A Journey Through Small Intestinal Bacterial Overgrowth

The other day I ate a doughnut. It was my first doughnut in about 14 years—I’d been dreaming about them, and I thought it was finally time to try gluten in its highest glory: in the form of sugary fried dough. And let me tell you—it was good. It was so good that I laughed so hard I actually started to cry. You would be right to think this was a total overreaction to this most mundane manna from heaven, but that’s just because you don’t know what it means to me.

I started having gut problems when I was about 11. It was a season of funerals—three of my grandparents died within two years of each other, and my parents were suffering in their own cycles of grief. I was a preteen, facing the anxiety of puberty and graduating to new schools. At my maternal grandmother’s funeral, I got food poisoning and was keeled over a toilet for about two weeks afterward. As an anxious young teen, I decided to try the age-old coping mechanism of refusing to eat. My body became sticklike, and I liked that. The closer I got to disappearing and the longer I went without food, the safer I felt in my own skin.

I eventually recovered from my eating disorder, but I dealt with pain and anxiety almost daily. I tried every diet I could find to feel better, and the only one that seemed to make any real difference was cutting out gluten. My symptoms were manageable but would flare from time to time, especially so after a traumatic sexual experience in my 20s. I spoke to several doctors, a dietician, and even a gastroenterologist, and all they would tell me was to eat more fiber. No one was taking me seriously. No one was helping me.

Finally, I committed to spending a full year of pouring time and money into figuring out this problem. If I didn’t have any answers in a year, I’d accept that this pain and discomfort was just my life forever. I did some deep-diving with Google and some social networking. I found out about something called SIBO, which stands for small intestinal bacterial overgrowth. I went to a naturopath and demanded a test. Sure enough, I passed the test with flying colors.

SIBO can cause digestive problems, pain, hives, inflammation, mood problems, and body pain—among plenty of other symptoms. The gut controls so many aspects of our bodies, including our hormones and inflammatory responses. SIBO is often misdiagnosed as IBS or gluten intolerance, but it’s actually a treatable bacterial imbalance that doesn’t have to be chronic. It’s still a relatively new condition for the medical system to recognize, but luckily more awareness is helping more people get tested and diagnosed.

I started the treatment with the help of a naturopath. It included a round of antibiotics and a restricted diet for a month or two and then a long process of slowly reintroducing food. Even here in Canada, where basic healthcare is covered, I had to pay for my test and treatment out of pocket. If the gastroeneterologist had been willing to test and treat me, it would have been covered, but he just wanted me to take antidepressants—because it was all in my head, right? But the cost was worth it. About a year and a half after beginning treatment, here I am eating doughnuts—and sourdough, and naan bread, and scones from the local bakery. Life is good with gluten, my friends.

Now that I know what was going on with me, I understand that my anxious teen years provided a perfect storm for SIBO. Because of the anxiety and the eating disorder, I basically never allowed my body to right itself after the food poisoning at my grandmother’s funeral. Add to that the excessive antibiotic use of the era (oh, those antibiotic-happy 1990s) and my microbiome became out of balance. Fiber and probiotics are almost always suggested for any kind of gut issues, but they can make them worse. Ironically, I needed an antibiotic to begin the rebalancing process. The reason cutting out gluten helped so much is because gluten is one of the most aggravating foods for SIBO, along with most sugars. I accidentally cut out a lot of sugar with the gluten, which also made my gut feel somewhat better.

Not all gut issues are related to SIBO, of course, and some people have SIBO and IBS or other issues. But it’s not all about the diet or even the diagnosis. If there’s anything I’ve come to learn about the way my gut works it’s that what’s going on in my nervous system has a bigger impact than almost anything else. Now that I’ve mostly rebalanced my microbiome, I can eat almost anything. But stress and anxiety will throw things off right away.

I learned a lot about what was going on in my gut when I went through my process of recovering from sexual assault (which I wrote about extensively in my book Want). When we’ve experienced trauma of any kind, what generally tends to happen is that the nervous system can never get out of the stress cycle. One definition of trauma is any unhealed wound. Whether it’s a bike accident, childhood neglect, or a difficult birth, it’s an unresolved experience that still lives in the body even after the initial threat has passed.

Digestion takes a lot of work. It’s a very energy-intensive process. So is survival—when we need to fight or run away from a threat, all the body’s energy that is normally used for digestion is redirected to producing adrenaline, sending blood to the limbs, and revving everything up to make sure you can run from or fight the tiger you perceive before you. The reproductive system similarly requires a lot of energy, which is why stress can also so deeply impact fertility, menstrual cycles, and sexual desire.

In a healthy system, once the threat has passed, the body rebalances, returning blood flow and energy to digestion, reproduction, and other important functions like, I don’t know, thinking. But with trauma, the stress stays in the system. The body does not believe the threat has gone anywhere, so some of the body’s energy lingers in the fight-or-flight zone instead of focusing on healthy digestion and reproduction. Survival is always going to come first. None of the treatments for SIBO, IBS, or other chronic issues will work totally effectively if the nervous system can’t find a way to rebalance as the gut rebalances.

Like most things in the body, the nervous system tends to run on habit. If it’s used to being stressed and afraid, it will expect to constantly be stressed and afraid. It can be challenging to get out of this habit, but just like with any other practice, we can do it. We can get into a new habit of calm and relaxation, of allowing our bodies to heal. For me, this included daily meditation, journaling, yoga and other forms of exercise, and work with a good therapist alongside the support of my naturopath. It can be a lot of work to figure out your unique health journey and how to support your body, mind, and heart in healing what ails your belly. But for me, it was worth it: There were doughnuts on the other side.