u/BethImker

Hi all! First I want to say thank you to everyone who posts here, I have been reading for a few months and it has been so helpful.

I have had IBS-C my entire life, going through phases where I didn't have a bowel movement for 2 weeks, always very painful digestion, bloating, gas, etc.

I started eating Low Fodmap about 4 years ago, and even when I was very strict with it, I was still in pain most of the time. Even foods that were supposedly low Fodmap would be so painful to digest. I was glued to the Monash app for every food decision and it was so anxiety inducing to figure out what was safe to eat.

I tried so many laxatives and supplements that didn't seem to make things much better. Magnesium citrate (600mg tablets each night) seemed to help somewhat. I tried various laxatives containing senna and cascara sagrada, but they were so painful, caused so much intestinal distress, not a real long term solution.

Finally, my doctor gave me a referral to a GI specialist. First they did a CT scan to look for abnormalities in my abdomen, but everything looked normal, just severely constipated. I switched from magnesium citrate tablets to Magnesium Oxide Oxy-Powder, which is much more potent for me, and kept things moving much faster, even if it was a bit too potent sometimes.

Then they had me take a SIBO test, which came back positive for methane / IMO.

I took 2 weeks of Xifaxan and Metronidazole and I started to feel really good within a few days! I finally felt like I could eat a meal without being in pain afterwards.

While taking those, I was reading this subreddit and r/SiboSuccessStories and trying to get the perfect motility routine happening so that I could prevent relapse. I ended up with a routine like this:

Wake up (4:30am)
- Warm lemon water
- Yoga (cobra, twisted cobra, and child's pose seem to be best for motility)

Breakfast (8:00am)
- 2 Atrantil
- Digestive enzyme (NOW super enzymes)
- B complex vitamin
- 2 green kiwis (most days)

Lunch (12:30pm)
- 2 Atrantil
- Digestive enzyme (NOW super enzymes)
- Multivitamin

Dinner (6:00pm)
- 2 Atrantil
- Digestive enzyme (NOW super enzymes)

Before bed (8:30pm)
- Oxy-Powder (3-4 capsules) or Magnesium Citrate tablets (600mg), depending on if I feel like I needed the more potent Oxy-Powder or the gentler magnesium citrate
- Gut Motility supplement - ginger and artichoke extract - Enzymedica
- Throughout the day, reach 144oz of water

Despite these efforts, it seemed that the SIBO had come back after a few months.

I was able to convince them to give me another round of Xifaxan and Metronidazole, which I've started today, and I really want to get the motility perfect this time so that there is no relapse.

Some notes on how I got to the routine above:

- I'm still taking the 2 Atrantil 3 times per day, but I'm not sure how much it really helps me. It seems to not do much at all, but I'm just going to keep finishing this bottle and seeing if it helps.

- When I first started the Enzymedica Gut Motility ginger/artichoke, I was taking it as directed on the bottle, 3 times a day with meals, but then I read that it's better to take it on an empty stomach. One night, I took it on an empty stomach before bed, 2 capsules, and it tore me to shreds, it was so harsh and painful, I barely slept that night. Then I changed it to just 1 capsule before bed, along with the magnesium, and that seems to be more tolerable. It still feels pretty harsh as it travels through my system, though.

- I took Gaia activated charcoal (Gas & Bloating) for about a week and it seemed to do more harm than good. People say it can be constipating, it tries to bind up the gas. I was hoping I would be one of the people for whom it didn't cause constipation, that it would just address the gas, but unfortunately it did seem to constipate me, and I had to take more Oxy-Powder than usual to fix it.

- Stevia: As much as I loved my delicious favorite protein powder with stevia in it, I do think now that stevia is too hard on my gut, and slows the Migrating Motor Complex. So I broke up with stevia entirely and I switched to a protein powder that only uses a bit of coconut sugar, and no stevia, monkfruit, or other non-nutritive sweeteners.

- Nerva: When I was doing low Fodmap and it didn't help much, I did the Nerva app, gut-directed hypnotherapy, for about year year. They were nice and calming, I did enjoy them, but after a while I wasn't sure how much I was getting out of them.

I think that stress is a big factor in my gut issues. I notice that I'm holding tension in my body for most of the day, my job is just quite stressful with a boss who loses his temper unpredictably. I have been looking for another job, but no success so far, so I can't do much about that now. I have pretty poor sleep a lot of nights, I'll sleep from like 9pm to 1am and then not be able to sleep at all between 1am and 4:30am, and then just get up, but really I've been awake since 1am, and it makes it a hard day on many levels, digestion included.

Also, throughout the day, I notice that I'm holding my breath unintentionally a lot of times, and then I do some diaphragmatic breathing and physiological sighs.

If you have any suggestions for things I might try now, to hopefully make it stick after this round of Xifaxan/Metronidazole, please let me know!

I'm trying not to add too many more things to my supplement graveyard, but I really want to get it right and find a stable routine that allows me to just enjoy my life and not have every waking moment consumed by stomach issues.

I have an appointment with the doctor again this Monday and I'm not sure if I should ask to be put on a prescription prokinetic or not. The side effects of Prucalopride, for example, seem pretty gnarly, I am hesitant to ask for it. Please let me know if you can advise on any options I could discuss with my doctor at this visit.

Thank you! <3