# My neomycin experience thus far/ bacterial overgrowth



## Pete (Jan 20, 2000)

Well I promised to keep people updated since I seem to be one of the first people on the board to go to Cedar Sinai. I am on day 5 of neomycin and here are the results thus farBurping- So far no change. Reflux- No changeBloating- Much betterFlatulence- GONE. I literally fart probably 100 times a day. The past 2 days I have probably passed gas 3 or 4 times.This antibiotic really hurt my stomach the first 2 days. I had terrible cramping and the bid D. I usually don't suffer with Diarrhea too often. Maybe one attack every few weeks. Well this antibiotic like all others did it to me. I called the doc and he told me that this was normal and to stick with it. By day 3 the runs were gone. The past 2 days my bowel movements have been normal but more amazing is that my intestinal gas is gone. I mean gone. Unfortunately my upper GI problems give me the most discomfort and I haven't seen much of a difference yet. Doc says to be patient. I will keep everyone informed on how they continue to treat me and whether it is successful or not.


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## flux (Dec 13, 1998)

> quote:Flatulence- GONE.


This part is interesting since you might be one of the few (or the lone individual?) posting on this board who really has evidence for an abnormal amount of gas.Do you know what your peak H2 level was?[This message has been edited by flux (edited 01-29-2001).]


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## Guest (Jan 29, 2001)

Hi Pete - Thank you so much for keeping up updated on your progress. I also was interested that you had upper GI symptoms with your IBS-D also. I have had IBS - D for 10 years with no upper GI problems. Please keep us up-to-date. Will you take your medication forever to continue to relieve your symptoms? Also, did you travel to LA for your treatment, or is this a silly question!!!!!!! Judy


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## Guest (Jan 29, 2001)

Pete, thanks for the info, are you being treated by Dr. Pimentel? Flux, this may be a stupid question, but if someone takes antibiotics and kills off most of the bacteria in their intestine/colon, regardless of the complications, wouldn't the gas be expected to be reduced to near zero at that time? I was under the impression intestinal gas was almost entirely caused by bacterial breakdown. I.E. no bacteria = no gas. Where am I wrong here?


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## flux (Dec 13, 1998)

> quote:I was under the impression intestinal gas was almost entirely caused by bacterial breakdown. I.E. no bacteria = no gas. Where am I wrong here?


There are only a few reports of persons having abnormal amounts in the literature so we don't have enought information to say whether the source is the bacteria or the atmosphere or a combination of the two. Also, many bacteria eat hydrogen gas, so killing them could increase bacterial gas output rather than decrease it.


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## Pete (Jan 20, 2000)

Flux,I don't know my peak H2 level. Would these be from the breath test? I know it curved all to way up to the very top and then came back down like a mountain. So if my gas is caused by overgrowth and they are only able to treat it with antibiotics, is it your opinion that I would be able to take a long term maintenance dose to keep things under control? Or would the bacteria eventually become resistant? Since my burping is unchanged, I suppose you think this is due to delayed stomach emptying accompanied by airswallowing? I do have allergies. Could post nasal drip be adding to the burping problem? Maybe a trial of Claritin D would be worth a try down the road. One more question. Do you think that if this overgrowth is real, it could be a contributing factor to gastroparesis? The doc at Cedar Sinai doesn't think I have GP even though I showed him my emptying was 14% at 90 minutes. He feels the PPIS may have caused this. That the food may be stagnant for a while and then start emptying normal. He feels on my next visit a longer gastric emptying test off PPIS and manometry into the stomach and small bowel. Does this all sound logical? I value your opinions even though I don't always agree.


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## KateyKat (Jan 4, 2001)

Flux said: "There are only a few reports of persons having abnormal amounts in the literature so we don't have enought information to say whether the source is the bacteria or the atmosphere ...Which literature is this please and how are these abnormal levels confirmed?"... Also, many bacteria eat hydrogen gas, so killing them could increase bacterial gas ..."OTOH some bacteria produce hydrogen so their demise may reduce gas volume. Sounds like a fine balancing act to me.K[This message has been edited by KateyKat (edited 01-29-2001).]


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## Danaps (Dec 26, 2000)

My doctor had me on antibiotics and I had no relief of my IBS-D over that period of time (2 weeks). I have an appointment to see the doctor next week and we'll see what he says. I really just want the lotronex back.


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## Kathleen M. (Nov 16, 1999)

Now I can't find it... I remember seeing some of the studies that indicated that IBSers have no difference in gas than normal people.. however I did find these that would be the other side of the coin.Wait I did find it... the 1985 paper at the end.Title Quantitative analysis of bowel gas using plain abdominal radiograph in patients with irritable bowel syndrome [see comments] Author Koide A ; Yamaguchi T ; Odaka T ; Koyama H ; Tsuyuguchi T ; Kitahara H ; Ohto M ; Saisho H Address First Department of Medicine, Chiba University School of Medicine, Japan. Source Am J Gastroenterol, 95(7):1735-41 2000 Jul Abstract OBJECTIVE: Ideally, the diagnosis of irritable bowel syndrome (IBS) would be achieved using a minimal number of procedures. It is presumed that bowel gas is related to IBS, and it is easily visualized by plain abdominal radiograph. In the present study, to clarify the relationship between IBS and the quantity of bowel gas, the measured bowel gas volume using plain abdominal radiographs was compared with the pathology of IBS. METHODS: Plain abdominal radiographs were digitized and transmitted to a computer (computed radiography) in 30 IBS patients and 30 normal controls. The quantity of bowel gas, determined as the pixel value on images and standardized by physique, was defined as the gas volume score (GVS). Using the mean +/- 2SD of GVS in the control group as the normal score, IBS patients were divided into three groups: high, normal, and low. To examine the sequential reproducibility of a similar quantity of bowel gas, a second plain abdominal radiography was performed about 2 months later, and the GVS were compared. The colonic transit time was determined using radiopaque markers. RESULTS: There was a strong correlation between the quantities of bowel gas measured by two independent gastroenterologists. The mean GVS of IBS patients was significantly higher than that in the control group (p < 0.001). The sequential reproducibility was recognized in all 10 IBS patients. There was no significance between colonic transit time and GVS, nor between symptoms and GVS. CONCLUSIONS: Abdominal gas was analyzed objectively by using GVS, and GVS was considered to represent a useful tool for the diagnosis of IBS. Title Abnormal colonic fermentation in irritable bowel syndrome. Author King TS ; Elia M ; Hunter JO Address Department of Gastroenterology, Addenbrooke's Hospital, Cambridge, UK. Source Lancet, 352(9135):1187-9 1998 Oct 10 Abstract BACKGROUND: The cause of irritable bowel syndrome (IBS) is unknown. It may follow gastroenteritis and be associated with an abnormal gut flora and with food intolerance. Our study was designed to assess whether these factors were associated with colonic malfermentation. METHODS: We carried out a crossover controlled trial of a standard diet and an exclusion diet matched for macronutrients in six female IBS patients and six female controls. During the final 72 h on each diet, faecal excretion of fat, nitrogen, starch, and non-starch polysaccharide NSP was measured, and total excretion of hydrogen and methane collected over 24 h in a purpose-built 1.4 m3 whole-body calorimeter. Breath hydrogen and methane excretion were then measured for 3 h after 20 g oral lactulose. FINDINGS: The maximum rate of gas excretion was significantly greater in patients than in controls (2.4 mL/min IQR 1.7-2.6 vs 0.6, 0.4-1.1). Although total gas production in patients was not greater than in controls (median 527 mL/24 h IQR 387-660 vs 412, 234-507), hydrogen production was higher (332, 318-478 vs 162, 126-217, p=0.009). In patients, the exclusion diet reduced symptoms and produced a fall in maximum gas excretion (0.5 mL/min IQR 0.3-0.7). After lactulose, breath hydrogen was greater on the standard than on the exclusion diet. INTERPRETATION: Colonic-gas production, particularly of hydrogen, is greater in patients with IBS than in controls, and both symptoms and gas production are reduced by an exclusion diet. This reduction may be associated with alterations in the activity of hydrogen-consuming bacteria. Fermentation may be an important factor in the pathogenesis of IBS. itle Irritable bowel syndrome: current concepts and future trends. Author Krag E Source Scand J Gastroenterol Suppl, 109(-HD-):107-15 1985 Abstract About five per cent of the adult population each year will see their doctor with complaints that are finally characterised as irritable bowel syndrome (IBS). The complaints are constipation (perhaps alternating with diarrhoea), abdominal pain (dull or colicky), abdominal distension, abdominal rumbling and flatulence. The diagnosis of IBS implies that a relevant examination has precluded any organic disease. The etiology is unknown and the syndrome probably does not represent a disease entity. It is therefore difficult, if not impossible, to produce a definite rationale of treatment. However, several aspects of the pathogenesis of the individual symptoms of IBS are well known: 1) chronic constipation is most likely due to fibre-depleted diet, psychological factors, local organic disorders (e.g., anal fissures, hemorrhoids, diverticulosis) and disturbance of the body fluid balance (e.g., high consumption of diuretic compounds such as coffee and tea); 2) pain is related to spasms and motility disturbances causing increased intraluminal pressure; 3) meteorism is not due to an increased amount of intestinal gas, but "air traps" and segmental accumulation of gas seem to occur. Furthermore, psychopathological factors and perhaps also food intolerance may play an etiological role. At present the rationale of treatment in IBS is: 1) management of constipation, 2) ease of spasms, 3) reduction of surface tension of intestinal contents, 4) ease of mental stress. K------------------I have no financial, academic, or any other stake in any commercial product mentioned by me.


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## KateyKat (Jan 4, 2001)

This is helpful information ... thanks K ... now I need a little time to digest it Katey


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## Guest (Jan 29, 2001)

Glad to hear that it is at least helping you a little..Still waiting for my appointment in April. I too have the problem with the upper abdomen, so I am curious as to how they are going to be able to help me.. I will pray that this will work for you! Good Luck!


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## flux (Dec 13, 1998)

> quote:Which literature is this please and how are these abnormal levels confirmed?


Only three; they just counted passes:www3.infotrieve.com/medline/infotrieve/detail.asp?med7579+167167+"(flatulence)+AND+(levitt)"www3.infotrieve.com/medline/infotrieve/detail.asp?med7579+662498+"(flatulence)+AND+(levitt)"www3.infotrieve.com/medline/infotrieve/detail.asp?med9799+665444+"(flatulence)+AND+(levitt)"Regarding the studies quoted by K: the first one is interesting: it doesn't say IBSers are intaking or producing more gas than normal people, only that it doesn't move efficiently (and oddly does not make a difference with regard to symptoms). The second one is the one I pointed out is hard to decipher because of the contraption used to measure it and problematic because it can't easily be reproduced.


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## Kathleen M. (Nov 16, 1999)

I searched flatus not flatulence... I knew those studies were out there.The one study of Levitt's in the Levitt and flatulence search does indicate that at least in one individual swallowed air appears to make it into the colon, which seems to be something that most people seem to think doesn't happen. Ah for a complete set of studies on flatus!! For some reason no one wants to hang their academic future on that particular subject though.K[This message has been edited by kmottus (edited 01-29-2001).]


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## Guest (Jan 30, 2001)

Flux said:"There are only a few reports of persons having abnormal amounts in the literature so we don't have enought information to say whether the source is the bacteria or the atmosphere or a combination of the two. Also, many bacteria eat hydrogen gas, so killing them could increase bacterial gas output rather than decrease it."You mention "atmosphere." Are you referring to air swallowing? As K notes in the post above, I thought that was not thought to pass into the colon.And you said some bacteria eat hydrogen gas. Where does the hydrogen gas come from in the first place?


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## KateyKat (Jan 4, 2001)

Gulp ... lotsa air swallowing seems to be going on in these studies .. gulpKMottus said:"The one study of Levitt's in the Levitt and flatulence search does indicate that at least in one individual swallowed air appears to make it into the colon ..."K


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## Guest (Jan 30, 2001)

What if that "one individual" turned out to be Flux? lol


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## flux (Dec 13, 1998)

> quote:I don't know my peak H2 level. Would these be from the breath test?


Yes. (You seem trust all those test results without ever actually seeing them.)


> quote:is it your opinion that I would be able to take a long term maintenance dose to keep things under control?


It would be better to treat the underlying motility disorder rather than take antibiotics periodically.


> quote:Or would the bacteria eventually become resistant?


Yep.


> quote:Since my burping is unchanged, I suppose you think this is due to delayed stomach emptying accompanied by airswallowing?


Sounds right.


> quote: Could post nasal drip be adding to the burping problem?


Maybe.


> quoteo you think that if this overgrowth is real, it could be a contributing factor to gastroparesis?


Probably not unless you were taking something to stop acid production.


> quote:He feels on my next visit a longer gastric emptying test off PPIS and manometry into the stomach and small bowel. Does this all sound logical?


I believe the more you know the better off you are, so having this repeated and done correctly is a good move.


> quote:You mention "atmosphere." Are you referring to air swallowing?


Yes.


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## Pete (Jan 20, 2000)

Flux,Why do you think that overgrowth could be causing gastroparesis if I am on something to stop acid production? I am on pretty high doses of PPIS (prevacid 30 mg 2x a day for over 2 years)


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## flux (Dec 13, 1998)

> quote:Why do you think that overgrowth could be causing gastroparesis if I am on something to stop acid production? I am on pretty high doses of PPIS (prevacid 30 mg 2x a day for over 2 years)


Oops, I misread that. If you had gastroparesis (cause unknown) and you were stopping your acid production that could give you gastric bacterial overgrowth.


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## Guest (Jan 30, 2001)

My original question was..."Flux, this may be a stupid question, but if someone takes antibiotics and kills off most of the bacteria in their intestine/colon, regardless of the complications, wouldn't the gas be expected to be reduced to near zero at that time? I was under the impression intestinal gas was almost entirely caused by bacterial breakdown. I.E. no bacteria = no gas. Where am I wrong here?"Flux then mentioned that taking antibiotics would also kill off hydrogen eating (helpful) bacteria. I think you're missing my point here. My point is that it would seem to me that anybody on antibiotics should be expected to have reduced gas while taking them. So far Pete has reported that the major change has been a reduction in gas and bloating. Shouldn't this be expected regardless of weather or not he has a bacterial overgrowth of the small intestine?Sure he may be killing off the hydrogen eating (good) bacteria, but if ya kill off the hydrogen producing (bad) bacteria too, I don't see what is left to produce gas.


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## flux (Dec 13, 1998)

> quote:Flux then mentioned that taking antibiotics would also kill off hydrogen eating (helpful) bacteria. I think you're missing my point here. My point is that it would seem to me that anybody on antibiotics should be expected to have reduced gas while taking them. So far Pete has reported that the major change has been a reduction in gas and bloating. Shouldn't this be expected regardless of weather or not he has a bacterial overgrowth of the small intestine?


No, because the antibiotics are generally specific for certain types of bacteria and then are issues of resistance. So it's perfectly possible for the antibiotic to selectively kill the wrong (hydrogen consuming) bacteria. Or it may kill certain hydrogen producing bacteria but then allow other hydrogen-producing bacteria to flourish. Or it could kill the hydrogen altering ones but not affect the carbon dioxide producing ones, allowing them to flourish.


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## Guest (Jan 30, 2001)

Pete, what dosage (mg) of Neomycin are you taking and how often per day?


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## Guest (Jan 30, 2001)

Flux, is it possible to identify what are the species mostly responsible for hydrogen production in the small intestine? (ie. are they classified as gram-negative vs. positive etc)? Also, now that I've mentioned it, what are the ones responsible for sulfur, methanol, carbon dioxide etc. production down the lower end of the GI system?Thanks,ZD.


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## flux (Dec 13, 1998)

> quote:Flux, is it possible to identify what are the species mostly responsible for hydrogen production in the small intestine? (ie. are they classified as gram-negative vs. positive etc)?


Some of them are known (see below), but since any bacteria in overgrowth can cause problems, there be'd no reason to just to focus on them. The H2-producing bacteria in one study included: Bacteroides (5%),clostridia (8%), anaerobic corynebacteria (5%), Escherichia coli (67%), Lactobacillus (8%), Staphylococcus (8%), and Streptococcus (9%).


> quote:Also, now that I've mentioned it, what are the ones responsible for sulfur, methanol, carbon dioxide etc. production down the lower end of the GI system?


Methane is produced one group of bacteria and sulfur gases by another. Probably a good number of different types produce CO2.


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## Pete (Jan 20, 2000)

I am taking 500 mg 2x a day for 10 days


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## KateyKat (Jan 4, 2001)

Whoops [This message has been edited by KateyKat (edited 01-30-2001).]


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## KateyKat (Jan 4, 2001)

On the wisdom of treating bacterial overgrowth with antibiotics, Flux remarked:"It would be better to treat the underlying motility disorder rather than take antibiotics periodically."Yes indeed, the BO research seems to relate only to an *effect* of dysmotility and in some ways may be a bit of a red herring. I'm sceptical 'bout all this research being done, or at least funded, by drug companies who inevitably have an interest in finding a drug to 'cure' this widespread digestive illness. Just supposin', just for a mo, that research has/had shown the cause of dysmotility to lay in a healthy response to the quality of the stuff that passes for food ...KK - for clarity


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## flux (Dec 13, 1998)

> quote:Yes indeed, the BO research seems to relate only to an *effect* of dysmotility and in some ways may be a bit of a red herring.


Bacterial overgrowth may be the real red herring here.


> quote:the quality of the stuff that passes for food ...


What's wrong with our food?


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## KateyKat (Jan 4, 2001)

Apologies if this comes up twice - first one appears to have dis-appeared[This message has been edited by KateyKat (edited 01-30-2001).]


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## KateyKat (Jan 4, 2001)

Flux, you are joking when you ask...What's wrong with our food?... aren't you?Or would you really like a detailed analysis of the effects of - preservatives, pesticides, antibiotics, hormones etcKK


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## flux (Dec 13, 1998)

> quote:What's wrong with our food?


No, that wasn't a joke.


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## Guest (Jan 31, 2001)

Pete: I'm grateful you are keeping us informed of your trial and want to thank you for the update. Also are you diabetic? As gastroparesis is associated with it.------------------BJV/Female__(D)


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## KateyKat (Jan 4, 2001)

Flux said:"No, that wasn't a joke."Well, in all seriousness, what's wrong with our food really is no joke.And how many of these drug co. related research establishments are actively researching *that* little question - and publishing the results?KK


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## Ugh (Jan 30, 2001)

Pete,Did the Doctor mention anything about Probiotics? I too am about to take antibiotics for a possible small bowel overgrowth. I'm wondering if it's a good idea to help repopulate the colon with good bacteria after the treatment with antibiotics, or if they might just mess up the small intestine again.


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## flux (Dec 13, 1998)

> quote:Well, in all seriousness, what's wrong with our food really is no joke.


There is something wrong with our food?


> quote:And how many of these drug co. related research establishments are actively researching *that* little question - and publishing the results?


What question?


> quote:I too am about to take antibiotics for a possible small bowel overgrowth. I'm wondering if it's a good idea to help


No, it is not a good idea.


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## KateyKat (Jan 4, 2001)

Flux queried:"There is something wrong with our food?"IMHO - and that of others - quite definitely."What question?"Please see earlier post.KK


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## HipJan (Apr 9, 1999)

flux -- Please check out your answer to Ugh's question (see your last post and also Ugh's). I am wondering if you read Ugh's whole sentence (in her second sentence, she wasn't talking about antibiotics but about taking probiotics). ?? Anyway, I wasn't sure if you'd misread. (I think you probably meant that you'd advise Ugh to stay away from antibiotics, if possible, altogether.)[This message has been edited by HipJan (edited 01-31-2001).]


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## HipJan (Apr 9, 1999)

Yes, I do agree that there likely are some things wrong with much of our food. Our systems, esp. if healthy, should be able to tolerate a certain amount of toxins (I understand). But, personally, to be safe (and because I'm not so healthy), I buy good-quality foods (inasmuch as I can tell!), steering away from preservatives, pesticides (or I try to wash them off), and steroids (as in meat products).


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## BernieL (Jan 18, 2001)

Flux,You seem to be skeptical of the diagnosis of bacterial overgrowth of the small intestine based on the lactulose breath test. The Cedars-Sinai article did report that some 78% of 202 patients tested positive in the breath test.If there is no bacterial overgrowth, how would you interpret the data from the lactulose breath testing? Do you think there are simply large measurement errors with this sort of test? Or that factors other than a bacterial overgrowth of the small intestine could cause a positive result on a lactulose breath test?


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## Kathleen M. (Nov 16, 1999)

Bernie,The 78% of IBSers have overgrowth as reported in the media is a little misleading. 78% of people with IBS whom a doctor thought had bacterial overgrowth did come up positive in the breath test (alhtough the criteria for postive may not be the same as other clinics use it is hard to tell).Most other clinics that do this type of testing find a much lower prevelance of IBSers with postive H2 breath tests. see: http://www.aboutibs.org/IFFGD_IBS%20%26%20...0Infection.html K.------------------I have no financial, academic, or any other stake in any commercial product mentioned by me.


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## FPHHT! (Feb 1, 2000)

Hi Pete.I'm in the Study with Dr. Pimental at Cedars too.


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## Guest (Feb 1, 2001)

FPHHT!-What is your experience with the study?


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## FPHHT! (Feb 1, 2000)

blow air into bags with blue hose things on them. i think i filled up ten bags! another person took my blood. i answered a big questionnaire too. after it was all done they gave me pills to eat twice a day. they would not tell me what was in the pills or the results of the testing. they said i would have to wait until all the testing is over before even dr. pimental will know. he called me on the phone today, and i guess i'm doing okay. the pills were making me get bad d last night. if it is the medicine and not the fake stuff, it kills the bacteria on about the 5th day. dr. pimental said that as the bacteria dies it gives off toxins that make the d get worse. that is where i am now, day 5. he said if it's the real medicine, the d should get better in a day or two, and then all the bacteria will be dead. 5 days after i stop eating pills i might be 'temporarily' ibs free. that's also when i take the second battery of tests.FARTMAN!


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## flux (Dec 13, 1998)

> quote:IMHO - and that of others - quite definitely.


Not in my book.


> quote:Our systems, esp. if healthy, should be able to tolerate a certain amount of toxins


If it didn't, we wouldn't be here.


> quotereservatives


Preservatives serve a good function, don't they?


> quote:You seem to be skeptical of the diagnosis of bacterial overgrowth of the small intestine based on the lactulose breath test. The Cedars-Sinai article did report that some 78% of 202 patients tested positive in the breath test.


I'm writing up an editorial on this issue. I will post it in a separate thread and should answer your questions (once I get it done!).


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## Pete (Jan 20, 2000)

Ugh,If you are going to try antibiotics, it should be neomycin. I would stay away from probiotics. The small intestine is suppose to be sterile so by taking probiotics you are adding more bacteria to grow where they shouldn't. I am now on day 8 of neomycin and my D from the first few days has subsided. My gas is gone. I was literally farting 100 times a day. My burping, reflux, and upper abdominal discomfort has not changed. I still have the bad taste in the back of my mouth. The only benefit is the reduction of gas. I have gone to farting all morning and evening to not being able to remember if I farted once today. I just hope we can figure out how to keep it from coming back.


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## FPHHT! (Feb 1, 2000)

i'm sorry, but i do not understand what mr. flux is talking about.as for the medicine pete refers to, it is neomycin. dr. pimental said i would get neomycin or placebo because neomycin is not absorbed into the blood. if i said probiotic i was wrong.they also check my blood for cytokine? (is that right) levels. they can tell if my body is working to counter a bacterial overgrowth by looking at the before and after blood levels.so far, all of my ibs symptoms, (bloat, gas, 'sick feeling', cramps, multiple BM's) have disappeared except the D, which the dr. said should cease over the next day or two. even if i am 'cured' of the ibs, they tell me it will eventualy return. they are hoping to find a way to stop the overgrowth without antibiotic.


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## jcaf (Feb 19, 2000)

I dont understand the reason behind blinding Fphht on the meds used and then disclosing the information before the cycle is complete.


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## FPHHT! (Feb 1, 2000)

they did not tell me i was on the drug. they only told me that what i was experiencing would be normal for someone that was on the drug because i was all upset about what i perceived the pills were doing to me. the dr. helped me calm down about the whole thing by explaining that it was a a normal reaction if i were truly on neomycin, but he was also very clear to explain that even he did not know i was on neomycin or placebo. this was sufficient to calm me down, because if what i was experiencing was from a placebo, it was in my head anyway and was nothing to worry about. if it was from a real drug, i just wanted to make sure my reaction was not abnormal. i still do not know what kind of pills i am eating.


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## HipJan (Apr 9, 1999)

Pete -- Oh, no, have you learned in your study, from the docs there, that we shouldn't be taking probiotics?







ugh! Those are a mainstay for many of us "senior members" on this board. I'm confused now!


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## Guest (Feb 1, 2001)

It is my understanding when someone is in a clinical trial such as this there are certain rules to go by such as no other medications or supplements so as to have certain outcomes from the study.HipJan: I don't believe the doctor is saying never take probiotics, but not during the study would make sense to me.


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## Pete (Jan 20, 2000)

No. What he is saying is that if you have bacteria overgrowth of the small intestine then it is possible probiotics could add to the problem. So logic would say if they help you, stay on them. If they don't, get off them. I'm sure they help a lot of people who don't have Bact overgrowth.


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## FPHHT! (Feb 1, 2000)

Man, I'm going to start a new post to explain this. Also, pro biotics are VERY GOOD! But they also should not be taken during a clinical trial like the one I'm in. The best pro biotic for us IBS folks with D is YOGERT! The bacteria in yogert helps fight other bacteria. YOUR COLON IS A GIANT BACTERIA BATTLE FIELD! You can add a few soldiers of your own to help the good guys.All senior members PLEASE do not get afraid of pro-biotics if they are working for you. It's like anything else, if it works, great. For some folks the Pro Biotic can cause D.


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## KateyKat (Jan 4, 2001)

Pete said:"The only benefit is the reduction of gas. I have gone to farting all morning and evening to not being able to remember if I farted once today. "Even if this is only symptomatic relief, it can give u an invaluable 'break' "I just hope we can figure out how to keep it from coming back."If it does come back then they'll have to find the source rather than just treat symptoms. Antibiotics deplete yer immune system *and* develop resistance.KK


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## KateyKat (Jan 4, 2001)

Flux mused :"Preservatives serve a good function, don't they? ... " etc Food for Thought - new thread perhaps -antibiotics + food lead to indigestion  KK


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## HipJan (Apr 9, 1999)

Pete, well, it's been speculated (not tested though) for a long time that I've had bac. overgrowth. What seems to have, perhaps, been one of the best things for me is probiotics (among other things). So, anyway, if you learn more about this subject, please post it for us.







I do understand, though, that probiotics and antibiotics can sort of counteract each other -- so, you have to take each at different times.By the way, I've heard over and over that yogurt isn't in fact the best form of probiotics (not bad, of course, but...).


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## KateyKat (Jan 4, 2001)

I'll bump this as well .. for Shelley


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## bonniei (Jan 25, 2001)

Pete I am so happy to hear that neomycin helps gas. For me too there have been times when I have passed gas a 100 times a day though it is now under control with meds that have serotonin in them. I'll be looking for your posts to see if it comes back. Sure am gl;ad to know that there may be relief in sight and that they are looking in the right direction


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## Pete (Jan 20, 2000)

Bonnie,Which serotonin med are you taking. It has been close to 3 weeks since I took neomycin and the gas has not returned. I am going next week for a repeat breath test and will keep everyone informed. Unfortunately my upper GI problems remain. I believe I developed this overgrowth as a result of my stomach emptying too slowly and possibly as a result of daily PPIS(antacids) for 3 years. It is a relief though that the gas is gone. I am hoping that the release of zelmac will help my upper GI problems. There are current studies showing its effectiveness with GERD and dyspepsia.Pete


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## bonniei (Jan 25, 2001)

Risperidal. I hope Zelmac helps. I find if I drink a lot of tomato juice I burp a lot


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## HipJan (Apr 9, 1999)

Pete, have you had an upper endoscopy done? That test can be quite beneficial.Was wondering...Anybody know how the H. Pylori breath test (which I'll be taking in 3-4 weeks) compares to the bac. overgrowth breath test? Just curious.


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## Stace (Sep 20, 2000)

Hi HipJan,How are you doing on the Prevpak? The breath test for H. Pylori called the C-Urea Breath Test. I had this a month after my treatment for verification that the H. Pylori was eradicated. Sometimes the meds don't kill it the first time and repeat treatment with different antibiotics is necessary. Anyway, I believe the test Pete did is a hydrogen test, isn't it? Here's the info on the H. Pylori breath test.Stacey What is a C-Urea Breath Test? This test provides a non-invasive means of diagnosing a stomach infection with a bacteria called Helicobacter pylori. This bacteria has been linked to the formation of ulcers in the stomach and small intestine.How is the test performed?During the test you will be asked to swallow a pill containing a chemical called urea labeled with a very small amount of radioactivity. The level of radioactivity is much less than you would receive from one standard chest x-ray. If the bacteria is present in your stomach, an enzyme produced by this bacteria will break down the urea to ammonia and carbon dioxide gas. This carbon dioxide gas is quickly absorbed through the lining of the stomach into the blood stream. It is eventually expelled in the breath. We will collect breath samples 6 minutes, 12 minutes and 20 minutes after the ingestion of the urea pill. These breath samples are then analyzed for their level of radioactivity. If radioactivity levels in the breath rise by a predetermined amount, infection with Helicobacter is present. This test lasts approximately 30 minutesTo prepare for the C-Urea breath test do not take any antibiotics or bismuth-containing compounds, such as Pepto-Bismol within 30 days of the test. You should not take Carafate, Prevacid, or Prilosec for a least one week prior to the test. Twenty-four hours before the test, discontinue taking medications such Pepcid, Tagamet, Axid or Zantac. You should take all of your regularly scheduled medications aside from the ones mentioned unless specifically instructed to do otherwise by the clinic nurse or your physician.


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## HipJan (Apr 9, 1999)

thanks for the info, Stace. I'm glad the procedure only lasts 30 min. hmm, it says you should wait 30 days after antibiotics, but my doc was talking about waiting about 3 weeks. I guess I'm doing ok on my Prevpac, but suddenly the stuff seems to have kicked in and the toilet is becoming a good friend again.


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## Stace (Sep 20, 2000)

Hi HipJan,You know, the doctor told me I would definitely have D with the treatment, but I never did get it. I felt wonderful for the whole 2 weeks. My mother got the D bad, though, with her treatment. I would try to re-schedule your breath test....push it back a couple weeks....after what you've been through, I wouldn't want you to even risk another false neg. (like the blood test). I was off the meds a good 6 weeks when I had the test.Stacey


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## Guest (Feb 17, 2001)

Can someone please tell me what is Zelmac? What is it used for? Anyone try it and does it work?


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## Island girl (Jul 24, 2000)

HipJan-I was surprised about the warning from Pete's Dr to stay away from probiotics, too. Someone earlier said that the Small Intestine is sterile, and perhaps this is why.The small intestine is not a sterile body part, however. (sterile body areas: respiratory tract below vocal cords, sinuses & middle ear, liver, gallbladder, urinary tract above urethra, bones, joints, muscles, brain, spinal column, lining of lungs & lining of abdominal cavity.)The small intestine has a low concentration of bacteria, when compared to the billions in the colon, but it's got bugs. In healthy people, the main inhabitant of the sm. intestine is the lactobacilli species.Overgrowth of the sm. int. occurs when bacteria in the colon travel into it. It seems to me that MDs now fall into 2 categories with regard to probiotics:they either say probiotics defeat the purpose of the antibiotics, or else they recommend probiotics during a course of anti's, to help someone with a low immune system protect their intestinal flora balance.I seem to agree with the latter... [This message has been edited by Island girl (edited 02-18-2001).]


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## Kathleen M. (Nov 16, 1999)

shellygirl--Zelmac is doing well in clinical trials where it is being used for constipation predominate IBS.If all goes well it should be coming out later this year.I suspect that like all treatments it will work better for some people than others.K.------------------I have no financial, academic, or any other stake in any commercial product mentioned by me.And from the as if IBS isn't enough of a worry file...from New Scientist's Feedback column: photographed on the door of a ladies' loo in the Sequoia National Park in California by reader Liz Masterman: "Please keep door closed to discourage bears from entering."


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## flux (Dec 13, 1998)

> quote:Overgrowth of the sm. int. occurs when bacteria in the colon travel into it.


No, it occurs when the motility of the small bowel is hampered. Bacteria in food is not flushed. The bacteria come from food.


> quote:hey either say probiotics defeat the purpose of the antibiotics,


Who says that?


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## HipJan (Apr 9, 1999)

how does the motility get hampered?


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## Ugh (Jan 30, 2001)

traditionally I believe the general thinking was motility got screwed up due to surgery. As I understand it this whole bacterial overgrowth related to IBS (that is, something non-surgical) is a relatively new event. At least that's the impression I've gotten.My guess is that taking probiotics wouldn't make a bacterial overgrowth worse since if you eat yogurt, or probably any food for that matter, a fair amount of bacteria get in there anyway. I suppose if you just took antibiotics for a bacterial overgrowth it wouldn't be a great idea to take probiotics.One thing I still don't understand is what bacteria is supposed to be causing this overgrowth. I know the small intestine is supposed to be relatively sterile, but how would a probiotic (non-gas causing) type of bacteria cause the symptoms that these doctors seem to be looking for like gas and bloating? Is it because it would be eating food that hasn't been digested to it's proper point in the small intestine? Does that somehow cause more gas to be released? Or is it a non-probiotic type that causes the problems of bacterial overgrowth? I guess if they're testing for H2, I should ask if probiotics release H2? Anyway, just thought I'd toss out some questions that were in my head. On a side note, are probiotic bacteria gas free, or do they just release much less gas than other intestinal bacteria?[This message has been edited by Ugh (edited 02-19-2001).]


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## Island girl (Jul 24, 2000)

THE SMALL INTESTINE IS NOT STERILE. It just isn't colonized as heavily as the large intestine. There is no such thing as "relatively sterile." Look it up in a text book. It's like saying DNA isn't involved with heredity, or only relatively so."they either say probiotics defeat the purpose of the antibiotics">I've read that twice here on this bb when people quoted their MD."Overgrowth of the sm. int. occurs when bacteria in the colon travel into it.">From the book "Digestive Wellness," 2nd editionThey also say in this book---"Chronic pancreatitis, Crohn's Disease, and lupus can cause small bowel overgrowth. It can also be a result of poor hydrochloric acid production in the stomach or an insufficient amount of pancreatic enzyme function. It is often found in conjunction with parasitic infection. Many people with small bowel overgrowth experience diarrhea, poor nutrient absorption, and weight loss. Other people who may be affected are those with poor ileocecal valve function, POOR INTESTINAL MOTILITY, scleroderma, or recent gastric surgery. People infected with small bowel overgrowth often have difficulty with digestion of fats, which come through undigested in the stool, called steatorrhea. They may also experience B12 deficiency, chronic diarrhea, and poor absorption of vitamins A,D, E, and K."There is an entire chapter dedicated to probiotics and it details which probiotics are where. The probiotics in yogurt are HIGHLY beneficial-esp. if you make it yourself.Ugh- I wish I had an answer re: your gas questions. I don't have a gas problem...I also eat yogurt and take take probiotics daily. I know I used to have bad pains before I got proactive with this monster. Maybe the probiotics help. My bloating stopped when I cut back on grain products.Also, I've recently gone from having Diarrhea 6-12 x's daily, to 1-2 xs normal. (I'm keeping my fingers crossed.) This chronic diarrhea lasted for one and a half years with a two week remission after taking Flagyl last fall. I've done many different things, but I've never stopped with the probiotics.[This message has been edited by Island girl (edited 02-19-2001).]


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## flux (Dec 13, 1998)

> quote:as "relatively sterile." It's like saying DNA isn't involved with heredity, or only relatively so.


No, it really is relatively sterile. That's a comparison to the colon. The comparison above is not logical.


> quote:"they either say probiotics defeat the purpose of the antibiotics"


I don't get it, though.


> quote:"Overgrowth of the sm. int. occurs when bacteria in the colon travel into it."


I don't get that either; there'd have to be reflux into the ileum. But usually BO refers to the upper gut.


> quote:"Chronic pancreatitis, Crohn's Disease, and lupus can cause small bowel overgrowth.


Well, if you gum the works in the small bowel, that could reduce the efficiency of the MMC.


> quote:My guess is that taking probiotics wouldn't make a bacterial overgrowth worse


Any bacteria headed there will have the chance to make it worse.


> quote:One thing I still don't understand is what bacteria is supposed to be causing this overgrowth


Dysmotility is the primary mechanism. Other conditions could conceivably gum up the works.


> quote: I know the small intestine is supposed to be relatively sterile, but how would a probiotic (non-gas causing) type of bacteria cause the symptoms that these doctors seem to be looking for like gas and bloating? Is it because it would be eating food that hasn't been digested to it's proper point in the small intestine? Does that somehow cause more gas to be released? Or is it a non-probiotic type that causes the problems of bacterial overgrowth? I guess if they're testing for H2, I should ask if probiotics release H2? Anyway, just thought I'd toss out some questions that were in my head.


Some probiotics make gas, though probably only CO2, not H2. However, the gas is used to detect overgrowth. One could have overgrowth of all non-gas making bugs. It's not a requirement.


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## Island girl (Jul 24, 2000)

By definition, a sterile body area is one which does not play home to ANY bacteria-ever. There are numerous nonsterile body areas, and none of them have the billions similar to the colon. It's got fecal matter. It does not mean that all of these areas are "relatively sterile" because they've got less than our feces. They just aren't sterile, because they play host to good & bad bugs(ie, small intestine.) When the small intestine becomes over-run with the bad bacteria, it seems to make sense to help the body replenish with the good(probiotics) to help balance it out. This has been proven in so many studies, it seems to be rather indisputable. Isn't this why probiotics are becoming so popular? People aren't buying them just because they like the idea of swallowing microscopic bacteria. I've taken an rx'd antibacterial twice(flagyl). The first time I took it without any probiotics. Afterwards, I became incapacitated and unable to even leave my home due to pain and diarrhea. That is when I decided to look for answers myself and found this bb.The second time I took it, I took it with probiotics, on the advice from this board(Unfatigued & her MD), and was actually 100% afterwards for just 2 weeks. Then it resurfaced. My point is that some MD's advocate probiotics, some don't.Obviously, while I am happy Cedars-Sinai made the role of bacteria in IBS more mainstream, I can't see how treating it with neomycin or any broad-spectrum can help patients long term. I'd heard through the grapevine they had good luck treating it with S. Boulardii but have yet to come across anything substantiating that.


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## flux (Dec 13, 1998)

> quote:When the small intestine becomes over-run with the bad bacteria, it seems to make sense to help the body replenish with the good(probiotics) to help balance it out. This has been proven in so many studies, it seems to be rather indisputable.


this is







1) Nobody is trying to tell when the small intestine gets bad bacteria. 2) The only clinical condition is bacterial overgrowth which includes any bacteria. 3) Probiotics should theoretically make it worse. I know of know data demonstrating any real benefit of probiotics for any condiition of the small intestine and there is only some data for its use overall. Certainly, nothing that even approaching the "proven" claim


> quote:Obviously, while I am happy Cedars-Sinai made the role of bacteria in IBS more mainstream


It could just be red herring.


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## dianne (Jan 16, 2000)

Pete .. what a good story. A thought about your remaining symptoms -- do you drink enough water to be properly hydrated ? Maybe have a look at www.watercure.com for a doctor's radical view on your remaining symptoms and how they might be signals of dehydration and nothing more. ( Pulling the skin on the back of your hand will show you what your hydration level is like -- see how fast or slow it is to return to normal postition.)Tea, coffee, juice and colas etc do not count as water -- needs to be simple water for your body to make proper use of it.Keep healing ... Dianne


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## Ugh (Jan 30, 2001)

> quote:It does not mean that all of these areas are "relatively sterile"


Island girl, I'm not sure why you are so hung up on my statement. It was a way of saying it has a lot less bacteria than the colon. I'm writing a post, not a thesis, you really couldn't understand what I meant?


> quote:When the small intestine becomes over-run with the bad bacteria, it seems to make sense to help the body replenish with the good(probiotics) to help balance it out. This has been proven in so many studies, it seems to be rather indisputable. Isn't this why probiotics are becoming so popular?


No, I think you are confused here, people take probiotics for the colon. I've never heard of anyone taking probiotics with the intention of populating their small intestine.Flux, the reason I thought taking probiotics wouldn't hurt a BO problem is because I figured if you had one, you would have introduced enough bacteria with regular food that probiotics wouldn't have an effect. Although, I guess if probiotics can effect the colon, you'd expect them to effect the small intestine in a person with BO.One last question. BO is related to an ongoing problem right? In other words, if you introduced a lot of bacteria into a normal persons small intestine, would it be eliminated through normal body safeguards? Or, on the other hand, if you restored these safeguards (proper motility, etc) in a person with BO, wouldn't they eliminate the BO?thanks for any info[This message has been edited by Ugh (edited 02-19-2001).]


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## Island girl (Jul 24, 2000)

Ugh-I didn't mean to get nit-picky with your wording. Sorry. So many people read from this forum without doing their own research and it bothers me when misinformation abounds. My pet peave.Like, say for instance, when someone says that most people take probiotics just for the colon. That is utterly ridiculous. They've been taking it for the entire intestinal tract for years & years. Likewise, this small bowel overgrowth is not a new finding. I've got books from the early 90's referencing it. There are many new studies being done at this very moment on the possible application of specific probiotics to fight specific bacterial infections; we'll be learning so much more conclusively in these upcoming years.Here's a new study that's found a way to erradicate E. Coli in cattle with the probiotic strain: http://news.ft.com/ft/gx.cgi/ftc?pagename=...gid=IXLYK5HZ8CC


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## HipJan (Apr 9, 1999)

flux, the subject of probiotics must have popped up a few hundred times over the past year alone. I'm surprised to see your graphics only now! what's wrong? LOL







this can be so confusing. I'm sticking with my probiotics for now, since they seemed to have made a bit of a positive difference for me. (when I was on acid reducers and proton pump inhibitors a couple of years ago, without also taking acidiophilus, my system went nutty. I immediately had digestion problems, weight loss, pain, uncontrollable D or totally unformed stuff, etc. right now I'm taking probiotics and, knock on wood, even though I'm taking Prevacid plus two antibiotics, my stools are not doing so badly; ditto with my last round of antibiotics. could be a coindidence, I suppose, but I still am a probiotics believer for now. 'course, for me, the antibiotics themselves could be helping my intestinal situation a little. we'll see!)


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## flux (Dec 13, 1998)

> quote:flux, the subject of probiotics must have popped up a few hundred times over the past year alone. I'm surprised to see your graphics only now! what's wrong?


Island Girl's posts seem to be confusing bacterial overgrowth with "bad" bacteria (aka dysbiosis). The issue with the small intestine is not dysbiosis, it is any "biosis". You want as a little bacteria as possible there; otherwise, they can gum up the works and interfere with digestion and absorption. The same goes for probiotics. You don't want them to treat this condition.Dysbiosis is having the "wrong" bacteria in the colon. C. dif is the only sure example we have of it. There are probably others, but we don't enough about it to say. This condition is what probiotics are used to treat. Lactobacillus GG has been shown to treat C. dif.


> quote:Likewise, this small bowel overgrowth is not a new finding. I've got books from the early 90's referencing it.


Probably discovered last century on autopsies, but not in live people until endoscopy in the 50s.


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## HipJan (Apr 9, 1999)

good explanation. ahhh, thanks! so, we really ought to try to find out if we have overgrowth or bad bacteria, right?


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## Island girl (Jul 24, 2000)

Probiotics actually help the small intestine do its job & absorb nutrients. Specifically, they've been shown to:1. Manufacture Vit's B1, B2, B3, B5, B6, B12, A & K.2. Digest lactose.3. Digest proteins to amino acids4. Produce antibodies and antifungals which deter over-colonization of harmful bacteria and fungus.5. Increase the number of immune system cells.6. Protect from xenobiotics like mercury, pesticides, radiation and pollutants.7. Break down bile acids.8. Convert flavonoids to useable forms.9. Manufacture EFA's.Probiotics 101







I understand your point, Flux, about the dysbiosis vs overgrowth. I just disagree.


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## Ugh (Jan 30, 2001)

> quote:So many people read from this forum without doing their own research and it bothers me when misinformation abounds. My pet peave.Like, say for instance, when someone says that most people take probiotics just for the colon. That is utterly ridiculous. They've been taking it for the entire intestinal tract for years & years.


Island girl, I'm sorry, I didn't realize anyone would ever *want* a bacterial overgrowth of their small intestine. I guess you are the one person on Earth who does. My pet peave is you have no idea what you're talking about.


> quote:When the small intestine becomes over-run with the bad bacteria, it seems to make sense to help the body replenish with the good(probiotics) to help balance it out.


Huh? I repeat: *most people take probiotics for the colon*


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## flux (Dec 13, 1998)

> quoterobiotics 101


You get a C- here.


> quoterobiotics actually help the small intestine do its job & absorb nutrients.


First, I doubt they play a real signficant role in this. Second, you are confusing probiotics with commensal bacteria. Commensal bacteria do some of things you state (and that's mostly in the colon), though not all (or the role may not well know or well-characterized). Probiotics are bacteria that can be grown in culture and made available to be ingestible and can colonize the gut. There are 400 different species of commensal bacteria but only a few strains of probiotics.*And third, the important thing is that if one has bacterial overgrowth, you don't want to add more bacteria to the mix.*


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## Island girl (Jul 24, 2000)

I'm currently studying to become a nutritionist and this is a subject I am currently studying about 3+ hours every day. The Lactobacilli strain is found mainly in the small intestine. L Acidophilus came out as a supplement over 20 years ago specifically to treat imbalances in the small intestine(and the benefits that it would in turn provide.) It's aerobic and cannot survive in the colon, which supplies no oxygen. Ergo, Ugh, this is why I say historically, people haven't been taking probiotics mainly for the colon. Things have advanced since then and now the entire intestinal tract can be helped with probiotics.Small bowel overgrowth is NOT too much bacteria in the sm. intestine. From its name, it's easy to see why people assume that. It is bacteria from the colon backing up into the small intestine(according to Cedars-Sinai), or an overgrowth of any harmful bacteria in the small intestine while there's been a decrease in probiotics(good bacteria). <Colonic bacteria is bad bacteria when it's in the small intestine.> This is why another name for "small bowel overgrowth" is "bysbiosis of the small intestine."We can all learn from one another here. I've learned from Flux. But I've also learned he isn't always correct(like when he last year said that "IBSers absorb their nutrients just fine.") Quote:_______________________________________There are 400 different species of commensalbacteria but only a few strains of probiotics._______________________________________Correct. Friendly bacteria do comprise of just a small amount of our total bacteria. Likewise, the bacteria that cause chronic illness are generally weak organisms of low virulence. They're found in all of us and have been assumed to be harmless. When the natural probiotics in our bodies become depleted(from poor food choices, antibiotics, NSAIDs, alcohol, stress, the list goes on)-the harmful bacteria are given the opportunity to grow into large colonies. This is intestinal dysbiosis. When it occurs in the small intestine, it's called "small bowel overgrowth" This is regardless of where the harmful bacteria originated.If Pete is still with us, I apologise about all of this. I hope the Neomycin works for you long term. You and your Dr can then say "Ha! Told you so" I'd love to be wrong and that just by taking this drug, a large percent of us could be cured.I think the big question is-Why is bacteria from the colon finding it's way into the small intestine. Is it motility? Valve disfunction? Autoimmunity? If you eradicate the harmful bacteria from the small intestine, what's to prevent it from coming back from the colon & recolonizing?I'm sorry to anyone reading this if I came across as though I think I know everything. I sure don't. I just know a bit about anatomy and bacteria. I wish I did have the answers though, so that we could kiss this intestinal problem good-bye. Now that I feel like a complete sh*t, I'll sign off and go to bed. It's been a long day...


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## flux (Dec 13, 1998)

> quote: am currently studying about 3+ hours every


Maybe you need to put in a few more hours?


> quote:The Lactobacilli strain is found mainly in the small intestine. L Acidophilus came out as a supplement over 20 year ago specifically to treat imbalances in the small intestine(and the benefits that it would in turn provide.) It's aerobic


*You have it reversed.* Lactobacilli are anaerobes, not aerobes. However, they are facultative anaerobes so they can live where oxygen is present but don't require it.


> quote:Things have advanced since then and now the entire intestinal tract can be helped with probiotics.


Advanced? The field of probiotics has only started recently in the West. So far they haven't gotten past treating C. dif as far as clinical stuff is concerned. And even that hasn't gotten anywhere. Most probiotics are fed to livestock.


> quote:Small bowel overgrowth is NOT too much bacteria in the sm. intestine.










*THIS STATEMENT IS FALSE. Small Bowel bacterial overgrowth IS too much bacteria growing in the small intestine.*


> quote:It is bacteria from the colon backing up into the small intestine(according to Cedars-Sinai), or an overgrowth of any harmful bacteria in the small intestine while there's been a decrease in probiotics(good bacteria).


*Also misrepresentative.* Colonic bacteria probably can back up in the small intestine under certain circumstances, but that's generally not what is meant by bacterial overgrowth; it generally means overgrowth in the duodenum or jejunum. And probiotics have nothing to do with this.


> quote:This is why another name for "small bowel overgrowth" is "bysbiosis of the small intestine."


I take you made that term up.


> quote:"IBSers absorb their nutrients just fine.


*They do.*


> quote:from poor food choices, antibiotics, NSAIDs, alcohol, stress, the list goes on)


]*There is no such list.* Antibiotics may change the flora, but beyond that, there is no evidence.


> quote:When it occurs in the small intestine, it's called "small bowel overgrowth" This is regardless of where the harmful bacteria originated.





> quote:Why is bacteria from the colon finding it's way into the small intestine.


There is no good evidence to say he ever had SBBO at all. The Cedars test doesn't count in my opinion.[This message has been edited by flux (edited 02-21-2001).]


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## Ugh (Jan 30, 2001)

Island girl, if I'm wrong, I will admit it. I'm not here to argue for something I don't think is correct. Don't take the arguing personally, I think discussions/arguments like this one help clear up misconceptions.I will say that you may have something when you say acidophilus is aimed at the small intestine. While I am now undecided as to its use in the colon (I too found that it was facultative anaerobic), it does appear from some stuff I've read that Acidophilus is found at the end of the ileum near the colon. Having said that, supplement manufacturers seem to have created an incredible industry built upon unsubstantiated and misrepresented claims about acidophilus. Often it seems like some nutritionists propagate this information (remember candida?). I will thank you for just bringing up the topic though! I am going to read up on these bacteria.As for the bacterial overgrowth question, I hope you respond to flux's post. It seems logical that if "bad" bacteria can over populate the small intestine, then the probiotic type can too. Island girl, are you saying you don't think probiotic overgrowth of the small intestine would be unhealthy? Or that it doesn't occur? If you have some information that points to bacterial overgrowths being only caused by so called "bad" bacteria, please post it. I would very much like to read it as my current thinking has been along the lines that flux stated.


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## Guest (Feb 21, 2001)

Hi there...Maybe the question should be: what is the most consistent bacterial profiles that show up in stool test samples for healthy non-IBS people?For example, do healthy samples show (on average) counts of say 50% lactobacillus vs. 30% Bifidobacterium vs. 10% E.Coli vs. 10% and others? Or is it simply a broad spread across the 400 species or so, which in healthy subjects would indicate bowel flora is not as big a factor in the cause of IBS symptoms? The use of probiotics (while sound in theory) is really only speculation until we have some idea of what the optimum balance of GI flora is compared to our own individual state and what we are aiming to acheive.Zapdos...


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## flux (Dec 13, 1998)

> quote:For example, do healthy samples show (on average) counts of say 50% lactobacillus vs. 30% Bifidobacterium vs.10% E.Coli vs. 10% and others? Or is it simply a broad spread across the 400 species or so, which in healthy subjects would indicate bowel flora is not as big a factor in the cause of IBS symptoms?


Here's a sampling...In order of decreasing freequency along each segmentDuodenum = lactobacilli (apparently some strains may be aerobic!)Jejunum = Streptococci, Bacteroides, EnterobacteriaIleum = Enterobacteria, Bacteroides, BifidobacteriaAlphabetically.Colon (really feces) = Actinomyces, Propionbacterium, Bacteroides, Bifidobacteria, Clostridium, Eubacterium, Fusobacterium, Lactobacillus, Peptostreptococcus, Streptococcus and many others.A couple of points of note. Different sampling methods come up with different results. There is variation depending on whether one looks at the lumen of the gut or at the surface (and fecal bacteria may not represent colonic mucosal bacteria). The information is really out of date since it comes from 74 when we didn't know about H. pylori. The samples all seem to come from healthy people and a diverse grou of subjects (different cultures and diets). In addition, not all bacteria were present in everyone in these studies. some may have very little or none. There are actually huge tons of tables and charts here and I'm summarizing in a big way. There are also tons of studies on how antibiotics affect the bacteria. Nobody has done formal studies like these for IBS subjects I don't think. However, people with UC seem to have more sulfur-reducing bacteria and in some Crohn's patients there are supposed to be mycloplasma (what that means is another matter).[This message has been edited by flux (edited 02-21-2001).]


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