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Discussion Starter · #1 ·
My IBS (mostly D) started 20 years ago. Just only a few years ago, I was able to bring it under control (mostly with the help of Glutamine).A few months ago I had an episode of food poisoning. Lots of diarrhea and no way to stop it for a few days. My stomach hurt. A couple of weeks later, still with a achy stomach, decided to go to the family doctor - there, I was diagnosed with Helicobacter Pylori infection (did the breath test). Was prescribed Prevpac, a common triple therapy prescription.Two days after starting the two antibiotics and proton pump inhibitor, the diarrhea was gone but not the stomach pain. Interestingly enough, I had exactly ZERO IBS symptoms. My bowels were working like never before. Those well formed stools were the most beautiful thing I had seen in a very, very long time.Went back to the family doctor and told him the stomach pain was still there. Told me to continue to take the proton pump inhibitor and see a gastroenterologist. Took the proton pump inhibitor for two months and the pain was gone. Good! Didn't go the the gastroenterologist, though.Meanwhile, I was back to my normal me, managing my IBS-D with Glutamine but not forgetting that interesting data-point, of ZERO IBS symptoms while taking the antibiotics. Did a little bit of research and ended up stumbling on Pimentel's book, "A New IBS Solution". Went to Borders, bought it and read it in 4 hours. Suddenly, things started to make sense.Decided to schedule an appointment with my long time doctor, an internist always willing to listen to patients, their concerns and even crazy theories.Now in the doctor's office, told the story above and explained Pimentel's ideas. Brought along the book and relevant Pubmed abstracts. Given my recent experience with those two antibiotics for H. Pylori, we both agreed to forgo the lactulose breath test and go directly to the antibiotics, 1200mg/day of Xifaxan.Started treatment on Nov 9. The almost immediate effect was virtually no intestinal gas. Towards the end, I was even getting a little bit constipated. At the same time, I was taking a bunch of different digestive enzymes and closely following the dietary guidelines in Pimentel's book, to avoid having undigested carbs reach the bacteria.On Nov 19 I was off the Xifaxan. I had ordered B. Infantis 35624 and started taking it. I also started taking a Jarrow's Bifido formula. I didn't want those 10 days of antibiotic use to transform themselves in years of dysbiosis. Recolonization of beneficial bacteria is a must.Following those 10 days of Xifaxan, my bowels complained 2 days ago with some gas and diarrhea but now things have improved considerably: yesterday, no diarrhea; today, no diarrhea. However, I am very well aware of the fact that it is still *WAY* too early to tell whether all of my IBS symptoms are gone for good or not. Now, for the really interesting stuff.For many years, I had had a rosacea-like skin rash on my face. I've also had a nasty 3-inch diameter skin rash right in the middle of my chest.Guess what? The rosacea-like skin rash on my face is totally gone. The skin rash in my chest is mostly gone but not completely. I'm in observation mode and looking at what might develop in the next couple of weeks.Conclusion: Got skin rashes? Have IBS? Go see your friendly doctor and take Pimentel's book with you.
 

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Discussion Starter · #3 ·
quote:Are you taking any motility drugs like Zelnorm now? Did I miss it? That is a very important part of Pimental's regimen.
I'm doing an experiment, taking 5-HTP instead. 5-HTP is readily converted to serotonin in the gut. Given that serotonin is fundamental for motility, I'm betting that it will work. In any case, I'll be on the look out for potential problems. AT the very least, my skin rashes will let me know!
 

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Nanobug,Good for you! The amelioration of your skin condition does not surprise me. If you look at published studies on the use of elemental diets, you will find that all kinds of conditions are remediated. If you buy Pimentel's view that the elemental diet eliminates bacterial overgrowth, then many conditions--not just obvious digestive ones--may be caused by bacterial overgrowth. There were dermatological conditions, rheumatogical conditions, and others.
 

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Discussion Starter · #5 ·
quote:The amelioration of your skin condition does not surprise me. If you look at published studies on the use of elemental diets, you will find that all kinds of conditions are remediated.
To be honest with you, I was not surprised either. I was just not sure that it would totally clear the skin rash on my face. When I did the triple therapy for H. Pylori, I noticed an improvement in those skin rashes as well but nothing as dramatic as what's happened this time. At the time, I was able to find some abstracts on Pubmed about how some doctors were successfully using triple therapy to treat people with rosacea. However, while I wasn't surprised, I wasn't sure that it would work so well either. So I guess my surprise was in the effectiveness. Oh, by the way, the skin rash on my chest appears to be clearing as well just at a much slower pace. No idea why it's longer than the one on the face, though.
 

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Nanobug, this was posted some years ago from Havard health and some one asking about 5ht and a thyroid med. I am not positive, but I don't think taking 5ht helps the problem in the gut cells in IBS as to the release or non release or flow of serotonin from EC cells. It may also cause d.Just for the info.The Trusted Source..Harold J. DeMonaco, M.S.Harold J. DeMonaco, M.S., is senior analyst, Innovative Diagnostics and Therapeutics, and the chair of the Human Research Committee at the Massachusetts General Hospital. He is author of over 20 publications in the pharmacy and medical literature and routinely reviews manuscript submissions for eight medical journals...June 19, 2001.A:Irritable bowel syndrome is now recognized as a disorder of serotonin activity. Serotonin is a neurotransmitter in the brain that regulates sleep, mood (depression, anxiety), aggression, appetite, temperature, sexual behavior and pain sensation. Serotonin also acts as a neurotransmitter in the gastrointestinal tract.Excessive serotonin activity in the gastrointestinal system (enteric nervous system) is thought to cause the diarrhea of irritable-bowel syndrome. The enteric nervous system detects bowel distension (expansion) on the basis of pressure-sensitive cells in the bowel lumen (opening). Once activated, these pressure-sensitive cells promote the release of serotonin, which in turn promotes both secretory function and peristaltic function (the contractions of the intestines that force the contents outward). At least four serotonergic receptors have been identified to be participants in the secretory and peristaltic response.Patients with diarrhea-predominant IBS may have higher levels of serotonin after eating than do people without the disorder. This recognition led to the development of the first drug used specifically to treat diarrheal symptoms of IBS, alosetron (also known as Lotronex). Alosetron blocked the specific serotonin receptors responsible for recognizing bowel distention. In doing so, it blocked the effects of serotonin and reduced both bowel secretions and peristalsis. Constipation was the most common side effect seen. (Note: Alosetron was removed from the market by the manufacturer after repeated reports of a dangerous condition known as ischemic colitis became known.) Tegaserod (Zelmac) is another drug under development and under review by the U.S. Food and Drug Administration for approval. Tegaserod is indicated for the treatment of constipation-predominant IBS and works to increase enteric nervous system serotonin activity.So, increasing serotonin activity in the enteric nervous system produces increased bowel secretions and peristalsis (and potentially diarrhea), whereas depressing serotonin activity produces reduced secretions and reduce peristalsis (and potentially constipation). Increasing serotonin activity in the brain would increase awareness and, in higher doses, produce anxiety, insomnia and restlessness. So I would have expected exactly the opposite effects of those that you experienced.I am unable to identify any possible drug interactions between 5-HTP and Synthroid (levothyroxine) but the symptoms described suggest a check with your doctor may be in order. Persistent feelings of tiredness and constipation may be signs of an underactive thyroid (hypothyroidism).June 19, 2001
 

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FYI"There are nerves that line the intestinal tract, which use serotonin as their neurotransmitter. These nerves contain the carboxylase enzyme that converts 5HTP to serotonin, but not the hydroxylase enzyme that coverts tryptophan to 5HTP.Thus, when 5HTP is swallowed, large amounts of 5HTP may be picked up by these intestinal serotonergic neurons and quickly converted to serotonin, leading to hyperactivity of these nerves.This in turn may lead to nausea, vomiting, cramping, constipation and/ or diarrhea, and indeed, the research published on 5HTP since the 1970’s has consistently shown various forms of intestinal discomfort to be the main side effect of 5HTP use."There are some questions I need to ask someone about this as well.
 

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FYI"MedGenMed GastroenterologyIBS -- Review and What's NewAmy Foxx-Orenstein, DO, FACG, FACP Medscape General Medicine. 2006;8(3):20. ©2006 MedscapePosted 07/26/2006"Serotonin SignalingOf the putative mechanisms underlying the pathophysiology of IBS, the strongest evidence points to the role of serotonin in the GI tract. The effect of serotonergic mechanisms in the manifestation of IBS symptoms has led to development of a new drug class for the treatment of IBS patients: the GI serotonergic agents.Normal GI function relies on a properly functioning brain-gut axis, which involves the coordinated interplay of the GI musculature, the CNS, the autonomic nervous system, and the enteric nervous system (ENS). The ENS contains millions of neurons embedded in the wall of the digestive tract and functions, at least in part, independently of the CNS. The size, complexity, and independent function of the ENS has resulted in application of the terms "the second brain" and "the mini-brain."[81] Impaired function or coordination of any of these systems, or the communication between these systems and the GI musculature, can lead to symptoms of dysmotility and altered sensory perception, which are characteristic of IBS and select other GI motility disorders.[82]The neurotransmitter serotonin (5-hydroxytryptamine [5-HT]) is a predominant signaling molecule in the ENS. Most (90% to 95%) of the body's serotonin is found in the gut, and smaller amounts are found in the brain (about 3%) and in platelets (about 2%).[83] In the GI tract, serotonin facilitates communication between the ENS and its effector systems (muscles, secretory endothelium, endocrine cells, and vasculature of the GI tract), thus playing a key role in normal GI tract functioning.[84] In addition, serotonin plays a role in the communication between the ENS and the CNS.In the gut, serotonin is synthesized by and stored in the enterochromaffin cells, which are located within the mucosa of the intestinal wall. When material passes through the lumen and the mucosa is stimulated, enterochromaffin cells release serotonin, which then binds to its receptors (primarily 5-HT1P receptors) on intrinsic primary afferent neurons, initiating peristalsis and secretion. Serotonin also binds to 5-HT4 receptors on interneurons, which augments the transmission of signals to motor neurons, resulting in enhanced peristaltic activity. In transgenic mice lacking 5-HT4 receptors, colonic motility is abnormally slow, confirming the role of these receptors in facilitating normal colonic motility.[85] By binding to 5-HT3 receptors on efferent sensory innervations coming from the vagus and the spinal nerves, serotonin mediates signaling between the ENS and the CNS and, thus, modulates pain perception.To regulate the signaling process, excess serotonin must be removed; this is accomplished by the SERT molecule expressed by intestinal epithelial cells.[86] Human studies have shown that defects in serotonin signaling contribute to the pathophysiology of IBS and, potentially, other GI motility disorders. In a recent study by Coates and colleagues,[87] biopsy specimens from patients with IBS showed significantly lower mucosal serotonin concentrations than those from healthy controls, potentially the result of lower mRNA levels for tryptophan hydroxylase (the rate-limiting enzyme in serotonin synthesis), which were also significantly lower in patients with inflammatory bowel disease.[87] There was no significant difference in the number of enterochromaffin cells or in the capacity of these cells to release serotonin under stimulated conditions. In another study, higher serotonin levels were observed in mucosal biopsy samples from patients with IBS with constipation (IBS-C) than in patients with IBS-D or in healthy volunteers.[88]Serotonin levels may also be affected by altering the amount or function of SERT. The study by Coates and colleagues[87] showed a significant decrease in the level of SERT mRNA and SERT protein expressed in the intestinal epithelial cells of IBS patients compared with that of healthy volunteers. In another study,[89] SERT expression and binding capacity in platelets were decreased in women with IBS-D compared with expression and binding capacity in healthy controls. Furthermore, Chen and colleagues[90] showed that mice with a SERT gene deletion had altered colonic motility. It is interesting to note that the mice thrived in laboratory housing conditions, indicating that other transporters could compensate for the lack of SERT. Additional studies have focused on SERT polymorphisms. Yeo and colleagues[91] showed an association between patients with IBS-D and the homozygous short polymorphism of the SERT gene promoter. This mutation results in lower levels of SERT gene transcription and reduced amounts of SERT protein available for reuptake of serotonin. In addition, Camilleri and colleagues[92] showed a possible link between the long promoter polymorphism and patient response to therapy.Thus, a substantially large body of work shows that normal gut physiology is predicated on the interplay between the GI musculature and the ENS, autonomic nervous system, and CNS. One of the central mediators of this complex interplay is the neurotransmitter serotonin. Impairment or imbalance in serotonergic signaling, which can affect GI motility, secretion, and visceral sensitivity, may be affected by defects or deficiencies in serotonin production, specific serotonin receptors, or proteins such as SERT. These changes can manifest in symptoms associated with IBS, including abdominal pain, altered bowel habits (constipation, diarrhea, or alternation between these 2 states), and bloating."http://www.medscape.com/viewarticle/532089_print
 

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Discussion Starter · #10 ·
quote:Thus, when 5HTP is swallowed, large amounts of 5HTP may be picked up by these intestinal serotonergic neurons and quickly converted to serotonin
This is exactly the reason why I'm taking 5-HTP to increase gut motility. I'm taking it with food, however, which tends to slow down rate of absorption. Please, understand that what I'm doing is an experiment meaning that I'm aware that it might fail.
 

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Discussion Starter · #11 ·
Thursday pigged out and totally deviated from Pimentel's diet for the first time since finishing Xifaxan. Unlike previous parties, I didn't have the need to fart until after I left, sitting in my car. I woke up with more gas than natural (but, who wouldn't, given the amount of sweets eaten!
), which was promptly expelled. Later, had a normal bowel movement with fully formed stools.So far, so good, it seems!
 

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ericmy daughter just gave me the info on rifaximin. the problem i have is the cronic constipation. i have gone through all the tests and am currently not taking anything. the zelnorm wouldnt work for me as well as the new drug amitiza. after awhile the amitiza didnt work and i continue to have the same hurt bloating weight gain of 5 or 6 pounds overnite. the doctor fluffs it off...my gastro..and tells me just to cut out the stress. well as you know very well that is not what you want to hear...just a way of saying i just dont know what to do for you!!!anyway i am not a complainer and i am just fed up with the way i feel. my husband is retired and my grandson who is 6 now lives with us and has for the past 4 years just cant understand why i feel the way i do somedays. i just cant feel so yucky.anyway im going to my family doc today and plan to show this to her and see what she says. there are so many things in what you talked about that i dont understand..i have the rosacia and tried to go to the dermotologist and gave me sulfa drugs which made me even sicker...im alergic to sulfa! if she prescribes this for me i know i will have a ton of questions.. do you think this would work for me?
 

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Grama,my wife also has rosacia and its hard to treat it seems. Certain things seem to make it flare also stress being one of them but the weather diet and other things do as well. So you know anxiety can contribute to consitpation. Stress and anxiety are very important in IBS, more so then I think a lot of people realize. So working on that is very important, even if it just makes you feel better. They can also greatly reduce pain.The problem sometimes is doctors know why stress reduction helps IBS, but they don't usally do a good job of explaining it to the patient. It is however very real and almost every IBSer with moderate to severe IBS can benefit from stress and anxeity reduction. A lot of people who go that route are then surprized sometimes how much it helps. There is something called "psychophysiological arousal is the core of treating functional gi disorders. There is so much distress, anxiety, antisipatory anxiety, and negative reaction to symptoms, that calming the mind and body often makes a significant difference to symptoms."With that said you could ask your doc about SIBO, although its much rarer for Consipation. It also has not been studied yet throughly in regards to IBS. It maybe a subgroup of IBSers have sibo due to motility problems. It has not been established as the cause of IBS. There is something called Post Infectious IBS where there is a clearer starting date and celluar changes in the gi tract. Post Infectious IBS has been recently demonstrated as a brain gut axis disorder as well as IBS. Also have you ever had a sitz marker test, that may help to explain slow motility. There are also "ConstipationThe symptoms of constipation are infrequent bowel movements [usually less than 3 per week], passage of hard stools, and sometimes difficulty in passing stools. One motility problem that can lead to constipation is a decrease in the number of high amplitude propagating contractions [slow transit] in the large intestine. The test used to detect this is a transit time (Sitzmark) study. Outlet obstruction type constipation (pelvic floor dyssynergia)The external anal sphincter, which is part of the pelvic floor normally stays tightly closed to prevent leakage. When you try to have a bowel movement, however, this sphincter has to open to allow the fecal material to come out. Some people have trouble relaxing the sphincter muscle when they are straining to have a bowel movement, or they may actually squeeze the sphincter more tightly shut when straining. This produces symptoms of constipation. "http://www.iffgd.org/GIDisorders/GIAdults.htmlOne treatment for the later is biofeedback.This is also a good site on Consitpation.http://www.aboutconstipation.org/and for IBShttp://www.aboutibs.org/There is also as you get older sometimes the muslces don't work quite as well as they use too.How long were you on zelnorm and the other drug?Hope that helps, ask any questions you want.
 

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eric to begin with i just wanted to tell you how much i appreciated your encouragement. i have had this problem since my daughter passed away 6 years ago. i know i have to stop the stress but its not easy. my grandson lives with us, for the past 4 years. his mom was murdered for him. im sure you remember the pregnant girl theresa andrews....well that was my daughter. the stress from all the pardon the expression "####" that we have had to deal with i know is what makes me sick. we have a great realationship with my grandsons dad...but you know being you have a wife, if you were to loose her it really would be hard. so i try really hard to help him, my husband, who has been very ill, and my grandson....plus my other two kids and their children. its a vicious circle. but i love them all and wouldnt change a thing! i did go to my regular doctor and she prescribed the antibiotic. she mentioned that another one of her patients has taken it with great results...im really hoping!!! thanks for listening...im sure when i posted before others thought i was a total wack job...sometimes i think i am!!! just knowing someones out there and really reads this is very comforting somehow!
thanks so muchgramav
 

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Discussion Starter · #15 ·
quote:i know i have to stop the stress but its not easy
Have you considered medication? In my case, 75mg/day of Effexor XR worked very well for my anxiety. I took it for just a little bit over a year and then stopped (which was kind of hard for a couple of weeks). That anxiety never returned.By the way, what Xifaxan dosage are you in? Please, tell us about your progress. If you don't mind my suggesting, start a thread just for you and keep us all updated.Good luck!
 

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Discussion Starter · #16 ·
Another 4 days of my life, another 4 days of intestinal bliss. I continue to have a bowel movement every day of fully formed stools.The skin rash on my chest is almost invisible now. I asked my wife if she could see it and she said "no". Because I knew where that thing was, I still notice a very small patch of slightly redder skin color but it is almost imperceptible.My order for Lactobacillus GG and Saccharomyces Boulardii arrived two days ago and I'm now taking them.So far, so good!
 

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Discussion Starter · #18 ·
Interesting factoid (at least for me):For the last 6 years or so, my blood tests have always shown a slightly elevated liver enzyme, namely, SGPT (aka ALT). Well, until now.My last day of Xifaxan was on Nov 18. On Nov 21, I went for my annual physical and had the regular blood testing done. Then, yesterday, got the results back by mail. Guess what? SGPT was very much normal!Given that SGPT is released into the bloodstream when there is some damage to the liver, could it be that my liver was having a hard time dealing with the toxic #### put out by whatever bacteria Xifaxan decimated? In any case, this is going to be one more marker (besides the skin rashes) to track for resurgence of nasty bugs in my bowels.
 

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grama v I am sorry I missed your post before.What happened to your daughter was a tragedy for sure and I am very sorry for your loss. There are some very sick people in the world.I would be happy to personally help you out in any way with the health problems as best I can.Do you know the name of the anitbiotic?Has it caused you any issues since you started it. Its preferably better to be breath tested before taking these, and recommended by a gi doc, more so then a regular md, but it sounds like your trying it and go from there.I would be happy to talk to you on the phone if you would like as well. I will also post some more information for you.Again very sorry to hear of your loss. I don't think words do justice, but I am sending good thoughts your way.
 
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