[bonniei]

Before getting too encouraged, it would help to identify some of the limitations of this study before drawing any conclusions: Patients were referred to the medical center specifically for breath hydrogen testing after being evaluated by physicians who suspected this diagnosis. This would tend to skew the proportion of persons with positive studies, simply because the doctors have already suspected the diagnosis. So the 78% figure may be higher than might occur in a better designed study.This is not a placebo-controlled double-blinded study. In well-designed studies, a proportion of subjects receive a placebo, so the investigators can compare the benefits of those on the active treatment to those on placebo. In addition, usually, neither the study subjects nor the investigators know who is getting the active drug or placebo. But when there is no placebo, then all patients (and investigators) will know they are receiving the active treatment (i.e., the antibiotics), and they may do better ("placebo effect") because they expect to do better. So the level of improvement here might be higher than if the study subjects did not know which treatment they were getting.Although 157 patients were tested for bacterial overgrowth, less than 1/3 were actually tested with regard to benefits from treatment. It is unclear why so few patients came back. Were the ones who didn't come back doing better or worse? Preferably, efforts need to be made to study all patients in order to know if the results are valid.This was a "convenience study". It appears that the authors went back in the clinical records to report their results rather than design a prospective study where patients follow a specific protocol. For example, at least four different antibiotics were used by different physicians. So it is unknown whether one antibiotic might be better than another, and these kinds of differences in how the study is conducted will interfere with the conclusions that can be drawn from the study.In summary, I believe that while the findings being reported are not a major breakthrough, they should increase awareness of one disorder that can mimic or worsen IBSfrom http://216.239.39.104/search?q=cache:0n0E2...&hl=en&ie=UTF-8

 

[skinny]

Bon, that's old news.Pimentel, Chow, and Lin conducted a second study that was a double blind study.Normalization of lactulose breath testing correlates with symptom improvement in irritable bowel syndrome: a double-blind, randomized, placebo-controlled study http://www.medicinedirect.com/journal/jour...002927002059026 Eric: Has Drossman critiqued this study?skinny

 

[bonniei]

Yes this is old news. I put it for the newbies like kel, meckle etc who weren't around when eric used to discuss this. Perhaps I should have specified. Even more recent than the study you posted is the connection between lactose intolerance and bacterial overgrowth which I posted earlier this evening. Have a look at it and it might give you insight into your problem http://www.ibsgroup.org/ubb/ultimatebb.php...ic;f=1;t=036409

 

[bonniei]

I might tell you also that the critique I posted is for some reason no longer directly available on the web. I had to go through the cached copies.

 

[skinny]

Google rocks! Ha I didn't notice that Bon. I wonder if that was removed because Drossman would have to recant what he wrote. Anyhow I'm interested in what Drossman has to say about Pimentel's second study.skinny

 

[bonniei]

eric I too am interested in UNC's response to the latest papers.