# Vivonex and Candida



## Rick (never give up) (Oct 7, 2005)

Hi,Perhaps this question has been posted a lot in the past, but I didn't find it so I had to ask.I'm planning to start the Vivonex Plus elemental diet next week, but I'm worried about Candida (actually any Yeast/Fungus) overgrowth.I've read that Vivonex starves the bacteria, but I'm afraid it may actually feed the yeats/fungus because of the high starch content. And in the absence of bacteria (they are bieng killed) may the yeats thrive and takeover?My breath test suggested SIBO but other tests suggested Candida as well, so that's why I'm concerned.Perhaps taking Fluconazole, Caprylic acid or the like while on the diet may help. I'm clueless. Dr. Pimentel has no official position on this matter, at least none that I know.Any suggestions, ideas?







Thanks everyone.


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## eric (Jul 8, 1999)

What test did you have that suggested SIBO?What tests did you have that suggested candida?What kind of doctor has preformed the tests?


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## Kathleen M. (Nov 16, 1999)

My guess is it would starve the yeasts as well.They have to eat too, and I thought the whole rationale of this approach was you absorb everything before the food gets to where the bacteria or anything else that might be living in the GI live, even when they are in the small intestine and should only be in the large intestine.While a lot of alt. med make a lot of claims of Candida there isn't much data to support it is causing anyone's IBS (or any of the hundred or so other conditions it supposedly causes)K.


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## Rick (never give up) (Oct 7, 2005)

Hi eric,I went to the Cedar's Sinai for a breath test which suggested SIBO.Then my stool test showed elevated amounts of blastospores suggesing Candida or at least some kind of yeast overgrowth.


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## eric (Jul 8, 1999)

Was it a lactolose breath test?Do you know the numbers?When was the last time you had a colonoscopy? Or stool and blood work?What did the doctor say about the blastospores?


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## Kathleen M. (Nov 16, 1999)

Some yeast is normal, that is why stool handling is very important when you run these tests.The yeasts grow really well out of the body where there is oxygen (why they usually don't grow that well inside is there isn't much so they grow slowly and the bacteria just keep them in check).Stool that sits at room temp for awhile can have elevated yeast that has nothing to do with what is going on inside the body. Yeast numbers also can go up a bit when you take antibiotics but usually go right back down after a few weeks when the bacterial population re-establishes itself.K.


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## Rick (never give up) (Oct 7, 2005)

I see what you mean, intestinal yeast shall also starve if no food is coming. Perhaps I've just read too much (very usual for IBS guys like us







), but my major concern is Candida or yeast elsewhere or at least not directly fed by food chime, but instead by blood sugar concentrations. For example, yeasts in the mycelial form (aggressive) may feed upon blood vessels and not directly by undigested food or fiber. So, my concern again is what happens to those yeasts which may still be feeding by the absorbed Vivonex and may not be kept in check directly by those other bacteria that are being killed by lack of food. I think it is kind of the same question about Candida overgrowth while on antibiotics, though I in the Vivonex case no food is supposed to be present inside the intestines.Please let me know if Iâ€™m getting too philosophical


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## Kathleen M. (Nov 16, 1999)

Do you have an immune deficiency disease?Most of what is claimed to be how you get these whole body in everything yeast infections that cause every ill known to man really are only ever seen in people with AIDS or things like that.A lot of what I read takes stuff that really only happens to a very few really sick people then tries to say it is happening in all people with all symptoms, when realy in a standard issue mostly healthy person that stuff doesn't happen.K.


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## 18835 (Nov 9, 2006)

I respectfully disagree. A compromised gut is prime target for candida overgrowth. Read Dr. William Crook's "The Yeast Syndrome" book (he's an M.D.). Candida overgrowth cannot reliably be tested for in a petri dish, but that doesn't preclude the chance that someone may have it. And for this thread, it certainly couldn't be a bad idea to add some anti-fungals to the program when one is living on a liquid diet that consists largely of a sugar (maltodextrin) such as Vivonex. Candida can live higher in the digestive system than can the troublesome bugs that SIBO sufferes may have, which appear to live lower down. The maltodextrin in the Vivonex can feed candida all the way down the throat, if one has enough of a starter colony of candida there, and if that person's system is compromised enough to not be able to fight off the candida.For a post on why a different sugar, other than maltodextrin, may have been a better idea for the Vivonex protocol, see the thread posted by Moises in Early November - I wrote about using honey intead of maltodextrin. Still feeds candida, but digests completely, higher up, to possibly avoid feeding the bugs that live lower in the person's system.


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## Kathleen M. (Nov 16, 1999)

We will have to agree to disagree on that.I go by a lot of what is in the peer-reviewed scientific literature rather than what people put in books.They tell two very different tales.With fructose it depends a lot. If you don't absorb it well, you will make things worse and a lot of people are fructose intolerant. They don't absorb it well when it is 1:1 with glucose and often not at all when it is solo. That is why High Fructose Corn Syrup is so bad for so many IBSers. It goes all the way to the colon intact.K.


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## Rick (never give up) (Oct 7, 2005)

Thanks again for your reply ericI had 2 colonoscopies, one 2 years ago when my IBS started and the last one 5 months ago. So far no organic damage.Stool tests were done 3 weeks ago.And if I may, I little background about myself: My IBS started 2 years ago after taking antibiotics for 6 weeks because of a severe pneumonia. I also experienced chronic prostatitis for almost a year before the pneumonia. Thatâ€™s why Candida for me is something to consider, at least I try not to underestimate it, since my Prostatitis was never explained.Back to your question, the breath test was lactulose indeed, and the Dr at that time explained to me the same things I read in Pimentelâ€™s book, expect maybe that in my case he strongly recommended the Vivonex since my readings where slightly higher that the norm (the norm for positive SIBO readings, that is







).He was surpised about the blastospore readings, mostly because I explained to him my previous Prostatitis and Penumonia conditions, but he was not sure about the Vivonex and Yeast relationship.


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## Rick (never give up) (Oct 7, 2005)

Kathleen, AIDS was one of the first tests performed by my regular GI, and along with my last colonoscopy another test was requested. So far I'm AIDS free (thank God). The thing about the inmune system is another reason why I'm concerned about Candida, some say Candida may lower your defences.But, as you said, there's a lot of contradictions between the books and the peer-reviewed scientific literature







That's why I find these forums very usefull to avoid getting mentally trapped into my own findings.


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## eric (Jul 8, 1999)

The case for candida as a cause IBS has grown weaker and weaker over the last ten years.A lot less was known about IBS ten years ago then is known now.Even SIBO as a cause for IBS is speculation and theory and right now does not present a strong case. Really they are trying to figure out how many people with IBS have sibo? Most IBS researcher around the world have gotten different reults on SIBO and IBS then Cedars.As for candidaWhy is there candida in the bowel in the first place in humans?""Candida albicans, and other strains of Candida are yeast that normally inhabits our digestive system: the mouth, throat, intestines and genitourinary tract. Candida is a normal part of the bowel flora (the organisms that naturally live inside our intestines, and are not parasitic). It has many functions inside our digestive tract, one of them to recognize and destroy harmful bacteria. Without Candida albicans in our intestines we would be defenseless against many pathogen bacteria. Healthy person can have a millions of Candida albicans."alsoComment in: Postgrad Med J. 1993 Jan;69(807):80.The role of faecal Candida albicans in the pathogenesis of food-intolerant irritable bowel syndrome.Middleton SJ, Coley A, Hunter JO.Department of Gastroenterology, Addenbrooke's Hospital, Cambridge, UK.Candida albicans was sought in stool samples from 38 patients with irritable bowel syndrome and 20 healthy controls. In only three patients with irritable bowel syndrome was C. albicans discovered and these patients had either recently received antibiotics or the stool sample had been delayed more than 24 hours in transit. C. albicans was isolated from none of the control stool samples. We conclude that C. albicans is not involved in the aetiology of the irritable bowel syndrome.PMID: 1437926Almost no major research on it being the cause was done after 92. IF you search pubmed there is almost nothing."About chronic candidiasisAn overgrowth in the gastrointestinal tract of the usually benign yeast (or fungus) Candida albicans has been suggested as the origin of a complex medical syndrome called chronic candidiasis, or yeast syndrome.1 2Purported symptoms of chronic candidiasis are fatigue, allergies, immune system malfunction, depression, chemical sensitivities, and digestive disturbances.3 4 Conventional medical authorities do acknowledge the existence of a chronic Candida infection that affects the whole body and is sometimes called â€œchronic disseminated candidiasis.â€œ5 However, this universally accepted disease is both uncommon, and decidedly more narrow in scope, than the so-called Yeast Syndromeâ€"a condition believed by some to be quite common, particularly in people with a history of long-term antibiotic use. The term â€œchronic candidiasisâ€ as used in this article refers to the as yet unproven Yeast Syndrome."Real Candidiasis which is a "Systemic Candidiasis are "systemic infections"http://www.emedicine.com/emerg/topic76.htmIBS is NOT an infectious disease.I have talked to quite a few lab people who do colonoscopies about this and they have never seen "yeast syndrome" but have seen "disseminated candidiasis" in aids patients and cancer patients where the immune system was highly compormised.IN IBS research researchers are using powerful electron microscopes and examing gut cells and still no "overgrowth" of candida.SIBO is also a functional disorder as well. What is causing malfunction in IBS and SIBO.SIBO, does not at this point explain a lot of IBS research already done.The strogest case for alternating d and c and d/c in IBS and pain or discomfort has to do with serotonin in the gi tract released from enterochromaffin (EC) cells.The research on the immune system in IBS also plays a role in IBS, especially mast cells. A ton of research has been done on mast cells and IBS and there are still working on that issue.About 30 percent or more of IBSers develop IBS after PI IBS. In those people they find an increase in enterochromaffin (EC) cells and mast cells. The mast cells are macroscopically inflammed.


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## eric (Jul 8, 1999)

By the way the lactolose breath test can over predict SIBO.


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## Nanobug (Nov 7, 2006)

> quote:Most IBS researcher around the world have gotten different reults on SIBO and IBS then Cedars.


Eric, could you please substanciate this claim with PubMed Id's? Thanks!


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## eric (Jul 8, 1999)

Nanobug, this area of IBS research is highly controversial.http://ibsgroup.org/groupee/forums/a/tpc/f...261/m/443103162also"However, other studies have shown a much lower prevalence of SIBO in patients with IBS. In a recently reported retrospective study of patients who were referred for glucose hydrogen breath testing for SIBO, only 11% of 113 patients who met the Rome II criteria for IBS tested positive for SIBO, suggesting that IBS symptoms are often unrelated to SIBO.[4] On the basis of currently available data, the contributing role of SIBO in the pathophysiology of IBS remains controversial, and the large variation in the prevalence of SIBO in IBS (10% to 84%) indicates the problematic state of this research, particularly with regard to the accuracy of breath testing in detecting SIBO in patients with altered (particularly accelerated) gastrointestinal motility.Further epidemiologic studies and placebo-controlled clinical trials aiming at eradicating SIBO are necessary to clarify the true impact of SIBO on IBS symptoms. With regard to the latter, several small treatment trials have been reported and demonstrated improvement in IBS symptoms with antibiotic (eg, neomycin and rifaximin) therapy.[2,5] However, the results of a larger multicenter study with rifaximin are awaited with anticipation.From a clinical standpoint, until this issue is clarified, clinicians should consider SIBO in an IBS patient with typical symptoms (eg, bloating, distention, and diarrhea), as well as in patients with these symptoms who do not fulfill the diagnostic criteria for IBS."http://ibsgroup.org/groupee/forums/a/tpc/f...261/m/947102852MedGenMed GastroenterologyIBS -- Review and What's NewAmy Foxx-Orenstein, DO, FACG, FACP Medscape General Medicine. 2006;8(3):20. Â©2006 MedscapePosted 07/26/2006Small Intestinal Bacterial OvergrowthThe presence of a higher than usual population of bacteria in the small intestine (leading to bacterial fermentation of poorly digestible starches and subsequent gas production) has been proposed as a potential etiologic factor in IBS.[71] Pimentel and colleagues have shown that, when measured by the lactose hydrogen breath test (LHBT), small intestinal bacterial overgrowth (SIBO) has been detected in 78% to 84% of patients with IBS.[71,72] However, the accuracy of the LHBT in testing for the presence of SIBO has been questioned.[73] Sensitivity of the LHBT for SIBO has been shown to be as low as 16.7%, and specificity approximately 70%.[74] Additionally, this test may suboptimally assess treatment response.[75] The glucose breath test has been shown to be a more reliable tool,[76] with a 75% sensitivity for SIBO[77] vs 39% with LHBT for the "double-peak" method of SIBO detection.[74] In a recently conducted retrospective study involving review of patient charts for the presence of gastrointestinal-related symptoms (including IBS) in patients who were referred for glucose hydrogen breath tests for SIBO, of 113 patients who met Rome II criteria for IBS, 11% tested positive for SIBO.[78] Thus, results demonstrated that IBS symptoms are often unrelated to the presence of SIBO. Despite the controversy regarding the contribution of SIBO to the underlying pathophysiology of IBS and its symptoms, short-term placebo-controlled clinical studies with select antibiotics, including neomycin and rifaximin, have demonstrated symptom improvement in IBS patients.[61,72,79] Antibiotics may therefore have potential utility in select subgroups of IBS patients in whom SIBO contributes to symptoms. However, the chronic nature of IBS symptoms often leads to the need for long-term treatment. Given the fact that long-term use of antibiotics is generally undesirable, the place of antibiotics in IBS therapy remains to be established""Serotonin SignalingOf the putative mechanisms underlying the pathophysiology of IBS, the strongest evidence points to the role of serotonin in the GI tract. "http://www.medscape.com/viewarticle/532089_printIs there a relationship between IBS and small intestinal bacterial overgrowth?IBS and small intestinal bacterial overgrowth (SIBO)"Although the theory that SIBO causes IBS is tantalizing and there is much anecdotal information that supports it, the rigorous scientific studies that are necessary to prove or disprove the theory have just begun. Nevertheless, many physicians have already begun to treat patients with IBS for SIBO. In addition, a lack of rigorous scientific studies demonstrating benefit from antibiotics and probiotics has not stopped physicians from using them for treating patients. "http://www.medicinenet.com/irritable_bowel...drome/page6.htmThere is a lot more and I have a editorial you might want to read if you email me, I will send it to you on this subject.


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## Nanobug (Nov 7, 2006)

Eric,I went through the references you provided. Based on those, a case can be made that the lactulose breath test may not be a good proxy for SIBO. However, none of the abstracts that I read on Pubmed suggested anything contrary to what Pimentel is proposing. Maybe I am missing something. If I am, please, provide the PubMed Id's. As for the editorials, those are opinions and I have mine too!


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## eric (Jul 8, 1999)

You asked if there were different results from different centers. If you do some research on it all you will see different opinions on the subject."*However, other studies have shown a much lower prevalence of SIBO in patients with IBS. In a recently reported retrospective study of patients who were referred for glucose hydrogen breath testing for SIBO, only 11% of 113 patients who met the Rome II criteria for IBS tested positive for SIBO, suggesting that IBS symptoms are often unrelated to SIBO.[4] On the basis of currently available data, the contributing role of SIBO in the pathophysiology of IBS remains controversial, and the large variation in the prevalence of SIBO in IBS (10% to 84%) indicates the problematic state of this research, particularly with regard to the accuracy of breath testing in detecting SIBO in patients with altered (particularly accelerated) gastrointestinal motility.*So differnnt centers have found different results from 10 to 80%. They also don't know the prevelence of SIBO in a non IBS population. Indeed in one IBS study controls had SIBO, but not IBS. The opinion is an expert opinion from a major researcher and chairman of the Rome Commitee to diagnose IBS. It is very much worth reading it regards to SIBO and IBS.For example this that Dr Drossman wrote for me a while back. However the other is an editorial balance to the information""Dear Shawn Eric,I do feel that the issue of bacterial overgrowth is an important considerations in IBS, and these authors have gone a long way to advance this area of investigation and raise awareness of bacterial overgrowth as a possible player in IBS. It kind of relates to other work being done in the area of post-infectious IBS and altered mucosal immunity in subsets of IBS. However, there is some disagreement within the community with regard to the prevalence in patients with IBS, these authors claiming up to 80% and others finding far less by standard methods. Another issue of concern is that explaining bacterial overgrowth as the cause of so many other aspects of the condition is going beyond the available scientific data. Their work should be considered more in the way of opinion/speculation, rather than accepted dogma within the medical community, and further confirmation is needed. You should keep in mind that all scientists will from time to time try to extend their data into understanding other aspects of a condition, but the checks and balances within medicine lead to common acceptance when there is confirmation from other groups and more conclusive evidence. That has not happenned as of yet but remains an area of interest in the field.Doug""I can also point out the last study did not show an improvement in global symptoms really, bloating got somewhat better. But not d or c or pain. It was also not by that high of a percentage.I believe the media is playing an important role in how this research and speculation is being presented.Also"Second, these findings suggest that SIBO can play a role in IBS symptoms and that development of effective therapies for SIBO would be beneficial for some patients. However, SIBO is not a disease; *rather, it is a consequence of ineffective small-intestinal motility, and the underlying dysmotility will still exist after SIBO is eliminated. One would hypothesize that SIBO and IBS symptoms will reoccur in most patients who initially respond and that retreatment or chronic therapy for SIBO will be required. "*http://gastroenterology.jwatch.org/cgi/con...ull/2006/1016/1At this time they are not the same conditions.There are also other treatments that IBSers respond too and that is important. There is also a large body of IBS research including post infectious IBS research which is very important.


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## Nanobug (Nov 7, 2006)

> quote:You asked if there were different results from different centers. If you do some research on it all you will see different opinions on the subject.


Yes, I'm aware of different opinions. But it's not opinions I'm after, though.


> quote:"However, other studies have shown a much lower prevalence of SIBO in patients with IBS.


I'm looking for these studies that purportedly show this much lower prevalence. Are you familiar with them? Could you provide references?


> quote:In a recently reported retrospective study of patients who were referred for glucose hydrogen breath testing for SIBO, only 11% of 113 patients who met the Rome II criteria for IBS tested positive for SIBO, suggesting that IBS symptoms are often unrelated to SIBO.[4]


This reference [4], do you know what it is?


> quote:Indeed in one IBS study controls had SIBO, but not IBS.


Could you provide the reference?


> quote:I can also point out the last study did not show an improvement in global symptoms really, bloating got somewhat better. But not d or c or pain. It was also not by that high of a percentage.


Is this the one you are referring to?The effect of a nonabsorbed oral antibiotic (rifaximin) on the symptoms of the irritable bowel syndrome: a randomized trial.


> quote:"However, SIBO is not a disease; rather, it is a consequence of ineffective small-intestinal motility, and the underlying dysmotility will still exist after SIBO is eliminated.


Agreed! And this is very much addressed in Pimentel's protocol with the use of erythromycin/Zelnorm, no?


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## Rick (never give up) (Oct 7, 2005)

You guys lost me at some point.I agree that the SIBO theory is still controversial, as I myself have read a lot about that as well.So in the end, I'll appreciate an informed advice on whether Candida or other yeasts may pose a risk while on Vivonex?Or perhaps in the end none of us have a clue







.Thanks everybody.


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## Moises (May 20, 2000)

Rick,SIBO is controversial. But it is much less controversial than the Crook, Truss, and others' belief that candida is the cause of all ills.I speak as one who has tried nystatin and every other candidacidal supplement made.At this point, there is no convincing evidence linking candida albicans with IBS.But, as Eric and others like to say, I am not a medical doctor, so why follow my medical advice?


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## eric (Jul 8, 1999)

Wow, your asking for quite a bit of work.I worded this wrong"You asked if there were different results from different centers. If you do some research on it all you will see different opinions on the subject. Yes, I'm aware of different opinions. But it's not opinions I'm after, though.'Different SIBO results from testing, not opinion. Although The BOOK " A new IBS solution" is opinion and speculation yes. Because its not proven SIBO causes IBS by any means. It is however important work to figure out the association first and treat sibo if you have it and IBS if you have it and both IBS and sibo if a person has both.Besides its a very important editorial from the associate editor for Gastroenterology on the latest study. Do you know who Dr Drossman is and his qualifications?http://www.med.unc.edu/medicine/fgidc/drossman.htmIt also lists important references to the article you can look up."I'm looking for these studies that purportedly show this much lower prevalence. Are you familiar with them? Could you provide references?"Not all of them are in Pubmed yet, but some of them are and all you need to do is type in IBS and sibo for the ones that are there.This reference [4], do you know what it is?I am looking for this, and mistakenly did not post the link."In this setting, Lupascu and colleagues[11] assessed the prevalence of small intestinal bacterial overgrowth by glucose breath testing in IBS patients vs healthy controls. The study involved patients with IBS as defined by Rome II criteria; an appropriately matched group without IBS served as the control population. The study authors found a significantly increased (P < .05) *proportion of patients with small intestinal bacterial overgrowth among patients in the IBS group: 20 of 65 (30.7%) compared with 4 of 102 (3.9%) controls.* These findings are consistent with an increasing awareness of a postinfectious IBS syndrome.http://ibsgroup.org/groupee/forums/a/tpc/f...m/926101562/p/2Is this the one you are referring to? Yes and you should let me send you the editorial on this with extremely important information and references on this study and topic. It has a list of the references for you to look up.Pain, d and c did not improved, bloating got somewhat better. This is explained in the editorial as well.But it has also been discussed herehttp://ibsgroup.org/groupee/forums/a/tpc/f...m/443103162/p/2So why did the antibiotic not improve d or c or d/c and pain? How effective really is the treatment for sibo and IBS if it didn't show all that much improvement, did not improve c or d or c/d and pain and you might have to follow up taking antibiotics for a long time. Why was Zelnorm invented in the first palce? What evidence is there for dysfunction in the serotonin system that is imprortant to gut function and motility? What do you know about other avenues of IBS research such as pet and fmri scans and IBS?Or the HPA axis and IBS.Or sert and serotonin?Or very importantly Post Infectious IBS.Or inflammatory cells, like mast cells.Or EC cells?


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## Nanobug (Nov 7, 2006)

> quoteo you know who Dr Drossman is and his qualifications?


Honestly, I don't care. I imagine these are the same bunch who ridiculed Barry Marshall and Robin Warren a few years ago, no?


> quote:Not all of them are in Pubmed yet, but some of them are and all you need to do is type in IBS and sibo for the ones that are there.


PubMed returns five studies suggesting an association between sibo and ibs when the terms 'ibs' and 'sibo' are used together.


> quote:So why did the antibiotic not improve d or c or d/c and pain?


I don't know. But then again I haven't read the full study. Until I do, I'll refrain from answering that question.


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## eric (Jul 8, 1999)

"Honestly, I don't care. I imagine these are the same bunch who ridiculed Barry Marshall and Robin Warren a few years ago, no?"What bunch?Imagination verses expert opinion?A. You should care. B. You don't know who he is but are accusing him of something?That is not really fair is it?So you have know idea what the Rome criteria are?Gastroenterology April 2006 Issue: Rome III http://www.romecriteria.org/GastroIssue.htm"PubMed returns five studies suggesting an association between sibo and ibs when the terms 'ibs' and 'sibo' are used together. "on the right click on all relatedThis is one of the problems in that most of those studies are from Cedar and not from other centers finding the same results. What they are looking at now is ONLY an association.Not all these studies from around the world are going to be instantly in pubmed and some of the studies are new and some of the information is from the experts discussing the information themselves.


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## eric (Jul 8, 1999)

Rick, sorry I missed that post. I cannot answer that for you other then to say ask your doctor about it.


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## Rick (never give up) (Oct 7, 2005)

I read in other posts that elemental diets may lower the body's defences because all the intestinal flora is being reduced.I'm still wondering if yeasts that thrive elsewhere besides the GI track may become oportunistic and multiply under this condition.My doctor told me yerterday over the phone that he knows of a case where a patient with a very compromised inmune system developed systemic candidiasis after several weeks on an elemental diet. On the other hand, he is endorsing me to try the Vivonex protocol for 2-3 weeks.Still trying to make sense, after all, it's my body


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## eric (Jul 8, 1999)

Rick, if you have a very compromised immune system, like aids or cancer, there can be a problem with candida.Bad diet can lower the bodies defences.It doesn't look like it would be to big of an issue to try the Vionex.Nanobug, In the editorial of Dr Drossman's he refernces at least one abstract that is ahead of publication. He also mentions problems in the research of the last study.


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## Rick (never give up) (Oct 7, 2005)

Thanks eric,Based on all the information you presentd here, and other things that I read, I think I'll try the Vivonex.I'll start late this week and let you know my progree.Thanks a lot for all your support, ansd specially your patience.


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## eric (Jul 8, 1999)

Rick, no problem and hope it helps.Let us know. One last thing on candida for you. "The Australasian Society of Clinical Immunology and Allergy has issued this paper on Allergy testing and treatments."ASCIA Position Statement: Unorthodox Techniques for the Diagnosis and Treatment of Allergy, Asthma and Immune Disorders Dr Raymond J. Mullins on behalf of the Education Committee, ASCIA October 2004 "INAPPROPRIATE TESTINGChronic CandidiasisUse: Treatment of a variety of ailments including allergy, irritable bowel, food allergy and intolerance, autoimmunity, arthritis and psychological conditions. Method: This approach is based on the concept that imbalance of gut flora results in overgrowth of Candida albicans within the gut. Release of fungal toxins results in a variety of symptoms including fatigue, arthritis, irritable bowel, food intolerance as well as psychological symptoms. These toxins weaken the immune system, predisposing to further symptoms from ingested foods and toxins. Treatment centres on dietary supplements, administration of antifungal drugs such as nystatin, and restriction of "Candida friendly" foods such as those containing sugars, yeast or molds. Evidence: Candida is a normal gut organism, and immune responses (antibodies, cell mediated responses) to this organism are both expected and observed in healthy controls as well as those allegedly suffering from this condition. There is no evidence of overgrowth of Candida or altered immune responses to this organism in patients complaining of this syndrome. There is neither a scientific rationale nor published evidence that elimination of Candida with diets or anti-fungal therapy is useful for management."http://www.allergy.org.au/pospapers/unorthodox.htm


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## Moises (May 20, 2000)

> quote:Originally posted by Rick (never give up):Thanks eric,Based on all the information you presentd here, and other things that I read, I think I'll try the Vivonex.I'll start late this week and let you know my progree.Thanks a lot for all your support, ansd specially your patience.


Rick,Please do let us know how your Vivonex Plus trial goes. I am considering starting one shortly.Thanks,moises


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## 21718 (Oct 30, 2006)

Rick--I had read about Candida and Vivonex on a different web forum, and asked my doctor about it. His reply:


> quote: No, I have never heard of candida being caused by the Vivonex. Candida is a yeast which is virtually ubiquitous in the environment and in many parts of the normal human body (eg. colon, vagina). Candida infections are oft recounted on internet forums and except in cases of major immune compromise or relatively easy to treat conditions (oral thrush, vaginal yeast infections) are no big deal.


 That made me feel better, so I hope it reassures you too.And please do post how you do on the Vivonex. My breath test on day 15 of the Vivonex showed that the bacteria were all gone. (Yay!) But my symptoms are _not_ gone-- in fact I am more bloated than ever. I wish you more success!


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## Nanobug (Nov 7, 2006)

> quote:I wrote about using honey intead of maltodextrin


This would be a really bad idea as honey has a bunch of free fructose.


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## 18835 (Nov 9, 2006)

The opposite opinion about candida:Before anyone discounts the possible influence of candida, think about this: why did certain groups of people dramatically regain their health when antifungal drugs (candida is a fungus) were started? This group of people, although by no means representative of the entire population, were NOT what Rick's doctor would call "immune compromised". I can't post the refs, as I collect this info and store it mostly in printouts, but a some people who overused antibiotics and/or ate very high sugar diets do fall into this group - and woe to them if they attempt to find help with a doctor like Rick's (and most U.S. doctors). NOw if they were in Europe, those people would hear completely differing advice:In Europe, candida overgrowth following overuse of antibiotics has been STANDARD knowledge for decades! Doctors there cannot understand why U.S. doctors refuse to consider probiotics and antifungal medications following antibiotics, as this is standard protocol overseas.I collect information about candida patients as well as information about people who thought they had candida but didn't (yes, the symptoms are similar to other parasitical infections).If taking antibiotics, and unwilling to take PRObiotics afterwards to repopulate the good guys, at least take some antifungal products during and for long after the antibiotics, to keep the fungus down until your own PRObiotics can hopefull regrow, from being nearly decimated by the antibiotics.


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## flux (Dec 13, 1998)

> quote:why did certain groups of people dramatically regain their health when antifungal drugs (candida is a fungus) were started?


Uh...


> quote:I can't post the refs


Without refs, this statement could be construed as a fabrication.Even it weren't fabrication, it sounds suspicious. What kind of study is it that a priori puts people on antifungal agents without a diagnosis of a fungal infection? If they were diagnosed this way, it wouldn't be a surprising result, so how did they get to be on in the first place. Secondly, what are the control groups?


> quote: ate very high sugar diets do fall into this group


Yeast don't feed on sugar. They feed on you. So this relationship if true sounds suspicious.


> quote:has been STANDARD knowledge for decades!


And this knowledge is posted where? In actuality, in the US, why don't we see these overgrowth, then?


> quote:I collect information about candida patients


Where are there these patients and how do you know they have candida?


> quote:at least take some antifungal products during and for long after the antibiotics


It's not necessary because fungus is not a big problem from taking antiobiotics. Antibiotic-associated colitis, on the other hand, is.


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## 18835 (Nov 9, 2006)

You are welcome to your opinion, however there are even a few M.Ds in the U.S, not mention many in europe, who say the opposite. I'm not your personal researcher - if you wish to find out more you will need to do so yourself: amidst all the candida-theory-bashing from most U.S. doctors, there are a few very good sources of info on the opposite of the coin, including some written by M.Ds, that are not just the wild speculation that you may associate this topic with.I don't have the time to type in point-by-point replies as you do, my internet time is limited. Go to a large bookstore and read about it if you, or anyone, wants info that is more in line with what some of the European countries are doing on this topic. The bookstore source is better for M.D. views on this side of the topic, than the Internet is. If you only want the "AMA" current point of view, then fine, that's your choice. I am finished with this thread due to needing to spend time discussing other topics that I have not yet researched to my own satisfaction.


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## flux (Dec 13, 1998)

> quote:I'm not your personal researcher - if you wish to find out more you will need to do so yourself:


It is up to the person making the outrageous claims to provide the evidence..


> quote:amidst all the candida-theory-bashing from most U.S. doctors,


This if false.


> quote:The bookstore source is better for M.D. views on this side of the topic, than the Internet is.


Both sources can be equally corrupted. The best source depends is from experimental evidence: peer-reviewed journals.


> quote:If you only want the "AMA" current point of view


There are no point of view; there are facts and non-facts.


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## Kathleen M. (Nov 16, 1999)

On rare occasion someone will posit a biological mechanism that turns all of biology on it's head and they actually often end up winning the nobel prize for that. Prions, Transposons, H.pylori all come to mind.Because of this a fair number of scientists tend to spend some effort trying to find something, anything, that the conventional wisdom does not accept. After all that is where the biggest rewards come.Most of the time that pursuit doesn't lead anywhere with scientists because they can't back the theory up with data (even though ideally the data comes before the theory).If it doesn't pan out with data you can always write a book or a web-page that sounds really good and gets lots of fame and sometimes lots of fortune that way. Why let the data stand in the way of getting ahead one way or another?That a few doctors promote X or Y has never been that good a reason to belive what they say is the truth IMO. However anyone is allowed to believe whomever they want. Just don't expect a book to trump actual data from actual experiments in the medical literature any time soon. When people have upset the conventional wisdom they always do it with experimental data that makes everyone sit up and pay attention. No one has ever done it with something they can convince a book publisher will make money. Lots of people have made lots of money with books that won't pass scientific muster. Most passed off as a scientific and revolutionary.Yep, science makes mistakes, but is by nature a self-correcting process. Eventually someone figures out that X really isn't what is going on Y is. Book or website publishing is rarely a self-correcting process and one often finds the exact same stuff that was proven false 20 years ago being presented as new and true all over again.Believe it or not when the Candida hypothesis first came out in what was that the late 1970's or early 1980's there was a flurry of papers with people checking it out to see what they could find. Very little panned out from that and science moved on to more promising lines of inquiry. However that didn't stop the psuedoscientific process from latching onto it and never letting go.My favorite for any of those things latched onto by the psuedoscientific process is the arguement that if your tests are negative that only serves to prove you have it, and if the treatment makes you much sicker that only means you need to stay on it until it makes you well. No matter what the result everything points to you have the "disease" they promote.Yep, the Candida diet tends to help some people. A lot of times because it limits all the things that are common IBS triggers. Even without changing one thing in your microbial ecology it will probably make a fair number of IBSers feel better.But then again some 20-30% of IBSers get better in every clinical trial just because they have hope the treatment will work (placebo effect). That is why anecdotal evidence never ever trumps clinical research data. For what it is worth many who promote alternative treatments often do a much better job of massaging the psychosocial factors that cause a person to get better all on their own. Unfortunately modern medical practice tends to diminish the very things that may heal people without medication, surgery, or other treatment. Yep, you may feel better, but it may have nothing to do with what you actually took, or what diet you tried, or why the person says you are ill. They just are talented at getting people to heal themselves, which in reality is a very useful skill. K.


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## Nanobug (Nov 7, 2006)

> quote:My favorite for any of those things latched onto by the psuedoscientific process is the arguement that if your tests are negative that only serves to prove you have it, and if the treatment makes you much sicker that only means you need to stay on it until it makes you well. No matter what the result everything points to you have the "disease" they promote.


Yeap! For me this is test number one for quackery: no falsifiability. Some people might be shocked that this test works equally well for many religious "arguments", too!


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## Moises (May 20, 2000)

Kathleen,I enjoyed reading your post that is two posts above this one.In the long run, as Keynes said, we're all dead. Often we can't wait for science to find the truth in the long run. But in some cases, and candida albicans is such a case, the long run has ended and we have something about as close to knowledge as we can get. Candidiasis just is not a factor in most chronic conditions. We know the truth.What you said about the desire of scientists to revolutionize their fields is so clearly true. Much of the heat that is generated on this board can be explained by the fact that there is, at this time, no dominant paradigm explaining IBS. The research community really cannot agree on how to define it. So we have Manning criteria, Rome I, Rome II, Rome III.This lack of a paradigm does leave the field wide open for quackery and pseudoscience. As you state, it provides a ripe opportunity for those who have little evidential basis for their beliefs to exploit a gullible public. And as I have stated elsewhere, it's difficult to build a patient base, or sell books, or gain the respect of your medical peers, by stating the truth: the amount we don't know about IBS is staggeringly large.I wrote that last comment a few days ago and then realized I was wrong. Michael Gershon, in his 1998 book, _The Second Brain_, did sell a few books and is on the Rome Committee, so, hence, has the respect of his peers. And he does say in his book that half of what is in his book is wrong. The problem is that he just doesn't know which half. I found his confession of ignorance refreshingly surprising. What Socrates was to philosophy Gershon is to IBS studies.


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## Kathleen M. (Nov 16, 1999)

*Whew*I was a little worried how people would take that post







Now some of the evolution of criteria is more the sort of "as the understanding deepens" than full on competing paradigm shifts like what Pimental is working on.It is rare and refreshing when scientists admit the unknown factor. I remember one paper we talked about in Biochemistry class where the authors started the paper with a statement about how they really designed this experiment to try to study something entirely different, but because of how it flopped they discovered this other thing. Usually people do the "I meant to do that" like a cat falling off the bookshelf in its sleep







K.


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## eric (Jul 8, 1999)

One thing to know about Michael Gershon is he is basically the father of neurogastroenterology a relatively new field from his research.He has contributed some extremely important science to the fields.


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