# My Neomycin Log



## surfboar (Oct 3, 2002)

Well, day 1 of the Neomycin and I haven't had explosive diareah..... thats good. Lots and lots of flatuence (farts) though, smelly ones!!I am taking 500 mg 2x a day for 10 days per the Pimemtel protocol. I will keep you updated.


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## 14416 (Jun 21, 2005)

Good luck, let us know how it works out for you!


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## 17176 (Mar 31, 2005)

good luck i hope it works for you


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## surfboar (Oct 3, 2002)

Day 2 - I still feel the same, intermittent cramping all over the colon. I did have a BM this morning that may have been the biggest I have ever had........ we are talking measured in feet not inches. It hurt like hell but once I was done, I felt really normal.


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## surfboar (Oct 3, 2002)

Day 3..... lots of cramping today under the left and right rib cage..... nothing new, but disappointing. No BM. On the other hand, I have felt totally normal for about half of the day. That is an improvement.


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## surfboar (Oct 3, 2002)

Day 4 was amazing...... I had a normal BM in the morning without straining or anything. It was perfectly shaped etc. (we are weird in what we appreciate!###!!!) The best part was that it was a pain free day excpet for a little rumbling right before the BM.I am on Day 5 now and I have a nagging pain under the left rib cage, maybe its my heart (just kidding) but thats it.


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## Popp (May 31, 2004)

Thanks for the daily updates. Hope all goes well for you.


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## surfboar (Oct 3, 2002)

Popp, thanks for the good wishes!!!I really feel good on today (day 6) and I felt 90% normal yesterday as well. I think the key to all of this is following it up with the Zelnorm to restore the wave function of the small intestine.


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## surfboar (Oct 3, 2002)

Hmmmmm, let me summarize the last 24 hours. I was feeling really good yesterday, so good I decided that I was going to McDonalds for lunch......... well, I don't know if it was IBS or just a normal reaction to that garbage, but I got really crampy. Then this morning, I have had major loose stools...... tons and tons. I think this is day 7.


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## Popp (May 31, 2004)

McFeces!!What were you thinking?


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## 13540 (Aug 18, 2005)

mcdonalds gives a noramal person the big d there is alot of old grease and other thinks whe nthey cook there food trust me i have done alot of remodels on mcdonalds and i wouldnt feed my dog that #### they dont change there grease bins for months they just keep adding to them when the grease gets low!!!


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## surfboar (Oct 3, 2002)

LOL.....McFeces. Yup.....that sums it up nicely.However, I did feel amazingly better after it was over. Its the Big Mac Value Meal colon cleanse. You can super size that colon cleanse for 49 cents. Oh, an update, thats why I am here. LOL After the McFeces episode this morning, I feel awesome. I haven't felt this good in years. Very pleased so far.


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## surfboar (Oct 3, 2002)

I guess the antibioti s have really kicked in now because I am on the McSquirts following my day of McFeces. The plus side is that it is generally pain free except for a bit of irritation at the exit point







I will finish up the antibiotics on Sunday and start to zelnorm a few days later.


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## 14751 (Feb 18, 2006)

Hi Surfboar,I grew up in the SW Florida area and have had IBS (mostly gas/bloating with C and D) for 15 years. Tried everything. Finally had a positive breath test last year and was put on Rifaximin (didnt do anything for me) and Augmentin (helped a bit more). I am thinking of going on Neomycin. I also occasionally have constipation, but it is more that the volume of the stool varies and is sometimes very hard and pellet-like. I wonder if thats what you have as well. Do you feel bloated/gas after eating?I dont know if Neomycin will be enough for me since I have probably had this overgrowth for around 17-20 years, so I may need something more drastic. Did you discuss the Vivonex protocol with Dr. Pimentel? I am thinking of going on it since you dont need a prescription, but I would like to be on antibiotics while I am on vivonex also, so I need to talk to my gi about it, but I doubt he has heard of either vivonex of neomycin for ibs treatment though.Anyway, I am interested in hearing how it turns out for you. Keep us posted.


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## 17176 (Mar 31, 2005)

hi and welcome alias


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## 15267 (Feb 19, 2006)

I don't I will ever eat at "McFeces", glad to know that this is working for you Surfboar!


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## surfboar (Oct 3, 2002)

Alias,We never discussed the Vivonex, but I read about it in the book. I don't know if I could go for two weeks on a liguid diet...... yech. But I guess I would try it if this doesn't work. I have had this problem for 7 years now. I don't think time is really a factor. My constipation is generally going 3, 4 and at the worst 9 days without a bowel movement. Then hard pellet like stool. Then it might alternate back to about normal. I did have occasional "purges" when I think my system did a self flush and I would have first massive bowel movements and then alot of watery acidic stuff coming out.When you talk to your doctor, take the book with you. It might help. Also, ask for two 10 days courses of the neomycin. I was just rereading Pimentel's book and you really need to know whether its methane, hydrogen or both that gave you a postive result. Some people have both methane and hydrogen and need both neomycin and rifaximin. Where did you get the breath test done?


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## 23770 (Nov 26, 2005)

I don't have the book with me since i gave it to a friend but I remember reading not to combine anti-biotics with the Vivonex treatment. This is because the bacteria "hibernates" during the Vivonex treatment and that anti-biotics don't work well against "hibernating" bacteria.You really should get your hands on Neomycin since that's the next treatment of choice aside from Rifaximin. I don't think that it really matters how long you've had the overgrowth problem.Vivonex is so expensive without a prescription if there is one. The Vivonex treatment really is just prolonged semi-fasting nourished by pre-digested elemental food in the hopes of starving the bacteria. I wonder if there are cheaper alternatives that can get you by two weeks on very little food like my "Precision Engineered" Whey Protein powder?Surfboar, You don't know how happy I am to see you getting better. Next, I'd really like to see Spasman get cured. He's been here like forever!


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## 14751 (Feb 18, 2006)

I was tested at a GI in Naples. The nurse took samples for about 80 minutes, declared that I had bacterial overgrowth and left it at that. In Pimentel's book, he mentions that you shouldnt cut corners in breath testing. I live in Boston now, so I am going to try to have it done again, this time on a Quintron machine that can discern between hydrogen and methane production.I'm really not sure how to classify myself. I sometimes have D, but mostly C. But I never go more than 2 days without a bowel movement. Usually when my symptoms are bad, the stool is small, round, hard, and pellet-like. That happens around 5 times a month. Would that be considered C? I don't know where I fit, basically. My one overriding condition is a LOT of bloating/gas after eating. I would live with C or even D if the gas would go away.I know that Pimentel says not to go on antibiotics while on Vivonex, but there are different classes of bacteria. Some form endospores when nutrients are scarce. These bacteria stop reproducing. Many continue to do so, just at a slower rate. Moreoever, only some antibiotics work by preventing bacterial reproduction. There are others that work by destroying the bacterial cell wall--penicillin is one such antibiotic. Neomycin and Rifaximin work by preventing bacterial RNA synthesis, which is the precursor to protein production, and thats essential for survival, so these antibiotics should be effective on Vivonex.I was a Microbiology major.As far as the cost goes, Walgreens is retailing it for $230 for 36 packets, and each packet is 300 calories, so for 1800 calories/day x 21 days x $230/10800 calories = $805. Thats certainly not cheap! But I have suffered for over 15 years, and have lost so much in quality of life, that I would be willing to pay ten times that much to get my life back. I believe many of the people on this board would as well. And it is the only treatment that has shown significant benefit in a large sample trial of people with IBS, so I think it is worth it.Surfboar, what dosage of Neomycin are you on? I believe Rifaximin is most effective at a 1200 mg/day dosage, but I don't know what dosage to ask my GI for Neomycin.Good luck guys. I hope you continue getting better Surfboar.


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## SpAsMaN* (May 11, 2002)




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## surfboar (Oct 3, 2002)

Alias,500 mg of neomycin twice a day. I am on day 9 now and I have plenty of diareah going on, but I feel fine. Funny, it took 6 days on the stuff before I started having diahreah. Perhaps the antibiotics got done killing off the stuff in the small intestine and now is messing around in the colon. I think Alias is right on the mark when she talks about gas. Dr. Pimemtel told me that it is the gas that causes the random pain and cramping and that the other side effect of the gas is C or D or both. i was rereading parts of Pimentel's book last night and noticed that he mentioned that methane is almost 100% predictive of constipation, but hydrogen can be associated with both constipation and diahreah. So if you take either rifaximin or neomycin blind, you might have the wrong one. Pimentel, for a second course, presribes both neomycin and rixaimin together.


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## 23770 (Nov 26, 2005)

> quote:I know that Pimentel says not to go on antibiotics while on Vivonex, but there are different classes of bacteria. Some form endospores when nutrients are scarce. These bacteria stop reproducing. Many continue to do so, just at a slower rate. Moreoever, only some antibiotics work by preventing bacterial reproduction. There are others that work by destroying the bacterial cell wall--penicillin is one such antibiotic. Neomycin and Rifaximin work by preventing bacterial RNA synthesis, which is the precursor to protein production, and thats essential for survival, so these antibiotics should be effective on Vivonex.


So if the small intestinal bacteria is "hiberating" or not reproducing while you fast, then taking Neomycin, which prevents bacterial reproduction, shouldn't help while you're fasting. Using your logic, I'm still coming to the same conculsion that taking Neomycin/Rifaximin while on the Vivonex will not really help.Yes, aliasIknow, 500mg of Neomycin 2x day for 10 days is what I've seen used in Pimental's studies. And, as far as Rifaximin, 1200mg/day is shown to be superior to 800mg/day for symptom reduction. For me, Rifaximin practically didn't work at all but Neomycin was nothing short of a miracle. I can't seem to hear anything anymore though. Just kidding!







What are you crying for Spasman?, I'm on your side!


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## SpAsMaN* (May 11, 2002)




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## 14751 (Feb 18, 2006)

Only some classes of bacteria form endospores and hibernate. There are over 200 strains of bacterial flora in a normal SI. Not all of the bacteria hibernate or even stop reproducing. The problem with bacterial overgrowth is that it is impossible to tell which strains of bacteria are disproportionately represented, so you have to try the shotgun approach. Rifaximin and Neomycin dont just inhibit bacterial reproduction, they inhibit RNA synthesis, which is essential not just for reproduction, but maintanence of homeostasis. Without RNA synthesis, bacteria will die because it will be unable to synthesize important proteins for its survival. Using Pimentel's argument strictly, if bacteria simply hibernate while on Vivonex, then they should awaken when nutrient supplies are plentiful, making Vivonex useless. It is more probable that only a small fraction of bacteria truly hibernate by forming resistant endospores. The majority will probably attempt to survive for as long as possible on diminished nutrient supplies. These bacteria should still be susceptible to antibiotics.


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## 23770 (Nov 26, 2005)

"Using Pimentel's argument strictly, if bacteria simply hibernate while on Vivonex, then they should awaken when nutrient supplies are plentiful, making Vivonex useless. It is more probable that only a small fraction of bacteria truly hibernate by forming resistant endospores."Obviously, bacteria can only hibernate for so long. It's not like its being cryogenically frozen. So the Vivonex theory can account for hiberating bacteria.You know better than me the likelihood of small intestinal bacteria being of the sort that hibernates or not.Really, the ideal treatment is to try Neomycin before the Vivonex and during. This way you can cover all bases.Thanks again for calculating the Vivonex treatment for two weeks. I'm sure other members are interested in the figures also.


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## 14751 (Feb 18, 2006)

> quote:Originally posted by CarmelRob:Obviously, bacteria can only hibernate for so long. It's not like its being cryogenically frozen. So the Vivonex theory can account for hiberating bacteria.


You are misunderstanding me. Pimentel says that antibiotics on Vivonex will not be helpful because the bacteria hibernate and so will not be susceptible to it. However, if bacteria are hibernating, they form endospores which enable them to remain dormant for years on end. So then Vivonex should not do anything at all! However, because Vivonex does help (at least according to the study), the majority of bacteria must not be dormant, and must be attempting to survive, eventually succumbing to a lack of nutrients. If the majority of bacteria are attempting to survive, the majority of bacteria should be vulnerable to antibiotics while on Vivonex. Pimentel may ultimately be right, that antibiotics are not effective during Vivonex, but if that is so, it is due to complex reasons that he fails to address--I don't disagree with his conclusion, but I do question his reasoning for arriving at it. I do agree with you though, I think 10 days of Neomycin followed by Neomycin (and possibly Rifaximin) with Vivonex would be the most effective option.The $805 for Vivonex is based on 3 weeks and assumes an 1800 calorie a day diet. If you consume fewer calories and choose to go for only two weeks, it will be significantly less.


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## 23392 (Jan 31, 2006)

> quoteimentel says that antibiotics on Vivonex will not be helpful because the bacteria hibernate and so will not be susceptible to it. However, if bacteria are hibernating, they form endospores which enable them to remain dormant for years on end. So then Vivonex should not do anything at all! However, because Vivonex does help (at least according to the study), the majority of bacteria must not be dormant, and must be attempting to survive, eventually succumbing to a lack of nutrients. If the majority of bacteria are attempting to survive, the majority of bacteria should be vulnerable to antibiotics while on Vivonex. Pimentel may ultimately be right, that antibiotics are not effective during Vivonex, but if that is so, it is due to complex reasons that he fails to address--I don't disagree with his conclusion, but I do question his reasoning for arriving at it.


Thanks, I follow this now! These are some great discussions, thank y'all!As to the above...maybe he's just being a pragmatist. Maybe the vivonex will 'get them' sufficiently that neomycin is an 'extra' that won't be needed. Or maybe, as they 'struggle' they aren't doing *enough* RNA synthesis for neomycin to be really effective...either too small a population of the ones that aren't dormant in spores, or not much of the activity that neomycin is effective against? Just speculating.


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## 23770 (Nov 26, 2005)

I'm not misunderstanding you. I was just raising the possibility that even "hibernating" bacteria could die in two weeks time without any nutrients. If this is true, then the Vivonex treatment could still work and Pimental would be right about Neomycin not being too effective.Still, you're probably right that it's only a small proportion that hibernates and that Pimental is overcautious.I had a side question:After taking a course of anti-biotics that kill good bacteria as well as bad, how long does it take for good bacteria to grow back? What helps it to grow back? Yogurt, friendly flora pills?I think that's where I am now.


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## 23770 (Nov 26, 2005)

Here's something else to consider:The Vivonex treatment of bacterial starvation could have seen the best results for the most amount of people because it works against IBS-D and IBS-C.However, Rifaximin and Neomycin might be more effective for any one particular subgroup while Vivonex is not.I haven't researched the studies in detail so I'm not sure just in what way Vivonex has seen "better" results.


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## surfboar (Oct 3, 2002)

Ack, the thread has been hijacked..... thanks Rob







Anyways, last pill tonight. The diahreah is gone and I had a nice solid BM this morning. Unfortunately, I am pretty crampy at the moment. I am not sure what to make of that. I will start the zelnorm this week although I am seriously considering doing another round of the antibiotics.


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## 23770 (Nov 26, 2005)

In retrospect I probably shouldn't have stayed on the Neomycin for 14 days because I think it killed a lot of good bacteria. How do you get the good guys back? What's the best yogurt? pills?


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## surfboar (Oct 3, 2002)

Good question. My dilemma is this. Everything you eat passes through the small intestine..... and we don't want bacteria in the small intestine, so if I eat yogurt or take probiotics, aren't I just reintroducing bacteria into the small intestine?


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## surfboar (Oct 3, 2002)

Rob,How long did you wait after you took the rifaximin to start the Neomycin?


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## Talissa (Apr 10, 2004)

This is a very interesting thread--thx to all, esp you surf...


> quote:so if I eat yogurt or take probiotics, aren't I just reintroducing bacteria into the small intestine?


I believe, from all that I've read, that the SIBO occurs due to low beneficial bacteria in the gut. This allows gram negatives(non-probiotic) to colonize where they otherwise wouldn't be able to, & they then overpopulate, causing GI distress. In small #s, these same commensal bacteria wouldn't cause a problem. Ie~Bacterial overgrowth implies abnormal bacterial colonization of the upper gut, resulting from failure of specific defense mechanisms restricting colonization under physiological conditions. Beneficial bacteria normally found in the sm int incl both Streptococci & Lactobacilli strains. They're very imp to maintaining homeostasis. They either mfr digestive enzymes, destroy pathogen directly or indirectly, normalizes muscle hypercontractility  , and influence anti-inflammatory cytokines , just to name a few.We need the good guys. Simply eating yogurt, imo, won't do much symptomatically unless its one of the new functional yogurts out.Perhaps even more so, we need to replenish the bifidobacteria strains...


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## Talissa (Apr 10, 2004)

ps--this is a short but good synopsis on probiotics for IBS & SIBO at Medscape~Good Gut 'Bugs' Help Irritable Bowel SyndromeBut when they talk about probiotics lowering inflammation, it's only ctn strains of lactobacilli & Bifido's. Ctn strains like L Acidophilus are actually proinflammatory...


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## 23770 (Nov 26, 2005)

Here are the links to my first course of anti-biotics last year: Here is a link to a thread detailing my Neomycin Trial: http://ibsgroup.org/eve/forums/a/tpc/f/71210261/m/923102902Here is a link to a thread detailing my Rifaximin Trial:http://ibsgroup.org/eve/forums/a/tpc/f/71210261/m/809108081I think the week after I had tried Rifaximin, I went on Neomycin.My second course of anti-biotics started on Feb. 26 which was 14 days of Neomycin, overlapped with 3 days of Rifaximin for the heck of it. I found no benefit at all trying the Rifaximin the second time as it was useless the first time. I found that Neomycin did wonders for me the first couple of days since I'm sure it eradicated any SIBO I had but alas, my underlying condition remains which I'm still trying to crack.Sometime I'm going to write a big ol post about my theories behind my Chronic Fatigue Syndrome, Obsessive Compulsive Disorder, Raynaud's Disease, medications, and how I believe that a part of my brain needs to be stimulated by chewing gum, studying, exercising, and just plain multi-tasking for my intestines to get back to normal.


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## gilly (Feb 5, 2001)

Surfboar Have your improvements continued?(hope so)Are you now following the diet or taking zelnorm or erythromycin?Gilly


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## 15682 (Jun 27, 2006)

I think that the bacterial overgrowth was just one part of my ibs. This medicine did help a lot though! I still can't go off a ibs diet but I now have normal bm every morning after I get up after doing the 14 days on neomycin


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## Moises (May 20, 2000)

> quote:Originally posted by CarmelRob:I had a side question:After taking a course of anti-biotics that kill good bacteria as well as bad, how long does it take for good bacteria to grow back? What helps it to grow back? Yogurt, friendly flora pills?I think that's where I am now.


Pimentel says that some of the bacteria double in volume every 20 minutes in the colon. He's not too concerned with us wiping out "good" bacteria. You will never wipe them all out of the colon. And the ones that remain will reproduce rapidly upon cessation of the antibiotics.


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