[Pete]

I had posted about my success with neomycin for the treatment of intestinal gas. Well it has been about 31/2 months since neomycin and the gas is definately returning. I will call my doc next week but I imagine the decision is to take another 10 day dose or to try a different antibiotic. Flux, if my gas was caused by a bacterial imbalance in the colon and not SIBO, is there any way to correct that balance? Is it a motility problem that allows these gas forming bacteria to go crazy, or is it more likely an intolerance? I appreciate your help. Also what is your opinion about a low maintenance dose of an antibiotic? I have tried a lot of them including Cipro, tetracycline, tequin, flagyl, and amoxicillin. Neomycin was the only one that got rid of the gas for such an extended period of time. I remember that tetracycline did the same thing but the gas returned as soon as I finished. So flux, what now? I value your opinion in my decision as to what to try next for this gas problem. I read about oil of oregeno but the truth is that if it kills bacteria why is it any better than a prescription antibiotic? Also do you think motility drugs like lotronex or zelmac can reduce the amounts of intestinal gas by possibly working on the motility problem that may cause them to overgrow in the first place. Right now I am trying gastrocrom to see if food allergy is playing a role. Will report if it helps.Pete

 

[bonniei]

Sorry to hear that the gas is returning. ? You must have really appreciated the 3 1/2 months of relief

 

[eric]

Pete, I know I posted this beffore but not sure you saw it. http://www.medscape.com/reuters/prof/1999/...0/cl10209d.html ------------------Moderator of the Cognitive Behavioral Therapy, Anxiety and Hypnotherapy forumI work with Mike and the IBS Audio Program. www.ibshealth.com www.ibsaudioprogram.com

 

[flux]

I'd go for a better evaluation before embarking on therapies, especially ones that could be agressive.1) 80 gram glucose CO2 breath study (Minnesota VA)2) jejunal cultures (this you could probably get anywhere although accuracy is a concern)3) really done well scintigraphy (Temple U in Philadelphia does this)4) really done well manometry (Penn State and Northwestern does this)5) analysis of the gas itself (Minnesota VA)

quote:Is it a motility problem that allows these gas forming bacteria to go crazy, or is it more likely an intolerance?

I don't know what the word "intolerance" means. Having pseudo-obstruction the upper gut can cause BO and other gas related problems such as pneumatotsis, but you'd need the evaluation above to better assess that.If you had BO ruled out based on testing above, the other choice would be some "dysbiotic" condition. Then you could try Miralax to flush the gut, though you'd be replacing gas with diarrhea. That should work for BO as well. There is also a fecal "transplant" which is done by a doctor in Australia and one in the US (St. Louis as I recall).I doubt that oregano oil would be of help even if it was bacteria since that probably only works against preventing pathogenic organisms from taking hold; otherwise, we could use spices to treat gastroenteritis and we don't do that.------------------I am not a doctor, nor do I work for profit in the medical/pharmacological field, but I have read scientific and medical texts, and have access to numerous sources of medical information that are not readily available to others. One should always consult a medical professional regarding advice received.

 

[Pete]

Thanks Flux,Your response is very logical. Could explain tests 1,2, and 3. I appreciate it. I take it you feel that my positive SIBO test could have been false.Pete

 

[Kathleen M.]

The medical literature would seem to indicate that lactulose breath tests like they do a CS tends to give a lot of false postive results when the validate it against samples taken for culture from the small intestine. That's why places like UNC don't use lactulose, but use sucrose or glucose for the SIBO test.Generally indirect tests like breath measurments are less accurate than direct measurments like take a sample and culture it. Some indirect tests predict the direct tests better than others.K.------------------I have no financial, academic, or any other stake in any commercial product mentioned by me.My story and what worked for me in greatly easing my IBS: http://www.ibsgroup.org/ubb/Forum17/HTML/000015.html

 

[Guest]

Pete, I hope that you find something that will work. What did Cedar-Sinai suggest. Did they even mention to you about the two week "no solid foods" idea?

 

[Ugh]

quote:Generally indirect tests like breath measurments are less accurate than direct measurments like take a sample and culture it.

This may be true, but they do mention in the Cedars study that "Direct culture is considered by some to be the gold standard. There is now mounting evidence that direct culture may not be adequate. Direct culture is fraught with difficulty including oral contamination during collection. Furthermore, direct culture has a reproducibility of 38% compared to 92% for proximal small intestine. In the absence of hypochlorhydia, most SIBO results from proximal migration of colonic flora and therefore, would intuitively result in substantially higher levels of bacteria in distal small bowel. Sampling in this area is difficult. A nondigestible sugar such as lactulose allows determination of SIBO in all areas of potential involvement."Now, who knows, maybe that's just a justification for not using from what I understand is a lot more expensive test. Also, in the study, they had 157 test "positive for SIBO" and of those 47 returned for follow up testing. I'd guess that if the testing was more invasive with samples taken they'd get even fewer people returning, so I don't know about their argument, but they do make an argument in favor of the breath test.

 

[Blair]

Pete have you tried elimination diets? Flux how can a jejunal culture be done? unless you cut somone open I don't see how anyone can get to the jejunal part of the intestine?A real good Gastro can get the Colonoscope into the terminal ilieum and maybe a endoscope can get a little ways from the top but ... its pretty tough to get to, thats what I was told.