# SIBO?



## ChrisJenas (Apr 15, 2010)

Has anyone looked into this topic with IBS-C and the potential of bacterial overgrowth in the small intestine causing bloating, constipation, diahhrea? If anyone has undergone treatment for this, please kindly share


----------



## Naomi889 (Sep 11, 2005)

One of the other users, idkwia, was telling about this guy in Australia who claims quite a lot of digestive disorders are actually caused by bacterial overgrowth/infection with a specific agent. Check his website out at http://www.cdd.com.au/pages/disease_info/constipation.htmlHe says:"At the Centre for Digestive Diseases long standing research in this area has indicated that the most likely cause of the common variety constipation found in the majority of patients is caused by an infection with a bacterial agent that has entered the bowel through the mouth and has begun to coexist with normal human bowel flora. Its presence in the bowel flora is marked by the production of molecules within the bowel which affect the enteric nervous system so partially paralysing the bowel. If the constipation agent produces severe paralysis the bowel may not empty for days or weeks. Most commonly very mild forms are present and people tend to overcome this with simple methods such as excessive fibre or even chemical laxatives such as naturally occurring teas which may contain senna. However, worldwide the research on constipation has been extremely slow because it has been hidden by an overwhelming belief both in the lay and medical population that it is the lack of fibre which causes constipation. We now know that nothing can be further from the truth since removal of fibre from the diet of healthy patients does not cause constipation.The actual causative agent or agents are yet to be detected. However it appears that constipation is almost certainly caused by agents which respond to antibiotics which also kill clostridia. So there is a high chance that a type of a clostridium (clostridia produced neuro-toxins (e.g. Clostridium tetuni, Clostridium botulinum, Clostridium difficile, Clostridium perfringens) and so constipation may be simply a chronic infection with a clostridium that carries a spore and so it is difficult to eradicate with antibiotics. The most powerful evidence for this is published indication that Vancomycin which is not absorbed in the GI tract when taken by mouth, can dramatically reverse constipation. [The effect of oral vancomycin on chronic idiopathic constipation. Aliment Pharmacol Ther 1995/9:63-68) Vancomycin] Vancomycin can be combined with other agents such as Metronidazole or Rifampicin to strengthen the affect upon a constipating agent and to give the patients relief from there straining and bloating. Interestingly, the paralysis of the large bowel may be accompanied by partial paralysis of the small bowel so preventing gas moving forward and causing bloating. Such circulating active molecules produced in the colonic flora can also partially paralyse the stomach and this causes Gastroparesis and in some patients vomiting and also paralyses the lower oesophageal sphincter causing reflux. In a subset of patients' partial paralysis of the gall bladder causes reduced ejection of bile, precipitation of cholesterol and formation of gall stones.This generalised motility inhibition in the GI tract with one or two geographical areas in the GI tract posing as the symptom inducing area - has puzzled researchers for many years. Diet, allergy, stress and other mechanisms have been invoked to explain all of this. However in patients who respond very well to specialised antibiotics such as Vancomycin or Rifampicin combination the reversal of dysmotility is so dramatic that it is quite clear that the bowel flora plays the major role in this common and chronic condition."Quite a claim. He also uses something called faecal bacteriotherapy - http://en.wikipedia.org/wiki/Fecal_bacteriotherapyHe says:"The intestinal flora may play a key role in the pathogenesis of certain gastrointestinal (GI) diseases. Components of bowel flora such as Lactobacillus acidophilus and Bifidobacterium bifidus have long been used empirically as therapeutic agents for GI disorders. More complex combinations of probiotics for therapeutic bacteriotherapy have also recently become available, however the most elaborate mix of human-derived probiotic bacteria is, by definition, the entire fecal flora. Fecal bacteriotherapy uses the complete normal human flora as a therapeutic probiotic mixture of living organisms. This type of bacteriotherapy has a longstanding history in animal health and has been used sporadically against chronic infections of the bowel, especially as a treatment of last resort for patients with severe Clostridium difficile syndromes including recurrent diarrhea, colitis, and pseudomembranous colitis. Encouraging results have also been observed following infusions of human fecal flora in patients with inflammatory bowel disease, irritable bowel syndrome, and chronic constipation. The therapeutic use of fecal bacteriotherapy is reviewed here and possible mechanisms of action and potential applications explored. Published reports on fecal bacteriotherapy are few in number, and detail the results of small uncontrolled open studies and case reports. Nevertheless, given the promising clinical responses, formal research into fecal bacteriotherapy is now warranted."I'm holding off judgement til I read his full length published research. I do wish he wasn't in Australia.


----------



## Kathleen M. (Nov 16, 1999)

Usually SIBO means non-pathogenic normal and healthy bacteria in the colon (or mouth) getting established in the small intestine where they do not belong.Methane producers do seem to play a role in constipation for those with SIBO.If you go to our books link up at the top there is a link for Pimentel's book about it.Several people have been treated on the board. Check out the Prescription Medicine forum as the antibiotics for IBS are there.Here is another article about traditional SIBO and SIBO in IBS. http://www.medicinenet.com/small_intestina...wth/article.htmSIBO in IBS as described by Pimentel is treated with antibiotics, not fecal transplants, and as I said does not involve any sort of pathogenic bacteria of any sort.


----------



## ChrisJenas (Apr 15, 2010)

Thank you so much Naomi and KathleenSo basically looking at the article it seems if untreated it can cause chronic bloating and chronic constipation. Do u any of u guys know whether a Hydrogen Breath Test would be a proper diagnosis for this?Does a powerful antibiotic like Vancomycin have any side effects?RegardsChris


----------



## Kathleen M. (Nov 16, 1999)

Vancomycin isn't one of the typical antibiotics I've heard of for SIBO diagnosed with a Hydrogen or Methane breath test (at least in the USA). It usually is the antibiotic of last resort and they are trying to use it as little as possible so bacteria do not become resistant to it. Usually used for things that are likely to kill you like MRSA rather than something that makes you uncomfortable, like SIBO.I can only find it listed for IV use in the USA, but then it isn't absorbed that well. http://www.rxlist.com/vancomycin-injection-drug.htmI don't know if you can get oral vancomycin for intestinal use or if they have to make it special for you. Typically the way they diagnose it is with a breath test. The other way is pretty invasive and they have to get a sampler down into a small intestine and take a sample to culture.The link I provided had the usual antibiotics used * Neomycin (especially for constipation to get rid of methanogens) * Levofloxacin (Levaquin) or ciprofloxacin (Cipro) for 7 days. * Metronidazole (Flagyl) for 7 days. * Levofloxacin (Levaquin) combined with metronidazole (Flagyl) for 7 days. * Rifaximin (Xifaxan)--The most commonly used


----------



## ChrisJenas (Apr 15, 2010)

Kathleen, if one doesnt have any abdominal pain, but just chronic constipation and bloating, does that mean one can rule out the possiblity of SIBO?Is ABDOMINAL PAIN, a major symptom of SIBO?


----------



## faze action (Aug 6, 2009)

I suffered from SIBO for 2-3 years (unbeknownst to me at the time) and I had very little abdominal pain. I had some cramping after eating most of the time, but I wouldn't really classify it as PAIN. The main symptoms I had that were the worst were bloating/distension (I still suffer from this), diarrhea, and incomplete evacuation.I think that you can have C with SIBO, but I think that D might be more common (I think I read that somewhere in a journal article).


----------



## Naomi889 (Sep 11, 2005)

Faze, how were you finally diagnosed with SIBO?


----------



## faze action (Aug 6, 2009)

Naomi889 said:


> Faze, how were you finally diagnosed with SIBO?


Hydrogen breath test... which can result in false positives, but my response to antibiotics was dramatic the first time I took them, so I think the test was accurate in my case.


----------



## Tiss (Aug 22, 2000)

I had to take a couple of zpaks last year for sinus infections and it totally worked for my C. So I told my doctor that and he prescribed another antibiotic, I think it was like ampicillin or something and it did nothing. But what can you do if it works? I mean you can only stay on strong antibiotics for a short time and then it seems to come back. Anyhow, I do fine with my magnesium and zelnorm but I've always wondered what people do if antibiotics are the only thing that work for them?


----------



## Naomi889 (Sep 11, 2005)

What is a zpak?


----------



## Kathleen M. (Nov 16, 1999)

It is an antibiotic where they put all the doses on one of those push out the pill cards with how many pills to take each day. http://www.drugs.com/mtm/zithromax-z-pak.html has more info.


----------

