Since the birth of Little Bit I’ve gotten a lot of questions about SIBO and pregnancy so I want to address some of those in a post or two.
When in my SIBO journey did we decided to pursue pregnancy?
My husband and I decided to wait until my health was in a good place before we wanted to try to get pregnant. As most of you know, doctors told me having children of my own was not possible because of all of the health issues I had had beyond just the SIBO. So, for ten years we believed we wouldn’t ever have children of our own. A couple of years ago after I had started to feel better from SIBO and my body was beginning to calm down from autoimmune issues we had a miscarriage. You can read about it here if you would like. With the miscarriage we discovered it was actually possible for me to get pregnant so as my heart healed we began to talk about what it would look like for us to try to have more children.
My health and broken heart (from thinking I would never get pregnant to being pregnant to losing a child) were the two biggest conversation pieces. At the time my hives were still really bad. Like constantly carrying my EpiPen, Benadryl, and prednisone – throat closing – arm completely swollen – how soon do we head to the ER – bad. I didn’t want this to be a thing while I was taking care of a child. Chronic hives and MCAS (Mast Cell Activation Syndrome) can change with the rise and fall of hormones and we experienced this greatly with our miscarriage.
So we waited. We waited for God to heal my heart. We waited until we found good solutions for the hives and controlling the MCAS, and we waited until I felt like my digestive system was in a good place to absorb nutrients and not give me symptoms. I had been SIBO free for a couple of years and hive free for three months before we decided to try to get pregnant.
My Biggest Concerns with Pregnancy and My History of SIBO
Of course I was worried that my gut issues would come back during or after pregnancy and how they would impact the baby. SIBO and autoimmune issues had been a huge part of my life for most of my life. But I tried not to let it affect my mindset by choosing to be proactive. My biggest concerns were the Migrating Motor Complex, quantities of SIBO-friendly food, and constipation that normally accompanies pregnancy.
Managing my MMC
The Migrating Motor Complex or MMC cleans out the digestive system and naturally pushes out bacterial overgrowths during fasting mode (3-4 hours after eating) and every 90 minutes after fasting mode has begun. Because the digestive system becomes so squished from the growing baby it is difficult to eat large enough meals to wait 3-4 hours without eating. Snacking is highly encouraged by the medical community in order to keep blood sugars up and sustain both mom and baby. Snacking is often even recommended during the middle of the night. But snacking is a terrible idea for the MMC and someone with a history of SIBO. So, I mades some hard decisions.
I decided I would eat healthy enough that I could make sure to get eat least 8 hours over my nighttime fast (while I was sleeping) and to get at least one 3-4 hour stretch during the day. This meant my MMC could clean out my small intestine at least once during the day and several times at night. While this was a lower amount than pre-pregnancy (probably about half total) it would allow me to snack if I needed to but continue to encourage my MMC to work properly.
Quantities of SIBO-friendly foods
When we decided to pursue pregnancy my diet was in a really great place for my body. While I tolerated foods beyond SIBO-only options I still at a ton of SIBO friendly meals and dishes. Prior to pregnancy my diet was still about 85% SIBO friendly. My biggest concern was what if I needed to go back to a SIBO diet 100% of the time (if symptoms returned). Would I then be able to feed both my body and my baby?
I was mostly concerned that I was going to have to eat tons of food in order to fuel my body. So, I decided to make a plan to stick close to the weight gaining version of the SIBO diet. You can read about those guidelines and tips here. This allowed me to eat plenty of food and get tons of nutrients. But my concern was unfounded. During pregnancy, the metabolism slows down in order to absorb more nutrients. So, for most women to grow a healthy baby, they only need to eat an extra 200-300 calories a day. I found this to be true for myself as well.
Because I had watched my diet closely for years, I knew what foods I could eat to fuel my body – what food prevented and healed symptoms and what foods made me feel good. So I based most of my pregnancy diet off of that. I ate a lot of SIBO-friendly meals and a lot of “almost” SIBO-friendly meals (for example adding an apple or other high FODMAP fruit to a meal).
– I will tell you more about my pregnancy diet next week.
Managing Constipation during pregnancy
Constipation is a common side effect of pregnancy. During pregnancy, the digestive system slows down in order for the body to absorb as many nutrients as possible and with the added weight of the uterus and baby the small intestine can be pressed tightly against itself. Knowing these things ahead of time allowed me to be proactive. I employed as many tricks as I could to keep my digestive system moving every day. I made sure to get exercise from walking, yoga, and hiking throughout the pregnancy. For yoga I did daily exercises of cat-cow (until my last week of pregnancy when my belly was so big I couldn’t move it in those positions any longer). I ate oranges often to help keep my digestive system moving. (A trick I learned from an old nursing friend.) And I made sure to stay plenty hydrated.
Near the end of the pregnancy when Little Bit was growing into his 8 pound birth weight I took papaya seed enzymes to help with digestion. This provided my body with much needed help to break down foods.
By managing my MMC, eating SIBO-friendly foods and foods my body absorbs, and making sure to keep my digestive system moving food along, I was able to prevent the return of SIBO during my pregnancy.
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Minoo says
hello Elena Thanks for sharing your experience
I have been diagnose with sibo and I want to be pregnant. BUT I’m so worry about my baby’s healthness.
If it possible I want to know about your baby’s healthness
she/he has not any digestive issue?
I have so much question in my mind about sibo and pregnancy and I CANT rely on doctors as like as you
please guide me to have a safe pregnancy
THANK YOU
Elena Wistey says
Hi Minoo,
Little Bit does not have any digestive issues and has been a very healthy baby. I chose to wait to try to get pregnant with Little Bit until I was the healthiest I had been since I was a small child… or maybe healthiest ever… I also had a fantastic team of doctors to see me through my pregnancy. It is so important to have a team of professionals you trust when you are pregnant as well as when you are treating your SIBO. My first recommendation would be to find a SIBO doctor you love!
Grace says
Hi Elena!
My sister in law has SIBO and recently became pregnant with her first child. I sent this link to her about your journey, which is really helpful!
I was wondering if you have any recommendations if there’s an online chat or other blogs like yours about having SIBO and being pregnant while having it, that is helpful for her to use/ask questions?
Hope everything is going great with you!
Thank you for sharing your experience and methods!!
Elena Wistey says
Hi Grace!
I don’t know of anything specific for SIBO and pregnancy but SIBO SOS often has chat sessions on their facebook. Your sister is also welcome to send me an email through my contact page if she wants to chat more one on one.
Elena
Hettie says
Hello, I’m so pleased to have come across this as I’ve just been diagnosed with SIBO. Mine came on after the birth of my 3rd daughter. What triggers it? I’ve no idea. Have people managed to get theirs under control and feel well again? Thanks so much
Holly says
Hello. I just found out that I am pregnant, about 5 weeks gestation. This was an unplanned pregnancy, I am 38 years old and I have SIBO. So what I really need to know is if and how SIBO affects the baby? I am guessing it could cause issues with the baby absorbing nutrients. Does SIBO put the baby at a high risk of birth defects or autism? I have done two different treatments to treat SIBO before pregnancy, but it still remains. So my functional medicine doctor wants to treat my SIBO during pregnancy with Flagyl, Megasporebiotics and Nystatin. Is this safe and necessary during pregnancy, especially in the 1st trimester?
Elena Wistey says
Hi Holly,
Congratulations! While not planned for in the moment your little one certainly sounds loved, well cared for and planned now. You sound like an excellent mother!
I’m not a doctor so I can’t actually advise you on these questions. However, to my knowledge there are no studies on SIBO and pregnancy and any resulting effects.
Please watch your email. I will send you contact information for a doctor who can clear up these questions for you!
Elena
Olivia says
Hi Elena,
I have been diagnosed with Sibo and just finished my antibiotic and I’m currently on the low fodmap diet. I definitely don’t feel like all my symptoms are gone. My depression and anxiety are at an all time high as well. How did you get your under control?
Elena Wistey says
Hi Olivia,
That’s a big question. Depression and anxiety are really common for those with SIBO. I used exercise, going outside, GABA supplements, essential oils, favorite lotions and smells, meditation, devotionals on contentment and gratitude to help with my anxiety and darker times. I also think reaching out to some good friends for coffee or tea or fun activities is a must! Some doctors use amino acids to help treat anxiety, so be sure to contact your doctor. You have natural and pharmaceutical options.
SIBO can take several rounds of treatment in order to heal. I used diet, herbs, abdominal massage, supplements, healing foods and more. I think it is important to take lots of time to heal your whole body while treating SIBO. And it is crazy important to work with a good doctor.
Keep working towards healing, and you will get there!
Elena
Elise says
Hi Elena,
I’ve had SIBO for over 5 years. It went away during my first pregnancy, and came back about 4 months postpartum. After I finished nursing I treated my SIBO for 4 months rotating various herbal anti microbials and supplements with the help of a functional medicine doctor. My SIBO was cured by the fourth month, but then a family member almost died, and the stress of that brought my SIBO back. I also scams pregnant with my second child during the recurrence. I’m happy for the pregnancy but devastated by my SIBO recurrence. My doctor does not want me to treat it while pregnant. I’ve already been eating low FODMAP Diet for about 3 years. What can I do while pregnant to ease SIBO?
Elena Wistey says
Hi Elise,
Cooking with herbs, roots, and spices can help ease symptoms and even help fight off the SIBO. Think turmeric, ginger, thyme, oregano, cinnamon, clove, cardamom, fennel. Fresh is always better for roots and herbs. Be sure to talk with your doctor about your specific case but culinary quantities are generally considered safe for pregnancy. There are lots of herbal (search “carminative”) teas that can help calm symptoms as well. Some doctors will also allow Iburogast to be used as a pro-kinetic during pregnancy.
I also think it is helpful to get gentle exercise daily if possible and to make sure your digestive system is clearing out waste every day. Magnesium may be helpful or eating a large orange every day. Again, be sure to talk to your doctor about your specific case, but there are lots of small things that you can do that can make a big impact and help you to feel better as your little one grows!
Best,
Elena
Carmen Perez says
Hi Elena
So happy to have found your blog.
I started stomach investigations in January this year and was diagnosed with SIBO, my levels of bad bacteria are huge, I started the given antibiotics treatment which was to last 10 days then followed by some other medicine but I only managed to take 4 days of antibiotics as I found out I was pregnant with my second child. The heartburn and indigestion have been out of this world and I think it’s exacerbated by SIBO. My doctor just said stop the antibiotics and we will connect after baby has arrived. I didn’t even have the time to get into the low-fod map diet, I am trying to follow it now, though I must admin not adding onions when cooking meals is a bummer! Onions are for sure my enemy these days.
I am of course concerned about the impact on my baby though I know there is no proven research on the topic. I try to do 30min exercise daily and ensure at least 1 bowel movement daily.
If there is anything you could advice, for example the totally no no foods, I will be very grateful.
Thank you
Carmen …from sunny Dubai
Elena Wistey says
Hi Carmen!
For the indigestion you can try papaya seed enzymes. They are safe during pregnancy and may help.
For onions, you can switch to spring onions (also called green onions) and the green part of leek is also low FODMAP.
I would recommend looking into Phase 2 of the Bi-Phasic Diet by Dr. Nirala Jacobi. It was a diet designed for SIBO so it has more helpful serving sizes than the LOW FODMAP diet and has a helpful list of foods to avoid. Otherwise, stay away from foods that cause symptoms and eat lots of good meats, fats and tolerated veggies!
You can also cook with lots of fresh herbs like thyme, rosemary, oregano, marjoram, and ginger. Culinary amounts are safe during pregnancy but also help fight SIBO.
Elena
Lynn says
Hello Elena,
Great article and tips! I’m going to try eating an orange every day now! I had never heard of that. Perhaps it is the fiber in the orange? Or is there another reason?
Today is my last day of a 14-day Rifaxamin and Flagyl course. I finally started feeling better on the 11th day. My bloating has gone down so much!
I have read that it is advisable to start on a prokinetic right after treatment. However, most are not recommended when trying to get pregnant. We will be trying again 48 hours after I finish this course. So I was looking into taking 1000 mg of dried ginger root (not extract) right before bed. I have read that it helps as a prokinetic and certain levels (1000 mg or less) are safe during pregnancy.
I also want to research the Papaya Seed Enzymes a bit more. Can you tell me the brand and dose you took? Was there a reason you didn’t start taking them earlier in your pregnancy?
Thank you so much,
Lynn
Elena Wistey says
Hi Lynn,
I actually don’t know why the orange trick works…
Yes, prokinetics are awesome and you can start them anytime in the treatment process. Ginger works well and you can talk with your doctor about iburogast. It is an herbal prokinetic that was safe for pregnancy and nursing and had decades of research behind it- although they made some changes to the formula and I don’t know if it is still safe.
My doctor didn’t have a preference on papaya seed enzymes so I just got one I could find easily. I used the “Now” brand and chewed one tablet with each meal. I did not start it earlier simply because I didn’t know about it.
Good luck getting pregnant! Praying for a happy and healthy baby for you!
Elena
Lynn says
Thank you so much, Elena!
Alison says
Hi there!
I am thinking of getting re-tested for SIBO and I am pregnant. Do you know if the lactulose test is safe during pregnancy?
Elena Wistey says
Hi Alison,
I have no idea. That is a great question for your doctor!
Elena
Megan refaei says
Hi Elena
I am 9 weeks pregnant and diagnosed with SIBO. I have suffering from panic attacks over the past 9 months. I was recently diagnosed with SIBO with my natural pad doctors . I have done so much test and doctors couldnot find out what is wrong with me . They wanted to put me on anti-depressant medication and I refused. That’s what I decided to do a GI map test with my natural doctor and I found out that I have SIBO. Immediately I have started the Low FODMAP diet . I am worried about my pregnancy. I don’t know if I should continue with this pregnancy or I should terminate and heal myself before I get pregnant again. My husband is very disappointed about the situation I just wish that there was a safe treatment during the pregnancy. I was hoping maybe you can help me . Thank you for your time
Elena Wistey says
Megan,
I am so glad you reached out! It can be such a confusing time when a lot is happening at once.
Let’s talk SIBO first. If the Low FODMAP diet is not providing relief look into phase 2 of the bi-phasic diet. It is safe for pregnancy and designed for SIBO. While the Low FODMAP diet can help for some people, it wasn’t actually created for SIBO.
Treatment. Ask your doctor what pro-kinetic they recommend for you. Iburogast is a huge help for a lot of people in pushing out the SIBO and was considered safe for pregnancy- they did change the formula for Iburogast so that is why I say double check with your doctor. You also may be able to start a gentle natural treatment during the 2nd or 3rd trimester of pregnancy.
Pregnancy. I would recommend going through with the pregnancy for three reasons. For you, your body will produce HGH or human growth hormone. HGH will help your baby grow and your body change to support the baby’s life. The female body dumps excess HGH into the digestive system (this is what makes us puke or makes us nauseous) and I believe the HGH going through our intestines can actually heal digestive diseases. While there is no research for this (I’ve asked a lot of doctors and searched myself) there are a lot of women that say pregnancy healed their digestive system. So, pregnancy can actually help heal your body. It is my personal opinion but I’ve seen it over and over again and experienced it myself. For me, it was like I got a new and healthy set of intestines from pregnancy.
Second, there is some research out there that suggestions helper T cells can actually be sent by baby to mama’s body to help mama’s body heal. I was told about it from a medical professional but haven’t seen the research myself.
Third, while it is up to you to decide, the experience of losing a child will have an impact on the rest of your life in some form. From experience, I would not wish the loss of a child’s life upon anyone. It doesn’t matter if you choose to terminate the pregnancy or you lose the pregnancy through miscarriage or trauma, or other means, the loss of a life is an experience like no other.
I think this pregnancy could actually be a huge gift to help heal your body. If you would like to talk more, send me an email through my contact page- we could email or set up a time to talk.
Elena