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Discussion Starter · #1 ·
I compiled this about SIBO. Feel free to ask questions or correct where necessary.Small Intestinal Bacterial Overgrowth or SIBOWhat is SIBO?SIBO is the overgrowth of bacteria in your small intestine.What are the symptoms of SIBO?Steatorrhea(from bile acid deconjugation), macrocytic anemia(low serum vitamin B12, high red cell folate) patchy small bowel lesions with villous blunting or nonspecific chronic diarrhea and/or gas and/or bloating within 30-45 mins after a meal.What are the causes of SIBO?It happens either as a result of low gastric acid(postgastrectomy, old age)or delayed intestinal transit(diabetes, sclerodoma. surgical blind loops) or with surgical loss of the ileocecal valve. A word about delayed transit-Small bowel bacterial overgrowth is a result of abnormal motility in the small intestine; when the housekeeper waves do not keep the bacteria swept out because the contractions are too weak or disorganized, the bacteria grow out of controlHow do I test for SIBO?The gold standard for SIBOis jejunal fluid cultureThe other common tests are the Lactulose or Glucose or Sucrose Breath Hydrogen test. You ingest a substrate, 10 to 12 g of lactulose, 50 to 80 g of glucose or 80g of sucrose, and then blow into a bag periodically which is passed through an analyzer to detect the amount of hydrogen in the expired air at different times. Some patients don't produce hydrogen. Then methane is measured.Which hydrogen breath test is better?Each test has its pitfalls. If you have SIBO you will see two peaks with lactulose in the graph of expired hydrogen against time, once when the substrate hits the small intestine and the second time when it hits the cecum. The peaks are caused by hydrogen being produced by the bacteria feeding off of the substrate and being absorbed and carried to the lungs, If you didn't have bacteria in the small intestine, you wouldn't see the first peak. However the interpreter needs to be careful to differentiate the two peaks, be careful in noticing timing and amplitude, and in order to capture the instances with slow transit oneideally needs the test to be done for 8 hours instead of the usual 4 hours. In addition, with bacterial overgrowth there may be an overlap of the early and later periods of hydrogen production that can be misinterpreted as a single period characteristic of rapid intestinal transit. This test only can diagnose only 60-70% of cases.Glucose is fully absorbed by the time it reaches distal parts of your small intestine so if there is bacterial overgrowth there, you won't see the peak when glucose reaches that part. Sometimes the transit is so fast that it is transported to the colon faster than it can be absorbed so the peak you see may be caused by the sunbstrate reaching the colon. However usually any peak is abnormal with glucose.What studies are there that link SIBO to IBSMark Pimentel's http://www.ncbi.nlm.nih.gov/entrez/query.f...t_uids=11151884 What are the criticisms of this study? http://www.med.unc.edu/medicine/fgidc/bact...rowthandibs.htm What are some treatment options?Long term Antibiotics if SIBO due to slow transit.Please note that antibiotics could bring on C.diff infections, change colonic flora so you produce more smelly gas and antibiotic resistance so if you really need them some day they might not workWhat is the alternative to antibiotics?This study says the lactulose breath hydrogen test was normalized after an elemental diet of Vivonex Plus of 14 days http://www.ncbi.nlm.nih.gov/entrez/query.f...t_uids=14992438
 

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Since i tried Vivonex plus,i think Peptinex is more tolerable and have a better taste.They have designed Peptinex because it have a better G.I. tolerance and taste.
Also,Some reports that after drinking Peptinex.
 

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Since i tried Vivonex plus,i think Peptinex is more tolerable and have a better taste.They have designed Peptinex because it have a better G.I. tolerance and taste.
Also,Some reports that after drinking Peptinex.
 

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The representating from Novartis who gave me a sample told me that patient who have a bowel surgery often use Vivonex.Poor them,it dosen't seems to push the stools or help the peristaltic.Also,The little flavor to mask the bad taste is soooosynthetic.
 

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The representating from Novartis who gave me a sample told me that patient who have a bowel surgery often use Vivonex.Poor them,it dosen't seems to push the stools or help the peristaltic.Also,The little flavor to mask the bad taste is soooosynthetic.
 

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Discussion Starter · #8 ·
The only beneficial effect of an elemental diet in IBS is that it is all absorbed and perhaps also it is predigested so you don't have undigested , unabsorbed carbohydrates left for the bacteria to eat and produce gas. The idea is to starve these bacteria which ferment these carbohydrates and produce gas.
 

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Discussion Starter · #9 ·
The only beneficial effect of an elemental diet in IBS is that it is all absorbed and perhaps also it is predigested so you don't have undigested , unabsorbed carbohydrates left for the bacteria to eat and produce gas. The idea is to starve these bacteria which ferment these carbohydrates and produce gas.
 

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-Quote:The only beneficial effect of an elemental diet in IBS is that it is all absorbed and perhaps also it is predigested so you don't have undigested , unabsorbed carbohydrates left for the bacteria to eat and produce gas. The idea is to starve these bacteria which ferment these carbohydrates and produce gas.Do you claims that you should fast before Vivonex?Graph:I can't barely see it but yeah very closely i can see the picks.What does it mean?Lactulose react at every hours and even more after 2,3,4 hours? Damn,maybe i have SIBO.
But my LOWER bowel is really altered.The small bowel is few inch higher.
 

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-Quote:The only beneficial effect of an elemental diet in IBS is that it is all absorbed and perhaps also it is predigested so you don't have undigested , unabsorbed carbohydrates left for the bacteria to eat and produce gas. The idea is to starve these bacteria which ferment these carbohydrates and produce gas.Do you claims that you should fast before Vivonex?Graph:I can't barely see it but yeah very closely i can see the picks.What does it mean?Lactulose react at every hours and even more after 2,3,4 hours? Damn,maybe i have SIBO.
But my LOWER bowel is really altered.The small bowel is few inch higher.
 

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A bad breath may indicated a poor digestion.That sound real also.
 

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A bad breath may indicated a poor digestion.That sound real also.
 

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Discussion Starter · #16 ·
quote:Do you claims that you should fast before Vivonex?
No having Vivonex is like fasting as far as the bacteria in the intestrine are concerned because Vivonex gets absorbed before it reaches those parts. So the bacteria have no Vivonex to feed off of.
quote:i can see the picks.What does it mean?Lactulose react at every hours and even more after 2,3,4 hours?
You see the first peak. It is at about 60 mins the time the lactulose reaches the small intestine. The peak is produced only because there were bacteria there. They ate some of the lactulose and created the rise in hydrogen production. That was why the first peak showed up on the graph. The other peaks happened after the lactulose reached the colon approximately 2-3 hours after the patient ingesting lactulose and became food for the bacteria there which once again produced the rise in hydrogen.. The three peaks which happened there form one peak approximately, the second peak.
 

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Discussion Starter · #17 ·
quote:Do you claims that you should fast before Vivonex?
No having Vivonex is like fasting as far as the bacteria in the intestrine are concerned because Vivonex gets absorbed before it reaches those parts. So the bacteria have no Vivonex to feed off of.
quote:i can see the picks.What does it mean?Lactulose react at every hours and even more after 2,3,4 hours?
You see the first peak. It is at about 60 mins the time the lactulose reaches the small intestine. The peak is produced only because there were bacteria there. They ate some of the lactulose and created the rise in hydrogen production. That was why the first peak showed up on the graph. The other peaks happened after the lactulose reached the colon approximately 2-3 hours after the patient ingesting lactulose and became food for the bacteria there which once again produced the rise in hydrogen.. The three peaks which happened there form one peak approximately, the second peak.
 

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The graph looks interesting,it indicates that i may experience gas in the few hours after a sugar consuption.My teeth reacts to the graph as well.Very acidic.
 

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The graph looks interesting,it indicates that i may experience gas in the few hours after a sugar consuption.My teeth reacts to the graph as well.Very acidic.
 
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