–Dr. Allison Siebecker
A guide to recognizing and overcoming SIBO, with a 21-day plan to stop feeling bloated, start losing weight, and fix your gut.
Millions of Americans suffer from bloating, constipation, diarrhea, food intolerances, and other gastrointestinal symptoms. Many spend years in pain before they figure out just what's going on with their gut. And while irritable bowel syndrome (IBS) is commonly diagnosed, SIBO, a disorder with basically all the same symptoms, is not. Some studies show eighty percent of people who suffer from IBS, mostly women, likely also have SIBO, an overlooked health issue that is difficult to diagnose.
So, what is SIBO? The acronym stands for Small Intestine Bacterial Overgrowth, a disorder in which bacteria that usually live in other parts of the gut start to proliferate and take up residence in the small intestine. This causes a whole confluence of symptoms, ranging from bloating and cramps, to uncontrollable weight gain or weight loss, to even malnutrition when the bacteria eat up vital nutrients from our food.
After decades of dealing with debilitating symptoms with no relief, Shivan Sarna's life finally changed when she was diagnosed with SIBO. As she eliminated her symptoms one by one through lifestyle changes and help from her physicians, she started to synthesize her personal experiences with Western and naturopathic medicine and dedicate herself to advocating for those suffering from SIBO, or those who think they could be.
Now, in this groundbreaking book, Shivan shares her step-by-step plan to treat, manage, and even heal SIBO, with information on what to eat and what to avoid, how to build a routine to manage your symptoms, and how to work with your doctor to find supplements and medications that promote healing. Shivan also includes a 21-day plan, which includes more than 40 recipes to put you on the path to recovery. Whether you're SIBO-diagnosed or SIBO-suspicious, this empowering guide will change the way you approach and think about your gut and overall health.By combining cutting-edge technical and medical information from health experts with her own expert advice and insights as a patient who has been there herself, Shivan has created an invaluable resource for the millions of people struggling with SIBO. I highly recommend Healing SIBO. - Dr. Allison Siebecker
Shivan has done more to help SIBO patients understand and heal their condition than anyone. Her mission is to educate the public on the most cutting edge information about SIBO treatments and this book is no exception. This is your one-stop guide to everything you need to know about living with and treating SIBO. - Dr. Ilana Gurevich
Healing SIBO is just like Shivan - very organized, full of insight, painstakingly researched, highly practical and imbued with warm-hearted fun. - Dr. Steven Sandberg-Lewis
Healing SIBO is an amazing contribution to those diagnosed with SIBO as well as those who are just beginning to address their gastrointestinal issues. Shivan Sarna has worked with the best doctors, nutritionists and other healthcare practitioners in the SIBO community for years and it shows in the wealth of information that she presents in this book. She offers practical advice and breaks down the intricacies of healing from SIBO to make it accessible to everyone. - Kristy Regan, MScN
Ms. Sarna has written an absolute gem of a book. As a sufferer of SIBO herself she includes tips and tricks for understanding SIBO and IBS from the inside out. She takes an incredible amount of information that can be overwhelming and turns it into an easily digestible and incredibly rich resource for not only the SIBO patient but also for physicians who need to understand what options their patients have for diagnostic testing and treatment of this disorder. Ms. Sarna has taken her access to interviewing all of the top clinicians and researchers in the SIBO landscape and has synthesized that information in a way that the reader can access all of the most comprehensive and uptodate ideas around testing, treatment and understanding of their health picture. This is a must-read. - Dr. Anne Hill
Shivan Sarna’s new book, Healing SIBO: Fix the Real Cause of IBS, Bloating, and Weight Issues in 21 Days, has a powerful dedication at it’s very beginning: “To anyone who has ever had a medical mystery.” Having spent over a decade as a Naturopathic Doctor treating medical mysteries, I say this book - a guidebook to overcoming SIBO - is long overdue. SIBO has been a medical mystery disrupting millions of lives around the world. In addition to a plan to eradicate SIBO, this book powerfully outlines the hurdles. Like so many chronic illnesses, one of the main obstacles is that it mirrors the symptoms of many other disorders, leaving it underdiagnosed and untreated. Make no mistake, the domino effect of SIBO is not just a digestive inconvenience or bloating, it is also often responsible for food allergies, as well as simultaneously causing weight gain AND malnutrition. In a world where Google floods us with more information than we could absorb in a lifetime (never mind discerning what is accurate and relevant to your own health journey), Shivan Sarna has broken down the causes, the condition, and most importantly, provided a step-by-step simple pathway back to health. Healing SIBO is a must-read for anyone navigating SIBO, digestive issues, or unexplained symptoms. - Dr. Christine Schaffner
Healing SIBO contains the practical steps a patient needs to take to get well. Shivan has interviewed and distilled the best practitioners in SIBO world to create a book that any IBS person should own. After reading this you'll end up knowing more about SIBO than 99% of doctors. Which is very important because healing from chronic conditions takes a multifactorial approach that Shivan lays out. If you think getting rid of SIBO is just about the right tests and killing protocols you're missing 50% of the getting well map. - Steven Wright of HealthyGut.com
Shivan has continually proven herself to be one of the most well connected and well investigators experts in the world of SIBO and gut health. She is always connecting with and learning from the brightest minds in the industry, and has done an exceptional job curating the information gathered into an easy to read, science forward, and effective plan for healing the gut. - Dr. Michael Ruscio, DNM, DC
Shivan Sarna is the founder of the SIBO SOS Summits and creator behind the docuseries Digestion SOS: Rescue and Relief for IBS, SIBO, and Leaky Gut. She has spent the last twenty years on TV as a host for the Home Shopping Network. Shivan lives in Florida with her husband, her cat named Bell, four koi fish, and her adopted mom, Linda.
I was in the bathroom sweating. It was close to three o’clock. I’d just finished lunch with my boss at a really fabulous restaurant, and I had to go to the ladies’ room. I hope you don’t know what I mean when I say I really “had to go,” but if you’re reading this book you probably do.
In fact, I’ve actually heard worse “tales from the ladies’ room.” One of my friends can’t drive for more than twenty minutes without having to use the bathroom, which severely limits the routes she is able to take. There are also families who haven’t seen relatives in years because they’re afraid to be on a plane with-out instant access to the facilities.
In that instance, I was in the bathroom that day for at least twenty minutes. This was before cell phones, and I knew that my boss and our waiter must have been wondering what had happened to me.
When I finally got out of there the waiter looked worried and my poor boss, a polite man in his forties, asked me if I was all right. What could I say? I just mumbled something about being sorry and said “body functions” and shrugged my shoulders. Truthfully, I was completely mortified and just wished I could disappear. My goal that day had been to ask for a raise, but clearly that wasn’t happening. He settled the bill and we left. It was awkward, to say the least, and all these years later, I still remember it.
I call my experience as a person with SIBO the journey of a lifetime because I remember having symptoms starting as far back as the age of four— even though I certainly had no idea what was causing them.
Back then, our family had pizza for dinner every Friday night, and most of those nights I threw up after dinner. My magnificent mother was taking care of three young daughters; she was tired, and she just wanted something that was good and fast for dinner at the end of a busy week. She knew that I wasn’t really sick; I wasn’t getting stomach flu every Friday evening. And she would have been horrified if anyone thought she was being a bad mother. In fact, I actually loved pizza night. I liked it enough going down that I was willing to tolerate throwing it up— and it didn’t happen every single time. Still, it should have been more of a warning sign than either of us realized.
My father, however, was from India and well-versed in the principles of Ayurvedic medicine, the ancient healing science of India, which include building and maintaining a healthy metabolic system (the conversion of food into fuel for your body) through good digestion and excretion. According to Ayurveda, regular, healthy bowel movements are a major indicator of good digestion and, therefore, overall health. So, when he noticed that I wasn’t “going” every day, he mentioned it to my mother, who began to question me about the quantity and qual-ity of my poops. Even at that early age, I already felt this was none of my mom’s business. Although I now understand that my parents were concerned about my chronic constipation, as a five- or six-year-old, I resented being questioned about my bathroom habits and having to sit on the toilet for what seemed to me inordinate lengths of time day in and day out. That is actually one of my earliest memories.
And those weren’t the only gastrointestinal issues that appeared very early in my life. By the time I was eight years old, I’d been to India four times on buying trips with my parents, who were importers of Indian art and handicrafts, and I suspect that on one or more of those trips I must have had some kind of food poisoning, which I now know is most often the primary cause of SIBO. Unfortunately, neither of my parents is still alive so I really have no one to confirm my suspicion, but it seems logical. Basically, I was just a skinny kid who was always constipated, with a big bloated belly and a sensitive stomach. But I just thought that was normal.
In middle school and high school I was uncomfortable a lot of the time, and my friends sometimes affectionately referred to my tummy as my Buddha belly, but for the most part— aside from one bad bout with mononucleosis— I was too busy being a teenager to pay much attention to my symptoms.
Luckily, because of my father’s knowledge of Ayurvedic medicine, which depends heavily on diet and herbal cures, and the fact that my mother was an early advocate of natural healing, I was brought up to follow a clean diet. By the time I was in my twenties I had given up eating meat and drinking alcohol, and I started to meditate. All of this put me on the spiritual path I follow to this day, and I’ve had more than one doctor tell me that if I hadn’t been following such a clean lifestyle, I’d probably have been even sicker.
You’d think that I’d want to get to the root of what was causing all my unpleasant, often painful symptoms and try to get rid of them once and for all, but actually it took decades. For a long time, I might men-tion my bathroom issues to a doctor in passing, but he or she never seemed to think my symptoms were worth serious consideration, and I certainly didn’t discuss my elimination habits with my friends. It’s a taboo subject, but we need to talk about it, especially if there is a problem. But those of us who suffer from SIBO don’t even realize we are experiencing a true health issue because we have become so used to our symptoms that they feel “normal.” We think we just have a “delicate” or a “sensitive” stomach.
At that point in my life, I was a successful yoga teacher. Shivan’s Yoga Studio was a hotspot for healing in Sarasota, Florida. I even had my own television program, and I traveled around the world speaking to women about how to hone their managerial skills. I loved the work, and I felt really good about helping so many people. But while there are people who actually thrive on traveling, being on the road so much of the time was wreaking havoc with my health— to the point where I knew I just couldn’t do it anymore. This was in the ’90s. I was a vegetarian at a time when restaurants didn’t know what to do with plant- based eaters, and, therefore, I ate enough pasta primavera to last for the rest of my life. I was anxious about my home and the kitties I was leaving behind every week. It was not a sustainable lifestyle for me. Plus, I was losing my hair from the stress and I was germophobic from being on so many planes and staying in so many hotel rooms.
That’s when my best friend and spiritual teacher suggested I become a host on what was then called the Home Shopping Network. I thought they were nuts, but, serendipitously, I met a woman at a seminar shortly thereafter who worked at HSN. It seemed to me that the Universe had put her in my path, so I went for an interview, and that meeting turned out to be the pivotal event that changed my life for-ever. Six months later I got the job. It fit my skill set perfectly, and it was great that I could sleep in my own bed, be with my cats, and see my friends. For the first six years, I was assigned the overnight shift. I drove an hour to work in the evening, got that adrenaline rush from appearing on TV, and then drove home and tried to sleep during the day. Needless to say, this schedule, plus the pressures of the work itself, really messed up my circadian rhythm, and the lack of sleep was wreak-ing havoc with my health. The perfect storm was brewing.
I’d been feeling sick and dealing with a bloated belly even though I was working out and eating well. Forcing yourself into slim wear to be on television every day so that America doesn’t wonder if you are pregnant is not a stress I would wish on anyone. So, I finally went to see a gastroenterologist, who diagnosed me with irritable bowel syndrome. IBS is a “functional disorder,” meaning that the symptoms are real but doctors can’t find any obvious cause for them. This makes it really difficult to treat. How do you cure something that isn’t being caused by anything?
He then prescribed an antidepressant, which was not only discour-aging but also confusing and extremely frustrating. I quite naturally assumed he was telling me that it was all in my head while I knew it wasn’t. I now understand that he was trying to raise my serotonin levels, because the majority of the serotonin in your system is actually made and stored in your gut, and it plays a significant role in regulating gastrointestinal function. But I didn’t know that then, and this doctor did not explain his reasoning to me. He also suggested that running three miles a day would help, but at that point I didn’t have the time or energy for exercise. I was living on Maalox to calm my acid reflux, taking Benadryl to help me get to sleep, and sleeping twelve hours a day just to have enough energy to do the overnight shows for HSN.
I’d already suspected that I might have IBS because I’d seen a Netflix documentary about it, and, having been into health food and yoga since I was a teenager, I thought I knew what to do. I was eating a textbook “healthy” diet— plant-based foods like whole grains and lots of fruits and veggies, so I didn’t understand why I still felt so bad. I’d eat an apple thinking it was good for me, not knowing that what was healthy for someone else wouldn’t work for me at all.The harder I tried to “be healthy,” the worse I felt— what with the fatigue and the fact that my gastrointestinal problems were getting worse and worse. I realized it wasn’t just random symptoms but a pattern, and I began to get scared— very scared—thinking I might have cancer or some other devastating illness.
I’m normally a very social person. I loved meeting friends for lunch, but, because I was so exhausted and felt so sick, on a regular basis I was starting to cancel plans I had made. I was pretty much just working, sleeping, and doing the bare minimum to stay afloat. I was alive but not really living, and I knew I couldn’t keep going the way I was. I needed to get to the bottom of this once and for all.
I went back to the doctor and had more testing done, trying to rule out anything more serious than IBS. I had virtually every kind of scope you could think of— colonoscopy, endoscopy— basically, if it ended in “oscopy” I did the procedure. All my tests came back negative. I felt worse than ever, and I wasn’t getting any closer to an answer for my problem.
When I finally got tested for SIBO it was almost by accident. I had a work friend at the time who had similar gastrointestinal issues and who was also gluten-free, and we often compared notes on our health and diet. One day she mentioned very briefly that she had just taken a test that required her to drink a special solution and then blow into a tube every twenty minutes for three hours, and that, based on the results, she was now taking what she described as a radical antibiotic to try to solve her digestive problems. It turns out she’d taken the SIBO breath test, and her doctor had then determined she should take the antibiotic rifaximin (Xifaxan). Armed with this information, I called Dr. Run-Three-Miles for a prescription so that I could go to the Uni-versity of South Florida and get tested myself.
Three weeks after taking the test I received the results (these days you can get test results almost immediately and even take the test at home), which were negative. By that time, I had changed doctors and was seeing another gastroenterologist named Michael Schulman, who a friend had told me was a “digestion detective” and would definitely be able to help me. On my first visit, he sat with me for two hours, which to me was unbelievable, and he kept insisting that he wanted to see the full results from my test and interpret them himself. But I just kept saying that it had come back negative and shrugging it off. I was just too overwhelmed by everything I had to deal with to find that piece of paper or call the doctor’s office to get it sent over. It took about a year and a half (really) before he finally convinced me to call my pre-vious gastroenterologist’s office. Part of my reluctance was undoubtedly because I’d already left the practice and therefore assumed that they’d give me a hard time. In the end, however, the woman who answered the phone couldn’t have been nicer or more helpful.
When I handed the form to the “digestion detective,” he told me that in fact I should have been told the test was positive— the results had been interpreted incorrectly. If I hadn’t allowed my fear to hold me back, I could have had that information a lot sooner. I had learned my lesson.
So now I knew. Not only did I have IBS; I had the number one underlying cause of IBS, small intestine bacterial overgrowth (SIBO). Bacteria were overgrowing in my small intestine, causing my symp-toms. That was a huge turning point for me. Finally, I not only had a name for my condition, I also had an explanation for symptoms that were terrorizing me. For the first time, I had hope that I might find a cure.
I wasn’t alone, and I wondered how many other people were strug-gling with pain and had no idea it was being caused by SIBO. I was both angry and relieved. I vowed to find out everything I could about SIBO.