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Discussion Starter · #1 ·
I am going to do the lactulose test for SIBO(small intestinal bacterial overgrowth)test on Nov 1st and meeting my doc on Nov 10th to discuss the results and also to get to the root of fructose intolerance other than SIBO if I don't have the latter.So how many of you are doing or thinking of asking the doc of doing the SIBO lactulose breath test?
 

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I am going to. I will try anyhting at this point
 

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Discussion Starter · #6 ·
joolie I don't think they have breath test in Scotland. In fact I am not even sure that London has it.kitkat if you are in the States near a big hospital then you are in luck. Otherwise maybe Great Smokies diagnostic lab although there have been rumors that there have been problems with their test. I didn't know how to answer to your thread about Prozac but all that I know is you get those jittery feelings if you don't withdraw from the med gradually. But you say you had the problem before you stopped it so I don't knowRoo, I think you will be the ideal candidate for SIBO-flatulence is definitely a symptom. And if you say that you had a problem with HFCS(coke) you could be fructose intolerant. And SIBO could be behind fructose intolerance.As for persuading docs to take this theory seriously, I told my doc that I had liquid incontinence last week(luckily I was at home) and that is an urgent enough reason to take this theory seriously if it could lead to a cure of my diarrhea and gas. They can't snatch us of that hope
 

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bonnieiI am definately going to request my doc to do the test. My gp doc did not know about it but will ask my gi doc after my gastroscopy test next week. I want to collect as much info as possible from the internet links as possible to show him, as my own word will be not taken seriously. You also mean that if you exeggerate symptoms that then doctors may actually take you more seriouly. Never thought of that, will try it. I know pretty well that I have SIBO because many times being on antibiotics I have always had reduction in my ibs symptoms, but they just didn't last. Maybe the right cocktail of antibiotic and the package deal of Dr. Pimentel will work for me. Can you provide some specific links for me instead of searching the whole bb or google.
 

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Discussion Starter · #8 ·
No I didn't exaggerate my symptoms. I did hve liquid incontinence because I was not following the diet. But I know I can control it with diet so in that sense I may have slightly exagerrated. But who wants to be on a zero fructose diet for the rest of their lives if SIBO is indeed behind it and there is a cure for it. Ok a semi-cure
since you will have to take meds long term.I will compile a bunch of abstracts for you so that you can present them to your doc. I did ask flux for the abstracts corroborating Pimentel's work but he didn't reply. Anyway I will do a search and get back to you.
 

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Discussion Starter · #11 ·
This was the first study done to establish a link between SIBO and IBS.http://www.ncbi.nlm.nih.gov/entrez/query.f...1884&query_hl=4You will see at the top of the link there are many Comment links. These were the criticisms of the scientific community to this research and Dr Pimentel's response. Also Dr Drossman's(eric's guru's) initial comments were herehttp://www.ei-resource.org/articles/ibs-art06.aspThen Pimentel did a better studyhttp://www.ncbi.nlm.nih.gov/entrez/query.f...2438&query_hl=4And this was Dr Drossman's reaction to it. Read the section A role for antibioticsDr Drossman's second reaction to PimentelOther related studies done by Pimentel were Motility problems in IBSMethane and its relationship to IBS-CThis summarizes very nicely how IBS is connected to SIBO, written by Dr Pimentel's collaborator, Henry Lin http://www.ncbi.nlm.nih.gov/entrez/query.f...6000&query_hl=9Ask your doc to read the entire article.I haven't read this article written by Henry Lin but it sounds promising. May help your doc to treat you. I will see if I can read it and get back to you on that.Management of SIBOI will look for work corroborating Pimentel's work and get back to you on that too.
 

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Discussion Starter · #12 ·
Hi joolie, sorry
hanna I found two studies corroborating Pimentel's work -kind of. It says that 65% of IBS patients had SIBO by the lactulose test and eradicating it with antibiotics (i.e norrmalizing the lactulose test) resulted in the carbohydrate malabsorption disappearing. http://www.ncbi.nlm.nih.gov/entrez/query.f...370&query_hl=13And the topic of this link is very interestingCulture-proven small intestinal bacterial overgrowth as a cause of irritable bowel syndrome: response to lactulose but not broadspectrum antibioticsWonder what it says. Sounds terribly interesting. I'll see if I can go to the library.
 

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Hanna,i think you will have to go in MTL to see my breath test doc or travel to USA.
 

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SpAsManIf my gi doc says nay to the test or I cannot find any doctor in Toronto then Montreal it will be for me. Then I can maybe meet you in your doctor's office, by chance maybe! Did you get the results of your lactulose test? I have not been following all the posts recently.
 

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bonnieiThanks for all the abstracts. I have printed them. Is it possible to find the abstract which gives the treatment protocol? I have found one which Spasman posted in another thread, but any additional will be better, the more info I give the doc the more chance they will do something for me.
 

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Discussion Starter · #17 ·
My library didn't have these articles so I purchased them.
The Management of SIBO paper was disappointing. It didn't give the exact dose of the a/b as I amlooking for that info incase I have SIBO. But it gave the reasoning why the lactulose tes is preferable to the culture method. It was pretty convincing. And it says that if the lactulose breath test normalizes after a course of a/b then it is proof that you are dealing with SIBO and not rapid transit, which is a possibility with a positive test. says to do the small intestinal manometry to rule out abnormal motility. If the latter is established,then to add a prokinetic to the treatment after the normalization of the test.The paper "Culture-proven small intestinal bacterial overgrowth as a cause of irritable bowel syndrome: response to lactulose but not broadspectrum antibiotics." reports the case of someone who had all the normal tests negative except the culture. I don't think they did the lactulose test on him. However this is a novel treatment of this person with lactulose.They give 20 g of lactulose b.d for four weeks and the culture normalized. Apparently lactulose is metabolized to short chain fatty acids and this acidifies the lumen and discourages the growth of bacteria. They call it "targeted" antibacterial therapy. So don't despair people who don't have the right type of a/b. Lactulose might well be enough.
This was an Australian study. So Yay Arnie
 

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I am definately gettting the lactulose breath test done. I am fortunate to be friends with the secretary where my gastrenologist is. I talked to her about it and she said she would order it in for me like she did for the fructose test I wanted. Hanna....I live in Guelph so if I can get it done here I will let you know. It would be just over an hours drive for you. I will keep you posted.
 
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