# The Skin Rashes



## Nanobug

My IBS (mostly D) started 20 years ago. Just only a few years ago, I was able to bring it under control (mostly with the help of Glutamine).A few months ago I had an episode of food poisoning. Lots of diarrhea and no way to stop it for a few days. My stomach hurt. A couple of weeks later, still with a achy stomach, decided to go to the family doctor - there, I was diagnosed with Helicobacter Pylori infection (did the breath test). Was prescribed Prevpac, a common triple therapy prescription.Two days after starting the two antibiotics and proton pump inhibitor, the diarrhea was gone but not the stomach pain. Interestingly enough, I had exactly *ZERO* IBS symptoms. My bowels were working like never before. Those well formed stools were the most beautiful thing I had seen in a very, very long time.Went back to the family doctor and told him the stomach pain was still there. Told me to continue to take the proton pump inhibitor and see a gastroenterologist. Took the proton pump inhibitor for two months and the pain was gone. Good! Didn't go the the gastroenterologist, though.Meanwhile, I was back to my normal me, managing my IBS-D with Glutamine but not forgetting that interesting data-point, of *ZERO* IBS symptoms while taking the antibiotics. Did a little bit of research and ended up stumbling on Pimentel's book, "A New IBS Solution". Went to Borders, bought it and read it in 4 hours. Suddenly, things started to make sense.Decided to schedule an appointment with my long time doctor, an internist always willing to listen to patients, their concerns and even crazy theories.Now in the doctor's office, told the story above and explained Pimentel's ideas. Brought along the book and relevant Pubmed abstracts. Given my recent experience with those two antibiotics for H. Pylori, we both agreed to forgo the lactulose breath test and go directly to the antibiotics, 1200mg/day of Xifaxan.Started treatment on Nov 9. The almost immediate effect was virtually no intestinal gas. Towards the end, I was even getting a little bit constipated. At the same time, I was taking a bunch of different digestive enzymes and closely following the dietary guidelines in Pimentel's book, to avoid having undigested carbs reach the bacteria.On Nov 19 I was off the Xifaxan. I had ordered B. Infantis 35624 and started taking it. I also started taking a Jarrow's Bifido formula. I didn't want those 10 days of antibiotic use to transform themselves in years of dysbiosis. Recolonization of beneficial bacteria is a must.Following those 10 days of Xifaxan, my bowels complained 2 days ago with some gas and diarrhea but now things have improved considerably: yesterday, no diarrhea; today, no diarrhea. However, I am very well aware of the fact that it is still *WAY* too early to tell whether all of my IBS symptoms are gone for good or not. Now, for the really interesting stuff.For many years, I had had a rosacea-like skin rash on my face. I've also had a nasty 3-inch diameter skin rash right in the middle of my chest.Guess what? The rosacea-like skin rash on my face is *totally* gone. The skin rash in my chest is mostly gone but not completely. I'm in observation mode and looking at what might develop in the next couple of weeks.Conclusion: Got skin rashes? Have IBS? Go see your friendly doctor and take Pimentel's book with you.


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## 17908

Are you taking any motility drugs like Zelnorm now? Did I miss it? That is a very important part of Pimental's regimen.


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## Nanobug

> quote:Are you taking any motility drugs like Zelnorm now? Did I miss it? That is a very important part of Pimental's regimen.


I'm doing an experiment, taking 5-HTP instead. 5-HTP is readily converted to serotonin in the gut. Given that serotonin is fundamental for motility, I'm betting that it will work. In any case, I'll be on the look out for potential problems. AT the very least, my skin rashes will let me know!


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## Moises

Nanobug,Good for you! The amelioration of your skin condition does not surprise me. If you look at published studies on the use of elemental diets, you will find that all kinds of conditions are remediated. If you buy Pimentel's view that the elemental diet eliminates bacterial overgrowth, then many conditions--not just obvious digestive ones--may be caused by bacterial overgrowth. There were dermatological conditions, rheumatogical conditions, and others.


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## Nanobug

> quote:The amelioration of your skin condition does not surprise me. If you look at published studies on the use of elemental diets, you will find that all kinds of conditions are remediated.


To be honest with you, I was not surprised either. I was just not sure that it would totally clear the skin rash on my face. When I did the triple therapy for H. Pylori, I noticed an improvement in those skin rashes as well but nothing as dramatic as what's happened this time. At the time, I was able to find some abstracts on Pubmed about how some doctors were successfully using triple therapy to treat people with rosacea. However, while I wasn't surprised, I wasn't sure that it would work so well either. So I guess my surprise was in the effectiveness. Oh, by the way, the skin rash on my chest appears to be clearing as well just at a much slower pace. No idea why it's longer than the one on the face, though.


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## eric

Nanobug, this was posted some years ago from Havard health and some one asking about 5ht and a thyroid med. I am not positive, but I don't think taking 5ht helps the problem in the gut cells in IBS as to the release or non release or flow of serotonin from EC cells. It may also cause d.Just for the info.The Trusted Source..Harold J. DeMonaco, M.S.Harold J. DeMonaco, M.S., is senior analyst, Innovative Diagnostics and Therapeutics, and the chair of the Human Research Committee at the Massachusetts General Hospital. He is author of over 20 publications in the pharmacy and medical literature and routinely reviews manuscript submissions for eight medical journals...June 19, 2001.A:Irritable bowel syndrome is now recognized as a disorder of serotonin activity. Serotonin is a neurotransmitter in the brain that regulates sleep, mood (depression, anxiety), aggression, appetite, temperature, sexual behavior and pain sensation. Serotonin also acts as a neurotransmitter in the gastrointestinal tract.Excessive serotonin activity in the gastrointestinal system (enteric nervous system) is thought to cause the diarrhea of irritable-bowel syndrome. The enteric nervous system detects bowel distension (expansion) on the basis of pressure-sensitive cells in the bowel lumen (opening). Once activated, these pressure-sensitive cells promote the release of serotonin, which in turn promotes both secretory function and peristaltic function (the contractions of the intestines that force the contents outward). At least four serotonergic receptors have been identified to be participants in the secretory and peristaltic response.Patients with diarrhea-predominant IBS may have higher levels of serotonin after eating than do people without the disorder. This recognition led to the development of the first drug used specifically to treat diarrheal symptoms of IBS, alosetron (also known as Lotronex). Alosetron blocked the specific serotonin receptors responsible for recognizing bowel distention. In doing so, it blocked the effects of serotonin and reduced both bowel secretions and peristalsis. Constipation was the most common side effect seen. (Note: Alosetron was removed from the market by the manufacturer after repeated reports of a dangerous condition known as ischemic colitis became known.) Tegaserod (Zelmac) is another drug under development and under review by the U.S. Food and Drug Administration for approval. Tegaserod is indicated for the treatment of constipation-predominant IBS and works to increase enteric nervous system serotonin activity.So, increasing serotonin activity in the enteric nervous system produces increased bowel secretions and peristalsis (and potentially diarrhea), whereas depressing serotonin activity produces reduced secretions and reduce peristalsis (and potentially constipation). Increasing serotonin activity in the brain would increase awareness and, in higher doses, produce anxiety, insomnia and restlessness. So I would have expected exactly the opposite effects of those that you experienced.I am unable to identify any possible drug interactions between 5-HTP and Synthroid (levothyroxine) but the symptoms described suggest a check with your doctor may be in order. Persistent feelings of tiredness and constipation may be signs of an underactive thyroid (hypothyroidism).June 19, 2001


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## Nanobug

> quote:I don't think taking 5ht helps the problem in the gut cells in IBS as to the release or non release or flow of serotonin from EC cells. It may also cause d.


How can it cause D without messing around with gut motility?


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## eric

FYI"There are nerves that line the intestinal tract, which use serotonin as their neurotransmitter. These nerves contain the carboxylase enzyme that converts 5HTP to serotonin, but not the hydroxylase enzyme that coverts tryptophan to 5HTP.Thus, when 5HTP is swallowed, large amounts of 5HTP may be picked up by these intestinal serotonergic neurons and quickly converted to serotonin, *leading to hyperactivity of these nerves.**This in turn may lead to nausea, vomiting, cramping, constipation and/ or diarrhea, and indeed, the research published on 5HTP since the 1970â€™s has consistently shown various forms of intestinal discomfort to be the main side effect of 5HTP use."*There are some questions I need to ask someone about this as well.


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## eric

FYI"MedGenMed GastroenterologyIBS -- Review and What's NewAmy Foxx-Orenstein, DO, FACG, FACP Medscape General Medicine. 2006;8(3):20. Â©2006 MedscapePosted 07/26/2006"Serotonin SignalingOf the putative mechanisms underlying the pathophysiology of IBS, the strongest evidence points to the role of serotonin in the GI tract. The effect of serotonergic mechanisms in the manifestation of IBS symptoms has led to development of a new drug class for the treatment of IBS patients: the GI serotonergic agents.Normal GI function relies on a properly functioning brain-gut axis, which involves the coordinated interplay of the GI musculature, the CNS, the autonomic nervous system, and the enteric nervous system (ENS). The ENS contains millions of neurons embedded in the wall of the digestive tract and functions, at least in part, independently of the CNS. The size, complexity, and independent function of the ENS has resulted in application of the terms "the second brain" and "the mini-brain."[81] Impaired function or coordination of any of these systems, or the communication between these systems and the GI musculature, can lead to symptoms of dysmotility and altered sensory perception, which are characteristic of IBS and select other GI motility disorders.[82]The neurotransmitter serotonin (5-hydroxytryptamine [5-HT]) is a predominant signaling molecule in the ENS. Most (90% to 95%) of the body's serotonin is found in the gut, and smaller amounts are found in the brain (about 3%) and in platelets (about 2%).[83] In the GI tract, serotonin facilitates communication between the ENS and its effector systems (muscles, secretory endothelium, endocrine cells, and vasculature of the GI tract), thus playing a key role in normal GI tract functioning.[84] In addition, serotonin plays a role in the communication between the ENS and the CNS.In the gut, serotonin is synthesized by and stored in the enterochromaffin cells, which are located within the mucosa of the intestinal wall. When material passes through the lumen and the mucosa is stimulated, enterochromaffin cells release serotonin, which then binds to its receptors (primarily 5-HT1P receptors) on intrinsic primary afferent neurons, initiating peristalsis and secretion. Serotonin also binds to 5-HT4 receptors on interneurons, which augments the transmission of signals to motor neurons, resulting in enhanced peristaltic activity. In transgenic mice lacking 5-HT4 receptors, colonic motility is abnormally slow, confirming the role of these receptors in facilitating normal colonic motility.[85] By binding to 5-HT3 receptors on efferent sensory innervations coming from the vagus and the spinal nerves, serotonin mediates signaling between the ENS and the CNS and, thus, modulates pain perception.To regulate the signaling process, excess serotonin must be removed; this is accomplished by the SERT molecule expressed by intestinal epithelial cells.[86] Human studies have shown that defects in serotonin signaling contribute to the pathophysiology of IBS and, potentially, other GI motility disorders. In a recent study by Coates and colleagues,[87] biopsy specimens from patients with IBS showed significantly lower mucosal serotonin concentrations than those from healthy controls, potentially the result of lower mRNA levels for tryptophan hydroxylase (the rate-limiting enzyme in serotonin synthesis), which were also significantly lower in patients with inflammatory bowel disease.[87] There was no significant difference in the number of enterochromaffin cells or in the capacity of these cells to release serotonin under stimulated conditions. In another study, higher serotonin levels were observed in mucosal biopsy samples from patients with IBS with constipation (IBS-C) than in patients with IBS-D or in healthy volunteers.[88]Serotonin levels may also be affected by altering the amount or function of SERT. The study by Coates and colleagues[87] showed a significant decrease in the level of SERT mRNA and SERT protein expressed in the intestinal epithelial cells of IBS patients compared with that of healthy volunteers. In another study,[89] SERT expression and binding capacity in platelets were decreased in women with IBS-D compared with expression and binding capacity in healthy controls. Furthermore, Chen and colleagues[90] showed that mice with a SERT gene deletion had altered colonic motility. It is interesting to note that the mice thrived in laboratory housing conditions, indicating that other transporters could compensate for the lack of SERT. Additional studies have focused on SERT polymorphisms. Yeo and colleagues[91] showed an association between patients with IBS-D and the homozygous short polymorphism of the SERT gene promoter. This mutation results in lower levels of SERT gene transcription and reduced amounts of SERT protein available for reuptake of serotonin. In addition, Camilleri and colleagues[92] showed a possible link between the long promoter polymorphism and patient response to therapy.Thus, a substantially large body of work shows that normal gut physiology is predicated on the interplay between the GI musculature and the ENS, autonomic nervous system, and CNS. One of the central mediators of this complex interplay is the neurotransmitter serotonin. Impairment or imbalance in serotonergic signaling, which can affect GI motility, secretion, and visceral sensitivity, may be affected by defects or deficiencies in serotonin production, specific serotonin receptors, or proteins such as SERT. These changes can manifest in symptoms associated with IBS, including abdominal pain, altered bowel habits (constipation, diarrhea, or alternation between these 2 states), and bloating."http://www.medscape.com/viewarticle/532089_print


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## Nanobug

> quote:Thus, when 5HTP is swallowed, large amounts of 5HTP may be picked up by these intestinal serotonergic neurons and quickly converted to serotonin


This is exactly the reason why I'm taking 5-HTP to increase gut motility. I'm taking it with food, however, which tends to slow down rate of absorption. Please, understand that what I'm doing is an *experiment* meaning that I'm aware that it might fail.


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## Nanobug

Thursday pigged out and totally deviated from Pimentel's diet for the first time since finishing Xifaxan. Unlike previous parties, I didn't have the need to fart until after I left, sitting in my car. I woke up with more gas than natural (but, who wouldn't, given the amount of sweets eaten!







), which was promptly expelled. Later, had a normal bowel movement with fully formed stools.So far, so good, it seems!


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## 15278

ericmy daughter just gave me the info on rifaximin. the problem i have is the cronic constipation. i have gone through all the tests and am currently not taking anything. the zelnorm wouldnt work for me as well as the new drug amitiza. after awhile the amitiza didnt work and i continue to have the same hurt bloating weight gain of 5 or 6 pounds overnite. the doctor fluffs it off...my gastro..and tells me just to cut out the stress. well as you know very well that is not what you want to hear...just a way of saying i just dont know what to do for you!!!anyway i am not a complainer and i am just fed up with the way i feel. my husband is retired and my grandson who is 6 now lives with us and has for the past 4 years just cant understand why i feel the way i do somedays. i just cant feel so yucky.anyway im going to my family doc today and plan to show this to her and see what she says. there are so many things in what you talked about that i dont understand..i have the rosacia and tried to go to the dermotologist and gave me sulfa drugs which made me even sicker...im alergic to sulfa! if she prescribes this for me i know i will have a ton of questions.. do you think this would work for me?


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## eric

Grama,my wife also has rosacia and its hard to treat it seems. Certain things seem to make it flare also stress being one of them but the weather diet and other things do as well. So you know anxiety can contribute to consitpation. Stress and anxiety are very important in IBS, more so then I think a lot of people realize. So working on that is very important, even if it just makes you feel better. They can also greatly reduce pain.The problem sometimes is doctors know why stress reduction helps IBS, but they don't usally do a good job of explaining it to the patient. It is however very real and almost every IBSer with moderate to severe IBS can benefit from stress and anxeity reduction. A lot of people who go that route are then surprized sometimes how much it helps. There is something called "psychophysiological arousal is the core of treating functional gi disorders. There is so much distress, anxiety, antisipatory anxiety, and negative reaction to symptoms, that calming the mind and body often makes a significant difference to symptoms."With that said you could ask your doc about SIBO, although its much rarer for Consipation. It also has not been studied yet throughly in regards to IBS. It maybe a subgroup of IBSers have sibo due to motility problems. It has not been established as the cause of IBS. There is something called Post Infectious IBS where there is a clearer starting date and celluar changes in the gi tract. Post Infectious IBS has been recently demonstrated as a brain gut axis disorder as well as IBS. Also have you ever had a sitz marker test, that may help to explain slow motility. There are also "ConstipationThe symptoms of constipation are infrequent bowel movements [usually less than 3 per week], passage of hard stools, and sometimes difficulty in passing stools. One motility problem that can lead to constipation is a decrease in the number of high amplitude propagating contractions [slow transit] in the large intestine. The test used to detect this is a transit time (Sitzmark) study. Outlet obstruction type constipation (pelvic floor dyssynergia)The external anal sphincter, which is part of the pelvic floor normally stays tightly closed to prevent leakage. When you try to have a bowel movement, however, this sphincter has to open to allow the fecal material to come out. Some people have trouble relaxing the sphincter muscle when they are straining to have a bowel movement, or they may actually squeeze the sphincter more tightly shut when straining. This produces symptoms of constipation. "http://www.iffgd.org/GIDisorders/GIAdults.htmlOne treatment for the later is biofeedback.This is also a good site on Consitpation.http://www.aboutconstipation.org/and for IBShttp://www.aboutibs.org/There is also as you get older sometimes the muslces don't work quite as well as they use too.How long were you on zelnorm and the other drug?Hope that helps, ask any questions you want.


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## 15278

eric to begin with i just wanted to tell you how much i appreciated your encouragement. i have had this problem since my daughter passed away 6 years ago. i know i have to stop the stress but its not easy. my grandson lives with us, for the past 4 years. his mom was murdered for him. im sure you remember the pregnant girl theresa andrews....well that was my daughter. the stress from all the pardon the expression "####" that we have had to deal with i know is what makes me sick. we have a great realationship with my grandsons dad...but you know being you have a wife, if you were to loose her it really would be hard. so i try really hard to help him, my husband, who has been very ill, and my grandson....plus my other two kids and their children. its a vicious circle. but i love them all and wouldnt change a thing! i did go to my regular doctor and she prescribed the antibiotic. she mentioned that another one of her patients has taken it with great results...im really hoping!!! thanks for listening...im sure when i posted before others thought i was a total wack job...sometimes i think i am!!! just knowing someones out there and really reads this is very comforting somehow!







thanks so muchgramav


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## Nanobug

> quote:i know i have to stop the stress but its not easy


Have you considered medication? In my case, 75mg/day of Effexor XR worked very well for my anxiety. I took it for just a little bit over a year and then stopped (which was kind of hard for a couple of weeks). That anxiety never returned.By the way, what Xifaxan dosage are you in? Please, tell us about your progress. If you don't mind my suggesting, start a thread just for you and keep us all updated.Good luck!


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## Nanobug

Another 4 days of my life, another 4 days of intestinal bliss. I continue to have a bowel movement every day of fully formed stools.The skin rash on my chest is almost invisible now. I asked my wife if she could see it and she said "no". Because I knew where that thing was, I still notice a very small patch of slightly redder skin color but it is almost imperceptible.My order for Lactobacillus GG and Saccharomyces Boulardii arrived two days ago and I'm now taking them.So far, so good!


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## eric

FYI on the 5htphttp://www.wellnessletter.com/html/ds/ds5HTP.php


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## Nanobug

Interesting factoid (at least for me):For the last 6 years or so, my blood tests have always shown a slightly elevated liver enzyme, namely, SGPT (aka ALT). Well, until now.My last day of Xifaxan was on Nov 18. On Nov 21, I went for my annual physical and had the regular blood testing done. Then, yesterday, got the results back by mail. Guess what? SGPT was very much normal!Given that SGPT is released into the bloodstream when there is some damage to the liver, could it be that my liver was having a hard time dealing with the toxic #### put out by whatever bacteria Xifaxan decimated? In any case, this is going to be one more marker (besides the skin rashes) to track for resurgence of nasty bugs in my bowels.


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## eric

grama v I am sorry I missed your post before.What happened to your daughter was a tragedy for sure and I am very sorry for your loss. There are some very sick people in the world.I would be happy to personally help you out in any way with the health problems as best I can.Do you know the name of the anitbiotic?Has it caused you any issues since you started it. Its preferably better to be breath tested before taking these, and recommended by a gi doc, more so then a regular md, but it sounds like your trying it and go from there.I would be happy to talk to you on the phone if you would like as well. I will also post some more information for you.Again very sorry to hear of your loss. I don't think words do justice, but I am sending good thoughts your way.


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## Nanobug

> quote:FYI on the 5htp


Here's my reply to you, eric:http://ibsgroup.org/groupee/forums/a/tpc/f...261/m/849104072


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## eric

I replied to thatalsoStudy offers hope for reflux disease patients who can't live without chocolate "The researchers found that chocolate significantly increased the number of reflux events and the acid exposure time in the esophagus for the seven patients."We found that the chocolate causes a large amount of serotonin to be released from the cells in the intestines," says Wei Ming Sun, Ph.D., research scientist, U-M Department of Internal Medicine. "The serotonin causes the lower esophageal sphincter to relax. The relaxation means the 'door' between the esophagus and stomach is opened and acid is allowed to flow back up to the esophagus."http://www.med.umich.edu/opm/newspage/2001/chocolate.htm


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## Nanobug

These last seven days, I've been eating a lot of ####, in particular, #### with a lot of fructose (I just love Panettone!)







Two observations, regarding increased fructose consumption:1) There is more gas2) Transit is accelerated, although stools are still well formed for the most partI guess these two are consistent with what one knows about fructose and digestion but it would still be nice to find a solution besides just avoiding the stuff.If my hypothesis is correct, however, I need to be careful with fructose. For now, I am just potentially playing with fire.


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## 15278

ericjust wanted to thank you for your words of encouragement. i really am not crazy, the depression is not from the disease, i know that, but im sure it dosnt help. so many people are going through so much more than me, i know that too. you just feel helpless sometimes when you used to have soooo much energy to take care of all aspects of your life then you feel sooooo bad somedays that you have a hard time doing so! i guess what im really learning is that you take the good days and run! i did ask my doc for the meds that have been talked about some on the internet, starts with an x...it seems to be working a little. i hate to say so...seems as if the gas and hurting is a little better. problem is i have gained 30 lbs in the last few mo.and have not lost that feeling in the mid under the ribs of the huge feeling. my doctors cant even figure this one out. from 125 to 155 or more. thats a big jump since september, but, from what i have read to some others have done the same even with excercize, which i do all the time. the one med i do take is cymbalta, my doctor thinks i have fibromialga because of all the aches in my body...it seems to help that quite a bit. well im sure it sounds as if im rambling but i really appreciate someone to listen. my husband is really sick most of the time...he had his colon removed several years back because of irritable bowl...seems as if i need to get the answers to help him too. thanks again so much and for not thinking im crazy!!!!







grama g


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## eric

grama v , I am glad to see you posting again. On the weigh gain any changes in your hormones?from what I glanced at on cymbalta it doesn't really look like that would cause weight gain, although were all different. Glad its helps the fm it looks like they do prescibe it for that.Treating the depression is likely to help your health conditions and help make you feel better and help with your energy levels which will have benefits as well.Like I said I have no problem talking to you over the phone and would be glad to call you. I talk to a lot of IBSers over the phone from the bb. I am sorry to hear your husband had his colon removed. That was for IBS or IBD?


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## 17908

> quote:Originally posted by Nanobug:Interesting factoid (at least for me):For the last 6 years or so, my blood tests have always shown a slightly elevated liver enzyme, namely, SGPT (aka ALT). Well, until now.My last day of Xifaxan was on Nov 18. On Nov 21, I went for my annual physical and had the regular blood testing done. Then, yesterday, got the results back by mail. Guess what? SGPT was very much normal!Given that SGPT is released into the bloodstream when there is some damage to the liver, could it be that my liver was having a hard time dealing with the toxic #### put out by whatever bacteria Xifaxan decimated? In any case, this is going to be one more marker (besides the skin rashes) to track for resurgence of nasty bugs in my bowels.


This is an amazing statement to me. I have also had quite high liver enzyme readings for about the last year or so. However, I haven't had them tested since I had a successful treatment with Xifaxan.My liver enzymes were high enough that I almost had to have a biopsy, and I happened to be applying for life insurance at the time. All my life insurance quotes were as high as a smoker would get. That REALLY made me mad. I eventually found a good company that was willing to accept a letter from the Mayo Clinic stating that my liver enzymes were acceptable, although abnormal.


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## Nanobug

> quote:This is an amazing statement to me. I have also had quite high liver enzyme readings for about the last year or so. However, I haven't had them tested since I had a successful treatment with Xifaxan.


I'll be anxiously waiting for your results, then, because this could be an important finding!


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## eric

FYIMildly elevated liver transaminase levels in the asymptomatic patienthttp://www.findarticles.com/p/articles/mi_...71/ai_n13684247


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## 17908

> quote:Originally posted by eric:FYIMildly elevated liver transaminase levels in the asymptomatic patienthttp://www.findarticles.com/p/articles/mi_...71/ai_n13684247


As somebody that has been through MANY doctor visits and MANY tests regarding my liver enzymes, none of that information is even remotely new to me. I was hoping you had come across an article that related high liver enzymes to IBS or SIBO. Thanks anyway, though.


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## Nanobug

> quote:I was hoping you had come across an article that related high liver enzymes to IBS or SIBO


There appears to be some interesting stuff out there. Here's one I just googled:The role of small intestinal bacterial overgrowth, intestinal permeability, endotoxaemia, and tumour necrosis factor alpha in the pathogenesis of non-alcoholic steatohepatitis


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## Nanobug

Just stumbled on this and found it interesting:Uninvited Guests: The Impact of Small Intestinal Bacterial Overgrowth on Nutritional Status


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## eric

Thats from the same group at Cedar.I find it really odd weight loss and malabsorbtion, malnurtion and anmeia are red flags to a diagnoses of IBS. Yet the hallmarks of sibo?I believe they have also really played up the actual results of their studies it seems as far as symptom improvements. As well as no body else has been able to replicate them? In fact they have shown way lesss people have sibo and IBS as reported by Cedars. Hmmmmmmmmmm?Bloating got somewhat better in a third of the patients? But that was basically it?Which might just be explained by taking them in the first place and killing all the bacteria. Of course you can't do that forever.It makes it sound like a "cure" to a new IBSer when the last study only 1/3 got better and that was on bloating, not d or c or very importantly pain?Some of these things are really not adding up here.


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## Nanobug

It's been a month since I finished my 10-day course of antibiotics. Since then, and mainly due to the season, I've been eating a lot of crappy food (read: sweets).With a few exceptions, my bowels have been working very well. I get one bowel movement a day some time after lunch (thanks, gastrocolic reflex) and stools are well formed and come out easily.The few exceptions were experienced following meals high in free fructose. Although I'm not ready to conclude that I suffer from fructose malabsorption, the symptoms are eerily similar to this condition. In an experiment in which I took 25g of free fructose with water, I got pretty much all IBS symptoms within the next few hours.Lately, I've been reading quite a bit about Saccharomyces boulardii and the effects these yeast goodies have on the digestive system. In particular, several studies show how this non-colonizing yeast has the ability to increase absorption of nutrients (for example, "Effects of Saccharomyces boulardii on intestinal mucosa".) This led me to increase my intake of this yeast sucker today, to be more in line with the dosages used in the studies.


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## 21184

hello there! I finally found someone who can relate with an illness that has no cure! I feel your frustration and can say that I have the same problems that you have described. My doc has put me through hell and back with all testing and comes back IBS. I have tried so many different medications and cannot understand why we have to suffer with this. Just lately I have noticed rash on my face and very bad sinus pressure with headaches that make me throw up. The bad thing about getting the spell over the holiday is that my doc is not to b found. I would love to speak with you via email or here. Hope you can and will reply. My email is andyval###vista-express.com


> quote:Originally posted by grama v:ericmy daughter just gave me the info on rifaximin. the problem i have is the cronic constipation. i have gone through all the tests and am currently not taking anything. the zelnorm wouldnt work for me as well as the new drug amitiza. after awhile the amitiza didnt work and i continue to have the same hurt bloating weight gain of 5 or 6 pounds overnite. the doctor fluffs it off...my gastro..and tells me just to cut out the stress. well as you know very well that is not what you want to hear...just a way of saying i just dont know what to do for you!!!anyway i am not a complainer and i am just fed up with the way i feel. my husband is retired and my grandson who is 6 now lives with us and has for the past 4 years just cant understand why i feel the way i do somedays. i just cant feel so yucky.anyway im going to my family doc today and plan to show this to her and see what she says. there are so many things in what you talked about that i dont understand..i have the rosacia and tried to go to the dermotologist and gave me sulfa drugs which made me even sicker...im alergic to sulfa! if she prescribes this for me i know i will have a ton of questions.. do you think this would work for me?


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## eric

In regards to taking Tryptophan Supplementation in IBS.More GI Symptoms, Less Anxiety With Tryptophan Supplementation in IBSNEW YORK (Reuters Health) Dec 21 - Patients with irritable bowel syndrome (IBS) have an increase in gastrointestinal symptoms after ingestion of a large dose of tryptophan, according to a new study. At the same time, they report having fewer symptoms of anxiety and depression.British researchers, led by Dr. Jonathan Shufflebotham of the University of Bristol, studied 18 patients with ROME II-defined IBS and 11 age-matched controls. The subjects were evaluated during a phase of acute tryptophan depletion and a phase of acute tryptophan increase.Participants ate a low-protein diet on the day before each phase of the study and fasted from midnight to 9:00 am on the day of intervention. Baseline levels of tryptophan were measured on that day and patients completed a questionnaire, answering questions about IBS symptoms and symptoms of anxiety and depression.During acute tryptophan increase, subjects drank a concoction containing 2.3 g tryptophan, 150 ml water, 100 ml flavoring of their choice and 2 spoons of sugar. During acute tryptophan depletion, subjects drank the same drink without the addition of tryptophan.Total and free plasma concentrations of tryptophan decreased 73% in both patients and controls during tryptophan depletion and increased approximately 60% on the day of supplementation.IBS patients reported more gastrointestinal symptoms but less anxiety with acute tryptophan increase compared with acute tryptophan depletion. Controls did not have a difference in symptomatology on either day. IBS patients had lower mood scores overall than controls during all phases of the study.In the study published in the November issue of the American Journal of Gastroenterology, Dr. Shufflebotham and colleagues write that the findings "suggest a difference in serotonergic functioning between these two groups and provides evidence to support the hypothesis that 5-HT dysfunction is involved in IBS."IBS symptoms respond to treatment with 5-HT4 agonists and 5-HT3 antagonists in some IBS patients, the researchers note. And, "the differing direction of GI and anxiety symptom responses to 5-HT manipulation is counterintuitive but intriguing.""Further researcher is now needed to clarify which parts of the 5-HT system are dysfunctional in IBS and how this relates to the symptoms experienced by patients with this condition," the team concludes.Am J Gastroenterol 2006;101:2582-2587http://www.medscape.com/viewarticle/549778?src=mp


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## Guest

nano, i'm interested in your experiment - you've followed a good process and seem to have some optimistic results.i've read your posts and tried to follow, but you've experimented with this and that and now i'm not sure - what exactly was the "cure" you've discovered?is it all just in that pimentel book?i really hate the idea of antibiotics...fyi - a little on me:i have suffered for the last few years with having d almost all the time, or at least loose, softies that never complete and tend to leak for the next few hours.after a return to a healthy lifestyle (including excersize, quiting smoking and healthy eating - i lost 50lbs and gained 14 back in muscle and i feel really sexy) and a visit to a GI doc for a probing in october, i have since had a horrible gas issue... lots of farting lots of stink.i have never had major GI pain, just the soft stool that doesn't want to stop and now the gas...


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## Nanobug

> quote:is it all just in that pimentel book?


I encourage you to read the book. The antibiotics made a big difference for me: no more bright-yellow diarrhea.Xifaxan is different in the sense that it isn't absorbed by the intestine. Therefore, it doesn't have the same type of issues as other commonly prescribed antibiotics.


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