# Can anyone here give me advice on SIBO and XIFAXAN?Many Details



## DOIHAVEIBS? (Feb 12, 2008)

Hello everyone I am a new member but a long term sufferer. Well for years that was my case, I have been to several GI docs, I had everything tested over and over and nothing solid has showed upUpper GI fine, Lower fine. I was tested + for Candida by some Holistic Doctors via a Saliva test and special blood test. I tested positive for food allergies by this ELISSA test from Imunno labs. I have tried diets, stress relief you name it and on a scale of 1-10 it varies with what I eat and where I eat.My symptoms which have gotten worse lower gas, cramps in left abdominal e(colon) weakness and fatigue and I have suffered from irregular bowel moments for years. I also suffer chronic aches and pains which I always figured was calcium related but its not, I did hear GI issues create these aches but who knows for sure. Rapid intestinal transist is a big issue and this can be SIBo related from what i read onlineSo I returned to the Gi few weeks back one of the best in NYC and we did the breath test, I tested +. Now something that surprised me and the Dr. was within 20 min of drinking the sugar I got gas and had to run to the bathroom (BAD) yet I ate light 24hrs prior with no dairy or fatty foods. They all said this has never happened before to anyone they can remember. My opinion my Bacteria levels must been very high. Well they are. Now I have over the years tried 10+ probiotics, homeopathic herbs for bacteria and Candida and more. I have taken stuff from oregano leaf, olive leaf extract, grapefruit seed, etc you get the point. Yogurts I have tried a dozen. Now all of these treatments give me the worse ever side effects that it makes me quarantined to my home and it ruins my life. I mean bad, GAS, pains, bowel movements up to 12 times per day, not normal or healthy at all. Some probiotics made me constipated. I always wondered why every time I try to help myself this occurs I just can’t explain it, nor can Doctors. And the diarrhea after 20 min of the sugar its obvious something is just out of balance inside of me. I researched SIBO and it makes sense this may be my primary problem.So I have been on XIFXAN 4 days they want me on for 30 and its expensive stuff now and I feel terrible. Headache, tired and the worst Gas pains under the sun. My lower abdominal is so sore and tender it feels like I got punched. I get the worst of this at night. I have a bowel movement I feel perfect then 45min it returns it’s so crazy. I have not had diarrhea and just 3 bowel movements a day since, 3 for me is normal. Now the side effects to me resemble all the other treatments I tried and I am getting nervous here and just want to hear from others who can relate to fill me in on details if this is normal, is this die off effect or is this treatment wrong for me. Im loosing all hope and as you know this takes over your life and it’s not easy. I am at the point I would sacrifice so much to have a normal digestive system. Shouldn’t I feel better and if the XIFAXAN kills the bacteria wouldn’t this stop my excessive gas and pains? Are my side effects normal and when should things start to get better? Dr. said its not from the XIFAXAN it must be from something else but i felt much more controlable prior to the XIFAXAN, I cant take feelings like this.


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## SpAsMaN* (May 11, 2002)

Just stop using it.Simple as that.This drug has never help anybody and as far as i know can make IBS worst.


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## SpAsMaN* (May 11, 2002)

> Rapid intestinal transist is a big issue and this can be SIBo related from what i read online


On-line informations are often lies.


> So I have been on XIFXAN 4 days they want me on for 30 and its expensive stuff now and I feel terrible. Headache, tired and the worst Gas pains under the sun. My lower abdominal is so sore and tender it feels like I got punched. I get the worst of this at night.


I told you!We have a chronic inability to move gas,no antibiotic help motility.


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## DOIHAVEIBS? (Feb 12, 2008)

Spasman I am starting to feel the same that this Xifaxan is far from a wonder drug. I mean if it supposed to kill off high bacteria levels then it should balance out your GI and reduce cramping, bloating and excessive fermentation of foods in the colon. Why the heck do Dr. think is a wonder drug?Have you tried other meds for these issues that were more succesful?Xifaxan is a fortune the 30 day supply which I havent paid in full yet is over $1400. I am buying 1 week increments at a time. This sucks bigtime for my health and my finances.


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## Kathleen M. (Nov 16, 1999)

It has worked for some people in clinical trials when they do get tested for SIBO.However it is not the only antibiotic used, and given they don't test for types of bacteria it might not be the right one for you, and usually they only treat for a couple of weeks then back off and retest to see if it killed the bacteria.Have you talked to the doctor about what is going on now. They might want to try another (and usually much cheaper) antibiotic, as well as redo the breath test.The side effect profile includes what you mention, but all at the same level that placebo causes those same side effects. So I don't know that it is the drug or not. However it is having some effect, and sometimes pain in the GI tract is not from gas, it might be you are not used to normal stool consistency and that alone is triggering some pain.K.


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## DOIHAVEIBS? (Feb 12, 2008)

When i went to the Dr. i asked if there was a specific way to test certain bacterias via a stool test etc because I figured if i tried all these probiotics and yogurts all which contain varuious strains of live culture maybe i was overloading my body with too much of one of these. However they said that it would be impossible to test for specific bacteria because there are too many.The cramping and gas is all later in the day and evening, I cant sleep well and i stayed home today from work. I ate breakfast and as always it triggered a bowel movement and it was massive and now i feel perfect. For some odd reason this Xifaxan is causing constipation type symptoms and slow transist something my body is certainly not used to. On the Rx form it says frequent bowle movments and urgency, something that i dont get.Same results happend with I took Culturelle and Flor Essence probiotics, very odd I must say.I wish things were easy to explain.I will continue for a few more days to see how things pan out, since I started my headaches stopped and i dont feel like vomiting which was a side effect 1st day. My only issue is this gas and sore abdominal pain linked to constispation


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## SpAsMaN* (May 11, 2002)

DOIHAVEIBS,i'm really concern about your Rifaximin intake.I want you to think about it:What if the side effect of Rifaximin would be irreversible?My left side motility has never recover from Rifaximin.Users by aware.


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## DOIHAVEIBS? (Feb 12, 2008)

I am a bit nervous, Spasman what do you mean your left side motility? Can you explain more what you mean?Why did Xifaxan ruin this for you? Was this confirmed by your Doctor or any explanation whyMy dosage is1200 MG per day


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## SpAsMaN* (May 11, 2002)

This drug is NOT approoved for IBS.What it did it somewhat reduce the blood flow on my left colon leaving me WORST than i was before i took this ####.This is *permanent* left side spasm so to speak.


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## SpAsMaN* (May 11, 2002)

I bet you are nervous.I'm leaving now for a G.I. specialist far from my home.This left side hypomotility is serious.I need to find what's going on in there.I suspect the mucosa in this particular area has lost it's electric impulse to push stool or the blood simply is lacking to this area.I have to ask the G.I. about Doppler echography to evaluate blood flow when my bowel is distended.I have others motility problems as well but i didn't need this extra problem in my left side.I'm on a cruisade against Rifaximin.


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## SpAsMaN* (May 11, 2002)

It look like the same problem that water enema cause in some IBSers.It cause SLUGGISH sigmoid colon.Enema are bad as well.


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## eric (Jul 8, 1999)

It sounds like you have IBS and SIBO depending on the test they did on you? Do you remeber the name?You have also really been messing it seems with your gut flora really. Good and bad perhaps.But first you have to really understand what sibo is and this is from an expert."FYII am trying to understand somethings in relationship to SIBO. I posted here so you both may see it. I am looking into but am not sure about somethings that you guys can possibly help with.Okay altered motlity can cause bacteria to enter the small bowel where it should not be really, at least in high counts, because its a pretty sterile environment. For the moment I am just looking at the altered motility reason for SIBO. What are small intestinal bacteria overgrowth symptoms? The symptoms of SIBO include:excess gas, abdominal bloating and distension, diarrhea, and abdominal pain. "A small number of patients with SIBO have chronic constipation rather than diarrhea. "How does small intestinal bacterial overgrowth cause symptoms?When bacteria digest food in the intestine, they produce gas. The gas can accumulate in the abdomen giving rise to abdominal bloating or distension. Distension can cause abdominal pain. The increased amounts of gas are passed as flatus (flatulence or farts). The bacteria also probably convert food into substances that are irritating or toxic to the cells of the inner lining of the small intestine and colon. These irritating substances produce diarrhea (by causing secretion of water into the intestine). There is some evidence that the production of one gas by the bacteriaâ€"methaneâ€"causes constipation. http://www.medicinenet.com/small_intestina...rowth/page2.htmAny Idea what those irritating substances are?This means these are just in the wrong place and not specific or multiple pathogens?A "classic" bacterial infection or a reaction to "all" the bacteria there themselves?"That was a post I didthis is an expert Dr replyI wrote to Dr Drossman on this and here is the reply. *Any Idea what those irritating substances are?*sorry its in bold type that is how he worte it into the email so I would see it was his answers."IT IS AN OVERSTATEMENT TO SAY THEY ARE "IRRITATING" SUBSTANCES AT LEAST IN THE SENSE OF BEING SOME TYPE OF TOXIN. THEY ARE NATURAL BYPRODUCTS OF DEGRADATION OF FOOD SUBSTANCES BY BACTERIA WHICH DON'T NORMALLY OCCUR IN THE SMALL BOWEL. SO WITH INCREASED BACTERIA IN THE SMALL BOWEL, THE BACTERIA ARE ABLE TO DIGEST SUGARS FOR EXAMPLE PRODUCING H2 AND CO2 FROM THE SUGARS WHICH ARE GASEOUS BUT WHICH ALSO HAVE OSMOTIC PROPERTIES, I.E. INCREASED PARTICLES THAT CAUSE SECRETION OF FLUID INTO THE BOWEL THUS CAUSING DIARRHEA. IT'S THE SAME PRINCIPLE AS USING NON ABSORBABLE SUGARS LIKE LACTULOSE OR SORBITAL TO TREAT CONSIPATION BY INCREASING FLUID IN THE BOWEL. IT'S JUST THAT WITHOUT BACTERIA IN THE SMALL BOWEL, IT DOESN'T HAPPEN AND THE FOOD SUBSTANCES GET ABSORBED. WITH INCREASED BACTERIA IT COMPETES FOR THE FOOD SUBSTANCES AND PRODUCES THE GAS AND DIARRHEA."*This means these are just in the wrong place and not specific or multiple pathogens?*CORRECT. HOWEVER, THERE IS GROWING INTEREST NOT IN THE AMOUNT OF BACTERIA BUT THE TYPE OF BACTERIA. CERTAIN BACTERIA CAN CAUSE SOME MILD INFLAMMATION OF THE BOWEL AND OTHERS PROTECT THE BOWEL FROM THAT POSSIBILITY. SO THERE IS "GOOD" AND "BAD" BACTERIA. POSSIBLY WHEN PEOPLE ARE TREATING PRESUMED SIBO (WHICH MIGHT NOT ACTUALLY BE HAPPENNING, BECAUSE THE TEST MAY BE INACCURATE) ANTIBIOTICS MAY HELP TO GET RID OF THE BAD BACTERIA AND THAT MAY BE WHY THEY ARE GETTING BETTER. THIS IS WHY SOME PEOPLE GET BETTER AFTER ANTIBIOTIC TREATMENT. BUT IT CAN ALSO GO THE OTHER WAY, I.E., ANTIBIOTICS HAVE BEEN SHOWN TO MAKE IBS WORSE AS WELL. THE OTHER IDEA IS TO USE PROBIOTICS WHICH CONTAIN "GOOD" BACTERIA (E.G., LACTOBACILLUS OR BIFIDOBACTERIA) WHICH REPLACE THE BAD BACTERIA, POSSIBLY REDUCE THE INFLAMMATION AND IMPROVE SYMPTOMS. SO THE ISSUE OF BACTERIA IN THE BOWEL IS MUCH MORE COMPLICATED THAN SIMPLE SIBO, BUT SIBO CAN BE A PART OF THE WHOLE PICTURE (THOUGH NOT THE WHOLE PICTURE FOR IBS).This was from a while ago. SIBO is not turning out to be the "cause" of IBS but maybe comorbid.It sounds like you had an IBS attack during the test, SIBO usally goes about 45 minutes after eating and IBS can go right away. Of course there could be other reasons.SIBO is a condition of the small bowel and "calssic" IBS the large colon.


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## DOIHAVEIBS? (Feb 12, 2008)

Some good points made Eric. Here is the deal isnt IBS just a general term for a host fo digestive issues. I still feel IBS can be caused from a number of reaons, genetic develpment, poor diet, stress, candida overgrowth and various bacteria imbalances. This is obviousThe test they did was the breath test for methane and hydrogen. I drank the sugar drink and I must make note to everyone sugars cause rapid bowel movements in my body, not all but some.Ever since i was a little boy Pancake syrups ( any high fructose corn syrup) and too much chocolates in minutes made me run to the bathroom, the same is true til today. Its crazy because I eat lots of fruits and no problem and if i limit the corn syrup products im cool.the sugar they gave me Kristalose triggered the bowel movements so quickly. The Dr. did tell me it does act as a laxitive but much longer after taken. I do have rapid transist i assume with certain foods and i always figured it was due to my body not liking what and the amounts i take in one shot. Hey if i eat ice cream i can have a scoop or sometimes 6 scoops, now 6 sends me running. Same is true with chocolate or pancake syrup its crazy how fast it triggers. I know some people where coffee has the same affects.From my test results I dont have celiac or anything else and my only abnormality was very high SIBO so i was glad they actually found something to treat for once. I have to be honest i dont feel super on the Xifaxan and I am able to deal with it. I do notice after i eat meals my gas is much much less so thats the only good thing so far. However when i get the excessive gas at night and the constipation like symptoms I think it sucks in general I have my last day tom so lets see how I feel before i get more meds.I am at the point now that i must have spent 20k+ on Dr. and test and no help I would give alot more if I could be cured for life. Its all trial and error for most and its wild how so many peolple suffer. Why is this and did these ailments exist 75 years ago?


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## Kathleen M. (Nov 16, 1999)

Yes, IBS has been around ever since people started writing down medical information.There are some descriptions in ancient medical texts that sound almost exactly what the current diagnostic criteria state.The name may change, but the description is consistent over centuries. K.


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## eric (Jul 8, 1999)

DOIHAVEIBS,"Some good points made Eric. Here is the deal isnt IBS just a general term for a host fo digestive issues."Actually this is incorrect. IBS is a distint entity. It is diagnosed on a very "specfic cluster" of symptoms.IS is a functional disorder How the digestive tract works. IBS is NOT caused by candida!IBS is not caused by foods or poor diet!There maybe gentic issuesIBS is very complex and the role of bacteria in IBS is very complex, but IBS is not an ongoing bacterial infection.IBS is actually diagnosed when they can't see any problems using conventional testing. Now however they can see problems in IBSers using more powerful testing methods.Its also rare really for someone with sibo to have C, it mainly causes d as the digestive system trys to expell the problem.also SIBO is usally caused by a different problem leading to sibo.However perhaps you do have sibo, although those tests are not very accurate, but if you had really high numbers that could do it.Fructose can be hard on IBS for the same reasons.FYI from the same expertDr Drossman's comments on foods for IBS Health.Shawn,To say that people with IBS may get symptoms from food intolerances is an acceptable possibility, since the gut will over react to stressors of all types including food (high fat or large volumes of food in particular). Futhermore, there can be specific intolerances. So if you have a lactose intolerance for example, it can exacerbate, or even mimic IBS. Other examples of food substances causing diarrhea would be high consumers of caffeine or alcohol which can stimulate intestinal secretion or with the latter, pull water into the bowel (osmotic diarrhea). *The same would be true for overdoing certain poorly absorbed sugars that can cause an osmotic type of diarrhea Sorbitol, found in sugarless gum and sugar substituted foods can also produce such an osmotic diarrhea. Even more naturally, people who consume a large amount of fruits, juices or other processed foods enriched with fructose, can get diarrhea because it is not as easily absorbed by the bowel and goes to the colon where it pulls in water. So if you have IBS, all of these food items would make it worse. *However, it is important to separate factors that worsen IBS (e.g., foods as above, stress, hormonal changes, etc.) from the cause or pathophysiology of IBS. Just like stress doesn't cause IBS, (though it can make it worse), foods must be understood as aggravating rather than etiological in nature. The cause of IBS is yet to be determined. However, modern research understands IBS as a disorder of increased reactivity of the bowel, visceral hypersensitivity and dysfunction of the brain-gut axis. There are subgroups being defined as well, including post-infectious IBS which can lead to IBS symptoms. Other work using brain imaging shows that the pain regulation center of the brain (cingulate cortex) can be impaired, as well as good evidence for there being abnormalities in motility which can at least in part explain the diarrhea and constipation. So finding a specific "cause" of IBS has grown out of general interest in place of understanding physiological subgroups that may become amenable to more specific treatments. Hope that helps.Doug http://www.ibshealth.com/ibs_foods_2.htmhistory of functional disordershttp://66.218.69.11/search/cache?ei=UTF-8&...=1&.intl=usYou should check all this outIBS is based on a specific cluster of symptoms, minus red flags.This is on diagnosing IBS.http://www.ibsgroup.org/forums/index.php?showtopic=65559These are all brand new state of the art on IBS.IFFGD's response:"Fibromyalgia and irritable bowel syndrome: How real must they be?(January 26, 2008) Nearly two weeks ago the New York Times published a front page story about a new drug approval for the treatment of fibromyalgia that questioned the validity of functional disorders and implied that both fibromyalgia and irritable bowel syndrome (IBS) are not "real." In response, IFFGD joined a group of internationally recognized clinicians and scientists in sending a Letter to the Editor at the New York Times. The letter is intended to provide perspective and balance to the article, which was entitled "Drug Approved. Is Disease Real?" We believe it to be a disservice to leave the millions of sufferers with fibromyalgia and IBS with the thought that their medical disorder is not legitimate. The newspaper has not published our response. We present it to you here."http://www.aboutibs.org/site/news-events/n...commentary#Real 2007 IFFGD Symposium Summary Report -very much worth readinghttp://www.ibsgroup.org/forums/index.php?showtopic=92806altered serotonin dysregulationhttp://www.ibsgroup.org/forums/index.php?showtopic=80198you have to register for free for this-This is in medscape and is an excellent article on"Review Article: Abdominal Bloating and Distension in Functional Gastrointestinal Disorders -- Epidemiology and Exploration of Possible MechanismsPosted 01/22/2008A. Agrawal; P. J. WhorwellAuthor InformationSummary and IntroductionSummaryBackground: A sensation of abdominal bloating, sometimes accompanied by an increase in girth (distension), is one of the most common and most intrusive features of functional bowel disorders.Aim: To conduct a systematic, evidence-based review of the epidemiology and pathophysiology of abdominal bloating and its relationship to distension.Methods: The terms bloating, distension, functional bowel, irritable bowel syndrome, constipation and diarrhoea were searched on MEDLINE up to 2006. References from selected articles and relevant abstracts were also included.Results: Approximately 50% of irritable bowel syndrome patients with bloating also experience an increase in abdominal girth and this is more pronounced with constipation than diarrhoea. Bloating appears to be more frequently associated with visceral hypersensitivity, whereas distension is more often related to hyposensitivity and delayed transit. Although there is little evidence for excessive gas as a cause of bloating, gas infusion studies suggest that handling of gas may be impaired in irritable bowel syndrome and there may also be abnormal relaxation of the anterior abdominal musculature in these patients.Conclusions: There is unlikely to be a single cause for bloating and distension, which probably have different, but overlapping, pathophysiological mechanisms. Relieving constipation might help distension, but the treatment of bloating may need more complex approaches involving sensory modulation.IntroductionAbdominal bloating and distension occur extremely commonly in the functional gastrointestinal disorders with many patients ranking them as particularly intrusive symptoms. Characteristically, the problem is exacerbated by meals, fluctuates in intensity, is worse at the end of the day and settles overnight. When these symptoms follow this pattern, they are almost pathognomonic of a functional gastrointestinal disorder and it is somewhat surprising that their diagnostic utility has not been harnessed more often. This is in part because these features do not appear to be so common in men, but to some extent, this is because men describe the problem differently often referring to it as a 'hardness' or 'tightness' of the abdomen. Probably the best way to view these features is that when they are present, they make the possibility of a functional bowel disorder almost certain but when absent, they don't exclude the diagnosis.Until recently, research into bloating and distension has been sparse and largely empirical as well as being based on the assumption that the two descriptors were describing the same phenomenon. Thus, interpreting the data from older studies is difficult and even today, patients and their physicians often use the terms synonymously. However, with the development of more objective ways of assessing it such as the gas challenge technique[1,2] or abdominal inductance plethysmography (AIP),[3,4] there is increasing evidence that bloating and distension may have different pathophysiological mechanisms."http://www.medscape.com/viewarticle/568555_1Excellent ibs videos from the expertshttp://www.aboutibs.org/site/learning-center/video-corner/There is a lot of research being done right now on the interactions of bacteria gut flora and IBS and it might be one part of the picture, but there are also structural abnormalities and other VERY important cell issues and brain gut communication.


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## eric (Jul 8, 1999)

PS there is a lot of information on sibo in the sibo forum including info on different drugs.In the sibo and IBS trials mainly gas improved but other symptoms did not.


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