# Bacterial overgrowth and irritable bowel syndrome:



## eric (Jul 8, 1999)

FYIFYIAm J Gastroenterol. 2008 Dec;103(12):2972-6.Bacterial overgrowth and irritable bowel syndrome: unifying hypothesis or a spurious consequence of proton pump inhibitors?Spiegel BM, Chey WD, Chang L.VA Greater Los Angeles Healthcare System, Los Angeles, California, USA.Some studies indicate that small intestinal bacterial overgrowth (SIBO), as measured by hydrogen breath tests (HBT), is more prevalent in patients with irritable bowel syndrome (IBS) vs. matched controls without IBS. Although the data are conflicting, this observation has led to the hypothesis that SIBO may be a primary cause of IBS. Yet, it remains unclear whether SIBO is truly fundamental to the pathophysiology of IBS, or is instead a mere epiphenomenon or bystander of something else altogether. We hypothesize that SIBO might be a byproduct of the disproportionate use of proton pump inhibitors (PPIs) in IBS, as follows: (1) IBS patients are more likely than controls to receive PPI therapy; (2) PPI therapy may promote varying forms of SIBO by eliminating gastric acid; and (3) existing studies linking SIBO to IBS have not adjusted for or excluded the use of PPI therapy. When linked together, these premises form the basis for a simple and testable hypothesis: the relationship between SIBO and IBS may be confounded by PPIs. Our article explores these premises, lays out the argument supporting this "PPI hypothesis," discusses potential implications, and outlines next steps to further investigate this possibility.PMID: 19086951


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## Moises (May 20, 2000)

Very interesting hypothesis! You get the PPIs, and then you have to get antibiotics to heal the damage caused by the PPIs.


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## distressed (Jan 7, 2009)

I believe from my experiences that there is something to this. I have had my problems following the removal of my gallbladder and a nissen fundoplication and being placed on high doses of PPI medication. I have tried to reduce the dose but cannot without suffering quite painful GERD leading to oesophageal spasming.My father recently was put on PPI medication and he now has a lot of gas.My hypothesis is that the PPI medication contributes to a destabilisation of optimal conditions for healthy gut flora, and then eventually....overgrowth. Of course most Dr's would probably think im nuts.


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## IanRamsay (Nov 23, 2008)

ericyou are a man after my own heart mate. i am also convinced bacteria is the key. i have spent half my life researching bacteria and through my research i have cured my self from IBS, candida and sibo after almost 12 years by specific gram positive bacterial therapy targeted to a specific strain of bacteria that i was lacking in my large intestine and another that was far too prolific.. as a result i am now trying to find and patent a test that will be free, quick and easy to test for bacteria overgrowth, undergrowth, or absence of single strains or whole families. sadly this is going to take a while i think........................cheers mate, your research is apreciated.Ian


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## overitnow (Nov 25, 2001)

distressed said:


> I believe from my experiences that there is something to this. I have had my problems following the removal of my gallbladder and a nissen fundoplication and being placed on high doses of PPI medication. I have tried to reduce the dose but cannot without suffering quite painful GERD leading to oesophageal spasming.My father recently was put on PPI medication and he now has a lot of gas.My hypothesis is that the PPI medication contributes to a destabilisation of optimal conditions for healthy gut flora, and then eventually....overgrowth. Of course most Dr's would probably think im nuts.


This is exactly why I try to talk people into at least trying the flavonoids before the medications. They have kept my digestion working well for over 10 years, and they also control the growth of bad bacteria. Given the amount of indigestion we have all already suffered, a couple of more months of it seems a lot less problematical than having to deal with the potential long term effects of the ppis.Mark


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