# If a SIBO is bad, why take probiotics orally.



## surfboar (Oct 3, 2002)

This stumps me. As I understand a SIBO, bacteria is supposed to few and far between in the small intestine and that a faulty leaking of material back from the large intestine can put too much bacteria back into the small intestine.So...... if we take probitoics orally.... we are just dumping a whole lot of bacteria into our small intestine..... right?I was one of Dr. Pimentel's lab rats that he found a high level SIBO. After going on several rounds of antibiotics, the SIBO was gone and I felt much better, not great but better. I have started on the Align and started thinking that I am just creating a new SIBO.It sounds gross, but why not take probiotics via an enema? That way you avoid adding bacteria to the small intestine.


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## Kathleen M. (Nov 16, 1999)

It appears that the probiotic bacteria may down-regulate the other species and not tend to cause problems with growing in numbers larger than they should be.In Pigs that get SIBO to where they do not grow as fast as they should they use probitoics in the feed to control it.K.


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## eric (Jul 8, 1999)

FYI"Treatment with antibiotics versus probioticsIt is the authorâ€™s personal belief that for short-term (1-2 weeks) treatment, antibiotics are more effective than probiotics. However, antibiotics do have certain disadvantages. Specifically, symptoms tend to recur after treatment is discontinued, and prolonged or repeated courses of treatment may be necessary in some patients. Physicians are reluctant to prescribe prolonged or repeated courses of antibiotics because of concern over long-term side effects of the antibiotics and the emergence of bacteria that are resistant to the antibiotics. Physicians have less concern over long-term side effects or the emergence of resistant bacteria with probiotics and, therefore, are more willing to prescribe probiotics repeatedly and for prolonged periods. One option is to initially treat the patient with a short course of antibiotics and then long-term with probiotics. Long-term studies comparing antibiotics, probiotics, and combinations of antibiotics and probiotics are badly needed. "http://www.medicinenet.com/small_intestina...wth/article.htm


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## surfboar (Oct 3, 2002)

Kathleen and Eric, Good info. But again I wonder why we don't put the probiotics into the back of the system rather than the front since the colon is where you want them.


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## Kathleen M. (Nov 16, 1999)

I'm not sure if putting them in the rectum would get them migrated up to the first few feet of the colon which is where you really want them to be.If you want them to reduce gas production you want them where the food enters the colon (where the second of the two peaks in a postive SIBO test is or where the first peak is in a negative SIBO test). they may do other things in the rectum, but by the time the stool gets there the majority of the gas production is doneGetting them pumped all the way up to there wouldn't happen with an enema, and I don't know how well the migrate "up stream" as it were. I think you'd just be putting them in to be pooping them right back out rather than getting them at the start of the colon where they can grow well and do some good.K.


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## surfboar (Oct 3, 2002)

LOL..... I wasn't going to actually try it. I was just wondering. It still amazes me that the live bacteria survive the stomach. It seems that they should put probiotics in a encentric (sp?) coated capsule.


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## flux (Dec 13, 1998)

Generally, you don't want *any* bacteria in the upper small intestine and not much in the deep small intestine. So it could make matters worse to treat SIBO with probiotics. That would occur only if the probiotics start overgrowing in the intestine and do the same things that the bacteria there are already doing. We probably don't know enough about what those bacteria are doing to know whether probiotics would do the same things.


> quote:It still amazes me that the live bacteria survive the stomach. It seems that they should put probiotics in a encentric (sp?) coated capsule.


If they didn't, people would hardly ever get gastroenteritis. You probably want bacteria without the capsule. Those that can't survive have a disadvantage from an evolutionary standpoint to those that do.In any case, it would never make sense to give probiotic enemas to treat something in the small intestine. It's just too far away, plus the gut is geared to move things in the other direction. There have been attempts to treat colonic diseases with enemas of vinegar and similar chemicals, which nourish the colon, but it didn't appear to work very well.


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## David LA (Dec 21, 2005)

Flux-I don't if you've read Dr. Pimentel's new book.."A New IBS Solution" but he believes that healthy people typically have 8-9 "cleaning waves" each day. These waves prevents bacteria from staying in the Small Intestines to long & causing problems. "IBS People" he states may only have 3-4 cleaning waves per day. The large numbers of bacteria in keeping with their own survival have somehow been to reduce the number of waves. Are you familar with this?? Do you believe there's any such thing as "cleaning waves" Just wondering???


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## 17176 (Mar 31, 2005)

hello and welcome david


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## David LA (Dec 21, 2005)

Thanks Joolie for the welcome but I've been a member for about 4 or 5 years. I stopped visiting the site, when my "IBS" symptoms went away. I started posting again...to let people know they don't have to continue to suffer with this condition....and they don't have to go the conventional medicine route to re-gain their health.


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## eric (Jul 8, 1999)

FYI"Although this theory is tantalizing and there is much anecdotal information that supports it, the rigorous scientific studies that are necessary to prove the theory have just begun."*"The most popular theory is that patients with irritable bowel syndrome have a subtle abnormality in the function of their intestinal muscles that allows SIBO to occur." * http://www.medicinenet.com/small_intestina...rowth/page5.htmThey know there is an abnormality with the functioning of the colon and motility and the 5ht3 receptor and serotonin.Is there a relationship between IBS and small intestinal bacterial overgrowth?IBS and small intestinal bacterial overgrowth (SIBO)http://www.medicinenet.com/irritable_bowel...drome/page6.htm"How is small intestinal bacterial overgrowth treated?â€œClassicâ€ SIBOSIBO has been recognized for many years as a problem with severe disorders of intestinal muscles and intestinal obstruction. The treatment has been antibiotics, and they are very effective. *The difficulty is that the disease causing the SIBO often cannot be corrected. As a result, symptoms frequently return when antibiotics are stopped, and it may be necessary to treat the patient with antibiotics repeatedly or even continuously."*"SIBO associated with IBS*There are very few rigorous, scientific studies on the treatment of irritable bowel syndrome with therapies that are directed specifically to the possibility of underlying SIBO. That has not stopped physicians from trying unproven treatments."*"The discussion of treatment that follows is based on the minimal scientific evidence that is available as well as the anecdotal (observed but not scientifically demonstrated) experience of physicians who see patients with irritable bowel syndrome." http://www.medicinenet.com/small_intestina...rowth/page6.htm Another center studying this only found 11% of the IBS patients with SIBO. The UNC only 10 percent.


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## 13364 (Dec 8, 2005)

Is this presumed to be only a one way process?By which I mean, does the "subtle" problem with the intestinal muscle have to be there to lead to SIBO, which in turn gives rise to the symptoms?Or can a normal, healthy person develop SIBO, which can lead to intestinal obstructions (intermittent or permanent), which then cause symptoms?Either way, the seat of the problem would appear to be the small intestine (more than likely the distal ileum), which would suggest some connection with the hypothesised (and not necessarily universally accepted) "midgut motility disorder" which I have tried to investigate elsewhere?And has anyone any info on whether SIBO can interfere with the opening of the ileocaecal valve? (But *please* no alternative cr*p about kinesiology or the spurious "ileocaecal valve syndrome" - real medicine/science or informed speculation only, *please*.)Apologies for the surfeit of questions, but this is an interesting area of investigation & I want to know more!


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## flux (Dec 13, 1998)

> quote:I don't if you've read Dr. Pimentel's new book.."A New IBS Solution" but he believes that healthy people typically have 8-9 "cleaning waves" each day. These waves prevents bacteria from staying in the Small Intestines to long & causing problems. "IBS People" he states may only have 3-4 cleaning waves per day. The large numbers of bacteria in keeping with their own survival have somehow been to reduce the number of waves. Are you familar with this?? Do you believe there's any such thing as "cleaning waves"


There is no good evidence (yet) that IBSers have fewer "cleaning waves", technically known as phase III of the migrating motor complex. Typically, those people have more severe symptoms that do not meet Rome criteria. They have pseudoobstruction. I haven't come across any evidence that suggest the bacteria have developed some physiological mechanism to interact with the migrating motor complex although there is evidence that methane-producing bacteria impair colonic transit. Why go through this trouble to live in the small bowel? The colon is a great place for bacteria to live happily without harming the host. The small bowel has toxic bile acids and high levels of oxygen. It's not a great place for bacteria, especially obligatory anaerobes, to be.


> quote:By which I mean, does the "subtle" problem with the intestinal muscle have to be there to lead to SIBO, which in turn gives rise to the symptoms?


It is not entirely clear yey. Presumably, one has to get gastroenteritis, then this "subtle" problem reveals itself. Further, there are complicating factors. For one thing, there is evidence that corticotrophin releasing factor inhibits small bowel transit in rats. And that is released in stress and may be released in higher than normal quantities in those with IBS.


> quote:Or can a normal, healthy person develop SIBO, which can lead to intestinal obstructions (intermittent or permanent), which then cause symptoms?


Neither SIBO nor the mechanism behind the supposed IBS-mediated SIBO can lead to an obstruction of any kind. However, pseudobstruction, which is a separate condition from IBS, by definition can cause a "false" obstruction.


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## 13364 (Dec 8, 2005)

I often get the feeling we're splitting hairs here, or counting the angels on the head of a pin.We are often so careful & precise to distinguish between reduced gut motility & physical obstruction & intermittent obstruction & pseudo-obstruction, and yet the result is the same - stuff doesn't go through, leading to identical symptoms - and, very often, the suggested treatments are the same.


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## flux (Dec 13, 1998)

> quote:We are often so careful & precise to distinguish between reduced gut motility & physical obstruction & intermittent obstruction & pseudo-obstruction, and yet the result is the same - stuff doesn't go through, leading to identical symptoms - and, very often, the suggested treatments are the same.


1) *Transit is essentially normal in IBS.* 2) *IBS never causes obstruction of any kind, ever.*3) Only macroscopically structural conditions cause physical obstructions. The underlying conditions have very different pathophysiologies and the treatments are very different.4) Only pseudo-obstruction causes functional obstruction. The symptoms are *not* the same as IBS symptoms. The underlying pathophysiology is different and the treatments with perhaps the exception that IBSers sometimes get prokinetics (even if they don't need them) are different, too.


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## SpAsMaN* (May 11, 2002)

Human Probiotics works by enema,especially for C-Difficile,







:Human probiotics infusion:http://ibsgroup.org/eve/forums/a/tpc/f/431...02902#224102902However,i have to admit flux,i would like datas on regular probiotics by enema.In the link,they use enemas to populate the gut so they get deep.


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## SpAsMaN* (May 11, 2002)

Oh and IBSers can even be cured by pacemaker artificial motility regulator:COLONIC PACING IN THE TREATMENT OF PATIENTS WITH IRRITABLE BOWEL SYNDROME:TECHNIQUE AND RESULTS:http://www.bioscience.org/2003/v8/b/989/pdf.pdfNow we need to find a surgeon games to follow this procedure.While we searching for years for relief,a simple pacemaker could cure us.







It takes too long to get this implant around here.


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## 13364 (Dec 8, 2005)

Is it the case that these troublesome overgrowths wouldn't necessarily raise any flags on routine blood work ?ie, you can have perfectly normal white BC counts, & even white BC subtypes, even in the presence of a severe, potentially symptom-causing overgrowth of a bad bug ?


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## Kathleen M. (Nov 16, 1999)

The overgrowth in SIBO isn't bad bugs in the sense of bacteria that you would consider invaders that must be destroyed.They are normal bacteria your body normally doesn't react to, they are just growing too much in a location where they shouldn't be. There is no real reason for you to mount an immune response. Most of the bacteria found when they do a sample from the small intestine to see what is in an SIBO patient are normal residents of either the mouth or the colon.Most people with SIBO other than the IBSers have some disease or disorder that effects movement of stuff through the small intestine (SIBO has been known for a long time in other things it is just the in IBSers that is fairly new).K


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## 13364 (Dec 8, 2005)

OK, badly phrased Q; so these are neutral bugs in the wrong place.I think you answered the Q nonetheless, in that no immune response guarantees no change in bloodwork values - ?(The reason I ask is that I am trying to get info to decide in what order to try various pharmacological treatments of my case to which my GP seems amenable. Top two options at present are antibiotic clearout (to treat possible SIBO toxic effects) which is relatively quick, and low dose paroxetine (to treat possible serotonergic problems, peripherally & centrally - which commits me to (at least) 2 months treatment. There are also other options.)


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