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Hi, I've posted here a few times in the past, but I'm not a frequent poster by any means (maybe I should be though). But anyway here's my story: I'm a 25 year old guy in Virginia, and I've had IBS-like symptoms for about 4 years (not officially diagnosed, but my doctors agree that its probably IBS). At first, it was excessive gas. Not smelly, just excessive in amount. Then came the mucus in the stool, and then alternating diarrhea and constipation. This persisted for over a year, maybe two years. I would periodically have episodes where I felt fine, alternating with episodes where I felt like I might be coming down with cancer. I got a colonoscopy/x-ray and everything was normal though. I flailed about with theories about what was wrong with me, and I tried various things from probiotics to eliminating so-called "trigger foods" and at one point I even tried a "caveman" diet which is high-protein and (very) low carb. Varying degrees of success. For awhile I thought I had parasites, but tests showed up negative. But eventually from my internet research it seemed that I had IBS. This led me to Heather Van Vorous's site, so I tried her recommendations of peppermint pills and acacia fiber. I probably adhered to this off and on for 6 months or so, and it seemed to help a lot, especially with the diarrhea and constipation. After this, even after stopping with the fiber and peppermint pills, my diarrhea, mucus in stool, and constipation more or less disappeared! This was a great relief, as you might imagine. (also I had completely eliminated dairy from my diet at this point, this may have had something to do with it - I now think it is that lactose that gives me problems not the dairy itself). However my ordeal was far from over. Now came the pain, spasms, and gas. I started getting this really bad pain in my stomach and lower back area, and my gas problem was getting worse. I started having really smelly gas, so I had to try really hard to not pass any with anyone present within a 15 foot radius. I think I tried the fiber and peppermint routine again but I gave up because it wasn't working with this new problem. So based on more internet research, I started to get the impression that IBS was caused by some miscommunication between the brain and gut. I theorized that this was responsible for the pain, and the cramps were somehow causing small intestinal bacterial overgrowth, which led to the gas. So therefore, I thought, I must need some drug to remedy this miscommunication. It seemed that a popular choice was antidepressants, so I convinced my doctor to prescribe me some. And I felt fantastic! The pain and cramping was more or less gone! But it became evident that it was not doing anything for my gas problem, which was in fact getting worse. And then the pain and cramping and spasms started reappearing. I upped the dose, still the same problems. So I figured, something must be wrong with my theory. And it didn't sound right anyway: brain-gut miscommunication? I'm a young healthy guy, and I didn't have any problem like that before. I don't often receive blows to the head. Seems like something that shouldn't happen to me. This puts me up this past month or so. I think I have a new theory of what's causing my symptoms, and maybe the symptoms of others with IBS too: a combination of one or more food intolerances and bacterial imbalance, along with possible SIBO. Now the causation might run in various ways, I'm not quite sure. But I think one plausible theory is that eating foods I can't tolerate causes spasms and cramps, which changes conditions in the bowel so that they favor opportunistic pathogens (like bacteroides, clostridium, etc) instead of the good bacteria like bifidus and lactobacillus. Another plausible theory is that somehow this bacterial imbalance arose, and then their release of toxins somehow causes the pain and spasms. Perhaps the causation runs both ways. This conception seems to be supported by both scientific evidence and my symptoms. The really smelly farts could of course only be caused by bacteria. But normally people's farts aren't anywhere near that smelly. They must have a healthier combination of bacteria - hence I have bacterial imbalance. And the spasms and consequent pain seem to occur after eating certain foods but not others - hence food intolerance. Also if this theory is true, it might explain why my diarrhea, mucus in stool, and constipation went away before: acacia fiber is a prebiotic which favors bifidus over other bacteria. As a result of taking the acacia fiber supplement, I may have boosted by bifidus population, which is less irritating to the intestinal mucus than bad bacteria, and also promotes regularity. Heather promotes acacia for diarrhea and constipation, but I don't think she knows that acacia fiber may work this way (as opposed to or perhaps in addition to bulking up the stool). But maybe I just didn't have enough bifidus to completely overcome my problem. But since I'm not sure which direction the causation flows, I must attempt to battle both the bacterial imbalance and the food intolerance simultaneously. And besides, if the causation runs both ways, then this is the only way to do it. Since I took probiotics before and they didn't seem to help much, either I didn't get the right kind or I failed because I wasn't simultaneously combatting my food intolerances effectively. So to cover both bases I decided to get the best probiotics I could find that weren't ridiculously expensive. I settled on ReNew Life Ultimate Flora Critical Care, which has 50 billion bacteria per pill, 10 different strains of bifidus and lactobacillus, and 25 billion of the main kind of bifidus. Also I'll start taking the acacia fiber again since it favors bifidus over bad bacteria. As a third measure to control the bad bacteria, I will deprive them of a food source. I stopped eating wheat entirely, and will only eat rice and corn, which (I think) are broken down mostly in the small intestine, leaving little food left for the bacteria in the large intestine. I'm still researching into other ways to deprive the bad bacteria of food and favor the bifidus. Previously, I had attempted to isolate which foods were triggering my symptoms through a combination of food/symptom logs and intuition. But I've found that my previous plan of statistically analyzing my food intake and symptoms to isolate triggers was rather impractical, because it required too much detailled logging. So instead, I'm doing an elimination diet, where I eliminate everything except the foods which I've learned to trust the most: rice, spinach, bananas, and plain fish/chicken. Plain tostitos chips for snacks. I decided to introduce lactose free milk and probiotic yogurt into my diet as well, for more balance and some extra probiotics. I think I tolerate them well, but I'm not completely sure and may have to eliminate them. Also some ketchup for my fish/chicken and salt for the spinach because otherwise they would be pretty hard to eat. So the plan is to establish an equilibrium, eating the same food day after day, until I've eliminated or greatly reduced my symptoms. Hopefully the lack of triggers combined with the probiotics and acacia fiber will accomplish this. Then after that, I will reintroduce new foods one by one, eating a significant amount and then waiting 2-3 days for symptoms to occur. I've read that with food intolerances, as opposed to allergies, reactions can be delayed up to that amount of time. This is also consistent with my experience. And of course I will record which ones gives me symptoms and how much. If I only get a moderate reaction then I could maybe experiment with a smaller amount. Otherwise continue to avoid. I've been doing this for a few days now, but I screwed it up two days ago by eating a dark chocolate bar and drinking some alcohol. As a result I felt completely miserable yesterday. But yesterday I faithfully stuck to the diet and today I feel pretty damn good! I will let you know how this experiment goes! Perhaps it will work for you guys as well. Have any of you attempted something similar? What do you think of my plan? Anything you think I should change/alter? Or should I abandon it and try another plan?
 

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Well, if nothing else, following this for a time should help you determine if SIBO is the problem or just another effect. The effects of the anti-ds would be a case in point. Change your serotonin levels and it stopped the symptoms, but only for awhile. I think listening to your body and developing a plan like this is a good way to proceed. The one thing to keep in mind is that our bodies' chemistry may not be as straightforward as logic might suggest. (In my case, I had presumably given my whole digestive system a case of low-level inflammation, from a life of personal abuse. I chased and eliminated triggers for 10 years but it never slacked off. I lucked into a supplement that had undiscovered anti-inflammatory effects and bingo, my whole GI system slowly improved. It may be that those effects come from altering the behaviour of blood platelets involved in the inflammatory response. There is no way that my intuition would ever have come up with that.)Good luck with this and do be prepared to give it enough time to really reverse your problems. (You might drop "IanRamsay" a line, as he is a biologist who has stopped his problems with probiotics and may well have some helpful input.) Also, if it doesn't work, keep looking. There appear to be a whole raft of things that can cause these problems.Mark
 

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Hey thanks for the response. That's great that you beat IBS! I think what you had is probably a lot different from what I have though. I think I have a new plan though. The anti-ds, combined with peppermint pills, I think have almost completely gotten rid of the pain and spasms. Except, I noticed, when I'm having a lot of gas - the smelly kind. Like really smelly - definitely abnormal. And this has been going on for awhile, at least 6 months to a year. So I researched into the cause of smelly gas, and it seems to be the presence of "sulfur reducing" bacteria in the large bowel. These bacteria feed off of sulfur in our diet, and they produce hydrogen sulfide (along with a few other gases), which are responsible for the foul odor of farts in general. So I theorized, since my farts are especially odorous, I must have a lot of these bacteria. Also, they produce toxins that irritate the bowel, which could be why I feel so bad when I have smelly gas (but not when I have not-smelly gas). The main sources of food for these bacteria, I found, are the sulfur-containing amino acids methionine and cysteine, along with vitamin B1 (thiamin). Therefore, if I limit my intake of these amino acids (which are found in large amounts in meat, fish, and cheese, among other things), as well as continue my probiotic regimen, I may be able to reduce their numbers to a manageable level. I just started limiting my intake yesterday and I feel better already! I'll let you guys know if this works out. I'm wondering, do you know if particularly smelly gas is a common thing among people with IBS? If so, my theory may work for them too, if it works for me.
 

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Gas odor really varies. Some people without any IBS have very stinky gas.Sometimes IBSers are just a bit more sensitive to things that don't bother normal people (so sometimes normal levels of non-smelly gas can set off IBS symptoms just from the volume alone).Pepto Bismol can absorb the sulfurous gases from a small clinical trial so adding a small dose and working up to the study dose (8 tablets a day) to see if adding a bit of that helps as well.
 

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Thanks for the tip with the Pepto Bismol, I'll make sure to try that. I've cut out meat entirely from my diet, so now I'm getting my protein just from probiotic yogurt, which I think is low in sulfur-containing amino acids. I think I've noticed a decrease in odor, but its still bad on occasion for some reason. Maybe I have some inability to absorb these amino acids so they pass undigested into the large bowel, so they're fermented? I'll have to check with my doctor to see if that's possible.
 

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Vegetables and other foods have sulfur in them, but protein is a major source.http://livingnetwork.co.za/chelationnetwor...phur-food-list/ has a low and high sulfur food list so may be helpful.Dairy shows up on the high in sulfur list. Probitoic bacteria don't do much to change the amino acids, mostly just reduce the lactose and add acids.A lot of meat shows up on the low sulfur list, but the general rule of keeping portion sizes small seems to help. If you eat a lot more than you need even a lower amount of sulfur will add up to something significant.
 
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