I’ve gone back to work and haven’t had a chance to look at this board for a while, but I thought I’d check in and see what’s up with the SIBO/Rifaximin efforts. I finished my 14 day rifaximin course two weeks ago now, and I still have IBS. It did not cure me. I pretty much lost faith in Pimentel and SIBO about half way through my treatment, when my symptoms did not seem to be abating. My symptoms mostly revolve around bloating, gas and pain, with occasional D. Antibiotics now seem to be too easy an answer. I figure that before pharmaceutical companies spend hundreds of millions of dollars trying to get something like cilansetron through the FDA, they do some in-house testing on the word-of-mouth cures to make sure their super-expensive drug sales don’t get undercut by the sudden realization that $10 worth of antibiotics cures IBS. So, here’s my question: has anyone on this board been cured of IBS with rifaximin or any other A/B?
Is SIBO a myth? Probably.
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Did you have a breath test prior to the antibiotics to confirm SIBO?It is not found in all IBSers even by Pimental, and I think some people respond to different antibiotics. Depends on what bugs you got. You should have another breath test to see if you cleared the SIBO at all or not.K.
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Wornout,SIBO maybe a factor but it appears that IBS is multifactorial.Hypersensitivity seems quite an important one:Role of visceral sensitivity in the pathophysiology of irritable bowel syndrome http://gut.bmjjournals.com/cgi/content/full/51/suppl_1/i67Multifactorial:http://www.conference-cast.com/ibs/Lecture...cfm?LectureID=2
The SIBO theory takes care of the hypersensitivity issue "Immune Response to Bacteria Explains Abnormal Motility and Visceral Hypersensitivity:Lipopolysaccharide, a product of gram-negative bacteria, accelerates small intestinal transit. This leads to hypersecretion and power peristalsis. The immune response to these bacterial products also explains Visceral hypersensitivity. Also Weston et al proposed earlier that increased mast cells in the ileum of IBS patients might be linked to altered visceral perception"wornout I have had good results from Augmentin lasting almost a month. The last few days I have been having D. Don't know if it is a bug. But you really need to do breath tests. That is the only objective measure. If your breath test did not show that the SIBo had been cleared up Pimentel would have extended the dose of a/ b or given you a different one till your breath test normalized.
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Wornout,if you have no anatomic problems then it is IBS.Since the SIBO theory is the more accessible,it could be the way to threat.You also can do the anti depressant way but you need a convincing doctor.You can also do other experimental treatments but only the time will tell about them.
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Spasman, what is the antidepressant way? Just curious as I'm on anti deps. My D has stopped since I started taking them. I still get a lot of gas and pain but I suspect that's because I might have a food intolerance (well I'm about 90% sure, just need to test the theory). Thanks for any info you have on this
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One of the research:http://www.ncbi.nlm.nih.gov/entrez/query.f...8&dopt=Abstract
So why couldn't lets say hypnotherapy be somehow returning the phase 3 MMC's or whatever to a more normal level of functioning by releaving stress. Then the phase 3 MMC's slowly get rid of the bad bacteria, which then slowly lets some of the mast cell issues return to normal, followed my a lessening of IBS symptoms. I have no idea if hypnotherapy does that, I'm just wondering if the doctors think that stress could be involved in this way. While the SIBO stuff looks promising, I don't see how you can ever disregard the high percentage of IBS'ers with anxiety/depression personality type issues (that existed -before- the IBS) for whatever reason. I mean the link between emotional stress and IBS seems too strong to deny, and it seems unlikely that the SIBO could have been present in these people pre-IBS. But that does make me wonder, how many people without IBS have SIBO type readings on the breath test? Have they completely ruled out the idea that these people would have had SIBO type readings prior to them getting IBS?
Gutuy, I have tried hypnotherapy and I think it does alter transit. Sio it could affect the Phase III's too. Stress is one of the factors which leads to a reduction of the Phase III. Even a physical illness like an infection could be classified as stress, not just emotional factors. Further "Activated Immunity May Explain Altered Brain-Gut Interaction and Autonomic Dysfunction in IBS:Since inflammation in animal models leads to multiple changes in the brain, including activation of neurons as documented by Fos expression,84-85 alteration of hypothalamic-pituitary-adrenal axis including elevation of corticotropin-releasing factor (CRF) concentration and change in neurotransmitter levels such altered brain-gut interactions may be a part of the systemic response to a trigger of inflammation."The SIBO theory thus incorporates the brain gut factor.
screamer on another thread you said that you took Paxil for diarrhea. Diarrhea is caused by more than normal serotonin around the 5HT-3 receptors. If there is even more than that it desensentizes the receptors and causes constipation. Paxil is a selective serotonin reuptake inhibitor. So it prevents serotonin from reuptaken back so you start out with more than normal serotonin around the 5HT3 receptor and as a consequence end up with even more serotonin desensitizing the receptor leading to constipation or for you lack of diarrhea.
So, as I thought, no one is IBS-free as a result of A/B. It seems to me that many of us here are clinging to this theory. But no one has been cured, or even substantially helped. I’ve read all the papers we’re commonly quoting from here: breath tests, Phase III’s, etc. But this theory does not seem to be actually helping anyone I’ve spoken to or heard from on this board. Pimentel et. al. have apparently produced some who have been helped, but the overwhelming consensus in the GI community is that they are only helping a tiny fraction of IBS sufferers. Further, there seems to be a pretty clear consensus that the guys at Cedar Sinai and USC are hyping their success—in terms of the percentage of IBS sufferers they can help. As for Bonniei, I don’t see “good results lasting a month with “Some D†as relief—it falls perfectly in line with a typical placebo effect. Further, the Lin paper says that symptoms should not return, at the fastest, before three months.Pete is the closest to seeing relief, but he is clearly still sick. Lastly my GI says he’s always willing to give antibiotics out if patients want it—he did for me (first Cipro, then Rifaximin)—and he says a lot of people come in talking about Pimentel. He says he hardly ever sees anyone improve from this therapy. This treatment is too easy—everyone should go out and try it, but for anyone who is serious about being cured, don’t fall for all the hype like I did. A lot of people here are talking about this like it really works, but not one of the frequent SIBO posters has been cured to the point that they resume their life and stop posting. The real cure is going to come from a pharmaceutical company.
You are wrong about that. He said it may return a quickly as two months. Besides a I didn't take Rifaximin. Thirdly and most importantly, if I decide to follow Pimentel's protocol I will do a before and after breath test to make sure that the SIBO has been really eradicated. As you know I have neither done the before or after test. Without the tests , as you seem to be doing is totally unscientific and does not invalidate Pimentel's theory.
It has not been figured out what sibo and IBS have to do with each other yet.From what it looks like sibo, seems to be a different condition then IBS, but IBSers can have it as well. Non IBSers can have sibo also.There are problems found in IBS that are not related to sibo that are extremely important.IBS is extremely complex.also Hypnotherapy for IBS works in a variety of ways, not just stress reduction, but on motility, viceral sensivity and viceral perception and brain gut axis dysfuntion and stress and anxiety reduction is a side effect.The mast cells can become inflammed without a pathogen from chronic stress and mast cells have to do with PI IBS as well.And anxiety and stress in IBS is also related to serotonin and mast cells.Serotonin is also related to sleep problems which they have seen in IBS and appetitie and sexual issues as well and its importance in motility and communication signals to the brain.They KNOW serotonin is dysregulating in IBS, but don't know exactly why yet.Also viceral hypersensivity is NOT completely understood.and many other functional gi disorders are comorbid with IBS and may have some of the same problems. But sibo doesn't explain all of those either.For example functional dyspepsia shares motility, viceral sensivity and brain gut axis dysfunction as does IBS.For sure getting tested for sibo if you have the symptoms is a good idea and in general why not be tested.There are many unanswered questions in regards to sibo and IBS still.
I was so excited about rifaximin I saw my Gastro doc last month. He said he never had a patient so knowlegeable. lol He went on to say he has been to Pimental's talks in the past and has tried erythromycin on patients, some of his staff with no results. He gave me a script for zelnorm and would consider a/b's in a month. In the meantime I've been re-thinking my history with antibiotics. It usually goes like this. I take a/b for something else (not IBS) then within a month my ibs is worse. eventually it gets better with strict diet in about 3 to 6 months. This has happened 6+ times in last 2.5 yrs. This last time has been way worse, last January I had a sinus/tooth infection had Keflex which caused bowel pain and soft stool, it didn't work so had to take Azithromycin which did not give me any bowel complaints. this was early February....in March I had d twice. My symptoms changed from IBS c to feelings of urgency with softer stool. In June I may have had stomach flu or ? had the worst d ever for 3 days. now I am more prone to d! I have been c my whole life. What I am thinking about all this is maybe there is a missing step in protocol. rifaximin or whatever antibiotic, then diet and (meds or natural) healing gut remedies, including biofeedback, ht etc. for several months might do the trick. One other thought....why do they not test the stool before treating to see what bacteria is overgrown? wouldn't the bacteria be in the stool eventually? Joann
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The problem I think with stool testing for SIBO is usually what you have is the normal flora from either the mouth or the colon growing in the small intestine. So all you would know is which set of normal flora you have (not everyone has the same bacteria) This is probably not useful. It isn't which bacteria it is where they are growing. So I don't think testing the stool would tell you any information. Also any signal there might be from SIBO is probably drowned out by the huge numbers of bacteria that live in the colon. It is a wrong place not wrong bacteria sort of problem. Stool won't give you location.K.
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