[Common Response]

Hi.I've suffered from a troubled gut & FBO for most of my life & have tried to deal with it as best l can.I've learned from my mother that l was weaned (taken off breast milk) within a week of birth & this may have contributed to my condition.l exercise regularly, avoid junk food, avoid alcohol, drink plenty of water, & meditate in order to bring balance to my life.Three years ago l was introduced to "gas testing" & learned that l'm lactose intolerant.Interestingly l was told my lactose intolerance produces "hydrogen" as a by product.Apparently most lactose intolerant patients will either produce hydrogen or methane.I'm wondering whether l'm intolerant to a range of foods & that the resultant hydrogen may mix with other things in the gut to produce FBO & IBS symptoms.l didn't display any intolerance for fructose or gluten but as l have increased physical symptoms l avoid any processed food particularly if it contains wheat.I've found any dairy, lactose free or not affects me so l'm totally dairy free, but l've also eliminated wheat, preferring rice as my major source of carbohydrate.The other theory is that when food travels through the gut too quickly undigested food enters the large intestine & feeds bacteria which cause FBO.lt was suggested that most of the digestion should have already occurred in the duodenum & small intestine with water absorption taking place in the large intestine leading to well formed feaces.I'd like to give probiotics a go but need to do this scientifically to get it every chance to work.I'd like to be tested for candida or any yeast infection in the gut first before giving it a go.Is there a test for candida or yeast infestation of the gut, both the small intestine as well as the large intestine?Is this test straight forward & conclusive?Which probiotic should l begin with?ls there any medical research which supports specific probiotics over others & are the results positive?

 

[Kathleen M.]

There really isn't any good straight-forward medically accepted test for Candida infection in the gut. Well not one that people like. The scientific studies usually show Candida is not an issue in anyone other than those severely ill with immuno-deficiency diseases and the alternative medical ones that show pretty much everyone has massive systemic candida infections.Remember bacteria make gas too. Lots of gas. Most of us have more than enough bacteria in there to make astounding quantities of gas. I really don't know if a single Candida cell makes more gas than a single bacterial cell (it is bigger) but I think the bacteria even in the usual candida infections in the mouth and vagina still out number them, and you don't hear of gas issues with either of those infections.Hydrogen and methane are produced by bacteria as they have a lot more variety of metabolisms than the Eukaryotes (cells that have nuclei) like Candida or Humans. They can do a hydrogen breath test for bacteria in the small intestine as producing hydrogen or methane is not unique to people with lactose intolerance, the bacteria make those gases from all carbohydrates they can eat, not just lactose. Probiotics do have a different metabolism and stop before they break their food all the way down to gases. That is why they are used to ferment certain foods as the compounds they stop at change the flavor of the food in ways humans like (why yogurt is sour).The odor of the gas comes mostly from sulfur reduction by bacteria in the colon (candida don't do that either) and you usually either have sulfur-reducing or methane-producing bacteria in the colon. They tend to live in the same conditions and one or the other (sometimes neither) will be dominate. Have you tried pepto bismol to reduce gas odor? It can absorb the sulfurous gases in side the colon in the wet conditions in there. Charcoal tends to do more when dry than when wet. Neither hydrogen nor methane have an odor (or the carbon dioxide that also can be produced but usually isn't measured because you make a lot of that) nor are they turned into something with an odor. Some people have done well on a sulfur reducing diet. If you don't give the bacteria sulfur from your diet to consume they can't make gases. Some people with fecal odors have TMAU (fish odor disease) although "fish odor" is really a bad name for it as the smells range from rotting garbage, through fecal to fish going bad.I know of virtually no head to head comparison studies for probiotics.There is this one http://www.ncbi.nlm.nih.gov/pubmed/1576538...mp;ordinalpos=7 and the B. infantalis is sold as Align.Other commercial products that have clinical evidence are Culturelle and VSL#3. VSL#3 may seem a lot more expensive, but it has a lot higher dose of bacteria and I once calculated it out on a per billion cells basis and the increased price made sense that way. Like most of these things they are tested against placebo, not against each other.

 

[Common Response]

Thanks for your detailed response Kathleen.Many things for me to consider.In order to eliminate TMAU is there a diagnostic test for this?Is it unlikely to be TMAU if the odor emanates only from fecal matter & the anal area? In my case excessive gas isn't an issue, but rather poor stool formation, inability to clear fully & FBO, all of which become worse without restrictions on my diet.Could the bacteria which colonise my small intestine produce anaerobic waste (smelly) compared to bacteria which colonise most people?Also, could candida or yeast infestation in the small intestine result in irritation causing undigested food to pass through into the large intestine where high bacterial activity continues. I understood that most of the bacterial digestion should occur higher up. Could getting rid of candida or similar infestation result in elimination of irritation allowing more time for bacteria to do their work before waste arrives at the large intestine?I'll definitely look at sulphur elimination from my diet & trying B infantalis probiotics.I need to make sure I eliminate any variables before going down any path.I'd hate to eliminate what could be a viable option due to the influence of other things.Many thanks for your input.R

 

[Waray]

Read "The Fungus Link" by Doug Kaufmann. It will open your eyes. It saved my life. He explains all you need to know about fungus in the body and what to do about it.

 

[Kathleen M.]

In order to eliminate TMAU is there a diagnostic test for this?It is a urine testI posted some info a few years ago of testing places, usually you have to send stuff offIs it unlikely to be TMAU if the odor emanates only from fecal matter & the anal area?A lot of people with FBO have a lot more than just the feces smell. If things that should reduce feces odor (and remember everyone's feces smell bad) or it seems more pervasive than just your rear smells then it is more likely you need to have TMAU ruled out. A lot of our FBO people do not respond to anything that should reduce gas and feces odor.In my case excessive gas isn't an issue, but rather poor stool formation, inability to clear fully & FBO, all of which become worse without restrictions on my diet.Probiotics are more about gas volume, then gas smell, but less volume means fewer farts. Incomplete evacuation is common in IBS as is stools being odd. Incomplete evacuation does not seem to always go along with odor. A lot of people have problems with incomplete evacuation that have no odor problem.Could the bacteria which colonise my small intestine produce anaerobic waste (smelly) compared to bacteria which colonise most people?The bacteria in the small intestine are almost always the exact same bacteria that colonize people's colons. The ones in the small intestine are not smellier than any other bacteria in there. It just depends if you have more sulfur-reducing bacteria or not. Does not matter at all where they are, just that they are anywhere in the intestines. Which bacteria you have probably depends on which ones you are around at the right time, and some of what you eat or other environmental factors. It is like an ecosystem in there and just like the plants can vary from place to place outside the bacteria any given human has varies from person to person.Also, could candida or yeast infestation in the small intestine result in irritation causing undigested food to pass through into the large intestine where high bacterial activity continues. I understood that most of the bacterial digestion should occur higher up.If anything you would have more food digested in the small intestine as the bacteria eat it before it gets to the colon. If you maintain weight with a pretty normal diet you are not dumping all your food into the colon. The normal levels of food in a perfectly healthy person that are left over and get to the colon can make them smell like something died in there. It is which bacteria you have in the colon. Although feeding them less sulfur sometimes reduces odor because they can't create the sulfur, it has to come from the food.Could getting rid of candida or similar infestation result in elimination of irritation allowing more time for bacteria to do their work before waste arrives at the large intestine?You are not supposed to have much bacterial action in the small intestine. The small intestine should be nearly bacteria free. So you do not need to make them work on anything in there. You want to get rid of bacteria (if you have an excess of them) in the small intestine, not make them more plentiful. Irritation of the small intestine doesn't seem to be the main issue with SIBO (small intestinal bacterial overgrowth).Everyone should have lots of bacteria in the colon and they should get a good amount of waste to work on. That is what is normal and healthy. You do not need to starve those ones out, if you are trying to get rid of or starve out bacteria in the intestines it is to reduce the number in the small intestine.I'll definitely look at sulphur elimination from my diet & trying B infantalis probiotics.Sounds like a plan!

 

[Common Response]

Thanks for helping me Kathleen.If things that should reduce feces odor (and remember everyone's feces smell bad) or it seems more pervasive than just your rear smells then it is more likely you need to have TMAU ruled out. I'll aim at seeking out the test to rule this out.Will discuss this at my next Specialists appt (suspect they won't be up to speed).Incomplete evacuation does not seem to always go along with odor. A lot of people have problems with incomplete evacuation that have no odor problem.As my fecal matter is is in a poor state incomplete evacuation means it sits in the rectum causing FBO to occur.I do recall a special period three years ago when my bowel system worked as it should (normal morning urge to go, well formed elastic stools, easy & complete evacuation, neutral odor with virtually no residue to wipe, leaving me with a great feeling of well being. Far from my current & usual state.It just depends if you have more sulfur-reducing bacteria or not. Does not matter at all where they are, just that they are anywhere in the intestines. Which bacteria you have probably depends on which ones you are around at the right time, and some of what you eat or other environmental factors. This must explain the difference l experience when l visit southern Asia. Although not 100% I've noticed a positive affect on my gut & bowel action during such trips.The normal levels of food in a perfectly healthy person that are left over and get to the colon can make them smell like something died in there. It is which bacteria you have in the colon. Although feeding them less sulfur sometimes reduces odor because they can't create the sulfur, it has to come from the food.Perhaps this is my problem. Too much undigested food hitting the colon. Should l concentrate on eliminating sulphur & re populate the bacteria with friendlier bacteria?You are not supposed to have much bacterial action in the small intestine. The small intestine should be nearly bacteria free. So you do not need to make them work on anything in there. You want to get rid of bacteria (if you have an excess of them) in the small intestine, not make them more plentiful. If the small intestine should be relatively bacteria free doesn't taking probiotics compromise this?How do you reduce bacteria in the small intestine?Everyone should have lots of bacteria in the colon and they should get a good amount of waste to work on. That is what is normal and healthy. You do not need to starve those ones out, if you are trying to get rid of or starve out bacteria in the intestines it is to reduce the number in the small intestine.How do you achieve this? Is it by eliminating sulphur or are there other methods?There really isn't any good straight-forward medically accepted test for Candida infection in the gut. Well not one that people like. The scientific studies usually show Candida is not an issue in anyone other than those severely ill with immuno-deficiency diseases and the alternative medical ones that show pretty much everyone has massive systemic candida infections.Do you think exploring Candida infection worthwhile?How can it be explored if there isn't any good straight-forward medically accepted test for it?I spoke to my GP about it this morning & he preferred I speak to the specialist but he wasn't comfortable prescribing Rifaximin as it's one of the last lines of defense against serious infection. What do you think? Also is the Chinese herb Rhizoma Coptidis worth trying to eliminate possible SIBO?Sorry to bombard you but many of the answers opened up many more questions.with thanks.R

 

[Common Response]

Thanks for the tip Waray.I'll definitely study "The Fungus Link" by Doug Kaufmann.

 

[Kathleen M.]

You cannot assume you have SIBO. There is a test for that and even if you find someone that will prescribe antibiotics blind it still is better to find someone that will test you before so if it doesn't work they can test you after.Limiting sulfur in the diet is about reducing odor, not killing bacteria. Taking pepto bismol can also reduce odor by binding the gases that are created.If you are maintaing weight with a normal amount of food you can assume you are absorbing food naturally.Every single healthy human has lots of bacteria food they can't digest and zillions of bacteria in the colon. Everyone has some odor to the stool and usually the gas, but if you have a methane predominate ecosystem in there you can have near odorless gas, but the feces still will have a fecal odor.You might get Pimentel's book as he has a diet to try to eat as much easily absorbable food as possible so it doesn't feed the bacteria in the small intestine too much, but it is not you only have bacteria in the colon because too much food gets in there. Everyone has zillions in there. You don't want to get rid of them. You actually do better with a healthy ecosystem in there than if you were devoid of bacteria in there.But if you do not have SIBO you don't need Pimentel's diet that much although it will reduce gas volume. It will not change the odor and it seems the odor is what you are most worried about.For odor try reducing sulfur in the diet and try taking pepto bismol. SIBO usually creates volume problems, not odor problems.

 

[Common Response]

So in summary you recommend:

• Work towards testing for SIBO & TMAU to eliminate them from the equation.
• Reduce Odor by limiting sulphur in the diet & taking pepto bismol.
• Improve my ecosystem with probiotics, preferably types such as B. infantalis sold as Align or Culturelle and VSL#3 which have clinical evidence.

Does pepto bismol have side effects?If SIBO testing is difficult to arrange is it worth trying the Chinese herb Rhizoma Coptidis?http://www.ibsgroup.org/forums/index.php?showtopic=113455

 

[Kathleen M.]

Can't say anything about the herb, do you have the right spelling? When I google it I only find a post where you mentioned it so I can't even seem to find out if the Chinese use it and what they use it for.Is it perhaps this http://www.made-in-china.com/showroom/huqi...s-Capsules.html Rhizoma Coptidis seems to have some google results or Coptidis Rhizoma as I've seen both orientations.One thing to remember with Chinese Herbs is that they generally are not used one at a time for a specific symptom. They are more often used in combination to balance the system and so it can be hard to pull one out and use it like Western Medicine and assume that you will get the same results a Chinese herbalist does. The reasons Chinese use various herbs do not line up with why Western Medicine uses various herbs (either traditionally or from recent scientific inquiry). I'm not sure if any of the claims on the site are how well tested, but it sounds interesting. There do seem to be some pubmed articles on Coptidis Rhizoma, but I'm not seeing much in the way of clinical tests in humans, but at least it seemed to do some good for some chickens (and sometimes the claims are only about what happens in test tubes).Looking through Pubmed this seems to be one of the forumlas it may be used in http://www.ncbi.nlm.nih.gov/pubmed/1990351...mp;ordinalpos=1San-Huang-Xie-Xin-Tang Like I said a lot of the times in Chinese medicine they are used in combination rather than individually, and it can be hard to extrapolate from those traditional combinations out to a single herb will fix a specific Western Medical diagnosis. http://www.acupuncture.com/merchant3/merch...Category_Code=D has what it is traditionally used for.The main side effect of Pepto Bismol is constipation. It can also turn your tongue or stools dark/black.The dose used in the study was 8 tablets a day for I think it was 8 weeks. Some people can if they take way too much (max daily dose is 16 tablets a day) or if they can't clear it properly can get some neurological issues. So some people recommend taking a break every few months for a week or so to prevent any build up and if you have kidney or liver disease you probably want to check with the doctor first. I would start with one a day and see how you do then work up to a dose that seems to work for you.SIBO testing does seem more common at larger medical centers, but whoever could detect hydrogen in your breath fro the lactose test should be able to detect hydrogen in your breath from an SIBO test. They do the same thing, just different sugar and with SIBO they have to check the timing of the hydrogen increases, not just amount.

 

[tidefan]

common response - I have the exact same problems that you do.

 

[Common Response]

Tidefan.If l ever get on top of this thing, l'll share the cure with you.

 

[Common Response]

This article seems to summarize the benefits of Rhizoma Coptidis & other similar herbs.Might be worth a go considering over the alternative route of powerful pharmaceuticals with their inherent side effects which can lead to new problems.http://healingtraditions.com.au/content/view/118/2/I just need to work on a SIBO diagnosis first, although I've got nothing to lose except the cost of the herbs.For me a results based solution is more important.The possible side effects of pepto bismol don't sound too appealing, particularly constipation.I had a quick glance at a list of high sulphur foods.It includes many commonly eaten foods & would lead to quite a limiting diet.It seems l can't win.

 

[Kathleen M.]

Pepto isn't very constipating and I find even one tablet a day make a huge difference for me, but my gas odor isn't that bad.For sulfur you still need some protein so just limit the amounts per each meal to like 3 ounces rather than having a large piece of meat. I'd replace the meat with veggies (just not a lot of garlic and onions).Some depends on how much the odor bothers you, but some people have had really good luck by reducing sulfur in the diet.

 

[Common Response]

Do you think bean curd or tofu is an issue?

 

[Kathleen M.]

Some people find soy anything tends to increase gas volume. I do not think is is more odor causing than any other protein source.

 

[Common Response]

After several internet searches & visiting local chinese medicine outlets l've tracked down a store which sells the Chinese herb Rhizoma Coptidis & have two weeks supply.This formulation apparently had amazing success with a board member who no longer posts here.The formulation was aimed at eradicating possible yeast or other infestation of the upper digestive tract.I'm now too scared to use it.I have an appointment with specialists in two weeks at the Box Hill Hospital to work towards testing for SIBO & TMAU to eliminate them from the equation.Firstly taking the Rhizoma Coptidis may affect any testing & compromise diagnosis.Secondly l'm worried this herb may lead to worsening of my symptoms.Thirdly if it doesn't work that's one less hope l have of improving my condition.What should I do?The dosage of the herb is 2 tabs 3 times a day.

 

[Common Response]

Took the plunge & started taking the Rhizoma Coptidas (Huang Lian) last night.Three week course, 2 tablets three times a day.Two week course cost me AUS$15.00.Will report on results.

 

[Moises]

Hey Common Response,My Huan Lian Su just arrived today. I am doing a few other dietary experiments right now, so I don't want to take my Huang Lian just yet.From a Western perspective, it is said to contain a lot of berberine, which is also found in many western herbs like goldenseal. I have taken berberine-containing herbs before.Let us know how you're doing. Thanks,moises

 

[Common Response]

Hi Moises.I didn't want to be premature, but so far I'm pleased with the Coptidis Rhyzoma (Huang Lian).My symptoms (many years) have been:

• Poorly formed stools ranging form diarrhea to constipation.
• Incomplete evacuation.
• FBO.

My baseline before commencing this Chinese medicine.Sensible diet.Daily multi vitamin capsule.Regular exercise.Dairy free (lactose intolerant).Minimal alcohol.No recreational drugs.No prescription drugs.Regular meditation.I've been taking the Huang Lian for one week now (2 little tablets 3 times daily) & I'm extremely pleased with the result.I won't say cure as these changes could end up being temporary.What I can say is:I haven't had diarrhea or messy formations.My stools are well formed with minimal odor.Evacuation feels complete & satisfying.Nothing to wipe (no messy toilet paper).I haven't had any remarks at work like "what's that smell".This has made me feel more confident & l haven't dwelled on negative thoughts.I did go backwards yesterday but this could be due to eating two candy bars loaded with dairy.It made me feel depressed but I'll remain confident going forward.If the positive effects I'm experiencing turn out to be temporary then I've discovered a preparation which can give me relief for nominal periods.If it provides longer term results then I'm very excited.I'm not taking anything else except a teaspoon of Normafibe (Sterculia 620mg/g) daily to provide that extra bulk to ensure regular movements.Normafibe provides soluble bulk to get over the line without bloating or gas, which can result when using psyllium husks.I plan to follow up with a good Probiotic after 4 weeks on the Huang Lian.Initially I was worried about taking this stuff but there's been no side effects.Here is an interesting description.http://alternativehealing.org/huang_lian.htmMy doctors only concern was whether the preparation you buy is as described.There's been a lot of publicity about counterfeit or adulterated products coming from China.Also the fact sheet warns against possible toxicity if you don't follow the dosage.I'll report again soon.