# NYC SIBO docs?



## hsy

Curious if anyone is loyal to any good NYC docs who understand/treat according to the Pimentel modality.Thank you!


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## Molmag

HI everyone,I have been reading all of these posts for a few months now and been using these boards as somewhat of a "support system". I also am in the the NYC/Long Island area and would be very interested in a doctor in the area that supports Pimentels studies. I read the book several times and brought it to my internist who was kind enough to prescribe me the xifaxan for 10 days. It was quite expensive as it is not authorized for usage other than travelers diarreah (according to my insurance co) and that treatment is only 3 days at a lower dosage. The treatment seems to have worked and I am now using the rest of my prescription Zelnorm that I had before it was pulled from the market. (I am IBS-C)My question is; has anyone gone through this protocol and had somewhat lasting success? I am following the Pimentel diet very strictly and not eating any of the foods that he says can enouragebacteria overgrowth. Thanks in advanceAndrea


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## eric

This center in New York specializes in IBShttp://www.mindbodydigestive.com/Its important to understand that IBS and SIBO are two seperate conditions. Each may require different treatments.Its possible to have both or one or the other.This is a newer studyBacterial Overgrowth Apparently Not Important in IBSBy David DouglasNEW YORK (Reuters Health) Jun 04 - An abnormally high number of bacteria in the small intestine does not appear to be a major factor underlying symptoms of irritable bowel syndrome (IBS), Swedish researchers report in the June issue of Gut."The data," senior investigator Dr. Magnus Simren told Reuters Health, "do not support an important role for small intestinal bacterial overgrowth, according to commonly used clinical definitions, in IBS."Dr. Simren and colleagues at Sahlgrenska University Hospital, Gothenburg note that a high prevalence of small intestinal bacterial overgrowth has been reported in patients with IBS, but those results were based on indirect determination using hydrogen breath tests.They therefore assessed small intestinal bacterial overgrowth by a direct test -- bacterial culture of small-bowel aspirates -- among 162 patients with IBS and 26 healthy controls. Cultures revealed small intestinal bacterial overgrowth in 4% of patients and 4% of controls.Signs of enteric dysmotility were seen in 86% of patients with overgrowth and in 39% of patients without. Nevertheless, say the investigators, motility alterations could not reliably predict altered small-bowel bacterial flora."However," said Dr. Simren, "mildly increased counts of small-bowel bacteria seem to be more common in IBS," but "its clinical relevance remains unclear."Gut 2007;56:802-808.Here they used a more accurate test for detecting sibo in IBSers.


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## hsy

tested positive for SIBO/hydrogen via breath testingput on 1200mg xifaxan dailyabove course halted after positive test for blastocystisnow on 500 mg flagyl 2xday 7 days


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## keith

I came across your question when surfing to find a study group of SIBO so I joined so I could help. I have been dealing with a problem for years and it has been getting worse.....after many years of tests I was given the cookie cutter answer....." you have IBS" .....then the tiredness and aches started so then reumatologist said....." you have fibro and or cronic fatigue".....my symtoms are as follows Terrible constant gas...... Insomnia (mostly from the discomfort of the gas that is constant) Flu like symptoms- achy and tired.... Brain fog Terrible anxiety Irrational thinking and fear Sweats.....am and then go on during the day.....even bottom of my feet. Consipated alot.... Now understand until these gastro symtoms started years ago I had no health problems except a weak immune system so I got upper respiratory infections...... Here is the clincher......I went to a Gastroenterologist a few months ago and told him my story and he smiled. He put Dr Pimentals book in front of me and told me to read it........read it- I COULD HAVE WRITTEN IT!!!!!! I then went for breath tests and tested positive for SIBO.......I wondered over the years why every time I got put on an anitibiotic I felt better! Well, I went through several rounds of the anitibiotics and every time during treatment I felt 75% better!!! Every symptom dissapeared except for the gastro symptoms.....my anxiety completely dissapeared, brain fog gone, energy returned, aches and pains got much better.........unfortunately a week to 2 weeks after it came back with a vengeance! Ok, sorry for blabbing on, but the reason is my gastroenterologist at this point doesnt know what to do with me so I called Mt Sanai in LA and asked for referral to someone on the East coast wh follows Dr Pimentals protocal.........here are the names and numbers I was given Dr Christine Frissora 212-746-4316 Dr Scott Tenner 212-368-2960 Dr Jeffrey Danzig 201-445- 8787 I have an apt with Dr Danzig next friday and hope the referral is a good one......when I asked the person who made the apt whether he specialized in small intestinal bacterial overgrowth they didnt know what I was talking about......so I scheduled a consult....got my fingers crossed.


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## UrbanUrbane

Hi! So glad to read this post. I'm in NYC. My gastro is willing to treat me if I have positive results, but says he doesn't do the test. My insurance won't cover it, but even when I offered to pay for it out of pocket, my primary care physician insists there is NO ONE in New York doing the breath tests. I know Mind Body does, but it is $800 and they require a consult with a physician first. I can handle 2 - 300, but not 8. Apparently Presbyterian and Long Island offer breath tests for children only. Please tell me where you had the test done - was it through one of these doctors? Please update when you can. Thank you.


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## hsy

i just started seeing christine frissora - she is great - and weill cornell is an amazing facility - she knows ALL about this stuff and the staff at the hospital is top notch - ive seen her once and am doing follow up tests and the like - my previous doctor was also great - his name is dr. anthony starpoli in greenwich village - he definitely does breath testing and that is where i got my positive result - keith i have 100% same symptoms and results as you - antibiotics generally solve the issue every time - im convinced at this point that the endless tetracycline i was on in high school caused these problems but that's just my opinion - i got a gall bladder sonogram today, am trying something called amazita to stimulate gut motility, and will be doing a follow up lactulose breath test in a couple weeks - i was told to discontinue benefiber as it may be contributing to the gas issues, though it has increased the frequency of my bowel movements and thus made me feel bettermore to come


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## sunspot19

Christine Frissora!I have actually been thinking of trying to get an appointment to see her. I am also in the NYC area and really think I need a good GI. So far I have done things thru my internist and I am just not sure he is really doing things correctly.I have IBS-D (well, whether it is IBS or not is up for grabs), but generally speaking chronic diarrhea since May. Before that it was not chronic and I had more itchiness than anything.Does Christine take insurance? If not, is she still relatively decent? I know Weil does generally take my insurance which would be good if she sends me for tests there.Also, will she do things like check for parasites, etc., before deciding it is definitely IBS versus SIBO versus a parasitical infection?Thanks in advance.


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## Jkristina

Hey all,I actually saw Dr Pimentel. I went to cedars last year. Actually he was not much help. The best remedy for me is to rid the BM's then take Neomycin one time a day on an empty tummy. Since this is not absorbed into the bloodstream it is safer than most drugs. Hopefully the docs in NYC are better than LA! Good luck!!


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## hsy

weill cornell is so far the best hospital ive ever been to - it's brand new, beautiful, the support staff is on point, dr. frissora does take insurance, and i have no reason to believe that she does not follow standard IBS diagnosis protocol which includes testing for the things you mentioned


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## UrbanUrbane

My doctor called Dr. Tenner and Dr. Baradarian today and was told, rather harshly, apparently, that neither doctor performs the Hydrogen breath test any longer. He even asked the receptionist at Dr. Baradarian's office to ask the doctor himself, and was told this test was not performed. Dr. Starpoli does perform the test, via a home kit. FYI


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## lynnem

Hi, I'm new here today. I've suffered from IBS for about, oh...30 years, but it seems to be getting worse. I mostly have horrendous pain (like Mike Tyson beating on my transverse colon), bloating , gas and diarrhea. When I found out what I had, I read everything under the sun and realized there were, at the time, no real treatments, so I've lived with it. But I've had 6 hip surgeries in the last 3 years and seem to finally be healing, and I'll be damn if I'm going to let this IBS go without at least some attack.Wierdly, yesterday I had just bought the book by Mark Pimental you all are talking about! I'm a biologist , so I skipped the anatomy stuff and I'm almost up to the protocol which I gather is going to be antibiotics????Are we cutting out one food group and a time, then adding back? I'll read it all tomorrow, BUT MOST IMPORTANTLY, has anyone had good results with his regime that lasted????Also, I'm in the deep south (Katrina put 5 feet of water thru the house), and many of our "caring" health care professionals left for good. Does anyone know a good GI person in maybe Mobile, Jackson, even New Orleans?By the way, thrilled to find this site! Lynne


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## eric

Lynem, it was speculation that sibo "caused" IBS fro Dr Mark Pimental , but they are finding that's not the case, but some people may have IBS and SIBO.There is still quite a bit of controversary over all of this.Another aspect is the lactolose test is not accurate.Since your a biologist, this is brand new current state of the art on IBS.This is brand new on IBS.2007 IFFGD Symposium Summary Report, Very much worth reading/state of the art researchhttp://www.ibsgroup.org/forums/index.php?showtopic=92806andVidoes from the conferencehttp://www.aboutibs.org/site/learning-center/video-corner/andThe stronest evidence they have on IBS has to do with serotonin regulation from cells in the guthttp://www.ibsgroup.org/forums/index.php?showtopic=80198


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## Noah

re the sibo breath test, I think this is the same/similar test if anyone wants to test without a doctor. Presumably to the same standard (?). http://www.crohns.net/page/C/PROD/Diagnostic_Test/GSD5000Possibly it's cheaper elsewhere, but the labs don't like shops selling direct so it may be hard to find a seller. There is also directlabs. Maybe they do the testhttp://www.directlabs.com/


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## lynnem

Eric and Noah,Thanks for the info - I will definitely read the references you sited. Yes, I knew serotonin's been suspected as a factor in IBS for awhile. I sure hope not. I've been taking one SSRI or another for years to ward off depression and it certainly hasn't helped the gut serotonin.For the last 4 years, I've had about 7 surgeries due to an infected artificial hip joint. This means I've been on one antibiotic or another most of the time. Now I'm on 100 mg of penicillin 4X a day and will be for the rest of my life. We may change the drug, but I'll always be on some kind of antibiotic - great for the gut.You should love this irony - the only thing that helps the worst pain and cramps is Lortab or similar opiates. Where they make everyone else constipated, they make me normal. I've been searching for clinical trials on IBS. Considering how many people have it, there's not very many trials. One would think the drug companies would see all that potential $ and start developing drugs. Or when I do find one, it's half over or almost always in a big city (obviously at teaching hospitals). Down here in what's left after Katrina, IF you can find a specialist of any kind, it takes months to get an appointment, and many MDs aren't taking new patients.


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## Matt R.

I first saw Dr. Pimentel more than ten years ago. I suffered from bloating, pain, fatigue, shortness of breath, and mostly stomach pain and reflux for years. I was never labeled IBS. My doctors before Pimentel were diligent but not helpful. It was thought I had a motility problem so I was sent to Cedars Sanai (I live in the LA area) where I saw Henry Lin, then the head of GI Motility their. Dr. Pimentel was his bright faced young assistant (although I guess Pimentel was running a lot of the studies even then). Lin has moved on, and Pimentel is the head now. He never mentioned IBS to me. Positive Breath test, then antibiotics and liquid Erythromycin three times a day in very low dosage for pro motility effect. Sure enough, the antiboitics (usually Doxycycline) took away the symtoms (at least 90%) for six months just about every time. In Spring of last year I didn't respond. Went back to Pimentel (finally, in August) and got on the new Cedars regimen. I had been one of their earliest patients. In the subsequent years I had just seen my regular GI doc on my insurance plan. Anyway, in September went on Xifaxan (high dosage) and powder E mycin one time a day at night. Sure enough again, symptoms cleared. Pimentel said new regime should keep symptoms at bay for more than a year. New regime includes Pimentel diet. Alas, six months later I'm suffering and back on Xifaxan. I'm having horrible shortness of breath. Just awful. Anyone else suffer from that?I love Dr. Pimentel. It's hard to believe IBS is so common, and this science is so nascent. Good luck all. -Matt R.


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## eric

Matt, have you ever gotten a second opinion as to IBS or SIBO or both?


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## XxJustMexX

any doctors on long island that have a clue about SIBO? My doctor is the best I've had so far.. but she wasn't very helpful or positive about the SIBO diagnosis.


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## AllStrZ

My therapist just recently mentioned SIBO to me and I'm really curious about it. I know this thread is from last year but does anyone know where they perform the breath test? Thanks.


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## freakzilla154l

Hello all, I was just referred to Dr. Jeffery Danzig in Yonkers. The people from Sedars Cinai (Sp?) told me to try him since I live in Philly, PA. So has anyone seen him and had help?


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## Jaimie1

Hi Everyone,I actually found a doctor at Mt. Sinai who has read Dr. Mark Pimental's book and subscribes to his beliefs about SIBO. I showed her my medical records, in which there was a test positive for SIBO from a few years ago(I did two rounds of antibiotics and felt better, but relapsed quickly. Probably because I didn't know at the time to help the antibiotics along by avoiding the foods mentioned in Pimental's book), and she agreed that I should try more antibiotics. She looked thoroughly over my records, which included every possible treatment for IBS, and was very attentive and personable. Although it was my first meeting with her, her willingness to listen and her intelligence make her a winner.She's a part of the Women's Gastrointestinal Health Center at Mt. Sinai (although I did see a few males in the waiting room so don't despair if you're not female; at the very least I'm sure they'll refer you).The doctor I saw was Dr. Yuki Young.Good luck, everyone!


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