# New Doctor / SIBO



## Blair (Dec 15, 1998)

I had the Lactulose test done a month or so ago and my usual GI didn't seem to want to consult with Cedars Sinai. I saw a new doctor yesterday who is more familair with the test and knows the doctors at CS. Highlites of what he said.1) other Hospitals have not had the same sucess as CS, this is a bad thing.2) he has great respect for Dr lee at CS and will try the antibiotic therapy as he feels its pretty safe. 3) His idea is Ciprofloxin and neomycin at the same time for two weeks and then retest at CS 4 weeks later. 4) Bently at 10 mg is Homopathy, 40 mg 3 times a day if tolerated is recomended. 5) Has not had success with antibiotic threapy for IBS as suggested by CS . 6) says IBS is very difficult to treat/cure7) I should write mt congressman to bring back Lotronex although doesn't think it will help. My immpression is he is one of the better and more experienced doctors I've seen.He personally knew my first GI who treated me(tried too at least). He was an intern under him. Wants to do one thing at a time in a controled fashion, that is try the antibiotics first, if that doesn't work can try higher dose of bently. doesn't like Lotronex but does like levsin. Diet is an individual thing , etc. So right now I'm waiting to hear back from his office about when I can start the Antibiotics, we want it to be 4 weeks after finishing that I get a lactulose retest so depending on the retest date will be when I start antibiotics. BTW my first GI called last Friday and wanted me to take Tetracycline, maybe for life? Says he has a few patients on it for SIBO. Feels if I do have SIBO it may AGGRAVATE an underlining IBS condition.So who's right? CS says neomycin, old doc says tetracycline, new doc says Cipro and Neomycin, first doctor didn't find any evidence of SIBO at all. FDA withdraws Lotronex, says it doesn't work enough to justify the risks.At this rate I don't see a permante solution to IBS in my lifetime. Although eventually one will come. Thats just the way technology works. Will keep you posted.


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## bonniei (Jan 25, 2001)

> quote:BTW my first GI called last Friday and wanted me to take Tetracycline, maybe for life? Says he has a few patients on it for SIBO. Feels if I do have SIBO it may AGGRAVATE an underlining IBS condition.


Antibiotics for life seems tobe the way for nopw for SIBO. So your first doc was on the right track. However it doesn't sound like he is convinced that SIBO can cause what seems like IBS in some. You could have just SIBO or SIBO as well as IBS that is not defined by SIBO. I guess the proof is in the pudding. If antibiotics cure you even if only temporarily you will know


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## bonniei (Jan 25, 2001)

> quote:BTW my first GI called last Friday and wanted me to take Tetracycline, maybe for life? Says he has a few patients on it for SIBO. Feels if I do have SIBO it may AGGRAVATE an underlining IBS condition.


Antibiotics for life seems tobe the way for nopw for SIBO. So your first doc was on the right track. However it doesn't sound like he is convinced that SIBO can cause what seems like IBS in some. You could have just SIBO or SIBO as well as IBS that is not defined by SIBO. I guess the proof is in the pudding. If antibiotics cure you even if only temporarily you will know


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## Ugh (Jan 30, 2001)

I believe tetracycline was the first thing most Docs tried for SIBO in the past. Maybe there's so many resistant bacteria they no longer use it. I was given tetracycline first, and took it for a week. It helped me a lot, although looking back I don't think it had anything to do with SIBO. Taking it completely eliminated my mucous problem. My best guess is that I had some sort of dysbiosis of bacteria in my colon.


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## Ugh (Jan 30, 2001)

I believe tetracycline was the first thing most Docs tried for SIBO in the past. Maybe there's so many resistant bacteria they no longer use it. I was given tetracycline first, and took it for a week. It helped me a lot, although looking back I don't think it had anything to do with SIBO. Taking it completely eliminated my mucous problem. My best guess is that I had some sort of dysbiosis of bacteria in my colon.


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## Ugh (Jan 30, 2001)

> quote:If antibiotics cure you even if only temporarily you will know


I'm not so sure about that, although I thought the same thing you did bonniei before I took antibiotics. I think it's possible you could feel "cured" while using antibiotics because of things other than SIBO. There's other bacterial problems that could be helped besided SIBO and some antibiotics have side effects on the intestine unrelated to a bacterial change.


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## Ugh (Jan 30, 2001)

> quote:If antibiotics cure you even if only temporarily you will know


I'm not so sure about that, although I thought the same thing you did bonniei before I took antibiotics. I think it's possible you could feel "cured" while using antibiotics because of things other than SIBO. There's other bacterial problems that could be helped besided SIBO and some antibiotics have side effects on the intestine unrelated to a bacterial change.


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## bonniei (Jan 25, 2001)

> quote:There's other bacterial problems that could be helped besided SIBO and some antibiotics have side effects on the intestine unrelated to a bacterial change.


You got me thinking Ugh. I suppoise you are referring to the antibiotics somehow fixing those colonic bacteria which flux refers to from time to time. While playing around with the colonic bacteria might fix a person with gas issues, can it play a role in fixing the diarrhea that Blair suffers from?.


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## bonniei (Jan 25, 2001)

> quote:There's other bacterial problems that could be helped besided SIBO and some antibiotics have side effects on the intestine unrelated to a bacterial change.


You got me thinking Ugh. I suppoise you are referring to the antibiotics somehow fixing those colonic bacteria which flux refers to from time to time. While playing around with the colonic bacteria might fix a person with gas issues, can it play a role in fixing the diarrhea that Blair suffers from?.


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## knothappy (Jul 31, 1999)

Now, Iam beginning to wonder..last week I was taking Cipro for a UTI and during that time I felt good-no D. Four days after the treatment ended IBS was back, a very bad bout I might add. WhenI asked my Dr. if I could have that bacteria he said I read too much into things and it was probably a coincidence that I did not have D during the Cipro treatment. I know he will not send me for the test, who is right?


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## knothappy (Jul 31, 1999)

Now, Iam beginning to wonder..last week I was taking Cipro for a UTI and during that time I felt good-no D. Four days after the treatment ended IBS was back, a very bad bout I might add. WhenI asked my Dr. if I could have that bacteria he said I read too much into things and it was probably a coincidence that I did not have D during the Cipro treatment. I know he will not send me for the test, who is right?


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## Ugh (Jan 30, 2001)

Bonniei, I would say yes it is possible it could stop D. Taking antibiotics could affect anything from C diff to H pylori. I'm not saying she has these, but it seems like D is a fairly common symptom of a lot of things that are probably more common than SIBO. Dysbiosis of the colon seems poorly understood, so it seems possible that could result in D. I don't see why antibiotics + stoppage of D = SIBO. Of course that could be the case, but I don't see why it'd have to be. I have become very skeptical of the Cedars study. It's not that I don't think antibiotics help some people, I just think there's more probable explanations than SIBO. When I started reading more on IBS I thought it was all a Brain/Gut problem (ala Mike's tapes) then I swung all the way into the bacteria related idea and now I'm pretty much back where I started thinking it's mostly brain/gut problems...although I do think bacteria play a role in some symptoms (I believe it did in my case, although I believe this appeared as very mild colitis). I know a lot of people kind of don't like the antibiotic idea, but I disagree and think it should be tried after you've tried everything else. I'd try a week of Tetracycline though before I'd try the other antibiotics mentioned.There's a thread on here with a guy who feels "cured" from Paxil. I'd guess there's a lot more people having their symptoms relieved with anti-depressents than antibiotics. That tends to support the Brain/Gut thing. Just a thought.


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## Ugh (Jan 30, 2001)

Bonniei, I would say yes it is possible it could stop D. Taking antibiotics could affect anything from C diff to H pylori. I'm not saying she has these, but it seems like D is a fairly common symptom of a lot of things that are probably more common than SIBO. Dysbiosis of the colon seems poorly understood, so it seems possible that could result in D. I don't see why antibiotics + stoppage of D = SIBO. Of course that could be the case, but I don't see why it'd have to be. I have become very skeptical of the Cedars study. It's not that I don't think antibiotics help some people, I just think there's more probable explanations than SIBO. When I started reading more on IBS I thought it was all a Brain/Gut problem (ala Mike's tapes) then I swung all the way into the bacteria related idea and now I'm pretty much back where I started thinking it's mostly brain/gut problems...although I do think bacteria play a role in some symptoms (I believe it did in my case, although I believe this appeared as very mild colitis). I know a lot of people kind of don't like the antibiotic idea, but I disagree and think it should be tried after you've tried everything else. I'd try a week of Tetracycline though before I'd try the other antibiotics mentioned.There's a thread on here with a guy who feels "cured" from Paxil. I'd guess there's a lot more people having their symptoms relieved with anti-depressents than antibiotics. That tends to support the Brain/Gut thing. Just a thought.


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## Blair (Dec 15, 1998)

Quote by UGH"I was given tetracycline first, and took it for a week. It helped me a lot, although looking back I don't think it had anything to do with SIBO." UGH Why not? [This message has been edited by Blair (edited 06-27-2001).]


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## Blair (Dec 15, 1998)

Quote by UGH"I was given tetracycline first, and took it for a week. It helped me a lot, although looking back I don't think it had anything to do with SIBO." UGH Why not? [This message has been edited by Blair (edited 06-27-2001).]


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## bonniei (Jan 25, 2001)

> quote:I was given tetracycline first, and took it for a week. It helped me a lot, although looking back I don't think it had anything to do with SIBO. Why not?


Why did you feel that teracycline helping had nothing to do with SIBO? It could have killed off the SIBO or any of the other harmful bacteria that might be in your system as Ugh pointed out. But it definitely could have helped with the SIBO. So what makes you so sure it didn't help SIBO? If the help was only for the duration of the antibiotics constipation might have been a side effect of the medication


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## bonniei (Jan 25, 2001)

> quote:I was given tetracycline first, and took it for a week. It helped me a lot, although looking back I don't think it had anything to do with SIBO. Why not?


Why did you feel that teracycline helping had nothing to do with SIBO? It could have killed off the SIBO or any of the other harmful bacteria that might be in your system as Ugh pointed out. But it definitely could have helped with the SIBO. So what makes you so sure it didn't help SIBO? If the help was only for the duration of the antibiotics constipation might have been a side effect of the medication


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## Pete (Jan 20, 2000)

Cedar uses neomycin first. Then when your overgrowth comes back in 3-12 months they will use Cipro. 3-12 months later tetracycline. They don't like to give 2 at once because they want to use as little as possible to avoid resistance. If you use cipro now, it may not be as effective down the road. You may develop a resistance to it. So using 2 together will get rid of SIBO but it may make it harder to treat in the future.


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## Pete (Jan 20, 2000)

Cedar uses neomycin first. Then when your overgrowth comes back in 3-12 months they will use Cipro. 3-12 months later tetracycline. They don't like to give 2 at once because they want to use as little as possible to avoid resistance. If you use cipro now, it may not be as effective down the road. You may develop a resistance to it. So using 2 together will get rid of SIBO but it may make it harder to treat in the future.


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## Blair (Dec 15, 1998)

Bonnie, I was tring to quote UGH and asking why they felt it didn't help. I never took it. Thanks Pete, I'm going to just take the Neomycin 500 mg twice a day, 10 days, I'll save the Cipro for later. Its making sense now why all the different Antibiotic stragies of these doctors. Although I was alarmed and dissipointed when I got home last night and found the filled presciptions " neomycin 500 mg BID ( 4 times a day) and Cipro 500 mg twice a day, at the same time, for two weeks. I don't think so, Thats too much IMO. Very fortunate to have this board and all of your help in making a Logical decision about this. I'll start as soon as this new doctor gets me a retest date. And of course if he flakes out I'll start this weekend on my own initive which really has been the story of my IBS fight anyway. Thanks again, keep you posted. And no more yogurt.


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## Blair (Dec 15, 1998)

Bonnie, I was tring to quote UGH and asking why they felt it didn't help. I never took it. Thanks Pete, I'm going to just take the Neomycin 500 mg twice a day, 10 days, I'll save the Cipro for later. Its making sense now why all the different Antibiotic stragies of these doctors. Although I was alarmed and dissipointed when I got home last night and found the filled presciptions " neomycin 500 mg BID ( 4 times a day) and Cipro 500 mg twice a day, at the same time, for two weeks. I don't think so, Thats too much IMO. Very fortunate to have this board and all of your help in making a Logical decision about this. I'll start as soon as this new doctor gets me a retest date. And of course if he flakes out I'll start this weekend on my own initive which really has been the story of my IBS fight anyway. Thanks again, keep you posted. And no more yogurt.


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## Ugh (Jan 30, 2001)

The reason I don't think I have/had SIBO is because I have been able to get most of the same benefits from altering the way I eat. Tetracycline has restrictions on when you can eat, and when you can eat dairy, etc. I had excessive gas, but after experimenting with the way I eat (not what I eat) I seem to have beaten that...although it has only been a few days, so I'm not ready to say anything definite. I'll post more about that later if it turns out I've really discovered something that helps me that might help someone else.


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## Ugh (Jan 30, 2001)

The reason I don't think I have/had SIBO is because I have been able to get most of the same benefits from altering the way I eat. Tetracycline has restrictions on when you can eat, and when you can eat dairy, etc. I had excessive gas, but after experimenting with the way I eat (not what I eat) I seem to have beaten that...although it has only been a few days, so I'm not ready to say anything definite. I'll post more about that later if it turns out I've really discovered something that helps me that might help someone else.


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