# EnteraGam



## jstezelecki

My gastro doctor just suggested that I try a new prescription medical food called EnteraGam. According to my doctor, the prescription is suppose to do wonders for IBS-D. The major drawback is that it is still very new and has yet been approved by many Insurance companies.

The prescription presently cost about $358.00 per month. Has anyone tried this product yet. The scientific name of the product is Serum-derived bovine immunoglobulin/protein isolate,SBI. Thank You.

John


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## jstezelecki

I had a conversation with a Vice President of EnterGam. It souds vey promising. Can't wait for my insurance company to approve it. All is looking good. www.enteragam.com.

John


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## Jeffrey Roberts

We are well aware of EnteraGam. The studies to bring the product to market look very promising at providing relief for a great many IBS-D patients. It is a very novel way to treat IBS and it wasn't something that researchers had examined prior to Entera Health presenting it at a medical conference last May.

We expect several IBS researchers to begin some additional research studies over the next short while to further validate it's use for IBS-D.

We will be very interested in your experience, if you decide to try it. Please keep us posted.

Jeff


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## PD85

I have never heard of this, is it available and how do I get it?


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## IBS2

I'm very surprised there isn't more literature on this product. It seems to have popped up overnight, with very little clinical research documentation. That said, the basic science in the literature seems sound. It will be interesting to start to get feedback from members who take Enteragam. Hopefully this product will prove to be really effective in giving control to IBS-D patients.


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## HumanistRuth

Interesting, and expensive.


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## Faulty

Any chance of hitting uk?


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## jstezelecki

If you contact EnteraGam they will send you an information package. They may even call you and up date you on their progress getting this prescription food approved with each insurance company. If I'm not mistaken their first meeting with Blue Cross was scheduled for this month followed with Harvard next month and then Tufts Medical. I'm guessing that like most new prescriptions, the Insurance companies will want additional data before they make the final approval. Usually once a major carrier like Blue Cross approves a product, the others follow suit.

Everything that I have read and have been told by my GI doctor about this product makes it sound very promising. I did receive numerous sample packages but I didn't use them since the product takes a few weeks or more to work in your gut and I had only enough samples for about a week .You'll need to contact them to find out it's availability in the UK. Thank You

John


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## IBS2

Sounds good. Were you able to get any additional information on its effectiveness? You stated it takes several weeks to work and wondered how many weeks is several?


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## jstezelecki

I'm hearing between 2-6 weeks. Once it kicks in, your in pretty good shape for continued success. If you contact them and give them a phone number, they will call you and give you updates on progress being made with the Ins. companies and additional testing. All Good


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## flitwit

I'm not sure where it was that I'd first heard about this... I believe it was in Mark Pimentel's book A New IBS Solution... but I'm pretty interested. Right now, I'm not getting any of the nutrients my body needs, nor the calories. I can't digest food properly, and just keep losing more and more weight. From 183 to about 90-something pounds. I thought it was something that was already being used.


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## jstezelecki

Flitwit,
It's now on the market and is being used.It's expensive. It's presently not covered by all insurance companies. This is not unusual when a new expensive product comes to the market. Many times over the years I have had to wait up to 90 days to get some prescriptions approved by my insurance company. Sometimes my doctors have written many letters or have had many telephone conversations with them before approval. My former wife has had the same problem. Quite often she has been hospitalized due to lack of approvals. It's cost the insurance company 10 times greater or more than the prescriptions would have ever cost them. That's when the insurance companies finally figure it out.


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## IBS2

If this is, as described, is a medical food then why does it need a prescription? The only contraindication listed on their web site is to beware of an allergy to beef. If that's the sum total of cautions in taking the product I can't see any need for a prescription, which only causes the cost to be higher.


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## Jeffrey Roberts

IBS2, the FDA category of medical food requires a prescription because it is meant to be used under medical supervision.

There is more information about Medical Foods on the EnteraGam website; http://enteragam.com/patients/medical-food/

Flitwit, no Dr. Pimentel did not write about this in his book, although he has expressed a great deal of interest in furthering research with it.

Please expect to see some coverage about EnteraGam here on our website beginning next month. Like all new treatment options, it takes time to get information about it to all insurers, health care professionals and patients.


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## lookingforcure

Very interesting. I thought I was on top of all new IBS drugs/products coming onto the market (check out my post http://www.ibsgroup.org/forums/topic/164500-current-drug-pipeline-for-ibs-d/) , but this one seems to have gone completely under the radar. I can't find any of the studies for it online, can anyone point me in the right direction? Very excited to see more info on this, Jeffrey! In the meantime, could you tell us more about how exactly this works? Is it similar to colostrum (seeing as its bovine)? My best guess is it seems to repair the intestinal wall somehow, leading me to believe it has something to do with intestinal permeability...


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## jstezelecki

Lookingforcure,
If you plug into your search engine the scientific name of EnteraGam it will give you a pretty good idea on how it works. Try this is in your search engine Serum-derived bovine immunoglobulin/ protein isolate,SBI

JOHN


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## lookingforcure

jstezelecki said:


> Lookingforcure,
> If you plug into your search engine the scientific name of EnteraGam it will give you a pretty good idea on how it works. Try this is in your search engine Serum-derived bovine immunoglobulin/ protein isolate,SBI
> 
> JOHN


Hey, maybe the fact that SBI is IBS in reverse is some kind of sign?









I've found plenty of info on SBI, but still can't seem to find any studies saying it works in IBS specifically, or the study cited by Enteragam showing it works.


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## Jeffrey Roberts

The FDA medical food category does not require the same type of Phase 1,2,3 testing as you would see in conventional prescription medications, so that's also way it was under the radar for everyone. This is so new that it caught everyone by surprise. I think we can expect a lot of research and data to emerge over the next year.

We are anxious to hear about IBS sufferers results with this. It has been used quite successfully in the livestock industry for many years by the manufacturer.


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## IBS2

Well if it works well for the cows, then you can quote me as saying "Moooo bring it on"!


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## Jeffrey Roberts

My recollection is that it was actually used with piglets.


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## IBS2

On a more serious note, usually what sounds too good usually isn't. I'm sure most of us are looking for that "magic bullet" that will cure our IBS or better stated a treatment that will at least allow a degree of control of our symptoms. Certainly the work done by Pimentel sounded the closest to the holy grail of IBS cures, but when you read the posts by patients who have gone through the "cure" many have had recurrence of symptoms. I guess the bottom line is I hope Enteragam proves to be effective in the management of IBS and gives people back their lives to be lived for better or worse.


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## jstezelecki

Jeffrey

I'll give an oink to that. EnteraGam has launched a new social media site called www.enterahealth.com
I have been informed by EnteraGam that this site will be uploaded in about two months with far more information about their product. Thanks,
John


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## ColinCharlie88

I was prescribed EnterGam this week. Its sounds promising for those of us with bacteria type IBS D...My first couple days of it have given me alot of burping, gurgling, and gas, but I will certainly give it alot more time...I will keep everyone posted on my progress + dealings with insurance (Im using samples right now).


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## jstezelecki

Colin,

To start the program , you'll need a lot of samples. The samples only have three packs in a sample box. It's my understanding that the product can take anywhere from 2-6 weeks before it start's working. For some people maybe longer. I'm assuming that your starting on one pack a day. Are you taking the full pack all at once or are you splitting it in two and taking it twice a day? It's my understanding that you may need up to 3 packs a day, depending upon the person. On one pack a day, how long do you have to wait to see if you need to increase your dosage to two or three packs a day? Thanks,

John


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## ColinCharlie88

I was told to take 1 pack per day...only been 6 days so Im being patient..Its giving me alot of gas but hoping it will solve my gut pain and "sick/nauseous" feeling that I get due to bacterial issues. I will keep all posted on my progress w/ this drug.


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## jstezelecki

*Cool,*

*This product is the only product that EnteraGam manufactures and sells. Millions have been spent on developing the product and bringing it to market. It's success is important to the company and to all of us IBS D sufferers. EnteraGam has a big company financially backing them. EnteraGam and the company backing them really believes in this product is going to be a BIG helper for us IBS D patients.*

*My Gastro doctors had real faith in this product to work. I'm hoping that my insurance company will be approving this prescription in a year's time and I want to try it.*

* I'm trying to get a sense on how people will be using this new food prescription including the amount of prescription they are taking as well as when and how much at a time. Your taking a pack a day which is the minimum amount. Are you splitting the package in two parts? Meaning are you taking half in the morning and half later evening or are you taking the one package all at once? Thanks,*

* John*


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## ColinCharlie88

Ive been taking EnteraGam for 2wks now and would Im doing good....perfect BM's, no pain, no bloating. But I am getting a lot of gas (diff from IBS type gas...may be a side effect). Either way I will keep all posted.

Insurance wouldnt pay for this so I may have to fork over the $350 per mth, if it keeps working.


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## jstezelecki

Colin

It appears that it's working for you with the minimum dosage in only two weeks. I just checked their web site and it's possible that some people may have to take up to 4 times the dosage your taking. Great news from you.. Just curious, how are you doing with oils such as olive oil and fats? What kinds of food are you eating now that you could not eat before. $i350.00 is a lot of bucks a month but if you can afford to buy it monthly that real good.


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## Jeffrey Roberts

We recently launched several new pages which will help explain Prescription Medical Foods as well as the product EnteraGam™


What You Should Know About Medical Foods
The First and Only Prescription Medical Food Product for Managing IBS-D: EnteraGam*™*

Additionally, Entera Health Inc., the manufacturer, has created a worksheet entitled A Guide to Discussing EnteraGam™ Prescription Medical Food with Your Doctor.


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## lookingforcure

Hey Jeff, is this something that you take for a limited time, to heal your stomach, or something you take indefinitely to control symptoms?


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## Jeffrey Roberts

lookingforcure,

This is a good question. It is so new that I don't believe anyone has the answer as to whether EnteraGam is to be used for a limited time or long term.

In studies which were reported at Digestive Disease Week in May 2013, "Dietary management with SBI 10.0 g/day for 6 weeks resulted in statistically significant improvement in the number f days with any symptom including abdominal pain, loose stools, bloating, flatulence and urgency." In the Prescribing Information and Usage for EnteraGam, there is no mention of re-treatment, which might suggest that you take a course of it for some period of time and retreat if there are no improvements in your symptoms.

However, like all treatments, this question might be best discussed with the prescribing physician who will follow the patient closely while under this new treatment plan.

Jeff


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## IBS2

I have to admit after reading the link Jeff gave describing "medical foods" why, unless there are significant contraindications or untoward effects, EnteraGam cannot be obtained without a prescription. I've reviewed EnteraGam's literature and don't see any problems other then having a allergy to beef why it shouldn't be over the counter. Having it available to as many ibs patients as possible will give us the best evidence of EnteraGam's effectiveness. If, in fact, EnteraGam does provide significant control of IBS-D, the potential market is huge and should be made available to as many patients as possible without having to jump through too many hoops. Having EnteraGam available over the counter should also lower the cost, especially in a global market.


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## PD85

IBS2 said:


> I have to admit after reading the link Jeff gave describing "medical foods" why, unless there are significant contraindications or untoward effects, EnteraGam cannot be obtained without a prescription. I've reviewed EnteraGam's literature and don't see any problems other then having a allergy to beef why it shouldn't be over the counter. Having it available to as many ibs patients as possible will give us the best evidence of EnteraGam's effectiveness. If, in fact, EnteraGam does provide significant control of IBS-D, the potential market is huge and should be made available to as many patients as possible without having to jump through too many hoops. Having EnteraGam available over the counter should also lower the cost, especially in a global market.


You are right on. I would have already bought it and used it if it was available OTC. Meanwhile I have no idea how to even get it and my Gastro Doc doesn't either.


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## Jeffrey Roberts

My understanding as to why EnteraGam is a prescription medical food is because it is a formulated food product and is thus regulated by the FDA. The FDA mandates that it be prescribed and dispensed this way as well as be monitored by a physician. Entera Health states that EnteraGam is not a probiotic, a dietary supplement or a change in diet because EnteraGam cannot be obtained by modifying your diet. It is formulated.

I can't speak for Entera Health. As myself, I would have also preferred EnteraGam to be OTC.

I think it would be useful for Entera Health and the FDA to hear about comments like this.


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## jstezelecki

My doctor gave me a prescription for EnteraGam. It was available at my local CVS but until it's approved by my medical insurance, I just cannot afford it's monthly cost.


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## IBS2

I hear you Jeff, but my concern is directly related to the last post regarding the cost, so EnteraGam, like Lotronex will be put out of the reach of many IBS patients because of price and the lack of insurance coverage. I'm also concerned that because of the cost we're not going to get to see the potential of this "medical food" in the treatment of IBS. The analogy I would use regarding medical foods is the product Glucerna or for that matter Vivonex, which don't require prescriptions. I have an appointment with my gi doc in December and I'll see about get a prescription. In the meantime I hope those who get a chance to take EnteraGam keep us all up to date.


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## Jeffrey Roberts

FYI

I see on the EnteraGam.com website that a Prescription Savings Program is available. Perhaps this will be helpful to some people.

http://www.enteragam.com/patients/savings-and-resources/savings/


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## jstezelecki

IBS2,

I have had a few conversations with the EnteraGam folks. They are presently meeting and have more meetings scheduled with most of the major health insurance carriers. Some companies have already approved it but I'm not sure which ones they are.Usually insurance carriers want additional studies to be done showing how effective a medical food or drug will be. I'm confident that this prescription will be approved and accepted by most health insurance companies in the very near future. Thanks You.

John


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## Moises

I see that it contains dextrose. I cannot find in the packaging insert pdf file how many grams of carbohydrate one dose contains. Anyone know the answer?


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## Jeffrey Roberts

I consulted with Entera Health for some clarification as to why EnteraGam is a prescription-based medication. These are my findings. I believe the fact that the FDA is "keen to maintain standards in the Medical Food category" is key to why this is a prescription medication.

Since Entera Health is performing clinical trials in diseased individuals, it is not appropriate from an FDA regulatory standpoint to have supplements on the market which are intended to maintain normal function in healthy individuals without being prescription-based. The FDA is keen on maintaining the standards in each category;


Supplements- maintain health
Drugs- treat, cure, prevent, mitigate a disease or condition
Medical foods- manage chronic conditions and diseases under physician supervision.

Entera Health's clinical programs are dictating that they not have supplements on the market which patients and/or physicians may use in an attempt to treat or manage diseased patients, without a prescription.


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## jstezelecki

Jeff,

In your discussion with EnteraGam did a conversation about how they are progressing in getting major health insurance companies to approve the product? Thank You.

John


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## BRAD B

Found out about Enteragam from an email from this website a couple of days ago( Thanks ibsgroup.org ). Called Enteragam and left a message, they called me back and looked up my Gastro doctor and said he had samples. Seems at this point they are mostly working only with Gastro doctors. I went to my Gastro doctor to ask/beg for an ok from my doctor to try Enteragam. One of the office girls said the Enteragam had called them to tell them I was going to come by. My doctor gave me about 9 days worth and a card for a free month supply if it works for me. I started yesterday. Took a half pack yesterday and half pack today. Will take a full pack tomorrow. Will keep you updated. I am still taking all my other anti D meds to. Wishing for a miracle.


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## legbuh

A cow antibody/protein to cure D? Hmmm..







I guess I would try anything.

Is this something you'll need to take forever, or can it be stopped after a while?

I'm actually having pretty good success with Kombucha. Kefir I've tried and it worked ok, but Kombucha seems to work much better. A big swig after every meal and I'm somewhat better, more solid, etc. Still have cramping, etc. But 20 years of a messed up gut won't be cured in a week.

I started out with store bought Kombucha and now make my own with a scoby I got from someone. Still trying to make it taste as good as store bought.  The reason I wanted to try this is because of all the success I've heard from fecal transplants. This works, as I believe the bacteria help digest the things I can't because of a messed up flora. But the only issue is the bacteria doesn't replenish my flora, only works in conjunction with it.


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## PD85

BRAD B said:


> Found out about Enteragam from an email from this website a couple of days ago( Thanks ibsgroup.org ). Called Enteragam and left a message, they called me back and looked up my Gastro doctor and said he had samples. Seems at this point they are mostly working only with Gastro doctors. I went to my Gastro doctor to ask/beg for an ok from my doctor to try Enteragam. One of the office girls said the Enteragam had called them to tell them I was going to come by. My doctor gave me about 9 days worth and a card for a free month supply if it works for me. I started yesterday. Took a half pack yesterday and half pack today. Will take a full pack tomorrow. Will keep you updated. I am still taking all my other anti D meds to. Wishing for a miracle.


I'm very interested as to how it turns out for you. Keep us posted Brad.


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## squeeshy3k

Please guys let us know of how it is advancing for you. A lot of people here are waiting for feedback.


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## jstezelecki

The product like many other prescription medical foods and medicines requires a doctors constant oversight . Until the FDA removes or ever removes this oversight requirement it will remain a prescription medical food.


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## Getreal

I also found this link to a clinical trial currently underway. Gives an idea about dosage, etc.:

http://clinicaltrials.gov/show/NCT01313910


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## Getreal

And here is one more link which is for IBS:

http://www.nutraingredients-usa.com/Research/Proliant-reports-IBS-benefit-of-ImmunoLin

This is pretty old, though, it is from 2006.


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## BRAD B

Well it has been a couple of days now and actually the day after I started enteragam I felt my stomach was feeling better. My stomach felt less bloated and gassy. Its could just be a placebo effect though like many other times before. I am cutting down on my other D meds and we will see what happens. My stomach feels so much more settled and slowed. I still have issues with anxiety. Like today standing in a check out line I felt like I had to go urgently. Left the line and went to the bathroom but once I got there I was fine and couldn't go. It was in my head. I thought I only had 9 days worth but counted wrong. I have 12 more packets (1 a day). So we shall see in another week. So far I think it is helping but $350-$400 for 30 packets a month will put a stop to enteragam for me if I can get my insurance company to cover it through appeal which is not likely.

Thanks for all the other info and research from all the other members I am going to look into them.

Brad.


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## Moises

BRAD B said:


> Well it has been a couple of days now and actually the day after I started enteragam I felt my stomach was feeling better. My stomach felt less bloated and gassy. Its could just be a placebo effect though like many other times before. I am cutting down on my other D meds and we will see what happens. My stomach feels so much more settled and slowed. I still have issues with anxiety. Like today standing in a check out line I felt like I had to go urgently. Left the line and went to the bathroom but once I got there I was fine and couldn't go. It was in my head. I thought I only had 9 days worth but counted wrong. I have 12 more packets (1 a day). So we shall see in another week. So far I think it is helping but $350-$400 for 30 packets a month will put a stop to enteragam for me if I can get my insurance company to cover it through appeal which is not likely.
> 
> Thanks for all the other info and research from all the other members I am going to look into them.
> 
> Brad.


Brad,

That's great news. The Enteragram package insert suggests that symptoms improve over 4-6 weeks. It also suggested that 2 packs/day had a more positive effect than 1 pack/day.

My SBI arrived today. I will take some soon and then go to bed.

The


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## Kathleen M.

Enteragam is 5 grams of SBI per packet (from the prescribing info sheet) whole packet weighs 10 grams.



> EnteraGam™ does not contain any milk products such as lactose, casein, or whey. It is gluten-free, dye-free, and soy-free. It contains the following inactive ingredients: dextrose and sunflower lecithin.


So when doing the cost calcuation if you want the equivalent dose you will have to take several doses of at least some of these other products.


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## HNat

jstezelecki -

Are you still taking enteragam? Did it help? Is there any body else who has tried it yet? If so, please do let us know how are you doing!


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## cuzi

Hi. New to the board and I just picked up my first box of this stuff and took the first dose (one packet). About 20 mins into the dose and a lot of "gurgling" going on in my stomach. Will continue to post progress over the next month.


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## cuzi

On day three. First day, mild cramps and a moderate headache. Day two, no cramps and really no headache. No other pros/cons just yet.


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## jstezelecki

Cuzi,

If possible, could you let us know what dosage your taking (how many packs a day) and if your splitting the packs or pack and taking it twice a day or once a day. It's my understanding that two pack a day which takes about 2-6 weeks to work is ideal. Thanks,

John


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## cuzi

John--I'm taking one pack a day all at once. So far after 3 packs, today, no headache at all, but a very "squirmish" stomach with a loose bowel movement, which is not normal for me.


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## JonSnow

I've been taking 10g of Enteragam daily for 15 days. It appears to be having positive effects. Stools are less frequent, much more solid, darker in color, and I have no urgency. I still have constant gas. It's too early to say definitively how beneficial the drug is or even that my results aren't coincidence. The first 10 days or so were masked by immodium use to get me through Thanksgiving and other events. But the last week I've been immodium free and have begun introducing less safe foods into my diet with no significant ill effects so far. Years ago, I had similar results with Lotronex for a month (I'm a dude but the doc had me try it anyway) until I became dangerously constipated. So far Enteragam has not made me constipated.


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## JonSnow

I'm now on day 20 of EnteraGam, 10g daily. I've scaled back on the unsafe foods. After eating, or after a BM, I now sometimes get stomach pains that would previously have meant an unholy hell of diarrhea is on its way. The good news is the diarrhea never comes and 1-2 hours later I feel ok. The bad news is this seems to happen even when I'm eating safe foods. My BMs have returned to their original color (see my previous post). My gas used to never smell, now it reeks, which sucks - I can no longer pass quiet ones. I do seem to have solid BMs more often but it will take a few more weeks to quantify by how much.


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## Jeffrey Roberts

We have now split this topic.

Please find discussion about *EnteraGam alternatives* here, http://www.ibsgroup.org/forums/topic/168751-enteragam-alternative-discussion/

Please only discuss your results using EnteraGam in this discussion.

Thanks for your understanding.

Jeff


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## legbuh

I showed the "bring to your doctor" form they put out to my GP who I met last week. He found the description interesting and since I'm meeting with a new GI doc later this week he said to bring it up with him as he would be more suited to know or research it.

But what he found interesting is the wording... he said that's the same way they found an antibody for tetanous. Injected it into a cow and harvested the antibodies. But IBS isnt a virus.


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## cuzi

OK, at day 14. I would say in general, there haven't yet been any positive results, and would say I'm slightly worse, in a different way. Stools are relatively the same from two weeks ago and no marked difference in urgency. Heartburn is terrible. Daily, all day. I'm going to give the entire box a try before I decide to stop taking. I was taking in the morning, but may start to take before bed to see if there is a difference. Still one packet.


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## jstezelecki

Cuzi,

 Thank you for the update. I'm guessing that 14 days is way to early as my GI Doctor informed that it could take up to 6 weeks for improvements. I guess every individual will require different dosages. My physician thought as a guess that two packs a day may be required for me. Have you thought about half a pack in the morning and half a pack at night?


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## legbuh

Doctors always say things take a long time. They can't explain how I went from normal to IBS-D in a day though. 

I look forward to meeting with my new GI on Friday. I will mention this as well as fecal transplants to him and see how up he is, or if he just schedules another "procedure".


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## jacqui1009

I have been dealing with stomach issues for over 10 years. I have had my gallbladder removed and even found that I had gastro-endometriosis. Now, I am being diagnosed with IBS-D. I have lost over 10 lbs in 3 months (I am 5'10 and 135 lbs), can't eat anywhere in public due to the urgency and have had to leave work numerous times as the pain is so bad. I am tired all the time and I just feel sick (lack of nutrition). I live on peanut butter and jelly sandwiches since my stomach can stand that most of the time.

I have had 3 GI Doctors and it feels that if it is not a definitive black and white answer, they no longer want to deal with me. I had to tell my Dr about the Gastro-Endo, which he didn't want to look into it, and my fertility Dr found it and told me the extent of it when I had surgery (all over my uterus, ovaries, intestines and colon). My current GI Dr gave me 5 boxes of sample EnteraGam. He could not tell me how much to take or anything about it except he has a few patients that tried this and had good reactions to it. I am on my 3rd week and it seems to be helping to a point. I have not had a D bowel movement in over a week which is awesome since it is usually every day. I do still get the gas pains and bloating but not as bad. So far, I have not had any of the side effects that I have read other people do. I usually take a little bit in the morning with water, a little bit after lunch and the same after dinner. I can take 1 packet and stretch it about 2 days. I am bummed about hearing about the insurance information and the cost of it. However, I will cut other things out in my budget if I can live at least a half normal life.

I am also waiting for a call from a nutritionist so I can start the Fodmaps diet and introduce food back in to see if it's a reaction to food as well (although I doubt it because there is no rhyme or reason with the foods I eat). I looked online at the list of foods to eat and it seems that every website has a different list where some say cheese is OK and others say it isn't, etc... I know this disease is a trial and error but I wish people would spend much more time researching it since so many people have it.

Jacqui


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## JonSnow

I'm on week 5 of Enteragam, 10mg daily.

It definitely causes more firm stools without constipation.

It doesn't seem to help gas or bloating at all.

I'm not sure about its impact on other symptoms, I'll report back after I've been on it longer.

I strongly suggest trying this product.

It's covered under Anthem BCBS, my copay is only $25 per month.

If you have the $75 voucher its free each month (up to 1 year I think).

Merry Christmas everyone!


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## jstezelecki

Jon,

I'm guessing that in general most people that have joined this forum have severe IBS D. maybe it would make sense for those with strong IBS D issues to increase the dosage to two packs a day and see how that works. I'm very happy to learn that your Anthem BCBS is covering most of the expense of the product. I'm currently on BCBS Massachusetts but's it's not presently covered and I'll be switching over to Harvard Pilgrim in two months. I'm hoping that they will soon cover EnteraGam. Thanks for the information and please keep us updated. Thank You.

John S


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## jacqui1009

Update: I am still on Enteragam and just found out the my insurance through United healthcare in Florida covers the prescription...I only have to pay $25. I really am liking this RX...I had barbecue tonight for dinner, usually a no-no, but I was fine. I had no gas, bloating or D and was about 45 minutes from my house (bathroom) but I had no issues.


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## legbuh

thanks for the reports! keep us up to date!


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## HNat

So how are the results so far on Enteragam? Any more updates??


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## Debbie Benning

I just got the script. I have Aetna. With the voucher, my copay is $125.00! I haven't purchased it yet. Has anybody tried the Immunolin?


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## jacqui1009

So it has been another week and I am really doing well to this medicine. I have had only 1 issue but that was my fault for testing it with certain food (McDonalds). I still watch what I eat but the D and bloating is pretty much gone. I get gas from time to time but can deal with that over the pain I used to have. And I have started to gain some of my weight back which is good since I am starting to look healthy. I have more energy which is great! I hope they start opening this up for more insurance companies to cover it. I know it can be expensive, and depending on your insurance and co-pay it can still cost a bit but with the misery and pain I used to have I would have given up my cable or anything else for that matter.


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## HNat

Awesome Jacqui....certainly great news


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## ColinCharlie88

Ive been on Entergam for 60 days and it has improved my D significantly. Gas went away after a few weeks (but it was bad). I have also started FODMAP diet plus Im taking amitripline, fiber pills, Welchol, and VSL#3 daily...Its all a pain but on a scale of 1-10, 10 being the best Im at a 6-7..I was at a 1 almost a yr ago and by adding each I am at a 6-7. Still having sick/naseous feeling a couple days a week (which sucks...knocks me out almost like the flu)and I have bad side effects from the amitripline (difficulty processing & speaking + blurred vision).

I am fighting with insurance now who wont pay for this so Im shelling out the $350 per mth. Considering changing insurance co's.


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## PD85

ColinCharlie88 said:


> Ive been on Entergam for 60 days and it has improved my D significantly. Gas went away after a few weeks (but it was bad). I have also started FODMAP diet plus Im taking amitripline, fiber pills, Welchol, and VSL#3 daily...Its all a pain but on a scale of 1-10, 10 being the best Im at a 6-7..I was at a 1 almost a yr ago and by adding each I am at a 6-7. Still having sick/naseous feeling a couple days a week (which sucks...knocks me out almost like the flu)and I have bad side effects from the amitripline (difficulty processing & speaking + blurred vision).
> 
> I am fighting with insurance now who wont pay for this so Im shelling out the $350 per mth. Considering changing insurance co's.


What were you on the scale before you started the FODMAP. How long have you been on FODMAP?

What I'm getting at is, how do you know the Enteragam is helping?


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## ColinCharlie88

Ive been on FODMAP for about 2-3 weeks. Ive been on Enteragam for 8 weeks..noticed D stopped within 2-3 weeks.


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## JonSnow

I've been taking Enteragam for 2.5 months. It began working the third week and plateaued the sixth week. It makes my stools more firm for a given diet. Trigger foods will still cause loose stools, but not nearly as loose as before. I also have less urgency. No other symptoms have been affected (I'm still in pain, bloated, gassy, etc). There are no side effects. I plan to continue taking this medication indefinitely. It's not a cure but it helps.


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## jstezelecki

Jon,

I know I have mentioned this before but would consider increasing the dosage? It appears to me that the minimum dosage may be for those who have a mild case of IBS D. Once again I' thinking that most of the folks on this site have pretty severe IBS D. Thanks,

John


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## Ray Smith

I have been on Enteragam for about 5 Weeks. Stated to notice a difference after 3 weeks. Before that I notice almost no difference. I was getting ready to change medicines when I noticed general improvement in symptoms and energy levels.

Diarrhea decrease to acceptable levels. Stools still a little soft. Energy levels are back. It did not seem to cure my restless leg syndrome but it seems to keep it to a minimum. I am on no other medicines but did just finish a round of antibiotics for my sibo. I am on the low FODMAPS diet.

Some days I will take two packs, but my insurance is not paying for the medicine. After a hard work out my stomach will be in pain and the Enteragam helps a lot. Not only my stomach feels better but my energy levels are better.

I am going to stay on this medicine for the time being. Everything else I have tried works for a short time and then it all comes back. This medicine seems to keep the symptoms away for a long time. Not a cure, but I am sold on it.


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## JonSnow

Jstezelecki: At some point I will try increasing the dose, but I'm doubtful it will help me. On a 100% safe diet Enteragam makes my stools so hard that I have to strain and risk hemorrhoids. Therefore I eat just enough fiber and fat to avoid straining. I'm concerned that if I took a higher dose of Enteragam I would need to eat more fiber and fat, which tend to give me gas, bloating, pain, etc. I will post an update when I do try the higher dose.


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## jstezelecki

Jon and Ray,

Thank You for the information. Please keep us informed.

John S


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## Getreal

After having been on SBI supplements for six weeks now (with good luck) my doc has prescribed the "real deal, " EnteraGam. I have been on 10grams of my equivalent supplement and love the results. At 5grams a day I was better but it wasn't where I wanted to be.

I think my insurance will cover EnteraGam which will make it cheaper than the stuff I've been buying on Amazon. The doc has also sent me a voucher for a free month.

I do the low FODMAP diet (mostly), avoid most dairy, and am also taking one packet of cholestramine a day, and the occasional probiotic. I also think peppermint oil can be very helpful so I take that between meals when I think of it.

I thought I should come back and update -- what happens is that folks who get better often don't report back because we aren't so consumed by our IBS-D anymore! It is wonderful to feel good again. I have gained some weight, have more energy, love life again and feel HOPE.


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## JonSnow

I ended up trying the increased dosage (20 mg a day). It doesn't seem to help any more than 10 mg/day.

I am having cramps/pain in the middle of the night that would usually indicate oncoming diarrhea. With EnteraGam, the pain goes away without diarrhea and I usually have a firm BM within 12-24 hours. This may sound like a good thing, but it makes me nervous. Lotronex had a similar effect on me for a month, and then gave me a terrifyingly painful night an order of magnitude worse than anything I've ever felt. I am going to reduce the EnteraGam to 10mg for now and see my doctor. I don't t think the increased frequency of painful nights has anything to do with the EnteraGam. My symptoms have slowly been getting worse for over a year now. I probably just need another round of Xifaxin. I am also going to get a biopsy for celiac disease, since I've learned night episodes are more common to celiac than IBS. It's probably a longshot, I had a blood test done years ago, but occasionally they give a false negative.

A few notes on EnteraGam:

It takes my body 2-3 weeks to adjust, both when I began the medication and when I increased the dosage. There were unusual pains and just a lot of weird feelings that went away after 3 weeks both times.

You can take up to 4 packets a day. The cost of one monthly prescription is the same, regardless of whether you get 1/day or 4/day. Therefore, if your insurance doesn't cover it, at least ask your doctor if he/she will prescribe 4 packets a day. Then take 1/day for 4 months. This reduces the monthly uninsured cost from about $350 to about $90.

Many insurance companies are now covering EnteraGam, including Anthem.


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## CSuzette

Can someone help me? I asked my GI doctor at Beth Israel in Boston to prescribe the Enteragam and she was (not sure of the exact word to use) outraged. My insurance company will pay for it (United Health). She was aggressive with me on the phone, as I think other patients had called and yelled at her when she told them no. Her reasoning: She would never take bovine immunoglulin and she would never prescribe it. I asked why not. "Because it could mess up your immune system." Also, she said there were no studies, which I would have to disagree with. In any event, I need an open-minded GI doctor in the Boston area that would be willing to prescribe. Thank you.


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## CSuzette

I should say that I started taking one of the alternative Enteragam products, which appear to all be discontinued, but I was able to find a supply that has not run out, yet. I pretty much noticed an immediate effect. Lots of gas at first. My bloating must be a little less, because I noticed that my pants were looser in the stomach. I did get one of my migraine headaches, but not convinced it was the product, because other things were going on.


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## jstezelecki

csuzette,

I would try a GI doctor with the Harbor Medical Group in Braintree, Ma. I'm pretty confident that they will subscribe it for you.


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## CSuzette

Thank you. I will have to see whether they are within my plan.

I am still floored by the response that I received. As far as I know, the stuff is protein isolated from cow's blood. It is GRAS by the FDA, because people have been drinking blood and eating blood (think blood sausages) for thousands of years with no ill effects.

The lack of curiosity to learn more is utterly amazing to me. I told her I was still having problems after taking the Rifaximin and she didn't even ask what kind of problems.

Obviously, I did nto get one of those "good" doctors. She was done with me and had nothing else to offer. It is no wonder that in the circle of family that I travel in that we are done with conventional medicine.


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## JonSnow

This medication seems to have had a long lasting (maybe permanent?) effect on me in regard to one particular symptom.

I still get terrible cramping and pain that comes and goes when I overdo it on bad food, as described in my March 11 post above.

However, it no longer results in a night of explosive diarrhea.

The pain subsides and the next morning I have a normal bowel movement.

This is in stark contrast to what I experienced the previous 11 years.

The change began when I started taking Enteragam.

I haven't taken Enteragam in over 3 months.

I have no idea what this means, I plan on discussing with my doctor and will have a follow up post in the unlikely event that he has an answer.


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## Kotik

I decided to give yet another medication a try. I've been taking EnteraGam for almost a a week, 2 packets per day. So far I am not feeling any different (no side effect either so far). I'm crossing my fingers that given more time, I'll start to feel better.

I don't have any issues with irregular bowel movement, mainly abdominal pain after eating, bloating, burning feeling in the mouth, and headaches, which began the past few months, low energy level when in pain. This is how I feel 85-90%% of the time, which is really sad. Exercise seems to help the pain go away a lot of the times, but then it could come back again the next day after eating.

I will keep you posted about the status of its effectiveness.


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## legbuh

If you don't have irregular BMs, why are you looking at an IBS-D product to help with things that seem unrelated? Maybe I missed something.


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## Kotik

Hi Legbuh, I don't think that EnteraGam is a drug that only regulates BM. My main issue was that I had never ending stomachaches that began after eating and they would last for 3-4 days and it'll go away on its own. Then I'll eat something else that my body wouldn't like and again it would start hurting for days. At first I thought it was terrible acid reflux and then I thought it was food allergies and I have tried a lot of medicines that did absolutely nothing for me. I have visited 3 gastros and did a lot of tests, which all came back normal, yet I had a constant stomachache that pretty much doubled my stomach in size due to bloating. My current gastro finally said that it must be IBS, even though my symptoms don't exactly match to what usually people get when suffering with IBS. He suggested I try EnteraGam and I decided to try it as I was desperate and was willing to try anything that will give me a normal lifestyle. I was becoming really miserable, as any person would with CONSTANT stomachaches and bloating. This has been going on for at least 6 years now, and it got worth with each year.

So far I have been on Enteragam for almost a month (2 packets/day) and believe it or not, but my stomachaches have gone away. I eat whatever I want (I used to limit myself a lot before as many foods seemed to upset my stomach and I couldn't catch a pattern). It took about 2 weeks for the EnteraGam to start working and now I feel totally normal. It's really amazing! I will test it out for another month to make sure that it will continue to work for me before I fully commit to taking it permanently. I haven't experienced any side effects to date but I will continue to monitor myself. I still avoid things such coffee and fresh garlic/onion as those foods upset my stomach no matter what, not sure if that is due to IBS or acid.

I hope this clarifies for you as to what my issue is.


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## Kotik

Hello, just when I wrote a lengthy comment below raving about how great EnteraGam was, I have to now say that EnteraGam stopped working for me after 2 months. Has anyone else experienced that? I felt really good the first two months of taking it but then it just stopped working...my daily stomachaches returned. I got off it for now and currently not taking anything else. Had yet another appointment with my gastro today and we will try other options. Wish me luck!


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## Greengal

I started Enteragam a month ago and am starting to see improvement with my IBS-D resulting from Short Bowel Syndrome caused by surgery. It's been almost 10 months since my surgery, followed by lots of unnecessary tests, useless medications, and bad medical advice. Enteragam has given me the most hopeful sign to date and was prescribed by the 3rd gastroeneterologist I have seen, who actually seems to have a clue!

I am sure that this medical food is not going to work for everbody, but it is certainly worth checking out with a well-informed, up-to-date gastroenterologist. With regard to the cost - Enteragam is now affordable for most people.

EnteraHealth, the manufacturer of EnteraGam, has a relationship with Foundation Health Pharmacy which is listed as the "EnteraGam Hub." They can sell EnteraGam to you directly, without insurance, or process through your insurance. In my case, buying directly from Foundation Health cost me less than 50% of what I was paying out of pocket with my Blue Cross Blue Shield coverage! No doubt, different insurers cover different amounts, so check on yours.

When you buy Enteragam directly from Foundation Health, they price it based on the number boxes you purchase. The rep I spoke with told me that the best deal is to buy 4 boxes at a time, since there is no additional savings after the 4th box. Each box contains 30 packets and most patients are prescribed 2 packets a day - so most of us will be using 2 boxes a month. I just ordered 4 boxes (a two month supply) for $124 which includes shipping. Again, I am paying them directly, without insurance. To get relief, I think $62/month is well worth the expense.

I hope this information will be of help.


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## garciastudios

I started Enteragam this past December (2016) and it took 2+ months to start feeling anything but it has been bulking up my stool. I had tried everything in the book over the past 10 years so it's nice to have something making some effect on my stool. I still take my daily Digestive Advantage pills with every single meal, and 1 packet of Enteragam each morning. We'll see how it goes. I still have some urgency, which is odd, but here's to hoping this will buy me more time between imodiums, which I take once a week to keep diarrhea at bay.


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