post-infectious SIBO

My Story: How I developed Small Intestinal Bacterial Overgrowth (SIBO)

I remember exactly what caused my SIBO.

Over the past ten years, one question that doctors usually ask me when I begin to tell them about my IBS (which I now know is SIBO) is if I can remember when my issues started, and whether there was any precipitating event. The answer is…yes, I know exactly what caused it!

Like approximately a quarter of SIBO sufferers, I developed what for years was diagnosed as post-infections IBS (irritable bowel syndrome) after contracting a nasty stomach bug. In my case, ten years ago I went on a trip to Egypt in between my junior and senior year of college. My dad and I had decided it would be a great idea to go see the pyramids, float down the Nile, ride some camels…little did I know that this trip would cause me years of pain and frustration, not to mention a heap of medical bills.

The first incident: food poisoning in Egypt.

For most of the trip I felt fine. There were several people on our tour group who got terrible bouts of food poisoning and stayed in their rooms for days—one woman even had to call a doctor. How lucky I am, I thought, that I’ve been fine this whole trip! Yeah, right. Famous last words.

A day or so after returning from the trip, I developed an absolutely horrific case of food poisoning. In retrospect, I’m not sure I had ever contracted food poisoning before this incident. Let’s just say…words cannot describe how awful I felt. In addition to running to the bathroom every two seconds, I felt weak and nauseous.

The food poisoning from hell lasted about a week and then I recovered…or so I thought. I returned to college to start my senior year, and everything seemed fine for a few weeks. But then I somehow got food poisoning again. I still feel this second case somehow related to the first incident, but I have no real proof of that.

Followed by round two of food poisoning.

Round two of food poisoning wasn’t as bad as the first round, but unlike the first time, when this one ended, it didn’t seem to fully go away. Between days of normalcy, I was also having bouts of diarrhea, stomach pain, bloating, and more gas. I started taking imodium to try and control the symptoms, which worked temporarily but added other side effects.

After about a month of hoping the mysterious “curse of the mummy” as a friend referred to it would go away, I decided to bite the bullet and go to the on-campus health center. The doctor there did some basic testing for parasites that can plague travelers and sent me on my way. A week or so later, the doctor called, telling me I had no parasites and should be feeling fine. But I wasn’t! I definitely did not feel fine.

Unfortunately, a diagnosis or treatment proved illusive.

Is this sounding familiar yet? It should, as diagnosis of IBS typically takes years. So began a merry go round of doctors appointments, testing, and being told everything looked fine. I had an endoscopy, a barium follow through test, and took probiotics and antibiotics. On the antibiotics I felt better, but the symptoms returned within several weeks. Years later, I learned that temporary relief from antibiotics is actually a sign that the real issue may be SIBO. Of course, in 2008 no one knew what the heck SIBO was.

Fast forward to a year later…I graduated college and moved back to Los Angeles. The mysterious digestive symptoms still remained, and were causing me increasing stress, anxiety, and depression. By this time, one of my doctors had prescribed me a tricyclic antidepressant, a common treatment for IBS, although at this point I hadn’t received a diagnosis. I constantly ruminated over how my life now often revolved around worrying if the next meal or snack would set off my stomach. Worst of all, I wondered if my health would derail my plans to attend law school. Would I be able to handle the stress of law school, and being a lawyer? Would I even be able to sit for the LSAT successfully?

In the fall after I graduated, my uncle, who happens to be a gastroenterologist, managed to get me an appointment to see Dr. Lin Chang, an IBS expert at UCLA. I went into the appointment with high expectations that she would diagnose me with something and prescribe a new medication or course of action that would actually help.

I get a diagnosis…but not a very helpful one.

Unfortunately, that appointment was one of the most dispiriting and disappointing things I have experienced. She took a quick look at my medical records and pronounced a diagnosis of IBS. I asked for an explanation of what this mean, and learned that it basically means that doctors can’t explain your symptoms and have no idea how to effectively treat them. Because I already took a tricyclic antidepressant at the time, she had little else to offer and sent me on my way. I remember getting in the car with my mom after the appointment and crying with the realization that I likely would deal with this my whole life and that doctors could not help me.

For the next ten years, I would not visit a gastroenterologist, or any doctor, for my IBS. I did spend hours researching anything that might help online, and trying an army of supplements, antidepressants, and other remedies. In short, nothing helped much.

Stay tuned for Part 2, where I  finally received my SIBO diagnosis.

 

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