# Cedar Sinai update



## Pete (Jan 20, 2000)

Well just wanted to report back in after my final visit to Cedar. My latest breath test came back inconclusive. The peak was quick but the number was under 20. My first breath test peaked at 90. This means that I reached 1 of the 2 criteria for SIBO. I'm sorry if this doesn't make sense, I personally am confused by it. A quick synopisis is that upper burping and dyspepia and lower flatulence are my main symptoms.Before Cedar- 100+ episodes of flatulence a dayAfter 10 day course of neomycin- Zero gas which lasted 3 months. Then it started coming back probably upto 20-40 per day. Now they are treating me with doxycycline.(He gave me the option of retreating) and again I am gas free.Here is the million dollar question for flux:1. Do you think that SIBO or colonic dysbiosis is the cause of the gas?2. IF it is colonic, do you feel that probiotics following antibiotic treatment may keep it from coming back. I feel this is risky because if the problem is SIBO, then I was told probiotics could make it worse.I appreciate your comments.ThanksAlso I am curious if you think that zelnorm could theoretically help functional dyspepsia and the feeling like you need to burp. I should be able to get my hands on this drug in a few weeks.


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## bonniei (Jan 25, 2001)

One of the other members on the board (Blair) had a theory that if you peak within 45 mins it is a small intestinal peak. I am not saying I agree with him but Pete can you tell me if you peaked within 45 mins?


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## Ugh (Jan 30, 2001)

Pete, I know you're asking flux, but what makes you think probiotics will worsen a SIBO? Kmottus has posted some things that suggest it either does not hurt or helps. From what I've seen I believe it would be helpful. The thing about your case that makes me question a problem with colonic bacteria is the rate at which your gas returned. You made it sound very gradual. I've seen graphs of bacteria and how quickly they return to pre-antibiotic levels in the colon. Since there is no barrier to their growth in the colon like there is in the SI I would wonder about them taking that long to return to your colon. There's so many variables though that it is almost impossible to know exactly what is going on. I read some study the other day that showed an actual change in the layer of the colon in some people that allowed bacteria to grow at a higher density per area. If you are heading back to pre-antibiotic levels of gas anyway, what do you have to lose by trying probiotics?


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## flux (Dec 13, 1998)

> quote:y first breath test peaked at 90


Some things to consider...1) The gas measured is hydrogen. Some people don't have H2 making bacteria and can get very low numbers or even *zero* and still have SIBO.2) The number in and of itself is perfectly *normal* for colonic bacteria.3) There is no easy way to know whether the bacteria contributing to this value are from the mouth, the small intestine or large intestine or a combination. That's why the test isn't all that reliable.


> quote:1. Do you think that SIBO or colonic dysbiosis is the cause of the gas?


Colonic "dysbiosis"


> quote:2. IF it is colonic, do you feel that probiotics following antibiotic treatment may keep it from coming back. I feel this is risky because if the problem is SIBO, then I was told probiotics could make it worse.


If it were from the colon, then they theoretically help. If you extend this to its logical conclusion, you'd be getting one of those fecal "transplants". If it were coming from SIBO, then I don't readily see how it could help (despite what appears to be research contradicting this idea).


> quote: I've seen graphs of bacteria and how quickly they return to pre-antibiotic levels in the colon


Where have you seen these graphs?------------------I am not a doctor, nor do I work for profit in the medical/pharmacological field, but I have read scientific and medical texts, and have access to numerous sources of medical information that are not readily available to others. One should always consult a medical professional regarding advice received.


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## bonniei (Jan 25, 2001)

> quote:I read some study the other day that showed an actual change in the layer of the colon in some people that allowed bacteria to grow at a higher density per area.


Ugh the studies you read sound very interesting. Where did you find this study?


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## Pete (Jan 20, 2000)

Flux,What is your opinion on this fecal transplant and where are they doing it?Pete


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## bonniei (Jan 25, 2001)

Pete did you overlook my question or am I barging in on your conversation with flux. If I am, I'm sorry. Please carry on[This message has been edited by bonniei (edited 06-09-2001).]


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## Pete (Jan 20, 2000)

Sorry Bonnie,I don't have my records. They are at my office so I should be able to answer your question on Monday. Hope you didn't think I was being rude.


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## bonniei (Jan 25, 2001)

Don't worry about it Pete. Just wasn't sure if this thread was mainly for a conversation with flux,


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## flux (Dec 13, 1998)

> quote:What is your opinion on this fecal transplant and where are they doing it?


It's hard to say because it is mainly anecdotal. It could be that some (a few) people out there do have some sort of "dysbiosis" (apparently what you have) and this type of therapy helps (I don't think it would help for Rome criteria-based IBS). Some of the anecdotes relate to treating C. dif infections with the fecal transplant. There are two places doing it, Tom Borody in Australia (he wrote an article about in the Medical Journal of Australia several years ago) and a doctor I believe in St. Louis who learned it from Borody.------------------I am not a doctor, nor do I work for profit in the medical/pharmacological field, but I have read scientific and medical texts, and have access to numerous sources of medical information that are not readily available to others. One should always consult a medical professional regarding advice received.


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## catherine (Aug 11, 2004)

Flux, could you please explain colonic dysbiosis?


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## flux (Dec 13, 1998)

> quote:Flux, could you please explain colonic dysbiosis?


It is idea that there is something abnormal in bacterial makeup of the colon. The most obvious instance is an infection of C. dificile. However, it appears possible that in a few people the bacterial makeup can become "deranged" (presumably after taking antibiotics) and that could lead to colonic symptoms such as excess gas. It has been documented only anecdotally in the medical literature.------------------I am not a doctor, nor do I work for profit in the medical/pharmacological field, but I have read scientific and medical texts, and have access to numerous sources of medical information that are not readily available to others. One should always consult a medical professional regarding advice received.


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## catherine (Aug 11, 2004)

Thank you.


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## Blair (Dec 15, 1998)

One of the other members on the board (Blair) had a theory that if you peak within 45 mins it is a small intestinal peak. I am not saying I agree with him but Pete can you tell me if you peaked within 45 mins?Not my theory, it's Cedars' Theory. I'm still waiting to see a gastro to Treat my Supposedly SIBO. I see him the end of June. I fired my old gastro BTW. I can tell you from experience that Probiotics make me sick. Also I think it was UGH makes a good point about bacteria growing back in the Colon, I bet its pretty fast. Good luck Pete. The 45 min early peak is only valid for "normal transient time" which I think is about 3 hours, sitting down I guess. If you ever get a small bowel series done you will know your transient time as they follow the barium through the small intestine with periodic X-Rays. [This message has been edited by Blair (edited 06-11-2001).]


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## bonniei (Jan 25, 2001)

> quote:Not my theory, it's Cedars' Theory


I stand corrected Blair.


> quote:The 45 min early peak is only valid for "normal transient time"


I wonder if the CS people figure out the transient times of the Lactulose hydrogen breath test patients before determining if someone has BO. [This message has been edited by bonniei (edited 06-11-2001).]


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## bonniei (Jan 25, 2001)

Bump for Pete and Ughpete- to remind you to find out when your peaks took place and did the CS docs figure out your "transient time" before telling you you had BO.Ugh- some references for the research you referred to in the thread would be really appreciated,Thanks both of you.


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## Ugh (Jan 30, 2001)

Bonniei, the article concerning the lining of the colon and changes to it that enable bacteria to live in/on it was as best I can remember posted on this board. I think I read it a few weeks ago. It may have been the article or a link to the article that was posted here. I believe it had to do with colitis patients. Sorry I can't be sure where I read it though. Maybe It'll come back to me, I have a bad memory.As for the return to normal of levels of bacteria in the colon during antibiotics....the graph flux asked about. I saw that in a book which contained many studies on probiotics. It was from a meeting where probiotic researchers met and would present their studies and discuss the findings. The book contained the discussion following each study, which was really interesting. I also can't recall what the title of this book was, but I can find out if you want. I do remember there were several volumes, presumably from different meetings.Okay, I just looked briefly, and I believe the graph was in one of three books, not sure what the full title of the first one was, but the last two I think were: Probiotics 2 : applications and practical aspects Probiotics 3 : immunomodulation by the gut microflora and probiotics


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## Blair (Dec 15, 1998)

http://www-east.elsevier.com/ajg/issues/9512/ajg3368fla.htm Bonnie see the text under methods, its not very explicit but shows they are aware of it.Maybe Pete has more details? I see a Gastro who works with Cedars at the end of June and will ask about this? Probably take antibiotics also and be re-tested. In the past antibiotics have helped but short lived.I took Ofloxicin which made my IBS worse while taking it,felt better afterwards. and Flagly which didn't hurt and seemed to improve things for a few months also. This was some time ago; 4 years I guess. I also took probiotics back then too so in hindsight that was not a good thing?[This message has been edited by Blair (edited 06-12-2001).]


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## Pete (Jan 20, 2000)

Blair,I peaked at 90 minutes. Do you know what this means?


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## Kathleen M. (Nov 16, 1999)

Usually they do the test for 2-3 hours and by 2 hours you should be in the colon--I believe. I'd suspect if the only peak you have is at 90 minutes that could be the colon. If it were the Small intestine there should be a peak later on as well (everyone should have a colon peak). Either that or you have delayed gastric emptying. if 45 minutes is the typical for SIBO.Also assuming the lactulose test is testing for something as it has a poor track record in the medical literature for SIBO testing.K.------------------I have no financial, academic, or any other stake in any commercial product mentioned by me.My story and what worked for me in greatly easing my IBS: http://www.ibsgroup.org/ubb/Forum17/HTML/000015.html [This message has been edited by kmottus (edited 06-12-2001).]


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## flux (Dec 13, 1998)

> quote:Bonnie see the text under methods, its not very explicit but shows they are aware of it.


It looks like they are confused about it.


> quote:I peaked at 90 minutes. Do you know what this means?


That's probably a colonic peak. You had a normal peak value I recall, was it also 90 ppm, so 90 ppm at 90 minutes?------------------I am not a doctor, nor do I work for profit in the medical/pharmacological field, but I have read scientific and medical texts, and have access to numerous sources of medical information that are not readily available to others. One should always consult a medical professional regarding advice received.


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## snoopy (Jun 24, 1999)

ok- what the heck is a 'fecal transplant'? How would this help someone with bacterial dysbiosis of the gut? Thanks!


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## Ugh (Jan 30, 2001)

Snoopy, you can find out more about the fecal transplant here: http://www-east.elsevier.com/ajg/issues/9511/ajg3277edi.htm I believe if you had a persistant case of C. Diff it would be worth a try. There is a stool test for C diff.I'm not sure what you mean by dysbiosis. Some people speculate that there could be an imbalance of colonic bacteria, other than pathogens, that somehow causes problems. I think this probably occurs, but it probably does in terms of other things, like an inflammed colon lining or something (of course you could also say which comes first). I'm skeptical that there's people with otherwise normal colons but such a bad make up of normal colonic bacteria that they get IBS symptoms. That's just my opinion. The first thing to try would be probiotics if you believed you had something like that. This area needs more research in my opinion.


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## bonniei (Jan 25, 2001)

Ugh, thanks for the references. Unfortunately the univ library did not have those books.Blair thanks for the site. It seems that in the study they may have taken care of the rapid transit time but just wondered if they have considered that with the non study patients. Curious about how they did that. Good to see you have found a doctor "in the know"(compared to that other doc). Hopefully he will work out better for you.


> quote:It looks like they are confused about it


flux why do you think that? Have they written some other papers where they contradict it?


> quote:That's probably a colonic peak


It would seem so if I understood the CS theory as explained by Blair last time. But in my opinion it need not be bcos I read there is something called the hydrogen delay-the difference between the time it takes for the food to reach the small intestine as measured by scintigraphy and the time measured by the hydrogen breath test.I read it can be as much as 25 mins in 1 study..So in addition to the delayed gastric emptying that k mentioned, it is just possible Pete you take a longer time to produce hydrogen and exhale it and things of that nature. So it's possible I suppose it a small intestinal peak .[This message has been edited by bonniei (edited 06-12-2001).]


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## bonniei (Jan 25, 2001)

Oh - just realized I don't know how the value of 90 ppm affects things. Maybe that tilts it towards it being a colonic peak, flux? I read a couple of papers and get all excited about them and feel I can contribute to the discussion.


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## flux (Dec 13, 1998)

> quote:flux why do you think that? Have they written some other papers where they contradict it?


Here is an excerpt from my *still being edited* editorial...So just what do the results of an LBHT look like and how is it read? Usually, before the test starts, a baseline hydrogen measurement is taken; the patient then consumes the lactulose and the periodic measurements are taken every 15 minutes or so for about three hours. The hydrogen content is reported in parts per million (ppm) and plotted on a graph against time. Bacterial overgrowth is determined by looking for changes in the amount of hydrogen according to set criteria. As I previously pointed out, rapid transit can deliver lactulose to the colon early in the test, potentially causing a colonic peak to be misinterpreted as a small bowel peak. The authors chose to take this into account by establishing criteria for diagnosing rapid transit and excluding those meeting it from the subject pool: They state there must be 1) only one peak hydrogen measurement and 2) hydrogen production must start before 90 minutes into the test. However, they also use this last criterion as the second criterion for SIBO, essentially making it useless to distinguish between the two conditions! And much more puzzling, to my eye at least, is that the graph depicted in figure I on page 3505 shows only a steady rise with just one peakï¿½despite their claim it is twoï¿½making it appear that they have really diagnosed rapid transit and not SIBO! Indeed, the LBHT is often used as a test of transit time (REF). In one other study, IBS subjects were given both the LBHT and a specialized type of X-ray test called a transit-time scintigraphy. From what I can see in the graph depicted on page xxx, the values they got for the LBHT were similar to this study. However, these authors drew no conclusion that their IBS subjects had either SIBO or rapid transit. They used it to correlate how well the LBHT could be used to judge transit time. (result) (I'm not sure this answers the question, though, because there was more, but it must have not been good, and I deleted it.)


> quote:So it's possible I suppose it a small intestinal peak


You are right. It is only my opinion that in Pete's case, the peak is colonic.------------------I am not a doctor, nor do I work for profit in the medical/pharmacological field, but I have read scientific and medical texts, and have access to numerous sources of medical information that are not readily available to others. One should always consult a medical professional regarding advice received.[This message has been edited by flux (edited 06-13-2001).]


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## bonniei (Jan 25, 2001)

> quote:2) hydrogen production must start before 90 minutes into the test. However, they also use this last criterion as the second criterion for SIBO,


That does sound confusing so it does reply my question. And it is pretty confounding that they use LBHT for transit time!Don't know what I am missing.Flux! Your editorial! It is *still being edited*?!That is bcos *you* love going to libraries.*And *you must be a perfectionist bcos


> quote:but it must have not been good, and I deleted it


 Ease up, relax and just send it off,flux . The excerpt looked good.







[This message has been edited by bonniei (edited 06-13-2001).]


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## Pete (Jan 20, 2000)

Flux,I think in my case it is SIBO because I don't have rapid transit. Diarrhea is not a problem for me. If anything I have had tests that showed delayed gastric emptying. This could explain the 90 minutes instead of 45. What makes me think it may be colonic dysbiosis is the symptom of excessive gas. How could SIBO have such excessive gas as a symptom? Also the Dr. at Cedar said that most of his patients have altered Phase III contractions. This will be in their next paper. They are doing manometry studies on most of their patients. I think that this Phase III connection may be proof that it is SIBO.


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## flux (Dec 13, 1998)

> quote:I think in my case it is SIBO because I don't have rapid transit. Diarrhea is not a problem for me. If anything I have had tests that showed delayed gastric emptying. This could explain the 90 minutes instead of 45.


I agree you don't have rapid transit. I think the gastric emptying studies were inconclusive.


> quote:How could SIBO have such excessive gas as a symptom?


You could have a huge amount of gas from it, if the food just sat there fermenting away, but you'd have to have next to zero motility, which is obviously not the case.


> quote:I think that this Phase III connection may be proof that it is SIBO.


That wouldn't be proof because they haven't demonstrated SIBO was present to begin with. The original study was too flawed to do that. (Presumably if their subjects had altered or infrequent or even absent Phase III, they would not have misdiagnosed with IBS.)------------------I am not a doctor, nor do I work for profit in the medical/pharmacological field, but I have read scientific and medical texts, and have access to numerous sources of medical information that are not readily available to others. One should always consult a medical professional regarding advice received.


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## Blair (Dec 15, 1998)

They state there must be 1) only one peak hydrogen measurement and 2) hydrogen production must start before 90 minutes into the test. However, they also use this last criterion as the second criterion for SIBO, essentially making it useless to distinguish between the two conditions! No because there are two peaks in the SIBO case, first one at or before 90 minutes, second one shortly thereafter. Then the H2 falls off. Test ends at three hours. Pete, a single peak at 90 minutes then falling off towards baseline ( about 0)according to Cedars is fast transient time. before you had a double peak? From what I was told the shape of the graph was the deterministic factor. Mine had the first peak at 90 minutes then went down a little bit then peaked again at 80 ppm before heading down again ( 3 hrs.) I have the graph in my car, I'll see if I can scan the graph and display it? It may take awhile to do this If i even can with the equipment availible here at work? [This message has been edited by Blair (edited 06-13-2001).]


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## bonniei (Jan 25, 2001)

Blair, I have seen double peak studies in which both the peaks happened after the lactulose reached the cecum(i.e after it left the small intestine). And the first peak happened before 90 mins too. That's why I find this double peak theory indicating SIBO confusing. BTW if you could scan your graph and have a link to it, it would be great[This message has been edited by bonniei (edited 06-13-2001).][This message has been edited by bonniei (edited 06-13-2001).]


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## flux (Dec 13, 1998)

> quote:No because there are two peaks in the SIBO case


No, I see *ONE* peak.------------------I am not a doctor, nor do I work for profit in the medical/pharmacological field, but I have read scientific and medical texts, and have access to numerous sources of medical information that are not readily available to others. One should always consult a medical professional regarding advice received.


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## bonniei (Jan 25, 2001)

> quote: No, I see ONE peak.


Flux that graph is a graph of the mean hydrogen concentration of the whole group vs time. It is quite posible then that the double peaks don't show up.Given that, I did also wonder why you put the following bit about the graph in your editorial


> quote: And much more puzzling, to my eye at least, is that the graph depicted in figure I on page 3505 shows only a steady rise with just one peak&#151;despite their claim it is two&#151;


 Is it to put pressure on the CS folks to publish all their graphs? Or do you really not believe that averages vs time need not show double peksBlair, flux is waiting for your graph. Maybe after he sees it he will be convinced that the CS patients had double peaks. Pete you too should try to put up your graph. We are all eyes here


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## flux (Dec 13, 1998)

> quote:Flux that graph is a graph of the mean hydrogen concentration of the whole group vs time. It is quite posible then that the double peaks don't show up.


It is a mean. It is *more likely* to show up in a mean.------------------I am not a doctor, nor do I work for profit in the medical/pharmacological field, but I have read scientific and medical texts, and have access to numerous sources of medical information that are not readily available to others. One should always consult a medical professional regarding advice received.


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## bonniei (Jan 25, 2001)

> quote:It is *more likely * to show up in a mean.


This statement is more true when most of the patients peak at approximately the same time. The problem is since the transit time is so varied for different patients,they probably peak all at different times . Whether the peaks disappear or show up in the average just depends on the distribution of the transit times in the sample. Please refer to page 2 of http://www.ibsgroup.org/ubb/Forum1/HTML/020455-2.html for an example. If 100 people peak at the time A does in that example, 100 people peak when B does and 100 people when C does, the average does not show apeak. if the 300 people show even more variability than A, B, and C have then there is even more unpredictability in how the average behaves. So I'll have to disagree with your statement that the double peaks are more likely to show up in the average. Besides even if it is more likely to show up in the average, the fact that it hasn't showed up in this average probably only shows a more atypical sample of patients.I hope I have convinced you flux bcos I am running out of words







. Beyond this I'll just be repeating myself if I haven't done so already


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## flux (Dec 13, 1998)

You argument is actually why the graph would show up as it does. We don't see the error bars, but when they got their mean, they should have gotten some standard deviation, so there is actually a range of values where everyone falls around the mean. Had there been multiple peaks, we should see the graph follow that. I'm not a statistician, but I think if some were signficantly outside that range, say 2 standard deviations or more, the statistics should raised a flag here and those inviduals gotten mentioned in the paper, even excluded from the study.------------------I am not a doctor, nor do I work for profit in the medical/pharmacological field, but I have read scientific and medical texts, and have access to numerous sources of medical information that are not readily available to others. One should always consult a medical professional regarding advice received.


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## bonniei (Jan 25, 2001)

You are right flux that my argument is why their graph shows up the way it does. As far as calculating standard deviation around an average goes, there are only two ways I can see that they can do it(but I am not a statistician) . One way is - since they have an average for each time period say A(t) they should have a standard deviation for each time period S(t). Then exclude those values for whicich don't fall in the range A(t)-2S(t) and A(t)+2S(t). Since they will do it for each time t, they might exclude the values of patient A but not those of patient B for t=15 and then the values of patient B for t=30 but not those of patient A for t=30. So at different time periods different patient values would get eliminated without eliminating the patient from the study which would be meaningless since patients don't get eliminated.The other way I see it could be done is to look at the mean small bowel transit time(84 mins) and eliminate the 3 % of patients whose small bowel time exceeds the two std deviations range and keep the other 97% in. The range of their small bowel transit times would be at the minimum 30 mins to 2 hr, possibly larger. I have used figures from American Journal of Roentgenology 174(3) pg 866 for the times and ranges. This range as you can see is a wide range(even wider than my example) and prevents you from getting a double peak i.e-even after elimination of those 3% cases. The only way you MAY be able to guarantee a double peak in an average is to have patiients with approximately the same short bowel time producing a narrow range for their peak values and a sufficient time lag between the first peak and next peak. These are very difficult conditions to get in a sample unless you just happen to be lucky.Incidentally have you seen studies where they have done std error etc for the mean hydrogen concentration of the group vs time graph? I would be interested in seeing such a paper to see what you are referring to. Maybe that's what I should have asked for in the first place instead of going on! :rolleyes


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## flux (Dec 13, 1998)

> quote:they might exclude the values of patient A but not those of patient B for t=15 and then the values of patient B fort=30 but not those of patient A for t=30. So at different time periods different patient values would get eliminated withouteliminating the patient from the study which would be meaningless since patients don't get eliminated.


I wouldn't call that a kosher approach.


> quote:The other way I see it could be done is to look at the mean small bowel transit time(84 mins) and eliminate the 3 % of patients whose small bowel time exceeds the two std deviations range


They apparently did something like this, only problem they set criteria the same for both transit and BO so they are begging the question, which is my original point.


> quote:Incidentally have you seen studies where they have done std error etc for the mean hydrogen concentration of the group vs time graph? I would be interested in seeing such a paper to see what you are referring to.


Don't have them handy, but most papers either present individual data either by itself or on the whole graph? The average display in this particular study seems to be less common way of representing it. Perhaps those other studies were trying to avoid this issue we are discussing.------------------I am not a doctor, nor do I work for profit in the medical/pharmacological field, but I have read scientific and medical texts, and have access to numerous sources of medical information that are not readily available to others. One should always consult a medical professional regarding advice received.


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## bonniei (Jan 25, 2001)

> quote:They apparently did something like this


Really? Oh is that where they came up with the 90 mins figure for rapid transit.That just made me realize something. I had said,"The range of their small bowel transit times would be at the minimum 30 mins to 2 hr, possibly larger". It might be narrower than that bcos they have already eliminated the rapid transit people. Anyway I think I have beaten this "average" issue to death. To discuss your original question, flux(sorry folks that I took a detour. I promise I won't bring up this issue again







)- where is Blair? He seems to know the CS people so he can direct all our questions to them.


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## Blair (Dec 15, 1998)

I'm having trouble saving it in a useful format. Will try again later. I also don't know how to paste it in this text box?


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## Kathleen M. (Nov 16, 1999)

What you probably need to do is paste it onto a web site and then link to that web site.Then you use the img command in ubb [ img ] website here [ / img] but take the spaces out.K.------------------I have no financial, academic, or any other stake in any commercial product mentioned by me.My story and what worked for me in greatly easing my IBS: http://www.ibsgroup.org/ubb/Forum17/HTML/000015.html


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## bonniei (Jan 25, 2001)

Many ISP's provide personal web space for their customers. So you could enquire with your ISP about it. And just upload the image there using FTP and create a web page with the image and then provide us with a link. But if you are having trouble saving it I don't know what can be done. I have heard flux is a computer guy so maybe he will have some useful tips. I hope it is not too much trouble, Blair


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## bonniei (Jan 25, 2001)

BTW you can try saving your image as a .gif file or a .jpeg file. What exact problem are you having with saving it? What format have you saved it in?To use the UBB code to paste the graph to the board you are going to need a place to store the image . I did some research and www.nbci.com has a link called unlimited web space which you could use. You have to become a member of that first. It is free. It has ftp software you can download and step by step instructions for it so you can upload your .gif file to their space. And then use that adddress in the UBB code. (When you reply you will see the link for the UBB code on the left. Look under adding images.)Hope that helps[This message has been edited by bonniei (edited 06-15-2001).]


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## bonniei (Jan 25, 2001)

Please note the last message has been edited bcos I just realized you don't have to create a web page. The earlier message had instructions on how to create a web page with the image.


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## Blair (Dec 15, 1998)

I can save it to a disk and then display it on my PC. I just couldn't get it to paste to this text box I'm writing in now. I think linking it makes more sense. I can try that later. Thanks. I went to a new doctor yesterday and will post my immpressions shortly.


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## Blair (Dec 15, 1998)

I can save it to a disk and then display it on my PC. I just couldn't get it to paste to this text box I'm writing in now. I think linking it makes more sense. I can try that later. Thanks. I went to a new doctor yesterday and will post my immpressions shortly.


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## bonniei (Jan 25, 2001)

I heard nbci is shutting down its unlimited web space feature. So- don't know if you are too late to take advantage of that feature.Will look out for your impression of your new doc.


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## bonniei (Jan 25, 2001)

I heard nbci is shutting down its unlimited web space feature. So- don't know if you are too late to take advantage of that feature.Will look out for your impression of your new doc.


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