’t originally going to do as I have an expert in mind to invite onto the show, but as a number of you asked, I hope that sharing my story will be somewhat helpful for you!  So, unlike with SIBO where I had quite a long-term plan in mind, this I am more so feeling out my journey because as I discussed in my previous update, I’m not 100% sure if the issue is gut dysbiosis or SIFO. So, to recap, let’s start with what SIFO is. SIFO stands for small intestine fungal overgrowth and it’s when fungus like yeast (or other fungi) grow in the small intestine. We do have some normal, non-harmful levels of fungus and yeast in the large intestine, but they become a problem either when they overgrow or when they’re found I the small intestine.  Unfortunately, the symptoms of SIFO are exactly the same as SIBO, so it can be very tricky to identify between the two. What makes it harder is that testing for SIFO is unreliable. Often the fungus hides in biofilms, which are protective mucosal-like layers, so they don’t show up on tests and even if they do, there’s no way, without a very invasive biopsy, to tell whether the fungus is in the large intestine or small intestine. What we do know is that the organic acids test tends to be the most reliable test, at least according to the practitioners I’ve trained with. We also know the candida tends to be the culprit behind SIFO in many cases, and just to be clear, that’s the type of yeast which causes thrush, and we also know that about xxx of SIBO cases.  Now there are some extra tell-tale signs of candida specifically, if that’s the fungus behind the problem, and those are…  ·       Allergies ·       Yeast overgrowth (vaginal, oral or on the skin) ·       Nasal congestion and excess mucus or phlegm  ·       Rashes ·       Joint pain ·       Brain fog and chronic fatigue ·       Headaches The difficulty is that unless you have the obvious thrush, whether oral, vaginal or on your skin, this symptoms are also typical of histamine intolerance, which you know if you listen to my podcast, is very common with our community and is also very common with SIBO, and hydrogen sulphide SIBO specifically.  As I had suspected hydrogen sulphide and for sure, have histamine intolerance, any possible SIFO really wasn’t obvious. Until more recently. As you may know, about two months ago, I cleared my SIBO! But unfortunately, I still had the majority of the SIBO symptoms. I also had an unusual test result, which showed no hydrogen gas in my large intestine, which is where it should be. In a healthy negative result, you should see little hydrogen gas in the small intestine and then a rise in the large intestine, but I had a flat line. So, this indicates two possible issues – either hydrogen sulphide or a bacterial imbalance in my large intestine, essentially, the bacteria in my gut having been wiped out. Because I’d done so many treatment rounds and most of them would target all three types of SIBO, I felt it unlikely it was still hydrogen sulphide remaining, and my colleagues agreed. Secondly, I had done a round of antibiotics, and I react quite badly to them, having lots of diarrhoea, fatigue, and headaches, and after I finished the course, I got shingles, which you only get when you’re very immune compromised. And 70% of the immune system is in and around the gut. If your healthy microbiome in the large intestine is wiped out, you can bet your immune system will be too. So, for sure, I was certain that there was some gut dysbiosis happening. But I didn’t believe it was enough to cause all my symptoms.  And a few clues made me suspect SIFO.  Firstly, I was doing pretty well with symptom reduction until the third week of the elemental diet, which is full of simple sugars. Suddenly, I began to bloat up again. I also had a strong white film throughout the entire elemental diet, which indicated the sugars were feeding bacteria or yeast in my mouth, and secondly, I started having thrush symptoms during the elemental diet. Then, from the elemental diet, I went onto the antibiotics, and I got thrush symptoms again! Now Dr Siebecker warns that the elemental diet may cause yeast or fungal overgrowth in people who already have it, in contrast, Dr Ruscio uses the elemental diet for candida overgrowth, because he says the simple sugars are absorbed too quickly for the yeast to eat it. I think it’s probably the case that both doctors are right, but that it depends on the individual and that they see different types of patients. Either way, it seemed quite clear to me that I had some yeast overgrowth as a result.  I went to my doctor at Vala, and they agreed that it looked like candida overgrowth in my mouth.  Additionally, I’ve always had a white film on my tongue, honestly ever since I could remember. I used to ask dentists about it, but they would shrug it off, and tell me it was down to what I had eaten, but I was waking up with it before I had eaten a thing. Back then I just took what they said as gospel. Then a few years ago, my boyfriend and I went through a real sweet tooth phase, long before I had gotten on top of my endo and eating an anti-inflammatory diet, and we were eating a lot of sugar. At that point, I got full on oral thrush, which thankfully was cleared with 24 hours of taking the medication – or so I thought! I’ve only ever had vaginal thrush a handful times, so again, initially, I really didn’t think candida was an issue for me! However, the fact that I then started getting the symptoms from two things which we know may cause yeast overgrowth – the elemental diet and antibiotics – made me think that maybe I have had SIFO all along, but the white film never got out of control, and it wasn’t really affecting my vagina too much. Now having said this, according to Dr Jacobi, candida can also cause a burning bladder pain, and for sure, that’s what my pain feels like inside my bladder. Like I have a fire going on in there, and there’s also a few rusty knitting needles sticking through it too!  So, alongside my colleagues who I trained with in SIBO and my doctor, I concluded I do likely have SIFO and gut dysbiosis.  The problem is, if you have SIFO, its usually quite hard to clear SIBO or to stay in remission, and even though I still had all the symptoms of SIBO, I felt like I relapsed about 2 weeks into my all clear. The changes were subtle, but they were there. I was still having bloating and loose stools, that hadn’t changed. But what had improved is I could no longer feel fermentation happening in my gut, like active bubbles forming and moving around in my gut, which I used to get all the time – and that returned. The second issue was that my stools changed, and I won’t go into the detail, but it was reminiscent of when my SIBO used to be really bad. Then I started getting the burping back, which was a new symptom originally, that started I think in 2019, but it went during treatment, and came back around the same time as these other symptoms. So, this occurred whilst I was in my prevention of relapse phase. So, when you clear your SIBO, you move into a three-to-six-month period where you put in place meal spacing, prokinetics (which are supplements or drugs which stimulate your migrating motor complex in the small intestine overnight, to clear out bacteria) and some kind of SIBO diet. There are also some additional extras you can do, which I was doing. I was pretty much doing everything perfectly, but I relapsed.  So, I was two weeks in, whilst deciding what treatment to start for SIFO. And at that point, sometime after my relapse, is when we decided to go to Greece.  Now originally, you’ll know my plan was to do a very specific reintroduction of foods, following the usual elimination diet reintroduction phase, where you try one new food basically a week. But now I had relapsed, and I was at a point where I never didn’t have symptoms. I bloated after every meal, despite being on the SIBO bi-phasic, so I couldn’t get any more restrictive. So, trying to tell what I was specifically going to react to was going to be incredibly difficult and frustrating.  Also, we have been wanting to travel for years, but in addition to COVID, we hadn’t because of my SIBO. I didn’t want to be in a position where I had to eat outside of a SIBO diet and ended up relapsing. But now I had relapsed. And part of what may cause relapse is chronic stress and an elevated nervous system. I won’t go into it now, but many of you know that I have felt very, very stressed and unsafe in our current home in Margate, but we’ve had continual circumstances that have prevented us from moving – one of them being that we didn’t want to just move to a new flat, we really wanted to move overseas and roam around for a while. Additionally, we had mould, which we’ve cleared as much as we can, but there’s likely a lot of hidden mould as the entire flat was flooded not long after we first moved in, and it was after that that I got very sick with histamine intolerance, which can flare up from mould triggering the immune system. But this is a stressor on the body and nervous system, and additionally, can cause relapse if your immune system is being compromised by something like mould. On top of that, I’d worked really hard, for really, really long and it had been a tough few years. So, we made quite an overnight decision to go to Greece for six week. You know, our original vision was to pack up, leave the flat entirely and just travel Europe for six months, because that’s all we’re allowed to do thanks to Brexit, but because of the restrictions with COVID, etc. it was just all so limited and so fingers crossed, we can do that this year. But we both decided enough was enough and we wanted a break from the house and a change of scenery, of course it was something we just wanted to do in life, but in a large part for me, my health was my motivation and my therapist even called it an intervention, and that’s for sure what it felt like. So, I made the decision to go to Greece, knowing full well I wouldn’t have total control about the reintroduction of food, but by this point I was pretty certain I had relapsed and giving that I still had the SIFO road ahead of me, a break away seemed not just like it wouldn’t do much more damage, but that it would be good for me. So, my plan for SIBO and SIFO basically revolved around Greece because I would have to take all my treatment with me. And I established three goals, I mean I didn’t, I’m not that organised, but that’s this is what I focused on – ·       Keeping SIBO at bay and continuing the prevention of relapse to the best of my ability so it didn’t progress rapidly. ·       Beginning to take on SIFO, but gently, to avoid any die off reactions whilst away. ·       And to rebuild my microbiome and improve my gut lining, which I was already working on anyway. So as a result, here’s what my current protocol looks like:   Diet Before we went away, I began expanding with one to three new foods a week. Just some of the key ones that I thought I should try before we went, that I would likely rely on in restaurants, like lentils and some nuts. Then, as we planned for Greece, my aim was to eat as expanded as possible, so basically the more lenient end of a SIBO diet, which looks more like the expanded version of the low FODMAP diet and the paleo diet. This is fine by the way; you won’t relapse if you expand. The point of the prevention of relapse phase is to expand to tolerance as rapidly as possible. Of course, I had no bloody idea what I was and wasn’t tolerating, so I just decided to follow the low FODMAP serving guidance to help me to stay within some kind of relatively low carb (that’s the basis of a SIBO diet) protocol. So, before we went, I basically started transitioning from the bi-phasic, which is very, very restrictive, to low FODMAP. Because we are here for six weeks, I had the advantage of not eating out all the time. So, I my plan was, and what I have implemented whilst here, was to eat low FODMAP during the week at home, and then at the weekend, to eat as low FODMAP or paleo friendly as I could manage whilst out and about, but also allowing for treats and just basically enjoying and appreciating a different cuisine. Now my doctor, who is a functional medicine doctor, sent me a candida diet. There are a few different versions, but essentially, it’s a low carb diet to a degree, that removes yeasts and sugars. I had a look through it and because in terms of servings, it’s generally less restrictive than the low FODMAP, I was essentially doing it, other than when I have some bread or ice cream over the weekend. But I didn’t really want to go down a rabbit hole with that, especially as I’m not sure how suitable the candida diet is for SIBO and equally, some practitioners debate whether the candida diet is even necessary. So that’s going to be a bridge that I cross when I get home. But for the most part, I am naturally doing it anyway. So, we’ve been here for about two weeks now and I’ve settled into a routine of this kind of pattern. The first weekend we were in Athens for 48 hours and were travelling and didn’t really have time to seek out gluten free and dairy free, etc. We did stumble across a few places, thankfully, so that was great. But I ended up eating quite a bit of gluten, and by the third day I felt really nauseas and started getting an upset stomach. I also had dairy too, once, or twice, because it turns out that in Greece, it’s really hard to eat vegan and gluten free in general restaurants. The protein options are mainly meat, fish or dairy and often the fish was things that I just wouldn’t be able to stomach, like octopus, and as you know, I was hoping to transition back off of meat after having to eat on the bi-phasic, so I had some cheese every now and then, as being a health coach, blood sugar is important to me and so you do need protein with every meal. Also, my blood sugar is very suspectable to lows, so just having a plate of carbs would really mess me up and ruin the rest of the day, so I had to make choices about having enough fat and protein and that sometimes looked like a little dairy. Now I know I’m intolerant to dairy, which actually might be due to having SIBO, because it causes temporary lactose intolerance until you clear it, so I wasn’t eating huge amounts and I tried to choose cheeses that I know I tolerate better, and I avoided cow’s dairy and milk for the most part – except for a scoop of ice cream here or there, but in Athens I could get vegan.  So, because I was nervous about eating foods out, that I hadn’t eaten for a long time, I took with me betaine HCL, which is stomach acid support; digestive enzymes; FODMATE, which is digestive enzymes specifically for FODMAP foods and charcoal capsules, which absorb gas if you have bloating and can also be helpful with diarrhea, and all of these have been really handy when out. I’ve still not had the happiest bowel movements, but I wasn’t having sudden severe reactions whilst out and needing to dash to the loo, which is what I used to get and what I was scared of. So that’s the diet side of things.   SIFO For SIFO, I didn’t want to go in too hard core now and then have lots of die off reactions whilst away, which would leave me feeling really unwell. So instead, I started subtle. I have a one-week course of an anti-fungal from my doctor, but I am also taking a high dose of saccharomyces boulardii, which is a healthy yeast probiotic that competes with candida for space in the gut and has been shown to be very effective. I am also taking another probiotic called lactobacillus acidophilus NCFM, which creates candida antibodies to kill it off.  I am also taking immunoglobulins, which are naturally a part of our immune system and line our gut, but I am very low on these. They bind to toxins and help expel them, and when they’re low, we’re more suspectable to infections, parasites, yeast, etc. So, I am taking them to help with both the SIBO and SIFO. Additionally, I am taking glutathione, which is an antioxidant that’s absolutely essential to liver function, and so this is supporting my liver to clear out all the toxins as the candida, fungus, etc. clears, helping me by lessening the die off.    SIBO For SIBO, I am keeping it at bay with the strongest prokinetic, called prucalopride. This is a pharmaceutical drug, but unfortunately, the natural prokinetics aren’t normally strong enough and this was certainly the case for me. I tried them all, and they just didn’t do the job. Whilst doing that, I am of course doing the diet 80% of the time, and then meal spacing as much as possible. So that’s 4 hours between meals and 12 hours overnight. Sometimes I can’t manage the 4 hours between meals because I’m hungry or I need to support my blood sugar, but at a minimum we’re required to do 12 hours over night. I think maybe three days I ended up doing less than that because of travelling, maybe 10 hours or something. And alongside that I am taking low dose allicin, which is an extract from garlic, and I use multiple times in my SIBO treatment with success, and allicin also kills off fungus. It’s reportedly not strong enough alone to kill fungus and yeast, but it can help and in combination with the probiotics, I think it’s a nice combo to keep the SIFO at bay at least, if not begin killing it off.  So, I am taking the allicin at a low dose to keep the SIBO at bay, and this is a common approach. Dr Siebecker doesn’t use it, but some other doctors do use it between treatment rounds instead of a prokinetic, and it does work. So, it may not be enough to kill the SIBO, in fact I know it’s not, but it just sort of keeps it from growing like crazy.  Then of course, the immunoglobulins help too.   Microbiome and gut lining repair So, I am taking high dose fish oil, about 2000mg, which helps to repair the gut lining.  I am taking 2000mg of quercetin, which again helps to repair the gut lining, and also lowers inflammation in the body and gut and is a natural antihistamine. I was taking l-glutamine before I left, which is the best leaky gut healer, but the tub was huge and was open, and is a white powder, so I thought I might get arrested for that one! Additionally, the saccharomyces boulardii also helps to repair the gut lining, and the lactobacillus acidophilus also contains two other strains which have been shown to repopulate the gut and increase levels of beneficial bacteria. Now normally, I wouldn’t take so many probiotics with SIBO, because taking too many can cause a flare up and even cause it to grow, but it’s about testing your tolerance. If you take a probiotic and you’re bloating or SIBO symptoms get worse, it’s probably not the best one for you because it’s feeding your SIBO. In contrast, certain single strains are better tolerated. I like to build people up to a few strains, and I was already on two, so with this combo I’m on four, and I tested them out before I left to make sure I wasn’t reacting. But essentially, I couldn’t find a single strain of lactobacillus acidophilus for the life of me, so this was the best I could find!  And the immunoglobulins help to rebuild the gut lining and support the microbiome too.  Additionally, in general, I have been supporting my gut by using the app. Nerva, which improves the gut-brain connection and using Arvigo massage at night to stimulate the migrating motor complex overnight. Both of these also help to lower stress, which damages the gut lining and microbiome, so addressing a stressed nervous system and an anxious gut is really important too – and I see Greece as part of that. I have to say, I haven’t been able to be consistent with the massage and the Nerva with all the travelling, but we’re a week into our new temporary home now and we’re here for another three weeks, so I can get back into my routine.  So that’s my current protocol. When I return to the UK, I am going to move into a high dose of oregano and another yeast antimicrobial, likely Candibactin AR, but continue with the probiotics, and I’ll of course retest for SIBO. If I am positive, I may do the elemental diet again, whilst taking anti-fungals, as that should kill it at the same time. I may then need to continue with the candida treatment for several months, as it can take some time to clear. But I think that will be judged on whether I am seeing any improvements, because if it’s not candida, then I don’t want to waste time treating the wrong issue. I’m hoping to do an organic acids test too, to see if any candida shows up. What I’ll do is take an anti-biofilm for two weeks ahead of the test, and that will hopefully break up the biofilm so it can be detected. It doesn’t always work, but we’ll see. But there are plenty of natural anti-fungals to rotate through and I have all the doses from my course with Dr Jacobi, so I’ll let you know which ones I’m doing as I go through the treatments. If it’s not candida, I may be still having symptoms because of possible Ehlers-Danlos syndrome, which I am being assessed for when I return, and I’ve been talking about that over on Instagram if you want to learn more about its connection to endo and SIBO. And it could also be that I am just rapidly relapsing and severely reacting because of an upregulated nervous system, in which case, there are two great courses for rewiring your brain if your body is very reactive, one is called DNRS and the other is the Gupta Programme, so I may consider those too. I see a lot of this with my clients, an upregulated nervous system from years of pain, inflammation, etc. It’s really too early to say which route I’m going to go down until I see what my SIBO results say, and I see how I respond to the candida treatment that I try when I get back. So that’s it. I hope that sharing my journey has given you some insight into your own, has maybe offered you some hope or some motivation to keep going. I know clearing these guys is tough, and I’m with you on that, but feeling well is possible.  Let's get social! Come say hello on Instagram or sign up to my newsletter. Sign up to my free Endo Belly Challenge here. To become a The Endo Belly Course Founding Member, email me at hello@thisendolife.com with ‘Yes’ in the subject line. Sign up to the wait list for my course, Live and Thrive with Endo here. My cookbook This EndoLife, It Starts with Breakfast is out now! Get 28 anti-inflammatory, hormone friendly recipes for living and thriving with endometriosis. Order your copy here. If you feel like you need more support with managing endometriosis, you can join Your EndoLife Coaching Programme. A 1-to-1 three month health and life coaching programme to help you thrive with endometriosis. To find out more about the programme and to discuss whether it could be right for you, email me at hello@thisendolife.com or visit my website. This episode is sponsored by The Pod Farm. Learn all about how to start your own podcast with the complete course from The Pod Farm. Aimed at beginners, this course takes a simple and straightforward approach to planning, equipment buying, setting up, recording, editing and hosting your own podcast. With hours of audio and video materials, and downloadable guides and useful links, this multimedia approach aims to have something for every kind of learner. From now until April 15, newsletter subscribers get 20% off the course price. Visit www.thepodfarm.com to enroll or find out more This episode is sponsored by BeYou. Soothe period cramps the natural way with these 100% natural and discreet menthol and eucalyptus oil stick on patches and CBD range. Click here to find out more and to shop: https://beyouonline.co.uk   Show Notes Nerva DNRS Gupta Programme Arvigo massage practitioner  

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