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Has anybody heard of a breathalizer that can detect a ceratin bacteria that is found in some cases of IBS? If this kind of bacteria is found then the IBS can be treated somehow. I heard this and was wondering if anybody else has heard about it. Like to get your input. Thanks!
 

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I had a hydrogen breath test, but they told me it meant I was lactose intolerant....not that there was an overgrowth of bacteria. The concept was that the lactose solution I drank prior to the test didn't completely get absorbed, so the bacteria that is SUPPOSED to be in the intestines begin to work on (ferment?) it and give-off hydrogen.I tried giving-up lactose after this, but guess what? It didn't help. Even if you could infer a bacterial overgrowth based on a test like this, what would you do about it? You don't know what type of bacteria it is, so prescribing an antibiotic would be total guesswork. You could take acidophilous which can't hurt...but I think anyone with IBS should try that anyway. It didn't help me, but it has helped many others.
 

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Ivory, there is a new test approved by the FDA to measure Helicobacter pylori for IBD, gerd. This really doesn't relate to IBS where they can find no organic reasons yet.Update on Helicobacter pylori DiseaseKenneth E. McColl, MD Introduction Studies have shown Helicobacter pylori to be an important factor in the etiology of peptic ulcers, noncardia gastric cancer, and low-grade gastric MALT (mucosa-associated lymphoid tissue) lymphoma. Its association with other disorders -- as either a causative factor or possible protective factor -- has been reported and further data on the role of H pylori in these settings were presented at the 7th United European Gastroenterology Week (UEGW), held November 13-17, 1999, in Rome, Italy. Diseases Associated With H Pylori Infection Nonulcer Dyspepsia Over the past year, several studies investigated the role of H pylori infection in nonulcer dyspepsia (NUD). Results of some of these double-blind, randomized trials have shown symptomatic benefit from H pylori eradication, whereas results of others have shown little or no effect. At this meeting, McNamara and colleagues[1] reported their 5-year follow-up of 100 NUD patients randomized to H pylori eradication or placebo. Those eradicated of the organism showed benefit with respect to complete resolution of dyspepsia (P < .04), reduction in use of medication (P < .03), and need for further investigations (P < .02). Interesting to note was that > 10% of those randomized to placebo developed frank peptic ulcer disease during follow-up. There is increasing evidence that symptomatic benefit from eradicating H pylori in NUD is related to the background prevalence of H pylori-induced peptic ulcer disease in the population being studied. The study by McNamara and associates discussed above was conducted in Ireland, where there is a high background prevalence of H pylori-related ulcer disease. The subgroup benefiting most from eradication may be patients in a pre-ulcer or between-ulcer state. It would be useful, therefore, if one could identify this subgroup of NUD patients and target them for H pylori eradication therapy. However, the Irish study found no way of predicting this subgroup of responders. At present, then, it is necessary to eradicate H pylori in a large number of NUD patients in order to achieve symptom resolution in a few. For this reason, treating H pylori infection to achieve symptom resolution in NUD may only be appropriate in regions with a high background prevalence of H pylori-related ulcer disease, where the proportion benefiting will be greater. Gastric Lymphoma H pylori infection is widely recognized to be important in the etiology of low-grade MALT lymphoma. Eradicating the infection leads to complete resolution of the neoplasm in the majority of cases. Roggero and coworkers[2] from Italy reported regression of high-grade B-cell gastric lymphoma after H pylori eradication. These investigators administered anti-H pylori therapy to 4 patients with localized (stage I) high-grade, diffuse large B-cell lymphoma with or without associated low-grade MALT component. Histologic regression was evident at the first endoscopy (40-70 days after H pylori treatment). One patient then underwent total gastrectomy that confirmed absence of any tumor. The remaining patients were followed up without institution of any other treatment. All patients were alive and free of lymphoma at 16 months. These researchers concluded that H pylori antigen drive appears to be important in at least some high-grade lymphomas. However, they emphasized that at present, data are insufficient to recommend antibiotics alone as adequate treatment for high-grade gastric lymphoma. Gastroesophageal Reflux Disease A study published by Labenz and colleagues[3] in 1997 attracted great interest when it reported that eradication of H pylori infection in ulcer patients increased the incidence of reflux esophagitis. Results of a further study examining this issue were presented by Chira and associates[4] at the UEGW in Rome. In this study, 142 patients with active duodenal ulcer and H pylori infection had endoscopy, esophageal pH manometry, and symptomatic assessment performed before and 1, 6, and 12 months after anti- H pylori treatment. There was no evidence of increased development of symptoms or endoscopic signs of reflux disease or of increased esophageal acid exposure. Additional studies are clearly required to clarify this issue. Barrett's Esophagus A reduced prevalence of H pylori infection in patients with Barrett's esophagus has been reported by some studies. This finding has raised the possibility that the infection may somehow protect against this premalignant condition of the esophagus and that the increasing incidence of Barrett's and associated gastroesophageal junction cancer might be due in part to the falling prevalence of H pylori infection. It has been postulated that H pylori might protect from gastroesophageal junction disease by inducing atrophy and thereby reducing gastric acidity. Russo and colleagues[5] reported the findings of a study in which they compared the phenotype of the gastric mucosa in 53 patients with Barrett's esophagus and 53 age- and sex-matched nonulcer dyspeptic controls. The prevalence of H pylori was less in Barrett's patients (32%) versus controls (64%). Evidence of atrophy was present in only 13% of Barrett's patients versus 32% of controls. These investigators concluded that the gastric mucosa phenotype coexisting with Barrett's esophagus is normal or nonatrophic gastritis, the opposite of that associated with increased risk of cancer in the mid- or distal stomach. This study confirms that the prevalence of H pylori infection and atrophic gastritis in patients with Barrett's esophagus is lower than in controls. However, it is unclear whether this negative association is due to the infection protecting against development of Barrett's or is due to some other factor, such as socioeconomic status, which both protects against H pylori and predisposes to gastroesophageal junction disease. Is H pylori Becoming Resistant to Currently Available Treatments? De Koster and coworkers[6] reviewed changes in the prevalence of resistant strains of H pylori between 1990 and 1998. They examined bacteria isolated from patients in Belgium who had not received anti- H pylori treatment. Imidazole resistance showed a slow progressive increase from 24.8% in 1990 to 35.2% in 1998. Over the same period, macrolide resistance increased from 2.2% to 9.8%, and combined resistance increased from 0% to 4.1%. The increased prevalence of resistant strains cannot be attributed to anti- H pylori therapy because these patients had not received such treatment. This finding is most likely due to the use of the antibiotics as single treatment for other intercurrent infections. This study highlights the need for the development of alternative antibacterial agents or therapeutic vaccines. What to Do When Anti-H pylori Triple Therapy Fails The triple therapies used for clearing H pylori achieve eradication rates of 80%-90% in clinical trials but are less effective in routine clinical practice. Several studies examined available treatment options for patients who have failed one or two courses of triple therapy. Di Mario and colleagues[7] studied 77 patients with persisting H pylori infection despite three courses of triple therapy. With a course of quadruple therapy consisting of a proton pump inhibitor (PPI), bismuth, and two antibiotics, they achieved eradication in 52/77 patients. In those still positive after all four treatments, a further course of quadruple therapy was successful in 4/7. Gisbert and coworkers[8] studied 60 patients who had failed triple therapy with omeprazole, amoxicillin, and clarithromycin. These patients were randomized to receive 7 days of either quadruple therapy with omeprazole, bismuth, tetracycline, and metronidazole (OBTM) or ranitidine bismuth citrate plus tetracycline and metronidazole (RBCTM). Intention-to-treat eradication rates achieved were 57% with OBTM versus 83% with RBCTM (P < .05). These investigators concluded that RBCTM may be the treatment of choice for patients failing standard triple therapy. It appears that eradication of H pylori can eventually be achieved in most patients failing triple therapy by using either quadruple therapy or ranitidine bismuth citrate plus two antibiotics. This outcome can be achieved without having to test the organism for sensitivity. The target patient must be very well motivated to maintain a repeated course of therapy and should have underlying disease that is known to benefit from the treatment. Stool Antigen Testing Several papers presented during this meeting reported results with the new noninvasive stool antigen test for diagnosing H pylori infection.[9-13] Sensitivity of this test varied from 96%-100% and specificity from 63%-93%. A potential major advantage of this study over conventional serology is its ability to confirm eradication of the organism within a few weeks of completing treatment.[13] This technology provides a useful additional noninvasive means of testing for H pylori and its eradication without any sophisticated equipment. The single disadvantage associated with this test is the need to obtain a fecal sample -- something some patients may find inconvenient and distasteful. Forthcoming data on patient acceptability will be useful. Noninvasive H pylori Test versus Endoscopy for Dyspepsia There is considerable interest in the possibility of replacing endoscopy with noninvasive H pylori testing for determining the approach to managing dyspeptic patients. Lassen and colleagues[14] from Denmark randomized 500 dyspeptic patients (< 45 years of age) presenting to their primary care physician for either endoscopy or H pylori testing, with eradication of H pylori in all positives. Primary outcome measured was quality of life using the Psychological General Well Being Index. The score improved in both groups and did not differ between groups at entry or at 1 month or 1 year postrandomization. However, the improvement in score was greater in H pylori-negative patients managed by endoscopy than in H pylori-negative patients who underwent H pylori testing and no other investigation. The greater reassurance value (as defined by improvement in quality of life score) in the H pylori- negative patients managed by endoscopy versus the H pylori-negative patients managed by the test-and-treat strategy may be due to the primary care physicians themselves not being "reassured by" or confident with a negative H pylori test. Summary No data presented at this meeting justified the need for dramatic change in current clinical practice regarding management of H pylori infection. Study results confirmed the negative association between H pylori and Barrett's esophagus, but it remains unknown whether infection confers a protective effect. Development of de novo reflux disease after H pylori eradication in ulcer patients has, however, not been confirmed. Quadruple therapy seems to be effective for patients who remain positive after triple therapy. The stool antigen test provides a new noninvasive test for checking H pylori status and confirming successful eradication posttreatment.------------------ http://www.ibshealth.com/
 
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