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Discussion Starter · #1 ·
Well just wanted to report back in after my final visit to Cedar. My latest breath test came back inconclusive. The peak was quick but the number was under 20. My first breath test peaked at 90. This means that I reached 1 of the 2 criteria for SIBO. I'm sorry if this doesn't make sense, I personally am confused by it. A quick synopisis is that upper burping and dyspepia and lower flatulence are my main symptoms.Before Cedar- 100+ episodes of flatulence a dayAfter 10 day course of neomycin- Zero gas which lasted 3 months. Then it started coming back probably upto 20-40 per day. Now they are treating me with doxycycline.(He gave me the option of retreating) and again I am gas free.Here is the million dollar question for flux:1. Do you think that SIBO or colonic dysbiosis is the cause of the gas?2. IF it is colonic, do you feel that probiotics following antibiotic treatment may keep it from coming back. I feel this is risky because if the problem is SIBO, then I was told probiotics could make it worse.I appreciate your comments.ThanksAlso I am curious if you think that zelnorm could theoretically help functional dyspepsia and the feeling like you need to burp. I should be able to get my hands on this drug in a few weeks.
 

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One of the other members on the board (Blair) had a theory that if you peak within 45 mins it is a small intestinal peak. I am not saying I agree with him but Pete can you tell me if you peaked within 45 mins?
 

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Pete, I know you're asking flux, but what makes you think probiotics will worsen a SIBO? Kmottus has posted some things that suggest it either does not hurt or helps. From what I've seen I believe it would be helpful. The thing about your case that makes me question a problem with colonic bacteria is the rate at which your gas returned. You made it sound very gradual. I've seen graphs of bacteria and how quickly they return to pre-antibiotic levels in the colon. Since there is no barrier to their growth in the colon like there is in the SI I would wonder about them taking that long to return to your colon. There's so many variables though that it is almost impossible to know exactly what is going on. I read some study the other day that showed an actual change in the layer of the colon in some people that allowed bacteria to grow at a higher density per area. If you are heading back to pre-antibiotic levels of gas anyway, what do you have to lose by trying probiotics?
 

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quote:y first breath test peaked at 90
Some things to consider...1) The gas measured is hydrogen. Some people don't have H2 making bacteria and can get very low numbers or even zero and still have SIBO.2) The number in and of itself is perfectly normal for colonic bacteria.3) There is no easy way to know whether the bacteria contributing to this value are from the mouth, the small intestine or large intestine or a combination. That's why the test isn't all that reliable.
quote:1. Do you think that SIBO or colonic dysbiosis is the cause of the gas?
Colonic "dysbiosis"
quote:2. IF it is colonic, do you feel that probiotics following antibiotic treatment may keep it from coming back. I feel this is risky because if the problem is SIBO, then I was told probiotics could make it worse.
If it were from the colon, then they theoretically help. If you extend this to its logical conclusion, you'd be getting one of those fecal "transplants". If it were coming from SIBO, then I don't readily see how it could help (despite what appears to be research contradicting this idea).
quote: I've seen graphs of bacteria and how quickly they return to pre-antibiotic levels in the colon
Where have you seen these graphs?------------------I am not a doctor, nor do I work for profit in the medical/pharmacological field, but I have read scientific and medical texts, and have access to numerous sources of medical information that are not readily available to others. One should always consult a medical professional regarding advice received.
 

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quote:I read some study the other day that showed an actual change in the layer of the colon in some people that allowed bacteria to grow at a higher density per area.
Ugh the studies you read sound very interesting. Where did you find this study?
 

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Discussion Starter · #6 ·
Flux,What is your opinion on this fecal transplant and where are they doing it?Pete
 

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Pete did you overlook my question or am I barging in on your conversation with flux. If I am, I'm sorry. Please carry on[This message has been edited by bonniei (edited 06-09-2001).]
 

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Discussion Starter · #8 ·
Sorry Bonnie,I don't have my records. They are at my office so I should be able to answer your question on Monday. Hope you didn't think I was being rude.
 

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quote:What is your opinion on this fecal transplant and where are they doing it?
It's hard to say because it is mainly anecdotal. It could be that some (a few) people out there do have some sort of "dysbiosis" (apparently what you have) and this type of therapy helps (I don't think it would help for Rome criteria-based IBS). Some of the anecdotes relate to treating C. dif infections with the fecal transplant. There are two places doing it, Tom Borody in Australia (he wrote an article about in the Medical Journal of Australia several years ago) and a doctor I believe in St. Louis who learned it from Borody.------------------I am not a doctor, nor do I work for profit in the medical/pharmacological field, but I have read scientific and medical texts, and have access to numerous sources of medical information that are not readily available to others. One should always consult a medical professional regarding advice received.
 

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quote:Flux, could you please explain colonic dysbiosis?
It is idea that there is something abnormal in bacterial makeup of the colon. The most obvious instance is an infection of C. dificile. However, it appears possible that in a few people the bacterial makeup can become "deranged" (presumably after taking antibiotics) and that could lead to colonic symptoms such as excess gas. It has been documented only anecdotally in the medical literature.------------------I am not a doctor, nor do I work for profit in the medical/pharmacological field, but I have read scientific and medical texts, and have access to numerous sources of medical information that are not readily available to others. One should always consult a medical professional regarding advice received.
 

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One of the other members on the board (Blair) had a theory that if you peak within 45 mins it is a small intestinal peak. I am not saying I agree with him but Pete can you tell me if you peaked within 45 mins?Not my theory, it's Cedars' Theory. I'm still waiting to see a gastro to Treat my Supposedly SIBO. I see him the end of June. I fired my old gastro BTW. I can tell you from experience that Probiotics make me sick. Also I think it was UGH makes a good point about bacteria growing back in the Colon, I bet its pretty fast. Good luck Pete. The 45 min early peak is only valid for "normal transient time" which I think is about 3 hours, sitting down I guess. If you ever get a small bowel series done you will know your transient time as they follow the barium through the small intestine with periodic X-Rays. [This message has been edited by Blair (edited 06-11-2001).]
 

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quote:Not my theory, it's Cedars' Theory
I stand corrected Blair.
quote:The 45 min early peak is only valid for "normal transient time"
I wonder if the CS people figure out the transient times of the Lactulose hydrogen breath test patients before determining if someone has BO. [This message has been edited by bonniei (edited 06-11-2001).]
 

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Bump for Pete and Ughpete- to remind you to find out when your peaks took place and did the CS docs figure out your "transient time" before telling you you had BO.Ugh- some references for the research you referred to in the thread would be really appreciated,Thanks both of you.
 

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Bonniei, the article concerning the lining of the colon and changes to it that enable bacteria to live in/on it was as best I can remember posted on this board. I think I read it a few weeks ago. It may have been the article or a link to the article that was posted here. I believe it had to do with colitis patients. Sorry I can't be sure where I read it though. Maybe It'll come back to me, I have a bad memory.As for the return to normal of levels of bacteria in the colon during antibiotics....the graph flux asked about. I saw that in a book which contained many studies on probiotics. It was from a meeting where probiotic researchers met and would present their studies and discuss the findings. The book contained the discussion following each study, which was really interesting. I also can't recall what the title of this book was, but I can find out if you want. I do remember there were several volumes, presumably from different meetings.Okay, I just looked briefly, and I believe the graph was in one of three books, not sure what the full title of the first one was, but the last two I think were: Probiotics 2 : applications and practical aspects Probiotics 3 : immunomodulation by the gut microflora and probiotics
 

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http://www-east.elsevier.com/ajg/issues/9512/ajg3368fla.htm Bonnie see the text under methods, its not very explicit but shows they are aware of it.Maybe Pete has more details? I see a Gastro who works with Cedars at the end of June and will ask about this? Probably take antibiotics also and be re-tested. In the past antibiotics have helped but short lived.I took Ofloxicin which made my IBS worse while taking it,felt better afterwards. and Flagly which didn't hurt and seemed to improve things for a few months also. This was some time ago; 4 years I guess. I also took probiotics back then too so in hindsight that was not a good thing?[This message has been edited by Blair (edited 06-12-2001).]
 

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Usually they do the test for 2-3 hours and by 2 hours you should be in the colon--I believe. I'd suspect if the only peak you have is at 90 minutes that could be the colon. If it were the Small intestine there should be a peak later on as well (everyone should have a colon peak). Either that or you have delayed gastric emptying. if 45 minutes is the typical for SIBO.Also assuming the lactulose test is testing for something as it has a poor track record in the medical literature for SIBO testing.K.------------------I have no financial, academic, or any other stake in any commercial product mentioned by me.My story and what worked for me in greatly easing my IBS: http://www.ibsgroup.org/ubb/Forum17/HTML/000015.html [This message has been edited by kmottus (edited 06-12-2001).]
 
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