This is what I do in a nutshell.
This is an email exchange I had with a patient to evaluate what their issues are & how I can help them.
The treatment is the same for everyone-because the issues are the
same no matter what the symptoms are. The only variables are dosage & length of treatment.
There are not a lot of different causes for the different symptoms you have. Please read this & see if it is logical.
This is how an appt goes.
21 Feb (1 day ago)
‘Hello Dr. Snow,
Not sure if you can help me or not. I had radical liver resection surgery in 2011 to remove a large parasitic cyst (that I acquired while living in Costa Rica) along with 80% of liver and my gallbladder (it was totally nectrotic). After the surgery I developed a bleeding duodenal ulcer. After healing from the ulcer, my gut was never the same. A couple years later I contracted a bad stomach flu, followed by Cdiff (caught it from my mother after she caught it from being in the hospital), and then finally SIBO. I can have periods of great improvement with the SIBO but it always comes back and each time it seems to be worse than the last. I also need to mention that I have addressed giardia and yeast overgrowth in this time period.
I have also made all necessary dietary and lifestyle changes to no avail. I am actually a functional health practitioner and lifestyle coach myself and so I am very knowledgeable in this area but I am stumped. I am wondering if I have neurological damage in the gut, scar tissue, or a blind loop in the intestines that is blocking me from healing. I would love to know if you think you can help at all; offer another set of eyes and perspective. My ongoing challenges are certainly not diet related at this juncture.’
My responses are in red
Me: ‘Please tell me your symptoms.’
My symptoms are:
1. Pain is the most predominant symptom and it is every day to some degree. It is am achey/sore/nausea like pain in the small intestinal area that radiates into my back and up into my chest; sometimes it radiates down into lower belly but now often. Pain is normally high up to mid belly area. Some days it is totally incapacitating. Always worse with eating and sometimes even with just fluids. ‘This is Gastritis’
2. Regular; daily bowel movements with a tendency for loose stools or diarrhea. Tendency for loose stools and diarrhea is not nearly as bad since addressing giardia and random parasites.
‘This suggests early stage IBS. I don’t doubt that there has been some degree of parasitic influence but on their own they do not create these symptoms for an extended period–you likely have several things going on here.’
3. Bowel movements have a weird odor to them yet they often look like normal,
healthy bowel movements.
4. Belching; sometimes can’t belch and gas gets trapped throughout sternum and becomes very painful. ‘
‘Gastritis & is likely influenced by constipation. BTW—every where I say Gastritis—Dysbiosis may also apply.’
5. Sometimes it is very painful to pass a bowel movement. Almost as if I am having labor pains in the intestinal area. This pain can start an hour prior to having the bowel movement. –
6. Sometimes the bowel movements are abnormally large but perfectly formed and with no signs of dehydration.
6. Pain after eating as if food does not move through stomach and intestines well.
7. Bouts of nausea with and without vomiting.
‘Dysbiosis – same for the bloating.’
8. Bouts of painful bloating but not every day.
9. Bouts of flatulance but not every day; depends on what I eat.
10. Intestinal spasms
11. Lots of noise, rumbling, and whistling in the intestinal area.
12. I respond well (symptoms all die down) to doing rounds of herbal antimicrobials but it is short lived. Everything soon returns after stopping them. This is because this is not the real problem.
13. I feel much better if I don’t eat and just drink bits of meat broth and coconut water. I am getting to the point where I am afraid to eat yet I am starving. I am often awoken in the middle of the night by ravenous hunger. If I do eat in the night; the mid to upper gut pain in the morning is unbearable.
14. I no longer eat any grains and have been strictly gluten free for a long time now. I am not able to tolerare any starches such as sweet potatos, beans, or plantains. If I were to eat them, the symptoms and gas buildup become unbearable.
‘Manipulating / avoiding food may give you some relief but no diet is going to give you lasting benefits—-it’s not about the food. You have a mechanical problem.’
15. When all of this is super bad; I feel very flu like and toxic with wrenching fatigue and depression.
Endoscopy in December 2016 was unremarkable. (over rated)
Upper GI study in December 2016 revealed abnormal thickening and inflammation in the jejujum consistent with possible celiac, infectioua enteritis, or sarcoma.
‘Of course I knew this when I read the 1st 2-3 sentences—-you have an inflammatory problem-I will comment below.’
Gastric emptying study in Dec 2016 was unremarkable
What are your thoughts? I already know that this is SIBO but do not understand why the SIBO keeps returning. I am beginning to wonder if I am developing intestinal neuropathy and/or myopathy. I surely hope not.
‘You may disagree but this is what you have. 1st—you may have SIBO / parasites / giardia—but those are not your primary problem they are a secondary problem from the primary problem.’
‘You have Gastritis—-inflammation of the GI tract. It is primarily in the stomach but also influencing the bowel.’
‘You have Dysbiosis which is a general term—-essentially meaning you digestion & GI immunity are weak / out of balance.’
‘Analogy—-think of your GI tract as a computer. The hardware is the physical tissue—the GI -stomach -bowel wall made of skin-fat & muscle with nerve tissue inside.’
‘The software is the mucosal lining–made of probiotics among many other things.’
‘When you swallow something that is like entering data into your computer–typing an email. To process the data there must be software otherwise there will be chaos—indigestion etc & also a lack of ability to process a computer virus.’
‘The mucosal lining should identify food types & germs & just like the computer software process / digest them–quietly.’
‘BTW–to not do this well allows ‘viruses’ (like a computer virus) to fester in the GI.’
‘Also–the mucosal lining acts like a firewall—-blocking stomach acids from making contact with the stomach / bowel wall—inflaming / literally eating the tissue = =’itis’ -pain.’
‘In some cases the body responds to protect itself by creating scar tissue so the acid does not eat a hole (ulcer) right through the stomach / bowel wall—that is why you have scar tissue—which btw even though it is a low potential—it does put one at risk for gastric cancer.’
‘What do we do? We feed the ‘computer’ the very nutrients that are need to rebuild the hardware.’
‘We install / upgrade the software—to a. block the acids from damaging the hardware. b. be able to identify & process the foods.’
c. the same for pathogens such as parasites.
‘This explains your symptoms & how to fix them.’
‘I can do all of this for you.’