SIBO Treatment: Antibiotics or Diet?

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I have vapors going into my lungs and it makes me cough and irritates my throat. Hemp, pea, and others are all made from unallowed foods on the autoimmune protocol, and are also highly processed. Also, FP can build up due to slowly fermenting hard-to-digest carbohydrates from previous meals. With this diet, the pain was gone almost immediately and has been gone for a month since we started the diet. Fodmaps was also recommended.

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Yes, you should be fine. But milk and milk products also contain several oligosaccharides that behave as dietary fiber, which can be problematic in higher quantities. Therefore even lactose-free products still have fermentation potential FP.

But since only a small amount of half and half is needed for tea, the FP value would be fairly low, particularly if you take a lactase pill. In many people, fiber supplements make symptoms worse. Also, some fiber supplements contain lots of sugar which is half fructose.

Symptomatic fructose intolerance is very common. Lastly the FDA has warned of choking and intestinal blockage risks associated with fiber supplements. Having a hiatal hernia is a bit like wearing tight clothes or being pregnant.

Because the hernia is essentially the top part of your stomach being pinched above the diaphragm. There is often extra intragastric pressure pressure in your stomach that can trigger reflux. The Fast Tract Diet FTD is designed to reduce this intragastric pressure at the source, gas produced by overgrowing bacteria in your intestines which is fed mostly by unabsorbed carbohydrates. There is every reason to believe that the FTD will help even in the presence of the hernia, but you might have to be extra diligent reducing FP points even more and following the proabsorption behaviors in the Fast Tract Digestion Heartburn book.

I am aware that gestational diabetes can arise half way into pregnancy sometimes. But, that is not an issue with FTD as the daily carbohydrate count of its meal plans is approximately 75 grams per day. FP is a mathematical formula that measures the symptom potential of foods. The Fast Tract Diet is based on the idea that certain carbohydrates are difficult digest because of their molecular structures in food chemistry. Difficult-to-digest carbs are more subject to malabsorption a failure to be fully absorbed from the gastrointestinal tract.

And they tend to persist in the small intestine, which potentially feeds blooms of SIBO. In the book, Breaking the vicious cycle, apple and banana are listed as legal foods. Breaking the Vicious Cycle Specific Carbohydrate Diet, SCD is a groundbreaking book that helped bring to light the connection between diet and gut microbes in digestive health.

Therefore, they have significant symptom potential. You can still consume apples and bananas on FTD, but adjust the amount. The diet reduces fermentable carbohydrates: Association of dietary, circulating, and supplement fatty acids with coronary risk: I am a little concerned about the lack of fiber for long term in the Fast Tract Diet, especially for my constipation. There is much more fermentable material both from plants and animals in our diet than we realize.

Unfortunately, the many health claims on dietary fiber are not supported by current research. And the dark side for digestive health is real. As for constipation, a recent study reported that stopping or reducing dietary fiber intake actually reduced constipation. I want to try the Fast Tract Diet, but I have grown so confused dealing with all of the conflicting food advice. FODMAPs suggests avoiding onions, garlic, artichokes, asparagus, avocado, beets, broccoli, green beans, mushrooms yogurt etc.

For this reason, reasonable sized servings of vegetables that contain small amounts of FODMAPs are still acceptable as long as you keep your overall FP levels in line with recommendations. For example, a few small cloves of garlic do contain a FODMAP fructose oligosaccharide but only a couple of grams which is also reflected in the FP value. Can you drink bone broth on a SIBO diet?

I do this mainly for my bone issues and its suppose to be very good for digestive issues. Such a gut-healthy delight. I should add a recipe and also add bone broth to the soup table in the book.

The FP of bone broth is zero. Cracked wheat bulgar is shown as having low fermentation potential. I am puzzled by that since whole grains and foods containing wheat in general are to be avoided or severely limited on the fast track diet. Would you please explain? Hi Susan, Thanks for pointing this out. There is a typo in the print book for cracked wheat. This has been corrected in the mobile app I will correct the print book at the next print run. I am very excited with the information in your book because it gives me hope that I can still improve.

With the gastroenterologist and dietitian I am also trying to figure out the underlying cause s. I would appreciate your opinion on biofilms.

I have your book, and it has helped me immensely. It seems that the Fast Track Diet will starve them to death. But is that true? Should she just gain weight on the fast track diet before adding in these?

Thanks also Norm for your book and really helpful website. Hi Norm, Would the amount of sugar alcohols in sugar fee gum, such as Dentine Ice cause a problem? Chewing gum seems to help my GERD and satisfys my sweet tooth.

Typically 2 grams per stick which can add up depending on how much you chew. The FP grams for sugar sweetened gum is about half that. I have been on and off the drugs for 4 years. Last year I had many bacterial infections and when on antibiotics nine times, which then resulted in thrush more recently.

Now, my goal is to stay off the PPIs and recolonize my digestive tract with several strains of bacteria that are helpful for digestion in hopes of staving off my GERD.

Any advice on probiotics here is most appreciated. Thank you so much. You should join the conversation. When you absolutely need to take antibiotics, taking a probiotic needs to be resistant to the antibiotic in question is an option some advocate.

I am not aware of data showing their effectiveness, but maybe someone else can find some. Luckily, though perhaps not perfect, gut microbes do gradually repopulate over time. You are basically receiving a slow fecal transplant from other people and the environment. Unfortunately it can take months and may never restore the full complement you had to begin with. Lastly, fecal transplantation research offers some hope for the future if things get really out of wack.

Hi Norm, Thanks for your book! I downloaded it the other day and really enjoyed it. I have a quick question…I realize that the FP for each food is around 35 for the first couple of week, but I was wondering what the average total carbs per day are on the Fast Tract Diet? If you go by the recipes, they averaged approximately 75 grams per day. But some people consume less and some more depending on how complicated the SIBO is an other dietary preferences.

Please keep us posted on your progress. Hi Norm, and thanks so much for being willing to answer questions!

I see people have already asked a couple that I wanted to know about quinoa and psyllium. Are all prebiotics off the menu? Is there an easy way to tell what is a low-amylose rice cake? If I have to contact the manufacturer to find out, what should I ask them? I do have a small hiatal hernia also. I also drink my own bone broth which not sure if good idea with histame issues. Hi I have 3 questions I need help with: There is no mention of FP and serving values etc for Lactose-free milk in the kindle edition I just downloaded on FTD for heartburn and LPR We normally only have lactose-free milk at home so it would be really good for me to know as I use it in my tea.

Regarding Jasmine rice, given its FP is zero, can I have as much of it as I want with every meal to increase my weight? However, I notice there is a serving size suggestion of 5. However, it says here that the dish serves 2.

So, if I want to cook for one. Should I halving every ingredient? Please can you clarify as I am so new to this diet. Do you have any other suggestions for vegetarians to get our protein in? How about soy products such as soy protein powder? Within your calculation for FP I see no weight being given for fructans onions and garlic. I tested positive for fructose malabsorption as well as SIBO so I am wondering if the onions and garlic should be avoided?

One gets the idea on the other diets that onion, garlic, peaches, watermelon, etc must be eliminated from ones diet while not really identifying when we should stop eating the foods that are legal during a given day,. Your approach makes much more sense in that we are staying within a given number of FP points per day.

It greatly expands the possibilities of recipes we can enjoy while quantifying with points what we do eat so that we are eating a diet that will keep the daily FP down to a safe level….

After just one day on the diet all of my heartburn symptoms were cured. Or once my intestines heal can I go back to eating as I please? Does this mean A. Even though my symptoms are gone, I still need more time to heal? No more gluten for me ever again? Do I need digestive enzymes? Will I need to continue this type of diet long term? One last sidenote — I had chronic heartburn for about a month after I had to take two doses of antibiotics for bronchitis.

Your book saved me!! Robillard, Thanks so much for your books and especially for answering questions. My question is this: I just bought the book and was planning to start the Fast Tract Diet soon.

I was wondering if I could make Graham cracker crust instead, since it says on the FP chart that graham crackers have a low FP. Also, do you have any suggestions for alternate snacks to substitute for the Snack mixes containing nuts?

However, I have many food sensitivities right now including eggs, chia seeds, bananas,and most nuts expect raw almonds. Also have been gluten free since I prefer to not have animal products with every meal. I can not find the GI to calculate the FP. I read a while ago that coconut products are hard to digest for IBS, etc people but wondering if you have found other research to dig deeper into that statement.

Coconut oil work fine for me as well as the can full fat milk small portions. Just not sure if I am hindering my healing process by using it. They do not list GI on the website. After rice flour made from jasmine rice, how would other GF flours rank as far as their fermentation potential? Any idea about the FP of tapioca flour, potato starch, sprouted oat flour, sprouted corn flour?

Three months ago I had been on PPIs for two years and began suffering more severe reflux. My doctor told me to double my PPIs from 40mg per day to 80mg per day. Instead I read your book, started the diet and found immediate relief. However, I am still slowly weaning off antacids due to acid rebound. I am completely of Prilosec and I am now down to 30mg of famotidine Pepcid per day. I would like to try to stop all antacids in the next weeks but would like to have a back up treatment for travel when food is less easy to control.

What are your thoughts about DGL deglycyrrhizinated licorice extract taken before a meal as a heartburn preventative? These are chewable tablets with 1 gram of sweetener per serving consisting of fructose, mannitol, and sorbitol. I have SIBO which I has been under control for since January this year with a very restricted diet and Biotics supplements specifically prescribed for the condition.

About a month ago, however, I developed extreme indigestion, which my kinesiologist diagnosed as gastritis and acid reflux and advised me to stop taking all my supplements and begin taking mg of ranitidine twice a day, which I got from my GP and which helped for a while, but now the condition is persisting and seems to arise unpredictably.

I discovered your site recently and apart from all the other carbohydrates I am not eating, also withdrew fructose in any form, and for an afternoon and evening I was symptom free and thought I had solved the problem, but yesterday the burning sensation in my chest returned for most of the day and evening.

I have been unable to find any conversion table on the internet that gives the amounts in volume that you present in weight. Any ideas, or am I missing something? I was very glad to see normal household measures in the recipes. Once for Low-amylose rice, once for high-amylose rice, and once for puffed rice cakes.

Can you please tell me how to find out which kind of rice cake is which? Thank you in advance. It was a sauce for fish or chicken: I used about 1 tablespoon of the sauce only. The garlic is the only ingredient I can think of that would have bothered me, but I used less than the recipe called for, and for my own portion, just a small bit — whatever was in that tablespoon of sauce. Any ideas on what happened? Could this mean fructans really do matter? Thanks if you have a chance to respond.

I am wondering if Stevia is okay on this diet? I am also wondering about an appropriate protein powder to put into smoothies. Feeling so confused and frustrated. Both times in the severe range with 2nd time worse. Review the trouble-shooting sections in the book and be sure you are limiting FP points in line with your symptoms. Some people need to go to 25 or less per day. Also the pro-digestion behaviors for choosing, preparing and consuming foods are critical.

Other underlying conditions beyond simply consuming too many fermentable carbs if they exist must be identified and addressed. If all else fails, you might consider our consultation program which you can find on this site. Thank you for your speedy response. Based on my reading which states …. Also, based on my IgE blood work there were many foods I was unable to eat even those considered safe in your book so it was super hard to find items to eat.

While I know flax, whole grain brown rice and quinoa are on the higher sides of fermentable foods, I thought since its in cracker form the amount of each would be minimal. Especially since there are other seeds in there. Was I wrong to conclude that? I will be discussing tomorrow at my doc appt about all the underlying causes to see what we can test for further. Thank you again for your previous quick response. I just purchased your book, you are the first person who seems to have both the science and the understanding.

My experience with a gastroenterologist was being told to see a hypnotherapist because I was she insinuated swallowing air.

Not sure I understand. Like wise I suppose chia seeds are out of the question? I had thought that both these, seemingly going through virtually unchanged, would have given little sustenance to bacteria… BTW I have always been so healthy, or so I Thought, exercising heaps meant I had to eat heaps, the more complex the carbohydrate the better… I made myself into a vat of bacteria!

Hi Veronica, With Flax and Chia seeds, they are both mostly fiber and fiber is fermentable. Hopefully most of the fermentation will occur in the large intestine. But the Fast Tract Diet limits all fermentable carbs at least until symptoms cease to be on the safe side. But FP is all about serving size. I am trying to better understand the prep of Sushi or Jasmine rice and Resistant Starch. If the rice is prepared earlier in the day, but remains in the pot on the warmer, does it keep it from becoming resistant.

At what point in the cooling process does it become resistant? How fast from pot to freezer must it go? And then when it comes out of the freezer, can I simply defrost in microwave before eating. Want to make sure I am not messing up my FP with the way I am preserving my rice once made. I have lost more weight than desired on this diet and wonder if you have recommendations for high caloric foods with low FP.

Is there a nutritional drink one could have to supplement that is low in FP? Appreciate any suggestions for weight maintenance.

I find it very difficult to eat 2, calories or more on this diet without gorging on fatty meats. On the positive side, I have had a lot of relief from pain from about mid August to Mid December. I am having a setback these last two weeks. Probably because my FP grew higher than I thought as I added in a few more things in the effort to gain weight. Appreciate any help with allowable high caloric foods or ways to gain weight but staying within FP guidelines.

One other solution is to get the new FTD Mobile app http: As I understand it, the fast track diet aims at starving the bacteria. However, can it truly eradicate them from the small intestine? Can the diet alone clear the bacteria once for all, as this is what SIBO sufferers are aiming at? How does SIBO affects the nervous system?

I am trying to figure out my health problems. I have lots of food allergies, eczema and urticaria being my initial symptoms. However I restricted my diet to a low histamine one and although my symptoms improved I now have chronic constipation even though my stools are soft.

I am wondering if I am eating too much fibre for whatever is going on in my digestive system. I am also very bloated by the end of the day. Hi there, firstly thank you Dr Norm for your really helpful book. It contains sorbitol, a sugar alcohol, which I know from your book can cause fermentation.

I can tell it gives me bloating and pain but without it, I completely lose my voice and have intolerable pain in my oesophagus and throat. Hi I like yourself have intolerable pain in my oesophageus and throat and have had good results on the diet for two weeks but now am experiencing symptoms have tried cutting back and following everything religiously , have lost so much weight too…what is the pain I am experiencing?

Hope you have had some joy in your symptoms! However, I continue to have chronic diarrhea once a day on waking. Any thoughts or suggestions? I have your book and am planning to try the diet. However, you suggest for best results to follow your menu plan for the first 2 weeks. I got you Krambo. As long as you keep your daily FP points low choosing low FP foods you will be fine.

Hello, I have been on a vegan diet for the past 5 years. I have been having symptoms of acid reflux, the doctors think it may be related to a hiatal hernia but they have not confirmed. How can I follow this diet as a vegan and vegetarian?

Hi Jen, I can appreciate your situation. Since some go-to vegetarian foods such as legumes and whole grains have high FP values and need to be limited. This presents some challenges.

Here are a couple of resources that might help. I have a chronic cough which I believe is related to silent reflux. I am adhering to the Fast Tract Diet rigorously but also avoiding caffeine, acidic foods, etc. I use some fats in cooking but not a heavy amount.

I am taking TUMS with my meals at present because it seems anything I ingest, even water with medication, results in another coughing fit. I applaud you for your excellent research helping so many people. I hope it can help me. I usually eat aged raw milk cheese. Thank you so much in advance! Can a person that has gastritis use the Fast Tract Diet just as it is? Or are there more things a person may have to be careful of, such as alcohol or nicotine, or other foods? Should I take a supplement to aid digestion?

I was recently diagnosed with LPR silent reflux. The past few years my breath has progressively gotten worse. Obviously, this has ruined my social life, romantic life, professional life and pretty much relationships with every single person I encounter.

Will this symptom go away if I can cure my silent reflux. Im a 35 year old beautiful smart woman who has so much to offer the world… I want to be able to be myself and live life to the fullest. I used to be happy. I want to be happy again and I want to be able to talk to people again. Thank you for your research and for writing this book. The 2 week induction diet that you have in your book, should that be followed as it is exactly listed and after the 2 weeks refer to your food list? Do you think my breath will be normal again — clean and fresh.

Do you think your diet modification will work for my reflux? What kind of toothpaste and mouthwash do you recommend? You had mentioned that most have sugar alcohol in ingredients. Hello, thanks for your insightful book! I have been following the diet for a few days the app is a huge help, by the way! I usually have a green smoothie for breakfast, which sets me back FP even if I seriously reduce the fruit to the bare minimum.

I could see how the mush that comes out from a vitamix is easier to digest and thus has lower FP… Thanks! Most juicers remove some of the insoluble fiber which would be expected to reduce the FP. A few days ago, I read your book, Fast Tract Digestion- Heartburn and determined to follow your guideline. One question I have is about apple cider vinegar ACV. I have taken apple cider vinegar ACV 30 minutes before every meal to facilitate acid production in my stomach, but I found that some insist that ACV should not be taken for fructose malabsorption because of fructose in it.

I prefer to use either as a last resort if diet for symptom control is thorough enough for long-term health of the digestive system. Yes, I do view all antibiotics under the same umbrella. Of course, there are many differences. Some kill, others inhibit. But each has a particular spectrum range of which types of microbes they are active against and strain-specific potency. At the highest level, I think diet first and antibiotics only if all else fails.

Even then, you need a careful approach to avoid numerous potential pitfalls linked to antibiotics. I read the book, implemented the dietary adjustments, got immediate relief from heartburn….

Hi Karen, The diet is flexible. People with diabetes need to watch their blood sugar levels. Carbs need to be limited including some of the low FP but higher carb, higher GI carbs.

This is lower than most standard diabetes diets, but it may be wise to lower total carb counts even more to be sure blood sugar levels are fully contolled allowing people to depend less on medications. If I can only afford one or the other, would it be better to purchase the downloadable book or the app for iPad? Hi Francine, The app will help you jump start the diet.

Read the Fast Tract Diet chapters in the app before starting the diet. I would also recommend reading the book, so that you can fully address your issue s. Hi Norm, i have your book for IBS and iphone app.

Hi Norm, I have recently started on the diet after suffering from daily reflux for about 18 months. Early indications are positive but I was wanting your thoughts on the supplement slippery elm powder I.

Whether this is counter-productive to the diet. A dose is 0. I am a Type! Do you recommend just leaving them out or using another diet? I have heard you recommend the ketogenic diet for diabetes but I have not found that on the website or in the book yet.

Hi Melinda, Great question. Low FP foods are either small servings, low carb or high GI. While most of the low FP foods in the tables are lower carb the vegetable table is a good example , some especially starches are high GI and high carb. Limiting these is a good idea for diabetes or other metabolic sensitivities.

The recipes in the books total approximately 75 grams per day which is certainly lower than the typical American diet, but I agree, you may need to reduce your daily carb grams even more. The ketogenic diet is a great alternative my view. Hi Dr Robillard, I recently bought your book and really like the concept! I am working on putting it into action. Is the diet okay for someone with hypoglycemia? I am concerned about some of the high GI carbs that have low FP.

I am already on the thin side as it is and reducing carbs too far will cause a problem. I have been combining fats and carbs to slow blood sugar release but does this cause the carbs to be more fermentable? How do you calculate FP when there are multiple foods together such as in a gluten free flour or cracker? Hi Molly, I hear you about this concern. At the same time we want to keep blood sugar from extreme fluctuations.

A very low carb diet is one way to do this since your liver will produce the required amount of glucose from gluconeogenisis. Another way to accomplish this is to introduce some carbs but focus on low GI carbs. The problem with the low GI carbs is that they can overfeed gut bacteria. The FTD is aimed at controlling fermentable carbs, but allows you to do it with a low carb approach or by adding higher GI carbs. Implementing the higher GI carbs approach in your case, may take some finessing.

Smaller but more frequent meals may be one way to do this. I am wondering why pumpkin seeds are considered to have a high FP because if you use the FP calculator they come out as having a low FP. Am I using the calculator incorrectly? Hi Kristen, I did the calculation using a one ounce serving containing 15 grams total carbs, of which 5 grams are fiber.

I entered a glycemic index value of 24 based on similar foods which have been tested and got Please check the values you are entering and give it another try. You should get the same answer. The label on my seeds superseedz brand says total carbs are 3 grams and 2 grams of dietary fiber.

That explains the discrepancy. A general search for pumpkin seed nutrition on the Internet shows what you are reporting, 15g of carbs and 5g of fiber. Any idea why there such a difference? I cannot eat tree nuts or sesame due to allergy so I was sorry to see the FP of pumpkin seeds was so high.

That would explain it. I will keep my eyes open on this. If the serving sizes are the same, likely one of these values is incorrect. In fact I have taken it daily for 10 plus years and now have Osteoporosis. I have read your ebook and downloaded the APP. I cannot find advise on what a daily target would be for FP Points. I experience noticeable gas and bloating even after eating proteins, such as fish and eggs zero FP , on their own.

I understand that some bacteria can ferment amino acids and assume this must be what is happening. Do you have any thoughts? I realized that by day 4 I cannot tolerate dairy it brings that phlegmy feeling back into my throat even when using enzymes and I want to avoid dairy until my symptoms go away. The nut mix also tends to upset my stomach.

However, I am concerned that my carb intake will be too low. I work out 6x a week and while playing tennis yesterday I felt very light headed and had to sit out. Am I getting enough carbs? Can you please respond to the review of the research by Dr.

Michael Gregor, MD regarding plant based food diet for reflux. His web site is nutritionfacts. I was ready to adopt Dr.

My main goal is to find the right strategy to help me resolve this difficult issue. I am not convinced including animal fat and eggs in my diet would be helpful. Hi, This diet really helped me. After three years of searching for an answer it only took a day for my symptoms to improve on the Fast Tract Diet.

I just have a quick question regarding the app vs the book. Why would 80g of parsnips in the app be 9FP but only 3 according to the book? If in doubt should there be more like this should I follow the book or the app? It shows the FP at 1g, but the ingredients in this supplement is sprouted brown rice protein and pea protein. Because this is a protein isolate, there are few carbs.

Protein is not assigned any FP points. Does parboiling rice affect the amylose in it? I am going from a mostly vegan, high fibre plant-based diet to following the FTD due to SIBO and am finding that motility is affected and also I am wondering about high glycemic foods such as jasmine rice and potatoes contributing to inflammation. Also, my pH has dropped. My lpr manifests in sinus symptoms and most remedies are not FTD friendly or may lower stomach acid.

I bought the book. But a FP of 1 for a white baguette? Is that possibly a misprint or is that, for me, a dream come true? But do use caution, eat slowly, limit serving size and chew well to optimize digestion. Norm, raw honey is known for containing digestive enzymes including amalyse. Does it get any FP grams credit? I personally use small amounts of raw honey — in the teaspoon range.

The FP value is relatively low. I agree with you that raw is best. Really enjoyed your book. Just started FTD about a week ago. Good results so far. Thanks for taking the time to answer questions on this forum. Have yet to read the book, that will be my next step. However I happened to see Prescript Assist on your store page, which I just looked in to this week.

I found this article, basically the crux of it being limited data re: Thank you for your great book. I have been on a PPI for many years and wish to get off them. I have started your diet but it is very difficult because I am Vegan. I have decided to include the yogurt and butter for the three weeks but I find that I have a greatly increased anount of stomach gurgling. Also I would like to eat lentils and beans eventually.

I suspect that Beano may also? Is it still safe to take this? Thanks for your help. Immediately from day one I felt a huge improvement. Thank you so much for this diet and app Over the last three weeks however the symptoms have started to come back and have been getting worse. This started the day after I started going to the gym again. Hey Stefano, Changing your diet involves many variables including macro and micronutrient changes, adjustments by your body and metabolism as well as changes in your gut microbe populations in response to diet changes.

One thing you might try is diligently limiting FP points even further short term and perhaps experimenting with avoiding certain carb types such as starch, for instance.

Feel free to contact us under the consultation page for more hands on support. This diet has been a godsend. Nor was the specific carbohydrate diet. We started to get a clue when we noticed she had really bad breath correlated with fructose malabsorption.

With this diet, the pain was gone almost immediately and has been gone for a month since we started the diet. We had been keeping it pretty low — maybe in the 20s. Should we just slowly introduce higher FP foods and see how she does? No idea how long that is never had an endoscopy — still on the wait list to see a doctor. I thought the app would be the most updated version so I was going with the FPs in the app; but in a previous post, you say to instead just go with the most conservative one?

The gym is the problem. Vigorous exercise is not good for GERD sufferrers. Something I discovered the hard way. No jogging, walking is fine. Swimming and cycling up right is fine etc.

Now back to me: I would love to try the 30FP per day concept however. I cant get my head around the maths, sorry! Which is contrary to all the advice out there that keeps advocating high GI food for health..

I agree about the vigorous exercise Nella. The tables in the appendix of the books do list the FP values. You may need to adjust your device a bit to see them. The tables are designed to be responsive to a wide variety of devices so you should be able to do this.

I had the contents up at the same time. I appreciate your prompt response! Would you be able to recommend what might be an appropriate maximum daily FP for someone who probably has SIBO and definitely has blastocystis along with overgrowth of streptococcus in the large intestine?

I assume from what you say in answer to other questions that normally in these circumstances it would be good to cut out or minimize starches, but does this still apply when someone is very thin and seems to do much better on a little jasmine rice than on squash, for example?

Thank you for your book and your efforts to unravel these mysteries. Hi Norm, can you advise me on carob? I like to make my own carob chocolate. Only when i use medicines, heartburn sensation reduces but burping and belching still over there,,,,,,,,,Now i have also throat problem,,,,,,,,Can you please help me in this regard??????????? It seems like there are basically two perspectives on LPR. My understanding of your perspective is that it is SIBO. The other main perspective is Dr.

Koufman and her outlook is about excessive pepsin in the tissue. But many people who have LPR have low stomach acid not high stomach acid.

Not every one has drank soft drinks or eaten the type of diet she describes as a causative diet. Since I have been bothered by heartburn and gas flatulance I was hoping your diet was the answer. Hi Anne, Since low acid, high carb did not provide a complete solution, I recommend giving the FTD diet at least two months since LPR symptoms are slow to respond to diet changes compared to simple heartburn for instance.

I would also adopt the most stringent form of the FTD for at least two months keeping your FP levels below 25 points per day. Check out the troubleshooting sections in the book and FTD mobile app. Thank you soo much for your work, the book and the application! I have a question in connection with the app. Can I export them somehow to pdf or e-mail? Hi Helga, Thanks for trying the diet and the mobile app. Currently the app does not have that capability, but I see how it would be useful.

We will consider something along these lines in the future. I also suffer from constipation. I used to drink 8 glasses of water a day.

Now when I try to drink more water, my reflux acts up. How can I up my water intake to help control the constipation? Hi Alana, Perhaps 6 glasses of liquid including other drinks as well would be enough. Further restricting carbs will also help. Does the fast tract diet help reduce or eliminate symptoms caused by ulcerative colitis. I have read through a ton of material, but have yet to see ulcerative colitis discussed or even mentioned.

But each has chapters on each condition. I recommend the Heartburn book. You can read lots about IBS on this website that will supplement the book. You might also consider the Fast Tract Diet mobile app to implement the diet. Thank you for your quick reply! I will get the heartburn book and the app. I look forward to implementing this program and getting much needed relief!

I read that potatoes and soybeans have an enzyme that inhibits protease enzymes from breaking down proteins during digestion. Hi Rob, Yes, soy, potatoes and many other plants, especially grains contain protease inhibitors. Cooking destroys them for the most part. Hopefully, cooking will minimize any problems with these. Can you recommend which probiotics to take and which strains they should contain?

Third, for weight gain, as long as it fits into a low FP daily calculation, is it ok to eat sweet potatoes and white potatoes? Thanks for this board and your work! Hi Beth, When using a juicer, some of the insoluble fiber will be removed so the FP will be a bit less than the ingredients.

But the best rule of thumb is to calculate the juice FP by adding up the FPs for all the ingredients. My personal experience is that that juiced veggies are a bit more active in my digestive tract often leading to soft stools. This can be a good thing for someone who is constipated. But for me, an ounce or two of juiced veggies is plenty. However, I read online that h. Is there anything else I should be doing or trying post h.

Thank you so much for any advice you may have. Any advice would be greatly appreciated. No more cakes, biscuits or cereal bars? They sounded quite intense. I am just in day one of your diet and ate very low fp today and am still having quite significant symptoms. Is this die off? When might I expect some easing?

Several Clinical studies show that GERD can be caused by low stomach acid hypochlorhydria , or high stomach acid hyperchlorhydria. In most cases the miss, will result in a patient that has Hypochlorhydria low stomach acid being placed on a PPI. The end result of the this misdiagnosis is the patient may develop Achlorhydria no stomach acid.

Hypochlorhydria will cause malabsorption of the necessary vitamins, minerals and micronutrients necessary to keep the body healthy.

It will also allow bacterial and pathogens to flourish in the digestive process. Hello Norm, There is so much information about probiotics, do you have any thoughts on how to use a probiotic in the best possible way?

Also, I seem to remember you selling the Dr Ohhira probiotic and now you only sell the prescript assist. Do you have any thoughts on both these probiotics? Hello Norm, is it safe to use a PPI over the short term to determine if I actually have LPR, or if it could be something else — chronic sinus infection. Hi Amy, This is a great question. I decided to dedicate a blog article to your question. You can find it here. I saw your comments about juice, that adding the FP value of each veggie should do the trick, however carrot juice is listed in your FP table in the book as very high FP, even though carrots have a low FP risk..

What can be done to eliminate an overgrowth of Archea? I have been on a low-fermentable as well as low-fodmaps diet and am desperately seeking an answer. I just ordered a copy of Fast Track Digestion — Heartburn. Thanks in advance and looking forward to reading the book!

I was diagnosed with polymyalgia rheumatica-Autoimmune Illness for the last year. Given prednisone for the chronic pain. Saw a Functional MD. Have been on a restricted Paleo diet for a year and given 3 different herbal microbial protocols for the SIBO over this last year and treatments for parasites. Now they are prescribing the antibiotic Rifaximin. Cant get below 15 mg per day without chronic pain. I have the app for the food potential list and am working on eating foods low in FP.

I have LPR and throat is all phlegm constantly, trying to clear it, with no avail and affecting my voice, hoarseness. Am a vegetarian so hard to find foods, but am going to adjust to it. I thought I would give a try asking you about the sphincter damaged, and even with this damage, can your diet still help get rid of the phleghm globus constantly in my throat.

I have had confirmation that a higher level of pepsin is in my throat areaas Peptest so am working on it. Hello Norm, I have a question about Jasmine rice. Do you know what the FP of brown Jasmine rice is?

Is it also low? YOu could try it or just play it safe with white jasmine rice. This is circuit training and weight lifting using many cross fit type elements. Hi Michael, There is a write up that explains the FP limits for the severity of symptoms. I itunes, you click on the more button, bottom right. Initially you said it was a 3 FP but that was before you realised it contained pure maltodextrin is it still a 3 FP or higher now that it has pure Maltodetxrin?

I lost my voice due to misdiagnosed Acid Reflux that was initially caused by my Brita water pitcher.

I had forgotten to change my filter and for 2 months I drank bacteria contaminated water. To make it worse I had no symptoms to let me know what the problem was.

Took 5 different doctors to properly diagnose the acid reflux. I started taking the FTD and got the app to help with food. My voice is slowly coming back but at a snails pace. I realize that after 5 months of no voice that any progress is good but how long until my voice returns?

Will anything help it recover quicker? I understand that he also blames imbalance in the gut for heartburn and has great success and reviews. I have decided to go with your book but was wondering if you know how his solution compares. Hi Michael, A couple of quick points. Not everyone can tolerate more carbs. Look at the numbers. You can still have sweets, but follow the recommendations in the book.

Correction to previous comment. It shpuld have stated I can only tolerate cooked fruits. Does this change the calculation? I have been working on ridding myself of SIBO, methane dominant, for years. Recently reading your book. Wondering where your research is from regarding the Neomycin being damaging?

Thank you so much; your book has been very informative. And some in the group were retreated up to 5 times. Another study looking at retreatment found that the efficacy of retreatment was also questionable. The cost of rifaximin also weighs against the frequent use of rifaximin for IBS. In other words, they recommended diet over antibiotics as a first line therapy. Aside from rifaximin, a variety of other antibiotics have been used for SIBO in the past including metronidazole, colistin, levofloxacin, ciprofloxacin, doxycycline, amoxicillin-clavulanate, trimethoprim-sulfamethoxazole, cephalexin and norfloxacin.

And new studies should also look at the effectiveness of retreatment for participants who revert to SIBO-positive. Many herbal extracts are known to possess antimicrobial activity.

But individual herbal extracts tend to be less potent than synthetic antibiotics. Therefore, they are often used in combination. While a variety of these extracts have been proposed as possible treatments for SIBO, there is not much published data on the efficacy. Recently, a small study found that a combination of herbal antibiotics were at least as effective as rifaximin, but we need more definitive studies to confirm these results. As with antibiotics, dietary treatment of SIBO needs to include an evaluation of underlying causes.

If present, underlying causes will need to be addressed for successful treatment. But in many cases, SIBO may simply be the result of over consumption of specific fermentable carbohydrates. Think of this as one of the potential underlying causes. If this is the case, a dietary strategy to control over consumption of fermentable, hard-to-digest carbohydrates may be all that you need.

In the past, many of the symptoms we now associate with SIBO intestinal gas, bloating, distension, diarrhea, etc. Carbohydrate intolerance is a form of malabsorption that can lead to dysbiosis, a general imbalance of gut microbiota, which may or may not include SIBO.

For instance, lactose intolerance is very common in SIBO patients and has been recognized for over a century while fructose intolerance which is also linked to SIBO was first documented in the s. More recently, sugar alcohols except erythritol and dietary fiber intolerance have been added to the list. According to the Merck Manual , the standard treatment for carbohydrate intolerance is to limit the offending species of carbohydrate.

This is precisely the group of carbohydrates that the Fast Tract Diet limits. Unlike antibiotic treatment, limiting fermentable carbohydrates provides a durable response. If you are lactose intolerant, you need to either avoid lactose or take a lactase supplement when consuming high lactose diary for the rest of your life.

Similar results were observed in a study that looked at both lactose and fructose plus sorbitol intolerance. Since there is no supplement for fructose intolerance, limiting fructose is a long term prospect. Certain carbohydrate types may be added back once tolerance to individual carbohydrates is confirmed.

Similarly, overall fermentable carbohydrate limits can be eased based on improvements in tolerance levels over time. I myself have been on this journey for the last 16 years.

Even in these situations, diet will certainly be part of the solution. Robbilard, What amazing work you have here. Hi Peter, Significant reduction in daily FP points often reduces other food sensitivities which may or may not have been the critical problem. If this approach does not work, you may consider our consultation program.

What a great article Norm! I will share it with many. Thanks for your great work and dedication. On a personal note I am glad you found this solution for yourself after 16 years of suffering — and that you did not stop there. You are now helping thousands of people.

These are 2 common questions that I get often: What am I doing wrong? What issue s are you addressing with the diet? What is your daily FP?

Do you need individualized help at https: I often wonder if having a colonoscopy could contribute to SIBO. Any thoughts on this. I could swear all my problems started after the procedure was done and progressively got worse. Hi Sharon, The bowel preparation does affect the diversity of the microbiome as highlighted in this article which cites a couple of studies http: But as time goes by there is a recovery as descibed in this study that followed colonoscopy patients out to 6 months http: Intermittent fasting and limiting fermentable carbs in the diet seems a prudent course following this procedure.

It appears to be a real problem for many. I would like to choose NOT having a colonoscopy ever again. I have hoped for an answer to my PPI problem for a long time. I was on those drugs for 7 years and they have done so much harm to my overall health and vitality.

I do not want to have such an invasive procedure if it is not necessary. Hi Nicole, There is no doubt that colonoscopy disrupts your micribiome. Unless the procedure is truly justified to your satifaction, or you have a family history of colon cancer, I would advise significant caution as the risk of suffering even more serious complications is 5 people in getting the test.

Then I got a food poisoning and there all has gone so bad. In september I had a gastro, where they found Esophagitis and bile in the stomach, continued with PPI and changed a few other meds but got no improvements. So I changed doctor, who touching me found out that my liver was a bit too big, sending me to do an ecography which resulted in nothing bad, just a bit of fat liver and prescribing prokinetics. This thing is also ruining my social life cause I feel ill at ease everytime my friends ask me out for dinner.

Be diligent with the diet for the first couple of months and read the trouble-shooting sections and underlying causes chapter. I had sigmoidectomy and hysterectomy due to complicated endometriosis in Since then I had either soft porridgy stools with undigested food every weeks for days or unpleasant constipation thin , tiny stools pieces. I need to adopt a posture since my operation. I reintroduced one group after another slowly. I have EDS type 3. I am taking Zn, Mg, omega 3, vit D3, supplements for over 4 months have also tried bone broth for healing.

Hi Norman, Thank you for all of the useful information.