If fructose intolerance is as widespread as Thiwan and Pimentel claim, then Gottschall's theory is blown to smithereens. She claims that monosaccharides, including fructose, require no digestion before being absorbed in the small intestine.Pimentel, in his book (page 58), disputes Thiwan's claim in his final paragraph that cultures of jejunal fluid are required to make a conclusive determination with regard to SIBO. Pimentel claims that such cultures are unreliable because (a) we don't know how to culture many of the jejunal bacteria; (
the instrument used to collect jejunal bacteria would be contaminated by bacteria from the mouth and other locations; and © jejunal bacteria would die when removed from the patient and exposed to oxygen.I am not qualified to judge the legitimacy of Pimentel's claims. But even I am aware of Koch's Postulates and certainly Pimentel is. I can't believe he is intentionally avoiding culturing jejunal bacteria because he wants to protect his theory from being tested empirically. If that is what he is doing then he deserves to have scorn heaped upon him. But that does not appear to be his modus operandi. In the past, when his experimental methods have been criticized, he has redesigned his experiments to address those criticisms, including some of the criticisms levelled by Thiwan.I think it is important that we all be conscious of the attacks directed at Pimentel and Eric is doing us all a service by making sure none of us lose sight of them. But the journal articles are not all that we need go on. This forum and the experiences of its members provide lots of raw, unsystematic, but in many cases prospective, data. I would encourage everyone here to log their experiences on the SIBO protocols, starting from before they begin the protocol. We can develop our own data set using the resources of this forum.
