# After 5 Relapses - Now CURED! Here's how



## frantic1980

I have finally cured my SIBO, after relapsing 5 times in the past. This is basically a dump of all my info and research (with citations), and details of how I finally beat it. Hopefully this is my last post, I've been on and off the board for 3 years and it has helped me a lot. But rather than disappearing I wanted to share what I have learned. The method I used uses antibiotics to intitially get rid of the SIBO. Ginger and Grapefruit seed extract to keep your SIBO at bay whilst Glutamine repairs your gut until it can defend itself again. I believe probiotics were the biggest cause of my relapses and I will explain why.The facts you need to know to help you cure SIBO*Immune System*60% of your body's immune system is in the intestines. Antibodies that fight infection live in the fragile lining of your intestines. This lining becomes damaged by the bad bacteria that triggered your SIBO, and therefore the intestine's ability to protect itself is diminished.http://ajpgi.physiology.org/cgi/content/full/291/1/G82http://en.wikipedia.org/wiki/Gastrointesti...Immune_function*Probiotics*Television, Marketing & advertising for yoghurts, actimel, yakult....etc.etc. Lead us to believe that 'Friendly bacteria', 'probiotics', 'yoghurt', 'probiotic drinks', 'probiotic supplements' are essential for digestion. The truth is that bacteria actually play a minor role in the digestive process. The first 24 feet of the intestines (the small intestine)contains *no bacteria* (or only a very small amount - less than 1000 bacteria per ml of fluid; digestion in the first 24 feet uses bile, acid and enzymes. Anything more than 1000 bacteria per ml in the small intestine is classed as SIBO). The final 6 feet of the colon is where all your digestive bacteria live (1 Billion per ml of fluid), the bacteria here basically feed on the small amount that is left over after the small intestines.http://www.enchantedlearning.com/subjects/anatomy/digestive/*What causes SIBO*E-Coli, Samonelia and other bad bacteria are biologically similar to any other type of bacteria but have a nasty side-effect: They produce toxins when they feed. These toxins damage the sensitive lining of the gut, inflaming it and wearing it down to the extent that your small intestine's ability to cleanse and protect itself is reduced. With this protection diminished. Bacteria: (good or bad) is able to overgrow in your small intestines.If there was one piece of advice that I can give you to prevent your SIBO from relapsing it is this: *THROW AWAY YOUR PROBIOTICS*. If your problem has the words _"Small intestine"_ in it - then bacteria are not part of the equation because *bacteria are not part of the digestive process in the small intestine*. If your problem has the words _ "Bacterial Overgrowth"_ in it, then you have too much bacteria - *adding more bacteria won't help you!!* With your intestine's ability to cleanse and protect itself diminished, *good bacteria can overgrow just as much as bad*.*To quote "A new IBS Solution" by Dr. Mark Pimentel*Page 93: Chapter 7: _"Another problem with probiotic supplementation is that the cleansing waves in the small intestines of IBS patients are inadequate. It's possible that a person with diminished cleansing wave capacity who takes probiotic supplements could find his or her situation worse, as the *probiotics accumulate in the small intestine* where they don't belong"_I blame probiotics as the biggest culprit in my 5 relapses. My poor understanding of how the human digestive process works, and blindly absorbing in the yoghurt companys' "friendly bacteria" marketing cr&p led me to believe that bacteria and probiotics would help me when in fact they were re-triggering my SIBO.*"But probiotics alleviate my IBS symptoms!"*A lot of people get relief from Small Intestine Bacterial Overgrowth by taking loads and loads of probitics. Flooding the small intestine with good bacteria _temporarily _'overruns' the bad bacteria. The good bacteria don't produce the toxins so things improve. But *bacteria aren't supposed to digest food in the small intestine* - so although things are somewhat improved (no toxins) you still get the bloating (bacteria produce gas) and you still get hungry all the time (the bacteria are eating your food, not you). This isn't how the small intestine is supposed to work!! Yes it gives relief but its not solving the problem.*To quote "A new IBS Solution" by Dr. Mark Pimentel*Page 93: Chapter 7: _ "While a reduction in IBS Symtoms is certainly a good outcome, it is not the same as elimination if the IBS itself. According to current scientific study probiotics have not been found to eliminate IBS"_Once again, to stress this point. *THROW AWAY YOU PROBIOTICS.* 
 SMALL INTESTINE BACTERIAL OVERGROWTH - THINK ABOUT IT....
If your problem has the words "Small intestine" in it then bacteria can't help you because_ digestion in the small intestine doesn't work with bacteria_.
 If your problem has the words "bacterial overgrowth" in it bacteria can't help because you've got TOO MUCH bacteria - _adding more to an already overgrowing population won't help!!!_
Any notion of _"replacing the bad bacteria with good bacteria" _ as some people are suggesting on these forums is cr&p. You are trying to eradicate *all *bacteria from your small intestine. * To quote Pimentel again (Page 91)* _"When it comes to the gastrointestinal tract, the concept of "good" bacteria is a misnomer...very few of the 400 strains of bacteria are in fact "bad" or "good" rather they simply represent the various strains of bacteria that are normally found in the colon (or large intestines). It is when these strains of bacteria leave the areas of the gastro-intestinal tract in which they properly belong the problems occur."_*ANY bacteria in the small intestine is bad - THROW AWAY YOUR PROBIOTICS!!!**Here are the items you need to buy help you beat SIBO:*Rifaximin/NeomycinThese antibiotics act only in the small intestines and are not absorbed into the blood stream. There is plenty of info in the forums about these antibiotics. I would suggest at 400 - 600mg Rifaximin 3 times per day. It might help to have a systemic antibiotic as well e.g. Ciproflaxin. If you can, get a few extra rifaximin and take 400mg once every couple of days for another 10 days after that as a maintenance dose just to keep your SIBO from coming back.*Glutamine* - to repair the lining of your gut and allow it to defend itself again(get it on ebay - search for "glutamine powder" - you'll need about 1kg)http://shop.ebay.com/?_from=R40&_trksi...-All-CategoriesGlutamine is one of the 20 amino acids encoded by the human genetic code - these are the building blocks of proteins from which your body is constructed and are essential for repair.*quote*_"Glutamine is the preferred 'fuel' for the cells lining the mucosa of the small intestine (enterocytes). These cells have the ability to take up glutamine directly rather than waiting for it to be supplied through the blood. Glutamine is also required for the production of both intestinal mucus and Secretary Immunoglobulin Type A (SIgA) antibodies. As a result of these functions, a generous supply of glutamine will help repair and maintain a healthy small intestinal lining. These functions, as well as glutamine's ability to prevent translocation of bacteria from the gut to the bloodstream, have been established in a substantial number of clinical studies both in animals and in human patients with diseases involving impaired intestinal permeability"_ *Citation:* http://www.ei-resource.org/treatment-optio...rome-treatment/*Grapefruit Seed Extract* and *Fresh Ginger* - to keep the SIBO away while your gut is being repaired by GlutamineGet grapefruit seed extract drops on ebay -not capsules. http://shop.ebay.com/items/?_nkw=grapefrui...r&_osacat=0These are natural anti-microbial supplements, so like antibiotics they kill bacteria. Take these during your course of antibiotics and for at least 1 month after. These will keep the bacteria from overgrowing while the glutamine is repairing your gut so that it can defend itself again.I use the ready grated ginger in vinegar that you get in a jar for cooking with (in the condiments aisle). It tastes really sharp at first but I actually learned to enjoy it. You could buy root ginger and grate it yourself if you don't mind. Fresh garlic does the same if you can stomach it (I can't!), but I don't think 'odourless' garlic tablets do anything.*Putting the whole thing together.*Antibiotics for 10 daysTake the antibiotics with food as the antibiotics only work when the bacteria are feeding/reproducing (Pimentel page 76).Each morning eat 1 large dessert spoonful of Glutamine in a bowl of porridge oats with lactose free milk. Glutamine is highly soluble so drinking in water alone will mean that it gets absorbed early in the digestive tract. The oats transport it through the whole length of your small intestines. Drink grapefruit seed extract in water (approx 15 drops in half a pint of water - I usually put a few extra drops more than on the instructions.... enough to taste the sharp taste of grapefruit) 3 times per day and also with your lunch and dinner (drinking it with food helps attack the bacteria when they are feeding and also helps transport the liquid through your intestines rather letting it absorb early). Eat some fresh grated ginger before and after each meal including breakfast - about as much as you can pinch between your thumb and finger (this has a very very strong effect on SIBO. I take ginger root supplements as well for good measure - but I don't think they're as good as fresh ginger.Take some more glutamine in the evening 2 heaped teaspoons in a non-probiotic dessert - I used non-probiotic Alpro soya desserts (beware of probiotic Alpro - with added bacteria). Remember bacteria /probiotics are bad - I tried the glutamine in normal bio-yoghurt but my symptoms got worse again.Continue the glutamine/ginger/grapefruit seed extract for 1 month after stopping the antibiotics. This will keep the SIBO at bay while the glutamine works to repair your gut, and allows your digestion to defend itself. Avoid sweetners and sugars as much as possible, during this month.Right now I am off the ginger and grapefruit seed extract and my bowl movements have been solid and daily for 3 weeks. I'm going to keep taking the glutamine in my oats until my supply runs out, but I'm pretty sure I'm cured now.I am personally staying off the probiotics forever (I don't think taking bacteria in that form and numbering in their billions is either healthy or necessary). I am also going to stay off the yoghurt for at least 6 months. If you take anything away from reading this its that *the small intestine doesn't work with bacteria and a bacterial overgrowth can't be fixed with more bacteria!* I can't stress this enough! Throw away your probiotics!That's it. Hope this helps somebody.Good luckKevin.Added 20/6/09Here are details of my 5 failed attempts at beating SIBO:1. Rifaximin 400mg 3 times per day for 7 days probiotics immediately afterInitial good results, got solid regular bowel movements by about day 3. IBS-D symptoms came back 2 days after stopping.2. Rifaximin 400mg 3 times per day for 10 days probiotics immeidately afterInitial good results, got solid regular bowel movements by about day 3. IBS-D symptoms came back 2 days after stopping.4. Rifaximin 600mg 3 times per day for 14 days + LOTS of probiotics, Yackhult, natural yoghurtNo change - the rifaximin was totally ineffective5. Rifaximin 400mg + Neymycin 1000mg Co-amoxiclav (Augmentin) 500/125mg 3 times per day- probiotics immediately afterGood results whilst on the medication, symptoms returned almost immediately6. Ciproflaxin 500mg, Rifaximin 600mg, Neomycin 1000mg, all 3 times per day for 12 days Plus grapefruit seed extract, fresh ginger, glutamine.Very watery diareeha started about 3 days into the treatment. I persisted because allthough it was very watery, it was perfectly digested (no traces of food). I also felt a lot better, and had a lot more energy and could sleep better, so I stuck with it. The watery diareeha continued for over a week after the end of treatment. I continued to take the grapefruit seed extract, ginger and glutamine. I assumed that I had "antibiotic associated diareeha" due to the amount of antibiotics I had taken, so I took 500mg of Flagyl (Metronizodole) 3 times a day. The diareeha stopped after 2 days, continued with Flagyl for 7 days. Had perfect, regular digestion since. Did not take any probiotics.


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## IanRamsay

HiI am afraid i TOTALLY disagree, I have been working with bacteria for more than 12 years in a professional capacity and know from first hand experiance that reintroduction of targeted bacteria in to the GI tract as a whole is vital for the efficient treatment and recovery in the long term for SIBO of all kinds. telling people not to take probiotics and other suppliments is extremely narrow minded and may prevent people from finding some relief.Ian


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## frantic1980

Ian I know you're a big advocate of probiotics for SIBO - you've been recommending them to everyone! As I mentioned in the post, yes probiotics do provide "relief" for IBS/SIBO. I experienced this first hand myself; for 2 years I took high-count multi-strain probiotics. Yes it provides relief (this I acknowledge), but it prevents a complete cure.I've provided citations from Dr. Pimentel's book and various web sites to support what I have said. Pimentel is probably the leading GI Doctor in the world when it comes to IBS and SIBO and he recommends NOT taking probiotics. I would suggest reading his book and confirming this - also do some research into the human digestive system and you will confirm that a healthy small intestine does not contain bacteria! I was also brainwashed by the "friendly bacteria" marketing cr&p to make you buy more yoghurt and probiotics and believed that bacteria were the main component of human digestion - they are not.*SMALL*INTESTINE*BACTERIAL*OVERGROWTH - think about it... it makes perfect sense. Small Intestine (*should have no bacteria*) Bacterial Overgrowth (*Too much bacteria: don't add more*!). Its so logical. Yet it goes against everything that the yoghurt companies make us believe.If you want "relief" but to never get rid of your IBS, keep taking your probiotics. If you want to be cured completely, get Pimmentel's book - confirm the quotations above about not taking Probiotics. Reseach the human digestive system and confirm that bacteria are not part of digestion in the small intestine. And then go throw away your probiotics.I'm sorry but I don't think i'm being narrow minded. I tried the probiotic/bacteria thing for 2 years. After 2 years I still had IBS so I considered other approaches, looked at other possibilities, read the work of the worlds leading IBS/GI doctor and adjusted my approach accordingly.


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## frantic1980

This probiotic research you've done, Ian.... I can't find any of your publications on google. Maybe you could tell us why exactly why _"reintroduction of targeted bacteria in to the GI tract as a whole is vital for the efficient treatment and recovery in the long term for SIBO of all kinds"_. And back your claim with supporting evidence like I did?I spent over 4 hours writing this post and providing supporting links and quotations before I leave the site to try and help people get over SIBO/IBS like I have.... and I am actually very upset that the first reponse I got is completely knocking down my efforts to try and help people whilst providing no factual evidence to support your theory!


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## Kathleen M.

I've seen the theory that all bacteria must always be bad for SIBO, but haven't seem much data that probiotics can only make SIBO worse and must be avoided at all costs.That being said, different things work for different people and if this works for you, thank you for sharing. I see there is a paper with some data in humans that says probiotics may work. When this first came up on the board most of what I could find about probiotics actually helping to lower the bacteria in the small intestine were in animals like Pigs where they used probiotics to reduce the small intestinal bacteria that can slow weight gain.http://www.ncbi.nlm.nih.gov/pubmed/1876328...Pubmed_RVDocSum is the link for a recent paper in people.


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## IanRamsay

Im not talking about taking a yogurt or two every day, im talking about targeted strain specific gram positive bacteria in controlled doses based on a count of bacterial colonisation in teh Stomach, Intestines and bowel. its a bit different to a pot of activia on a whim.no offence, there are so many different strains of probiotic, you may not have found teh right one. over the course of 12 years i tried so many that i lost count at one point. i have used my self as a test subject, and, on occasion, suffered as a consequence. I despise blowing my own trumpet so i never claim that any research i have done can change the world, and untill i am sure that my research is 110% accurate, i wont publish it. I am developing a test for SIBO and IBS/IBD that will identify the specific bacteria that is in too much abundance an dthe bacteria that is in too little abundance that can be done at home in a few minutes. sadly it is about 4 years away. but it will be free and available to anyone who wants it. I dont promise a cure, sadly a cure may never happen. But i have been free of symptoms of GERD, GASTRITIS, IBS for almost a year now by exact bacterial (probiotic) therapy. (Given, the dosage has at times been scary and the help i have had from friends who are biologists, doctors and scientists has been invaluable) not to mention the use of a lab to culture my bacterial strains. If you take a antibiotic for sibo, you need to start off teh repopulation process with gram positive bacteria in numbers. I know some natural substances do have results where bacteria elimination is concerned, especially olive leaf and GSE, but there is very little research done in to these substances and teh effect that they have on Both Negative and Positive bacteria. the only way to suppliment the bacterial balance in teh GI tract is by adding to it. Its not just teh intestines that benifit form them, teh stomach, bowel, lungs etc all benifit from positive bacteria in teh correct amounts.i have read the good drs book. several times. i assume you have read other books on the subject?denying your intestines probiotics in any form is insanity. IanP.S. Im glad that you have found something that works for you and i hope that it continues to work, but telling people not to take probiotics is unnessesary. especially as some people who read these posts are desperate and confused and will try anything. (No offence to any one who is desperate, confused and willing to try anything.)


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## frantic1980

That's an interesting paper Kathleen, I have tried Yackult and like most probiotics it did alleviate my symptoms but never actually improved things beyond a certain point. Thanks for replying its good to know that the effort I put in to share my experiences is appreciated. I have learned a lot from this board and I didn't want to leave without passing on what I have learned.


IanRamsay said:


> denying your intestines probiotics in any form is insanity.


Humans and animals have survived for 100 Million years without probiotics. Once again I urge you to forget the 'brainwashing' of the yackult marketing-man that a daily supply of bacteria is vital for a healthy digestion and do your own reading into the role of bacteria in the digestion of a healthy non-IBS person. I would also encourage you to back up your assertions with factual evidence like both Kathleen and myself have. Subjective and emotive comments like _"denying your intestines probiotics in any form is insanity"_ does nothing for your credibility.At the end of the day we are only trying to help each other get over a debilitating disease that our doctors can't do much to help with. I have learned a lot on here and I wanted to give something back.


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## Kathleen M.

I don't think we survived millions of years without a single probiotic bacteria ever living inside any of us. They are part of the normal flora that likes to live in you. Even if you don't specifically try to take them you probably get some every once in awhile just because they are in the environment. A lot of them also commonly ferment food items and before refrigeration I suspect a lot of the food supply even if you collected it fresh every day and never tried to store anything was going to end up with some partially fermented foods.People often don't get enough on their own to effect things like gas volume, so for some people bumping up the concentration of probitoics will change their symptoms over whatever the usual background amount of probiotic species they normally wander around with.


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## frantic1980

IanRamsay said:


> If you take a antibiotic for sibo, you need to start off teh repopulation process with gram positive bacteria in numbers.


Re-population process??? The bacteria population is the problem. There should be NO Bacteria in the small intestine. I strongly encourage you to go do some research into how the small intestine works. In a healthy person it should have no population of bacteria. You're talking about wiping out your SIBO then reintroducing it. Bacteria should pass through your Small intestine on the way to the colon, but you seem to be under the impression that they take up residence in the small intestine; yet they do not. That's not how the small intestine works in a healthy person - it does not contain bacteria!


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## frantic1980

Kathleen M. said:


> I don't think we survived millions of years without a single probiotic bacteria ever living inside any of us.


Quite right Kathleen, what I meant to say was "....survived without probiotic supplements"


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## IanRamsay

Humans and animals have survived for 100 Million years without probiotics?do you know where probiotics come from? there in teh earth, on rotting fruit and veg, basically they are everywhere. you cant avoid them if you tried. the only time you are free of abdominal bacteria is when you are born, and even then it is only brief. these are some of the 1000`s of papers that i have used in my research over more than a decade. as you askedO'Mahony L, McCarthy J, Kelly P, Hurley G, Luo F, Chen K, O'Sullivan GC, Kiely B, Collins JK, Shanahan F, Quigley EM. Lactobacillus and bifidobacterium in irritable bowel syndrome: symptom responses and relationship to cytokine profiles. Gastroenterology. 2005 Mar;128(3):783-5. Nat Clin Pract Gastroenterol Hepatol. 2005 Jul;2(7):304-5.Caitlin O'Mahony, Paul Scully, David O'Mahony, Sharon Murphy, Frances O'Brien, Anne Lyons, Graham Sherlock, John MacSharry, Barry Kiely, Fergus Shanahan, and Liam O'Mahony. Commensal-Induced Regulatory T Cells Mediate Protection against Pathogen-Stimulated NF-?B Activation. PLoS Pathog. 2008 August; 4(8): e1000112. Published online 2008 August 1. doi: 10.1371/journal.ppat.1000112.Huffnagle, Gary. The Probiotics Revolution. Bantam Books 2007.


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## IanRamsay

Oh, and FYI, bacteria of all kinds DO take up the entire Digestive tract, from the mouth to the rectum. and i know, in minute detail, how the small intestine works. Ian


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## freakzilla154l

Hey all, I'm on day 11 of Xifaxin. For the next 10 days, im taking 2-200mg tablets 3 times a day. The last 10 days were 2-200mg tablets 2 times a day. Anyways, I haven't had any relief at all. I actually think I'm constipated... It's always one way or the other? Never understood it.I'm eating tons of greens and getting my fiber in. Is there any fiber supplements anyone would recommend? I think more is better...frantic1980, I'm also taking glutamine and using the GSE. I will start adding it to oatmeal to see if there is a difference. I also occasionally taking pepperment capsules, but not regularly like I should. After already being on the xifaxin for 11 days now, I was expecting to feel better, but that's not the case at all. My Bowel Movements are actually worse! There's more blood, but not too much and some mucous. The worse is the gas in my colon... Why???? There's only gas there, not in my stomach!I have been using canasa suppositories, but no other meds.... I stopped my Lialda, b/c it was doing zero!I can't believe to this day that I fell victim to this illness, b/c that's what it is. And no one understands til they encounter it. I can't believe it!My three main complaints:1. Fatigue2. Weight Loss - Malabsorption3. Skin Rash (Scalp/Face)Thanks for the postings everyone (frantic1980, Ian)


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## frantic1980

hey Freakzilla!The oats are basically to transport the Glutamine through the intestine. Alpro (non-probiotic) also works. Glutamine is very soluble in water and if you don't use something to transport it it gets absorbed early in the digestive tract.Are you saying you've gone from having diareha to taking xifaxan and are now constipated or are now more constipated that you were pervously? My problem was always IBS-D. Dr Pimentel talks a lot about the need to re-start the cleansing waves after treatment with Rifaximin. Its important that things are keep moving down there as poor motility could easily bring your SIBO back - this is why I (and also Dr Pimmentel) believe that probiotics are bad when you have SIBO, with poor motility the probiotics will just pool in your small intestine again.I am not sure what the solution is in your case to be honest, but its important that you keep things moving after your rifaximin. If you can get some low-dose Erythromycin, Zelnorm or some other drug that increases cleansing wave & bowel emptying activity and keeps your bowls moving then your chances of your SIBO recurring will be much lower. Dr Pimentel also says eat low-residue food. I don't think you should be eating all those greens & fiber... surely fiber is bad for constipation, isn't it?I sometimes feel a little constipated now. Takes a good 20 mins to take a dump sometimes but after 8 years of diarrhea its a very very welcome 20 mins.Have you been tested for Celiac or Crohns? The rash sounds like you might have an allergy to something, and the blood/malabsorption sounds like gastroenteritis or something. My workmate had a rash he was going to the doctors about for years and it tuned out he was allergic to eggs!!I really hope you have good results with the Rifaximin.


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## freakzilla154l

hey frantic, It's always been back and forth with me, even before the xifaxin. It's still the same... Sometimes it's IBS-D or IBS-C. Always alittle blood and mocous.Do you know why I have so much gas in my rectum, or lower colon?I had a blood test about 3 yrs ago that said I did not have celiac, but is that really accurate? And a year ago I had to swallow the pill with the camera to check for crohns and that was fine. I'll look up gastroenteritis.... I know when I take HCL tablets, I'm less gases but it only lasts a few days!I hate this!!!


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## frantic1980

OK... makes sense.When my digestion was really bad that I had really bad gas too. I think this is because carbohydrates are making their way to your colon (and your body's bacteria) where the carbs get fermented producing gas. In the small intestines, the carbs are supposed to be broken down into glucose (before being absorbed into the bloodstream) by acid and enzymes. This process should not involve bacteria and therefore should not produce gas. http://www.annecollins.com/digestive-syste...e-digestion.htm you will notice that bacteria aren't mentioned anywhere there. or here: http://www.google.com/search?q=carbohydrat...tines+digestion As far as I understand, gas happens in the lower part of the digestive tract when carbs aren't fully digested by the small intestine and make their into your colon where the bacteria eat (ferment) them and produce gas. Bacteria produce gasses when they digest - which is why we don't have any in our small intestine.Bacteria can't survive in acid which is why the small intesine is sterile - its very acidic. Bacteria themselves produce an alkaline (opposite of acidic) environment which makes a perfect environement for even more bacteria and the lack of acid makes it difficult for you body to digest carbs, giving food for bacteria and an even less acidic environment. -- its a vicious cycle.... BacteriaThis is just my understanding. I don't claim to be an expert, and i am not a bilologist, I've learned everything i have on these forums and online. Maybe ask Kathleen to confirm this, she's got a ph.d in biology. but the fact that HCL improves things seems to indicate that your intestine is not acidic enough - non acidic environments are perfect for bacteria to accumulate. I think this is why the grapefruit seed extract kills bacteria - like the natural environment of the smal intestine it is very acidic.The celiac test is only accurate if you were regularly eating wheat/barley/rye or other gluten-containing grains at the time of the test. Sometimes people recognise these as triggers for their problems and cut them out.... then when they have the celiac test it comes back negative - the antibodies that they test for when detecting celiac are only there if you have eaten gluten in the last week or so, so its a false negative. if you were eating gluten around the time of your test then it should be an accurate result.I think maybe the fibre needs to be removed from your diet for now.... pimentel says stick to easily-digestible low-residue food that doesn't leave much left over by the time it reaches the colon.


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## freakzilla154l

I'm just gonna stick with the regiment I'm on now. I'll wait til I'm done the Xifaxin and see what happens. I need the fiber or my bowel movements will be a mess. Thanks for all the info.


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## freakzilla154l

Can you send me a link to the book that you keep quoting? I'm gonna buy it and read it. Thanks


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## IanRamsay

Hi FreakTry some high strength bifidus infantatis. just for a few weeks, and see how you feel. here is some general info on taking and getting the best from your probiotics.the following strains have teh most research behind them in IBS studies with good positive outcomes in studies.L. bulgaricus, L. reuteri, L. plantarum, L. casei, B. bifidus, Lactobacillus Plantrum 299V, S. salivarius, and S. thermophilus and the yeast Saccharomyces boulardii. Bifidobacterium infantis 35624 THERE ARE MANY MANY OTHERS though!here is some general info on taking them, if you dont already know it!They are best taken in the morning on an empty stomach, 30 minutes before food. ideally they should be taken for at least 3 weeks as it may take that long to see any results. although some people have a very good reaction in days. after 2 to 3 months they should be stopped for a while. if after a few days you start to notice that you can feel a physical difference or a worsening of your symptoms, start taking them again. other wise, there is no need to continue taking them untill you feel that you do need them. there isnt any harm in taking them as a permanant suppliment if they are taken is small numbers like in actimel or activia yoghurt, but if you are taking 10 billion cultures a day, it is good to give the body a break every now and then.also If at all possible, replace the FOS prebiotic with natural fruit and veg if you can tollerate it. FOS can play hell with the tummy in some people while it dosent bother others.After you start to take the probiotics, you may feel initially worse for a day to a week or so. this is called the herx reaction and unfortunately is perfectly normal. (Google it to get more detailed info). some people are not affected by herx and some are.if it gets too much though, just stopp teh probiotics for a few days and re start them at a half dose for a two weeks, then a three quarter dose for two weeks and then the full dose, and see how you get on with that.CHeersIan


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## frantic1980

Hey freakzilla, here are the links to the book... not sure if you are in the USA or not but you can get it at amazon in your local country I got mine at amazon.co.uk as I am in the UK. Its a really great book; changed my life! I found about it on this forum and loads of people on here have read it. Try to finish reading before you finish you rifaximin though.... rifaximin gets less effective each time you use it so if you can nip this on the butt first time then your chances of it never coming back are much better.http://www.anewibssolution.com/http://www.amazon.com/New-IBS-Solution-Mar...6826&sr=8-1http://www.amazon.co.uk/New-IBS-Solution-M...6826&sr=8-1"Another problem with probiotic supplementation is that the cleansing waves in the small intestines of IBS patients are inadequate. It's possible that a person with diminished cleansing wave capacity who takes probiotic supplements could find his or her situation worse, as the probiotics accumulate in the small intestine where they don't belong"


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## IanRamsay

Bacteria are transient, so wont stay in the system boyond that of which they are needed, regardless of your "Clensing wave capacity". if the body wants them out, it will get them out. Gram postivie bacteria CANNOT harm a person. unless you are reading research papers that i dont know about. Honestly, i dont make this stuff up, or all my training has been in a fantasy world and i am in fact dreaming..........Ian


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## overitnow

> Bacteria can't survive in acid which is why the small intesine is sterile - its very acidic. Bacteria themselves produce an alkaline (opposite of acidic) environment which makes a perfect environement for even more bacteria and the lack of acid makes it difficult for you body to digest carbs, giving food for bacteria and an even less acidic environment. -- its a vicious cycle.... Bacteria


From what little I know about the acid levels in the small intestine, it is that they are somewhere between pH 6 and 8. (7 is neutral.) It would make sense that if this has turned somehow basic either from the bacteria overgrowth or from another cause, GSE would neutralize that; but other than at the duodenal opening, I believe it is not acidic at all.Mark


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## IanRamsay

spot on Mark. Ian


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## frantic1980

IanRamsay said:


> Bacteria are transient, so wont stay in the system boyond that of which they are needed, regardless of your "Clensing wave capacity". if the body wants them out, it will get them out. Gram postivie bacteria CANNOT harm a person. unless you are reading research papers that i dont know about. Honestly, i dont make this stuff up, or all my training has been in a fantasy world and i am in fact dreaming..........


I was using these forums because I had Small Intestine Bacterial Overgrowth that means that bacteria were pooling in my small intestine and were not "transient" as they are supposed to be. I know that bacteria are *supposed* to be transient between the mouth and the beginning of the colon, working their way downwards like our food - but we're all here because things ARE NOT working the way they should be.... this is the SIBO forum. Just a few posts back you were talking about 'repopulating' the small intestine now your saying that the bacteria is just passing through there...I don't claim to be a bacteria expert or have 12 years of training/research like you. I've learned everything I have on the web and on these forums. I program web servers for a living, I am not a biologist or a doctor and therefore I'm no expert. But my understanding about what I read on wikipedia about Gram Postitive / Negative is that its a detection technique for bacteria: G-positive bacteria have a positive result on a gram-stain test and G-negative bacteria do not stain - you seem to imply that GP are all good bacteria and GN are all bad bacteria. What about Clostridium difficile (the well known hospital bug C-Diff!!!), Staphylococcus aureus - Clostridium perfringens, Bacillus Cereus all gram positive pathogenic bacteria that cause serious harm. There's even a whole book about gram positive pathogens.Yet you say and I quote _"Gram postivie bacteria CANNOT harm a person"_I spent hours writing a long post about what I learned since discovering that I had SIBO a year ago and how I applied it to finally defeat my IBS which has been with me for 8 years. I wanted to take time and write this to help other people rather than leaving without sharing my knowledge but I have been very upset by your efforts to wade in and totally dismiss my efforts based on your with your "so called expert bacteria training". You are the only person on these forums who asks other people to accept you as some kind of expert - yet you make totally astounding claims like "repopulating the small intestine with bacteria" and "Gram postivie bacteria CANNOT harm a person". I actually think its pretty scary that you come on here and give people advice and tell them that you are some kind of expert therefore giving false credibility to your advice. I don't understand what your problem is or why you're so intent on knocking down my efforts to pass on what I have learned, but I have no belief in your credibility or in your expert bacteria training. So in response to your question has_ "all my training been in a fantasy world and i am in fact dreaming.........."_ -- based on what i've read so far on your posts.... yes, I think it probably is a fantasy.


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## IanRamsay

Steady. And FYI, ii was talking about Probiotic bacteria being transient. (allthough in theory and practice all bacteria is transient in one way or another).Gram positive bactera cannot harm a person in the numbers that it enters the body from the natural world (within reason). once inside, thats a different story. do you know what, i cant be a***d. i have never once given anyone advice that has harmed them, and i sure as hell have never told anyone to do anything that may worsen their symptoms or illness. and judjing by the amount of people that contact me saying thankyou, i dont think my advice is all that bad. i hope your recovery continues. but if it dosent, dont ask me for advice.Ian


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## freakzilla154l

Hey everyone, sorry I haven't posted.... I've read all the post though. I'm on a mini vacation with my girlfriend. I'll be back home later tonight and I'll write more.Well, I feel extremely constipated. I still on the xifaxin. It's been 13 days today. I'm having blood in my BM, which I didn't have before I started the xifaxin. I just feel like I have to go. Even coffee isn't really making me go now, which always does......I've been only using a canasa suppository every other night, but I stopped my lialda when I started the xifaxin.I still can't believe this. I'm still tired, my skin and these plugs are awful, and i know i'm not absorbing zero!I will be back later and discuss things. Thanks for everyone's comments. BTW, I ordered the IBS book. Thank You! Can't wait to read.


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## Kathleen M.

If you have more than just IBS going on then it may take more than IBS remedies to get you really feeling well.If your IBD is flaring up with the bleeding and all that even if you get the functional GI problems you may have on top of the IBD under control you are still going to feel lousy from the immune system going nuts.I "just" have allergies which are usually not nearly as bad as an autoimmune problem (does the doctor know you stopped some of the IBD medication when you started the antibiotics, and was that for a particular reason, like an interaction) and they can leave me totally wiped out from the immune system freaking out.I think any antibiotic can set you up for a C diff infection and that can sometimes cause blood issues, but usually with diarrhea, not constipation.Constipated hard to pass stools will make any bleeding problem at the outlet somewhat worse as they tend to tear at tender tissue rather than pass out smoothly, so it could just be the stool consistency issue.Have you talked to the doctor about how bad things have gotten since you started this medication? It might be time.


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## freakzilla154l

It's tough... All the docs keep telling me it's all about my GI issues . I have to get this under control..... So that's all I can go by. It's so confusing! I stopped the lialda, b/c it really does zero for me. The canasa suppository do help though.What other medication should I be taking with the Xifaxin? I'm going to see my therapist tomorrow and I'll ask him for it... Is it neomycin or erthromycin? What milligram? I have to beat this. I have about 7 days left of the xifaxin.


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## Patman75

freakzilla154l said:


> I stopped the lialda, b/c it really does zero for me. The canasa suppository do help though.


Sorry, I dont want to but into this spirited thread, but.... Freakzilla, do you have IBD? Ulcertative Colitits or Crohns. The meds you discuss are used for IBD not IBS.


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## frantic1980

Its weird that your skin is affected; I am pretty sure that coupled with digestive problems this strongly indicates a food allergy.http://www.healthy-skincare.com/food-allergy-rash.htmlhttp://www.gfree.co.uk/food_intolerance.htmMilk, Wheat and Eggs are usually the biggest culprits. Have you tried eliminating any of these to see if things improve? You said in a previous post that you are taking LOADS of fibre and greens; surely these are causes of constipation rather than solutions?Another stab in the dark: What color is your pee? Anything darker than crystal clear or clear with a very light yellow indicates that you're dehydrated; which might make you constipated and make your skin dry. http://www.realbuzz.com/static/images/microsites/lucozade/pee-chart-small.jpg ://http://www.realbuzz.com/static/imag...hart-small.jpg http://www.causeof.org/dehydrate.htm#DehydrationEffectsCons


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## freakzilla154l

Hey Patman, as of 3 weeks ago, there were no signs of proctitis, just alittle bit of inflammation and my GI said it was IBD. He lowered all my meds. But the lialda does nothing for me, so I only use the canasa.I really never tried to get rid of wheat. I stopped dairy for awhile, with the exception of coffee. I've tried the rice cakes with no gluten or wheat, but there is no alleviation of any sort. I do drink tons of water, but sometimes my pee is orange/brownish and tingles alittle. However, it's usually clear. It's only brown in the morning sometimes. I had a urine sample done about 3 months ago and there was a trace of leukocyte esterase. My doc at the time said that it could a slight UTI and not to worry. WHo knows?Gotta go. Be back in a few hours... Thanks everyone!


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## freakzilla154l

Can I take both Xifaxin and Neomycin at the same time? If so, what does of neomycin? Thanks


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## frantic1980

Yeah you can take them at the same time... Pimmentel prescribes this for patient's whose symptoms come back. The dosages of these drugs vary dramatically for some reason. The max dose of Rifaximin is 1800mg per day and the max dose of neomycin is 10000mg or something stupid like that. I was taking Neomycin at 1000mg 3 times per day along with rifaximin 400mg 3 times per day.


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## freakzilla154l

my therapist prescribed it for me. It's the same as the xifaxin. 400 mg 3/day... So 1200 mg total. This was not my GI.... SHould I take them both. I only have 7 days left of the xifaxin.. Don't know what to do????CAn it hurt at this point???? Really..


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## frantic1980

Hang on did your therapist prescribe you Neomycin or Rifaximin??Cos Rifaximin is the same as what you already have (Xifaxan) which is the American brand name. So whenever I say "rifaximin" in my posts what I mean is "xifaxan" they're EXACTLY the same chemical. You should be trying Xifaxan and Neomycin. I'm a bit confused cos it sounds like you got a prescription for the same thing in a different name!


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## freakzilla154l

hey frantic, No he gave me neomycin, 400mg 3/day. I didn't start it yet b/c it wasn't my GI who prescribed it to me. I've been on the xifaxin for over two weeks now. I have 5 days left i think. My BM are nothing but tons of gas, diarrhea, and some blood.... I dont get it... It's gotten worse since I started the xifaxin. Is this normal?Sorry for the confusion. Should I try the neomycin? If so, do I take it along with the xifaxin?BTW, i was looking on the internet and i came across something interesting...MASTOCYTIC ENTEROCOLITIS... Google this and check it out. Alot of this goes hand in hand with my complaints, especially the skin rashes.I'm also taking a teaspoon of Apple Cider Vinegar 2x/day.... Thanks!


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## frantic1980

I think you have the best chance of success taking them both together.


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## freakzilla154l

Hey frantic1980,I just read the drug facts on neomycin and it seems dangerous. I'm surprised at this. Are there test I have to get done or things I should be cautious about?Let me know, cause I'll start later today. Also, should I take them at the same time as the Xifaxin? Thank you!What do you think about the Mass Cells?


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## frantic1980

Yes I read the same thing about neomycin toxicity.... this is why rifaximin is the preferred drug now. As far as I understand it Neymycin is a nonsystemic antibiotic and does not pass through the lining of the gut into the blood stream. Very very little gets through. the problem is when you take very high doses 14000mg per day the 'very very small amount' that does get through is now a much larger amount, so taking very high doses for months at a time has been known to cause problems.A small dose for 10 days or less is aparently fine though - this is why it has not been de-approved by the FDA. its only high doses for prolonged periods that are bad.I skimmed the Mastocytic thing quickly. The connection with the skin rash is a result of histamine production - as I understand it, this is what gets released when you are allergic to something. hayfever remedies are 'antihistamine drugs' because they relive symptoms of hayfever by blocking the histamine that your body produces in reaction to pollen.One of the symtoms of the MAstocytic enterocolitis is excess histamine production which is why you associate it to your skin rash. I think a much more likely explaination is that you are allergic to something you are eating, which would also cause a skin rash due to histamine. To rule out to masto... Get some hayfever remedies from your phamacy and see if they solve your digestive problems (apparently the treatmet for mastocytic.... are antihistamines). I doubt it though when you consider the number of people that have this illness and the number of people who have common food allergies, I think its a lot more likely that you have a food allergy.NB I am not a doctor or a medical professional so I am not qualified to give any kind of medical advice. This is just my basic understanding of things.


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## freakzilla154l

thanks for the comments. I gonna take...I still didn't get the IBS book. Is there a special diet i should have been doing all along?


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## frantic1980

Avoid simple carbohydrates.... Sugars & fructose (the sugar found in fruit), Lactose (the sugar found in milk). Sweetners are even worse though - so diet drinks are totally out! Aparently Aspartame is not so bad but Sorbitol (Potasium Sorbate) is the worst sweetner. I'd avoid them totally though.


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## freakzilla154l

ok, so no fruit at all...? I usually make myself fruit smoothies and green smoothies. I use spinach, kale, apples, bananas, all berries, soy milk, and kiwi... I thought fruit was ok, not simple sugars from candy and chocolate?Also, I thought with taking this medicine that you should eat everything? I haven't been watching what I eat....


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## freakzilla154l

Is it ok to take coconut oil and/or olive oil?


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## freakzilla154l

Sorry to be asking so many questions, but I still haven't received the IBS book so I'm not sure what I should and should not do.Is there a type of protein supplement shake that I can take? I was taking the whey by Jarrow, but I dont think it agreed with me... This is important... I need a protein supplement, cause I'm shrinking to nothing..Thanks!


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## frantic1980

yeah oils are fats which are fine because bacteria don't feed on them. Something like the Atkins diet (protein and fat only) would probably completely starve the bacteria.I didn't eat wheat when I had IBS symptoms because it made me much worse but I ate it whilst on the drugs and I was fine. There's a whole chapter in the Pimentel book about what to eat and what not to eat. But I can't really type it all out here.


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## freakzilla154l

I'm alittle confused, but whatever... I'll have to wait to get the book. thanks!


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## frantic1980

I think the book basically pretty much says the followingBad FoodsSugar (Surcorse)Corn SyrupLactose (milk sugar)fructose (fruit sugar)Sweetners-Mannitol-Sorbitol-Sucralose (splenda)LactuloseSugar free gumLimit or avoid high-residue foods which leave residue in the small intestine:BeansLentilsSoy Products (milk tofu)Yoghurt, Milk, CheeseGood/Acceptable Foods - no need to limitBeefFishPoultryEggsPotatoesPastaRiceBreadCerialsOats"believe it or not, white bread is best in this circumstance. Try to keep multigrain breads to a minimum...." -- didn't realise this before but just read it in the book."Fruits should be eaten in moderation - no more than two pieces a day. Fruits contain fructose which is difficult to digest. Fresh not dried fruit""fresh nonstarchy vegetables cooked or steamed, not raw, as they are easier to digest when cooked. Avoid large salads full of raw vegetables as this can lead to too much residue.... do not eat vegetables exclusively as they are hard to digest""dairy should be avoided because of lactose, use almond or rice milk instead; not soya milk" "coffee tea and soda in very moderate amounts" Diet sodas are totally out


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## frantic1980

I actually take protein for muscle building.... its amazing since I finally got rid of my SIBO I have stacked about 4 kilos of muscle!!I use CNP Pro Mass after my workout - it seems to be fairly easy to digest. Its got whey protein, casein and I think they put stuff in it to make it digestable. Put some drops of Grapefuit seed extract in. The carb in this one is Maltodextrin - I don't know what the story is with bacteria and maltodextrin; i've looked into it several times but couldn't find an answer. I wasn't taking this stuff while I was being treated though - stopped going to the gym for a while so didn't need to.between workouts I use egg white protein rather than whey protein - just seems like a safer alternative for IBS. Again I don't have any definite ideas when it comes to this. The pro mass is fine for me now that I am SIBO free, but I would probably avoid when being treated as I don't know if the bacteria feeds on maltodextrin or not.


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## freakzilla154l

Thanks for all the details frantic. My diet is not exactly the way it should be. The white bread really surprises me too and so does the fruit. I thought most fruit wouuld be fine, but it makes sense as it is hard to digest.Well,, I only have today and tomorrow until I'm done the Xifaxin.... I guess I was expecting more out of it! If only I could get rid of my dry skin/rash, I think I wouldn't mind the IBS as much. I just feel that this is all related.I think I'm gonna try to eliminate a food soon. I may go with dairy first, then wheat. Wheat will definitely be much more difficult for me as I eat pasta and breads. I just never had this skin rash and dryness before any of this started.. Is there a substitute of cream or half and half that I can put in my coffee! This will be the only hard part with dairy. I also do use plain sugar, but it my coffee!I will hold off on the protein shakes, I guess.....Thanks again!


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## freakzilla154l

Also, should I be on an anti-anxiety and or anti-depressant? I;m always stressed and worried and in my head... Would this help?


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## *Amz*

Since ive been taking probiotic supplements my ibs symptoms arond my time of the month (when iget them) have improved alot. I dont get as badly bloated or constipated.They also work for my mum. i think that everyones body responds diffrently and that if probiotics dont work for them or make there symptoms worse they should stop, but for me its defintly been a help. I havent noticed any negative for it and my dr actually told me to take them as ive taken alot of anti-biotics in the past and 'bad bacteria' may be making my symtoms worse.


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## frantic1980

Hey AmzI also used probiotics to alleviate IBS symptoms, but I noticed that if I took probiotics during my treatment with antibiotics for my Small Intestine Bacterial Overgrowth that the probiotics cause the antibotics to have little/no effect. I also noticed that when I started taking probiotics after my treatment that it caused everything to return. I finally got rid of SIBO by cutting out the probiotics as recommended by Dr Pimmentel.If you decide to take the rifaximin/neomycin route then I would suggest you do the same. I took probiotics myself for over 2 years and they do provide great relief but my excperience was that to get rid of my IBS/SIBO completely that they need to be stopped. I tried 5 times before I finally cut the probiotics out and i've been IBS free for a few weeks now.I actually don't know anybody who takes probiotics who don't have IBS or other digestive problems. I am not saying that the probiotics are causing IBS, I just don't think normal healthy people need to take them - but they do provide relief for people with digestive problems. Some people on these board seem to think they are essential and its madness for anyone not to take them - we've all been brainwashed by the yackult advert if you ask me.


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## frantic1980

Hey freakzilla. No problem , hope the info helps.Do you think your Anxiety is related to your IBS? I've been on anti-depressants 3 times since I've had IBS, don't know if that's what caused it or not... I keep some 5-HTP handy for when I get on a downer - usually after a night of drinking. 5-HTP is the precurser to serotonin; the neuro-transmitter that promotes the feeling of happiness in the brain. I find it really helps, especially taking them before bed.


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## IanRamsay

I take probiotics and i DONT have IBS or other GI issues any more. there are a few of us on here actually.....


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## freakzilla154l

I got the ibs book today. Gonna start reading tonight. Also my last dose of Xifaxin is tonight... My plan is to read the book, get the knowledge, and then start everything all over again with the meds. I didn't do any specific diet at all. So, this is my plan!When is the earliest I can start the Xifaxin again? Should I wait a few weeks? I don't see my doc for 3 weeks.


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## IanRamsay

Christ alive man, speak to your doctor BEFORE you do anything else. please run the dosage, drug type, diet, additional probiotic supplementation and time frames for starting and ending the courses by him or her. basing your entire treatment theory from a BB is madness when Pharmaceutical drugs are concerned that can, in teh wrong dosages and in teh wrong time frames do you physical harm.Please speak to your doctor before you do anything else. get him on the phone if you have to, just run it all past him first.


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## freakzilla154l

hey ian, i hear you... I'm done my xifaxin. its been 20 days and i feel worse believe it or not.. im actually having a lot of blood in my BM.anyways, im half way done the book. it's interesting. Im gonna call Pimentel's office to see if there's a doc in Philadelphia,PA that follows his protocol.. This is ridiculous!Ian, did you have success with his protocol or did you follow anther game plan? Probiotics have never given me relieve and I've used them for a long time!Thanks!


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## IanRamsay

HiI diddnt follw pimantels plan. I have however tried a huge amount of single strain probiotics (alot of which i have cultured myself) untill i finally found the one that my body needed. it is very possible that you havent had any luck with probiotics because you havent found the one that you need. It took me 12 years.cheersIan


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## freakzilla154l

Hey frantic, What did you do the other 5 times that did not work? Did you use antibiotics all them times too? I'm just curious...Thanks!I called Dr. Pimentel office to see if they know a doctor in Philadelphia, PA that follows his protocol. They are going to call me back. I'm definitely constipated and I think this has held the xifaxin from working... I'm gonna take some senna tonight. hope it gives some relief.


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## frantic1980

Hey freakzilla,The other 5 times I took probiotics!!! I'm really getting annoyed now - Ian goes on and on about his bacteria (I thought he'd left after being exposed as a fraud). He has provided relief for his IBS by forcing his digestion to work in a way that is not normal and if he stops taking his probiotics things will go downhill again fast.I used to be dependent on probiotcs - I couldn't live without probioics before every meal at one point. I remember one Christmas going to visit my mother in a small village in scotland and was in a state of panic when I got halfway there on the train and realised I forgot mine! Had my sister running out looking for some on Christmas eve. Ian will sooner or later realise what i did which is that probiotics, although they provide relief will never cure you and when you stop taking them things will go back to normal. (See again the quotes from Dr. Mark Pimentel on my orignal post)This "one probiotic strain that your body needs" is the latest fantasy. There are over 500 bacterial strains in the Colon and ZERO in the small intestine of a healthy person. I fail to see how one magic strain can fix things and as usual his claims are not substantiated in any way. IAN: If you've got your own advice to share about your experience of curing your SIBO then I would kindly ask that you go start your own thread. Provide concrete details of your "magic strain" so other people can try it. Give citations of why this cures SIBO despite the small intestine having no bacteria. So far all i've heard is your self-declared status of 'expert' that has been exposed as false and fraud and a copy-pasted list of cultures with no proof, no citations and no credible scientific explaination.


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## freakzilla154l

Well, things are really bad. Much worse now that I'm done taking the Xifaxin. It's been 6 or 7 days and before I started the Xifaxin I was in much better shape. My BM are very bloody, mucous, tons of gas, and constipation and or diarrhea or both. It's really got me F'd up. My skin looks awful and this just isn't fair. I have no idea what to do. I feel like I tried everything. I'm almost done the book, but I'm not even that optimistic about the outcome of all of this. I also just saw he pharmacist and I told him my situation about IBS/SIBO and that I just got done the XIfaxin and how things have gotten worse. They ask if I tried probiotics and I said all of them...at least all the strains, maybe not all the different brands. They told me to try Floragen3. I've tried the strains that are in it. THey said many people love this brand and come back for more.. I didn't get it yet, but will read up on it. I just know in my head that I've spent so much money on probiotics in the last 3 yrs, that it's unreal. So, I'm just pondering what to do.Also, she said aumentin, the antibiotic can be used to treat SIBO. She did say how much of a vicious cycle it was.BTW, Primental's office called me and referred me to Dr. Jeffery Danzig in YOnkers on the east coast. I have no idea what to do. I'm really confused and cant believe I'm worse off now, than before.....


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## IanRamsay

HiHow long have you given each probiotic that you have tried? in an ideal world you need to start taking teh probiotic a couple of days before the end of the antibiotics or the day after you stop the anti biotics, and continue taking them daily first thing in teh morning for at least 4 weeks. you also need them in numbers of 3 Bil and above. when i suffered the nightmare of sibo some 8 years ago now, the only way i found relief was doing it teh above way. i tried everything including not taking probiotics. over a two year period i used my self as a guinie pig for all sorts of things and pharmcuticle drugs and different cocktails of proibiotics. i have been free of sibo now for six years and have a breath/stool/blood test every 6 months to check levels. I continued to take the probiotics daily there after constantly changing teh strains untill eventually i found one that fixed teh IBS/GERD and GASTRITIS all in one. to a certain extent it dosent matter what probiotics that you take after teh antibiotics as long as you take some to get the bacteria in the colon up and running. then teh small intestine will take care of its self. or at least that is how it worked for me.When i was 8 i had a nasty stomach bug which i believe started off the IBS and to some extent sibo as well. (in one way or another its all connected anyway!) thats when the IBS started and was constant for almost 20 years after. the sibo i think was always there in the back ground but too another stomach bug much later to kick it off. luckily by that time i was at university studying biology so i was better prepared for it and had already started playing with probiotic bacteria.sadly, SIBO tends to come back in waves. probiotics are the only way i have managed to take controll of it and at the time a very restricted diet as well. i have now been clear of all IBS etc (touch wood) for well over a year and sibo for over 6 years. i still have the odd bad day, but thats life. just out of curiosity, have you had a colonoscopy recently? teh blood in teh stool as far as i know isnt typical of SIBO (i may be wrong on that).cheers, dont loose hope.Ian


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## frantic1980

Augmentin is basically an Amoxicillin / clavulanic acid comnination drug. As far as i know the Clav Acid is to beat the resistance that some bacteria build towards amoxicillin. I took this drug and had very good success (I think on my 3rd and 4th Attempts), however I took probiotics afterwards and my SIBO came right back. I don't know whether it would have come back anyway - all I know is the only time I got rid of it for good was by not taking any probiotics.One thing I do agree with Ian about Freakzilla is that many of your symptoms don't fit with SIBO.... Never heard of SIBO affecting your skin, as I mentioned allergies do though, blood - never heard of people having blood on here, but since SIBO symptoms are caused by bacterias that produce toxins then the toxins can cause gastoenteritis. I dunno its weird. I would try the augmentin if I were you - worked for me but things came back.Get a small dose of Metronizodole as well if you are taking Augmentin. The problem with taking strong broad-spectrum antibiotics is that they kill the bacteria in your colon too. When the good bacteria in the colon die a bad bacteria that most of us have in very small numbers (C-Difficile) can flourish. C-Diff is a gram-positive toxin producing bacteria that causes watery diareeah and is the cause of "antibiotic associated diareeah".


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## freakzilla154l

hey guys, i had a party last night....and another today at 2.Anyways, Ian, I tried them all, so for now, im gonna wait it out until things fall into place. I had a colonoscopy about 6 weeks ago and my GI said it was IBS/IBD. There was no colitis or proctitis. Who knows? then a week after that I took the breath test and that came back positive. I definitely know that the Xifaxin exacerbated my symptoms. It's kind of upsetting how things are now. I feel like I took a step back. The constipation is awful. Would zelnorm or LD Erythromycin work?I had the organix test done about 6 months ago and that said I have an overgrowth of bacteria in the intestines of c.diff. This is through urine. I forget the lab, but it was expensive. My GI said it's 'GARBAGE'. LOL...I think the skin thing has to do with LGS and my intestinal tract being alittle damage. I know before this all started, I had no dry skin, never tired, weighed 25 pounds more, and felt like a million bucks! NOw, forget about it.THanks everyone!


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## MarcoITA

frantic1980 said:


> The problem with taking strong broad-spectrum antibiotics is that they kill the bacteria in your colon too. When the good bacteria in the colon die a bad bacteria that most of us have in very small numbers (C-Difficile) can flourish. C-Diff is a gram-positive toxin producing bacteria that causes watery diareeah and is the cause of "antibiotic associated diareeah".


 Hi frantic1980. Thanks for your being here. I've been diagnosed with SIBO/IBS by my gastroenterologist in Italy some weeks ago. I have BELCHING, bloating, abdominal pain and it seems my digestion/gut motility is very slow. I suffered from gastritis some years ago but the symptoms were VERY VERY different. My gastroenterologist gave me Metronidazole (500 mg twice a day: 1 gr. a day) and, *SIMULTANEOUSLY*, a probiotic (this) that contains (guess what?)... *SORBITOLE*. Antibiotics had no effects... and SIBO is still there. Now, I'm going to read Pimentel's book. In the meantime I'm trying to starve bacteria with a very low-carb, no fiber diet... (rice for carbs... no fiber) One thing I didn't understand is: do you think it's better to take - just Rifaximin or - Rifaximin + a systemic antibiotics (like Metronidazole)? That's beacuse in your first message you said that "It might help to have a systemic antibiotic as well e.g. Ciproflaxin". But in that case don't you kill the bacteria in your colon too (... need probiotics while taking "systemic antibiotics"?) p.s. - sorry for my English, and thanks a lot... I appreciate very much your presence here. Marco


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## frantic1980

Hey Marco,Its weird your GI gave you Metronidazole as (as far as I know - I am not a doctor or an expert) its only effective on certain bacteria. I actually tried it myself when I first realised that antibiotics seemed to resolve things. Doing a bit of googling of diareeha and antibiotics I soon found out about AAD and Metronidazole. Unfortunately it had no effect on my SIBO either.Yes, my final time when I finally got rid of my SIBO took the antibiotics I used Ciproflaxin as well as Rifaximin/Neomycin. Ciproflaxin is recommended for E-Coli and since all my problems started with food poisoning I thought this was a good bet. Yes this did clean out my colon too and gave me watery diareeha consisent with Antibiotic Associated Diareeha (AAD) caused by C-Diff. I had 6 days of metronizodole left at 1000mg 3 times per day and this cleared it up completely. I did NOT take probiotics to recolonize my colon - my digestion just went normal again after a couple of days on the metronizodole, and most web sites say that AAD goes away after 1-2 weeks anyway. This goes to show that probiotics supplements are absolutely not necessary. Its difficult to kill ALL the bacteria in the colon, I think you would have to be on very strong antibiotics for over a month to kill everything - the colonies reform themselves after a day or so. A normal healthy person does not need probiotic supplements; even wiping out 99% of your bacteria you don't need them, the remaining 1% will recolonize in a couple of days. You just need to keep the c-diff (if you have it - not everyone has this bacteria in their colon) at bay while the good ones colonize again. Taking probiotics is far more likely to re-trigger your SIBO and put you back to the beginning. I must point out that I didn't have any medical advice - The National Health Service here in the UK is so stuck behind the times that my doctors told me I probably had anxiety that was causing my digestion to work too fast. I tried to explain the antibiotic link and about SIBO and even showed them the Pimentel book, I changed GPs 3 times hoping for a more open-minded one. In the end I did it all myself by getting my drugs at Goldpharma.com - they have Rifaximin/Neomycin/Cirpoflaxin/Metronidazole and pretty much everything else and you don't need a prescription. This was a last resort for me though - and if you have a supportive doctor I would STRONGLY recommend following their professional medical advice rather than taking things into your own hands as I did.PS your english was totally perfect, I had no idea it was your second language until I got to the end of your post.... and I am happy to stick around and help people out, I can't tell you how good it is to be rid of IBS after 8 years!! ( I am only 28 so its my whole adult life so far). I feel better, look better, have more energy, am stacking on kilos of lean muscle in the gym and really can't believe how my life has been transformed by getting rid of this. So I want to help as many people get over this as I possibly can.


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## frantic1980

Hey Freakzilla,http://www.springerlink.com/content/n07338t8w45u170p/As far as I know for IBS-C Neomycin is a better bet. See the link above....Yeah my 4 failed attempts at curing things my symptoms came back with a vengance afterwards, but settled down again. I don't know what to suggest to you as it sounds like you are suffering a lot at the moment, but I would try the neomycin if I were you. If you definitely have a positive breath test and you've got severe IBS-C, I think give the neomycin a try. Did you ever find the grapefruit seed extract? Check ebay or google shopping!


freakzilla154l said:


> hey guys, i had a party last night....and another today at 2.Anyways, Ian, I tried them all, so for now, im gonna wait it out until things fall into place. I had a colonoscopy about 6 weeks ago and my GI said it was IBS/IBD. There was no colitis or proctitis. Who knows? then a week after that I took the breath test and that came back positive. I definitely know that the Xifaxin exacerbated my symptoms. It's kind of upsetting how things are now. I feel like I took a step back. The constipation is awful. Would zelnorm or LD Erythromycin work?I had the organix test done about 6 months ago and that said I have an overgrowth of bacteria in the intestines of c.diff. This is through urine. I forget the lab, but it was expensive. My GI said it's 'GARBAGE'. LOL...I think the skin thing has to do with LGS and my intestinal tract being alittle damage. I know before this all started, I had no dry skin, never tired, weighed 25 pounds more, and felt like a million bucks! NOw, forget about it.THanks everyone!


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## freakzilla154l

Frantic, check your inbox. I sent you a PM.. THANks!


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## IanRamsay

DO NOT TAKE GRAPE FRUIT SEED EXTRACT with other medications at the same time. it can increase the toxicity and blood levels of some drugs. it can also interact negatively with some drugs. ask a doctor or pharmacist BEFORE you mix it with other drugs.cheersIan


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## MarcoITA

frantic1980 post='747743 said:


> I had 6 days of metronizodole left at 1000mg 3 times per day and this cleared it up completely.


 Hi frantic1980. When you say "1000mg 3 times per day", do you mean 3 gr./day or 1 gr./day? I've ordered Pimentel's book this morning. Sorry, but I have two more questions: 1) I didn't understand if the adding Grapefruit Seed Extract/Fresh Ginger and/or Glutamine was somehow advised by Pimentel or is your idea. Could you explain? 2) How many grams of Glutamine did you take each time? 5 grams? 10 grams? How about a "dessert spoonful"? Thanks again. Marco


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## frantic1980

Hey Marco... yeah I meant 3gr /day For some reason the dosages of Neomycin are totally different from Rifaximin. The minimum dose of neomycin is 1000mg and the maximum dose is 12,000mg (12 grams).I found out about the grapefruit seed extract, ginger and Ciproflaxin here: http://www.ei-resource.org/treatment-optio...rial-treatment/. Glutamine I provided a citation for, but I knew that the lining of my small intestine was damaged as an endoscopy via the mouth showed villius atrophy - which is usually consistent with chrons disease or celiac put I tested negative for both. I took a large spoonful or 3 heaped teaspoonfuls twice a day.



MarcoITA said:


> Hi frantic1980. When you say "1000mg 3 times per day", do you mean 3 gr./day or 1 gr./day? I've ordered Pimentel's book this morning. Sorry, but I have two more questions: 1) I didn't understand if the adding Grapefruit Seed Extract/Fresh Ginger and/or Glutamine was somehow advised by Pimentel or is your idea. Could you explain? 2) How many grams of Glutamine did you take each time? 5 grams? 10 grams? How about a "dessert spoonful"? Thanks again. Marco


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## MarcoITA

IanRamsay said:


> DO NOT TAKE GRAPE FRUIT SEED EXTRACT with other medications at the same time. it can increase the toxicity and blood levels of some drugs. it can also interact negatively with some drugs.


 Hi Ian. Any refs/link about relationship between GSE and other medications? Thanks a lot. Marco


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## MarcoITA

Hi frantic1980. I've read an interview with Dr. Pimentel and it seems to me he says his cure with Rifaximin isn't really a cure, but that it's a "treatment". Does it mean it isn't definitive? I remember another user in this Forum (visited by Pimentel) reporting the same thing was told by Pimentel to him directly.


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## frantic1980

Hey Marco,Not sure what Pimentel means by that.... Although I think the answer may be in the fact that IBS is a "Syndrome" not a disease. Therefore, IBS is identifiable by signs and symptoms rather than an identifiable cause. It would be reckless for Pimentel to grandstand his technique by saying he had a "cure" for IBS. Just as there is no "cure" for cancer; there are a number of techniques that can be used to beat it. It certainly is not difinitive and I have said it took me 5 goes before I finally beat it.


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## IanRamsay

MArcoIt is best to speak to your doctor about GSE and teh specific medication that you are on.CheersIan


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## MarcoITA

frantic1980 said:


> It certainly is not difinitive and I have said it took me 5 goes before I finally beat it.


 Yes. NOT DEFINITIVE... Look at *this * So... no hope to get rid of it forever. Why you say you are sure you finally beat it? I wish you all the best, but maybe you have to wait for some months... hoping it won't come back again. No?


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## frantic1980

Hey Marco sorry it took so long to respond, I am checking the forums less often now, but I will keep looking in now and again.Hmmmm... ok well according to my understanding of what I read in the abstract (and it confused me greatly, had to read it twice) its basically saying that 43% of patients relapsed after 9 months. This is very disappointing to read, I hope I do not have another recurrence. I have been totally clear now for 7 weeks I think, perfect digestion, one easy solid bowel movement per day; and I feel like I am absorbing and digesting the nutrients from my food for the first time ever, no nighttime hunger, and I am gaining loads of lean muscle mass in the gym. I hope it stays like this: I will be very disappointed if it comes back after a few more months.I think there are two kinds of relapses..... short term and long term. I've had short term relapses 5 times already. The antibiotics never got all the bacteria and they bacterial overgrowth reforms itself in a few days. With a period like 9 months, wouldn't you say that the overgrowth must have re-acumulated from extenal sources? I think the thing I learned from reading that abstract is how sensitive the small intestine is to bacterial overgrowth - its seems to imply that once you have it you never get rid of it. I think it helps explain things if you go back to basics, back to nature and back to how things were when you were a baby....http://books.google.co.uk/books?id=WeH2qA_...lt&resnum=3http://www.newsday.com/topic/la-hew-booste...0,4736976.storyWhen we are born we have a digestive system that has no bacteria whatsoever, none in the colon, none in the small intestine - nowhere. We pick up very small amounts of bacteria from suckling on our mother's nipple, from sucking our thumbs and generally from the environment around us. This tiny, gradual amount of bacteria we absorb gradually passes through our digestion to form into colonies in our colon where the bacteria in our digestion naturally belongs. This is why I strongly believe that probiotic supplements are one of the most unnatural substances we can put in our bodies. These days people take a capsule that already contains billions of bacteria, rather than a gradual accumulation of a few bacteria from natural sources. Our digestive system has evolved for 100 Million years by gradually absorbing a few bacteria from our environment, from our sucking mothers nipple, licking our partners body during sex, and generally from our environment; that's how nature intended it - just a small amount at a time. These capsules of billions of bactera are not natural and I believe cause more problems than they solve. Nature never intended us to receive this much bacteria in one dose. Yes I know people like Ian Ramsay, and most people with digestive problems go on and on and on about how good they are and how much they help. I was totally dependent on them at one point as well, they gave me great relief. I've actually spent hundreds of pounds on expensive probiotcs over the last few years; But I now totally believe that if you want to get rid of SIBO and stay rid of SIBO then probiotics are the worst thing you can take.I think a lot of people who have IBS continue to take their probiotic supplements after the antibiotic treatment and I believe that this is what is cauing their SIBO to come back. It took 5 relapses before I realised that probiotics were causing my symptoms to come back. We have all been brainwashed by these damn yoghurt adverts. They lead us to believe that bacteria are a vital part of digestion; yet they actually play a relatively minor role after 90% of the digestive process has been completed.So what I would say is - yes bare in mind that there is a good chance that once you get rid of SIBO that it could come back (there's a very good chance)..... and minimize this risk at all costs. DO NOT take excessive amounts of bacteria in pill form. That's not how nature intended it. Your natural colonies can maintain themselves, and will be topped up from what is received from your natural environment, or the natural exchange of bacteria between you and your partner. Do you know anybody who takes probiotic supplements that doesn't suffer from digestive problems? I don't. I have been clear now for almost 2 months so I do not think my SIBO will reform unless I receive exessive amounts of bacteria from my external enviroment. And I will NEVER ever again knowingly give my small intestine a large amount of bacteria in one dose that will allow my SIBO to relapse. Yes I know Ian Ramsay is going to protest wildly about this and claim to have a magic bacteria that solves everything - but given that he's never followed the Pimentel/Antibiotic protocol, I don't even know why he's in this area of the forums at all.SIBO may come back - but if you think like a new-born baby, it probably won't. Fingers crossed! I'm 2 months and counting!


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## IanRamsay

Actually mate, i have suffered from SIBO, for almost two years (if you read the posts i stated this earlier.) i have also followed teh pimantell structure, sadly it diddnt work for me and in teh spirit of science i did it twice as an experiment, the probiotics did, along with diet.no two people are the same where bacteria are concerned, but the one base line that is the same for all people is that teh bacterial balance, even in teh small intestine, must remain balanced, or problems start and are extremely hard to finish. and i dont have a magic strain, i identified a single strain that i modified that worked for me after trying almost all of them. what worked for me may not work for you, and i have never proffered that the strain that worked for me will cure everyone.


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## frantic1980

Unbelievable.... you, sir, are a liar, a fraud, and a downright weirdo.Ian a few posts back you said _ "Ididn't follow pimanel's plan.. I have however....probiotics"_ and now less than a week later you say _"i have also followed teh pimantell structure, sadly it diddnt work for me and in teh spirit of science i did it twice as an experiment, the probiotics did...." _ Your 'expert' claims are astounding, and just don't stand up to scientific reason.... now you seem to be blatatly lying to defend your stance on probiotics!!







I don't understand why you feel the need to claim to be an expert and lie to try and defend your points. I wonder if you're some representative from some probiotic company trying to quash any claim that probiotircs might be bad for SIBO.... I really don't understand what your issue is mate... but seriously...... I just don't understand!!! Why have you been trying to quash this thread since you wrote the first reply???? Why do you knock down my posts but give no proof or scientific evidence. And you're still going on about "finding this one strain that your body needed" - but can provide no scientific fact or basis for why you needed it - or what this strain is so other people can try it. Your outlandish claims are absolutely baffling. Now you're claiming to have modified a bacterial strain - what did you rewrite its DNA or something? PROVE IT - give a citation why this one magic modified bacterial strain cures SIBO.... You can't because it doesn't.... it just alleviates your symptoms and when you stop taking it everything goes back to normal.To be hones, its actually very upsetting.....I spent over an hour writing my initial post, and now I have to stick around and police it because you try and knock down my attempts to help people. I've shared everything I have learned and given citations of where I have learned it and a logical explaination why it works I am trying to help people have the same success as me. but you knock me down with NOTHING but your unfounded probiotic theories and your claims to be an expert and again we have asked for proof and citaions or theories why it works and you can produce NONE. Go away please, you've had your chance to provide some credability to your theories - and from the number of people who have PM'd me about you - nobody believes you!! Sorry but you are a fake and a liar, and I really don't understand why you're knocking down my attempts to help people with uncredible "expert threories" and now you seem to be lying about things!


IanRamsay said:


> HiI diddnt follw pimantels plan. I have however tried a huge amount of single strain probiotics (alot of which i have cultured myself) untill i finally found the one that my body needed. it is very possible that you havent had any luck with probiotics because you havent found the one that you need. It took me 12 years.cheersIan


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## IanRamsay

I havent followed the book that you have read and followed, although i have read it. pimantels theorys and treatment regiems have been around for along time, before that book was published. the treatment plan that i followed was based on previous publications, which coincidently is just about teh same as a new IBS solution. his theorys and papers where around when i was at uni. all i am saying is that it diddnt work for me, it isnt a 100% cure for everyone. there is no 100% cure that is easily accessable for everyone. EVERYTHING should be tried untill you find the thing that DOES cure you, and nothing should be ruled out untill you have tried it. Even pimantell him self has said that.And im not knocking everything down, but telling people NOT to try something is denying them an option that may help them.


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## frantic1980

Imagine your intestines are a room with a closed door and SIBO is a pile of horse-sh1t in that room. Using probiotics for SIBO is a bit like going into the room and spraying air-freshener everywhere. Yes it smells nice for a while but the air freshener wears off and you need to spray again. That's what probiotics are doing for your SIBO. The minute you stop things go back to normal.I am sorry Ian, I know that probiotics/bacteria are a bit of a hobby for you and you've spent a lot of time working/researching them; but from your posts on this thread you've shown that you've got some serious misconceptions of the role of bacteria in digestion. And despite repeated requests for some kind of scientific explaination for how probiotics can help SIBO despite the small intestine containing no bacteria, you have not been able to provide this. It just doesn't make any sense. Yes it improves things, yes it makes the room smell nicer for a while. It seems like you are planning to take a probiotic pill before every meal for the rest of your life (as I myself did for 2 years), sooner or later I believe you will realise that you will never be cured by probiotics and try a different approach as I did.I am sorry for so adamantly defending my stance on this point, but I followed YOUR advice on these forums for my first 5 attempts at beating this using antibiotics. That advice, which was bad advice, cost me hundreds of pounds in buying drugs online, money I couldn't afford, frankly. It wasn't until, in despair, I re-read Pimentel book and read what he was saying about probiotics (a point which I previously missed) and abandoned probiotics completely. I then went from having no success with the Pimentel technique to being completely cured. I think you're so blinded by your conviction to probiotics that you are prepared to lie to defend your point, first saying you didn't follow the pimentel protocol then that you did, then saying you did but it was called something different back then. Maybe you'll be happy and satisfied taking a pill before each meal for the rest of your life, but I hope that you open your mind a little and accept that covering up a 'bad smell' with a 'nice smell' isn't curing things.After 8 years with IBS the freedom that comes from curing it is amazing, the Pimentel technique has cured thousands of people including me. And I will defend my stance (which is also Pimentel's stance) on probiotics for the treatment of SIBO as stongly as I can.... they are not compatible with the Pimentel protocol and cannot cure SIBO....Small Intestine : Does not normally contain bacteriaBacterial Overgrowth : Too much bacteriaIt just makes sense - and it works. Try Pimentel again, with no probiotics and you might find yourself cured, without the need to take a pill before each meal for the rest of your life.


IanRamsay said:


> I havent followed the book that you have read and followed, although i have read it. pimantels theorys and treatment regiems have been around for along time, before that book was published. the treatment plan that i followed was based on previous publications, which coincidently is just about teh same as a new IBS solution. his theorys and papers where around when i was at uni. all i am saying is that it diddnt work for me, it isnt a 100% cure for everyone. there is no 100% cure that is easily accessable for everyone. EVERYTHING should be tried untill you find the thing that DOES cure you, and nothing should be ruled out untill you have tried it. Even pimantell him self has said that.And im not knocking everything down, but telling people NOT to try something is denying them an option that may help them.


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## uncle-buck

This is a very interesting thread.frantic1980 you lost some credibility when you adopted such a strident, hostile approach to Ian. So, you may want to reconsider that. Also, how long did you say you've been cured of SIBO? I thought you said a "few weeks" - which really doesn't seem like a long enough period of time to declare victory. I'm happy for you and glad that you're feeling so much better. But I'm not convinced that a few weeks of symptom-free living can be considered a cure.And even if you are cured, it does not mean that Pimental's approach will work for everyone. Having said that, I'm going to read his book. Thanks for your efforts to help other people by sharing your successful experience.


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## frantic1980

Hey uncle-buck. Yes, perhaps I have been a bit hostile. Everyone is entitled to their opinion and to pass on their own advice. What I don't like is somebody knocking down my advice by claiming to be an "expert" - and then showing a very poor understanding of digestion and bacteria/probiotics generally. The latest incident of back-peddling first claiming not to have followed pimentel's plan then changing his mind a week later really really infuriated me. This guy is so blinded by his conviction to probiotics he has repeatedly lied to defend his theories because he can't provide any scientific evidence to his claims; they just don't make sense.. I had no intention of sticking around on the forums this long but I feel I need to 'police' this thread now.As for how long.... well I finished my last course of antibiotics mid-late april, but I had a 2 week bout of Antibiotic Associated Diareeha (watery diareeha caused by killing the bacteria in my colon and allowing c-diff to flourish). This went away after a few days on metronizodole which i remained on for 10 days, and I have been fine ever since. Kept taking the glutamine in oats for anoher 2 weeks- and I still have a little glutamine in my protein shake's as it is great for muscle building.I would stongly recommend reading Dr Pimentel's book. If your symptoms are indeed caused by Small Intestine Bacterial Overgrowth then there is a very good chance his solution will work for you. In saying that, IBS has a host of underlying causes. Who knows if its a "cure" - somebody already said Pimentel himself calls it a treament rather than a cure. Not sure of the difference. All I know is that for 8 years my bowel movements were a sticky smelly mess that occured 4-5 times a day... every day. I have had one daily easily-passed movement per day since I finished my last treatment. I'm trying to think positive and believe that its gone forever although I realise that there is a chance it may come back - I am not going to risk taking probiotics for this reason. Right now my digestion is working just fine without them.... I really think we've all been subjective to a massive amount of brainwashing from the yoghurt adverts about "friendly bacteria" I just don't think bacterial supplementation is at all necessary for people with normal healthy digestion.



uncle-buck said:


> This is a very interesting thread.frantic1980, you lost some credibility when you adopted such a strident, hostile approach to Ian. So, you may want to reconsider that. Also, how long did you say you've been cured of SIBO? I thought you said a "few weeks" - which really doesn't seem like a long enough period of time to declare victory. I'm happy for you and glad that you're feeling so much better. But I'm not convinced that a few weeks of symptom-free living can be considered a cure.And even if you are cured, it does not mean that Pimental's approach will work for everyone. Having said that, I'm going to read his book. Thanks for your efforts to help other people by sharing your successful experience.


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## IanRamsay

Frantic, Its not a hobby mate, im a bacteriologist, and i am currently training as a virologist as well. I know pimantels works has helped alot of people. for the record, whilst i was trying his approach, i was not taking probiotics of any kind as that was his instruction. sadly it diddnt work for me both times. this may have been because my guts where almost completely missing one type of bacteria that was somehow having a direct effect on the coherent working of my IC Valve between teh small and large intestines allowing it to stay open more than it should affecting a back flow of bacteria in to teh small intestines. As i have already said, if you have SIBO, try everything untill you find some relief. i have a stool culture, bloods ets done several times a year to keep an eye on teh bacterial levels in my gut. the way i found relief has worked for me for years without a relapse and i am now in near perfect health eating what i want when i want. The bottom line is, if pimantels approach works for you, it will work for some one else, but it dosent work for everyone, and in my experiance, those that it dosent work for have sucess with probiotic therapy, but like everthing else, it takes time to find teh right strains. for all of us it is just a process of trial and error, regardless of what approach you try. all the best and i hope your recovery lasts long.Ian


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## frantic1980

Well for what its worth Ian, I apologise for being rather hostile in defending my stance about probiotics. The thing is I truly believe that abstaining from probiotics is pretty fundamental to following the pimentel protocol, and I know you have had success with probiotics but you seemed to be contraticting yourself a lot. I am going to update my original post shortly to detail my 4-5 unsuccessful attempts to beat it. But on my 3rd attempt, I washed down a load of probiotics after each dose of rifaximin (I took the max dose this time), I ate LOADS of yoghurt and yackhult (probably about 4-5 per day), I was thinking that if I could get some good bacteria in when the bad stuff died I would be sorted... I thought maybe that the good bacteria would croud out the bad bacteria.... but you know what happened - absolutely nothing. This was the only time that Rifaximin had ZERO effect on my digestion. No improvement whatsoever, I might as well have been swallowing M&M's.I am familiar with the leaky IC valve can cause a 'backwash' of bacteria into the small intestine. This is not what was causing my SIBO though - I got food poisoning at an All you can eat chinese buffet in hawaii (never again will I eat food that's been keeping warm under bright lights for hours!! That mistake cost me 8 years of Misery!).


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## MarcoITA

Hi frantic1980.A couple of things about LACTOSE. I AM LACTOSE INTOLERANT. This came out from the Lactose Breath Test I did a couple of months ago. But (a big but...) I have two problems with lactose: *1)* - it seems that maybe some problems with gluten result in "lactose intolerance". Read these links: *this* (Peter is really a very smart guy, IMO...) * and this* Uhm... does lactose malabsorption regress on a gluten-free diet? So the problem is not lactose, but gluten...? *2) *- it seems that lactose breath test could give a "false positive" result if you have SIBO. Look *here*So here the problem is SIBO, even though you're sure about your lactose intolerance. I'm NOT on a gluten-free diet, at the moment. I'm waiting for my blood test for celiac disease (ready in 10 days). Even though I won't be celiac, I think gluten isn't a very good thing... Re butter... maybe Clarified Butter (Ghee) would be a better thing (99.8% fat). No lactose there.No problems for Parmisan Cheese or other kind of cheese, I suppose (*lactose contents*). What do you think about all this? Any suggestion would be very appreciated... Marco


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## frantic1980

Hey Marco.I think there are two types of lactose intollerant people in the world:- People who were born without the ability to produce the lactase enzyme and therefore can never and will never be able to digest lactose.- People who's small intestine has been worn-down/damaged and therefore they have (possibly temporarily) lost their ability to produce the lactase enzyme.The lining of the small intestine is covered in lots small finger-like protrusions. These little fingers can become worn-down by Celiac, Chrons or by toxins caused by Salmonelia/Ecoli SIBO. The lactose intolerance comes in because the lactase enzyme that is needed to break the bond in the lactose molecule to make it digestible is produced right on the tip of these little fingers. Therefore if the fingers are worn down, the tip has been destroyed and therefore no lactase to digest the lactose. My celiac tests came back negative, and I had them done several times in my 8 years with IBS. However, an endoscope via mouth did show villous atrophy (wearing-down of the fingers) in my small intestine. This is because the toxins produced by E-Coli, Salmonella and most other BAD bacteria cause the lining of your small intestine to wear down. This is where the glutamine comes in - it repairs the lining of the small intestine. So once the lining of your gut has been repaired fully you theoretically should start producing lactase again and you will be able to digest lactose. This will take time though - even after your SIBO has cleared up and your digestion is working well again it may take a while for your gut to be sufficiently repaired to start producing lactase again. Its worth noting also that if you are getting a Lactose breath test to test for lactose intolerance, it will come back positive:- 1. If you have lactose intollerance from birth (no lactase to digest the lactose means that the lactose will pass all the way to your colon where it will be digested by bacteria producing hydrogen: a positive result)- 2. If you have Small Intestine Bacterial Overgrowth (lactose is a sugar and will be digested by the bacteria in your small intestine to produce hydrogen: triggering a positive result)- 3. If you previously had SIBO, but your gut is not fully repaired (same reason as #1 - the lactose goes all the way through the colon where it gets digested by bacteria, producing Hydrogen (a positive result)So what I am saying is - all three of these things could be causing a positive result on a Lactose Intolerance test. If you were able to digest milk before you got IBS then you come under #2 or #3. If you've never been able to digest milk then you are #1........ If you were previously able to digest Milk but now you can't then you are probably #2/#3 - both of which are theoretically fixable; Theoretically when your gut is repaired following clearing up your IBS you should be able to digest lactose again when your Villi are fully repaired.


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## freakzilla154l

The probiotics are definitely a no for me. I do agree that I have to get all the bacteria out of my small intestine so why use probiotics.We will see what he does. Either way, I'm gonna do it with or without him. I need to get better and have my old life back. I was just thinking of doing the neomycin & Cipro and add the Flagyl when I'm done. Not sure about the Xifaxin as I took that for 20 days already!Another thing, I can't stop craving sweets and coffee.... I feel like a crack addict. Last night I had almost a half gallon of ice cream. Today, my skin looks worse to with these plugs. I really believe that when i eat sweets and certain carbs, that this bacteria releases toxins that are creating my skin rash. Anyways, I'll be checking for your new post about your unsuccessful treatments.


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## IanRamsay

Have you been tested for systemic candida? its just a thought, but the sweet craving thing rings a big bell.


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## uncle-buck

Ian, what are the definitive tests for Candida? From what I've read, it's a fairly controversial affliction.


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## frantic1980

Hey Freak,I know exactly what you mean about craving sweets. I needed to get up in the night, every night when I had IBS at 3am still half asleep and I would gorge on sweet things... usually a bowl of Kellogs Frosties or toast with honey... yeah at 3am!!!! The reason you crave these things is that the bacteria in your small intestine is eating your food and there's not much left over for you. Normally your evening meal should keep you going all through the night as it passes through the 20 ft of your small intestine and gets absorbed by your body, but when you have SIBO you have bacteria in your small intestine (where there should be none) the bacteria are feasting on your food leaving not much left over for your body. This is why people with IBS crave carbs and sweets and usually snack at night time or need to eat right before bedtime - I even tried eating loads of chicken before bed but I still got hungry in the night. This is exactly why there is no bacteria in the small intestine of a healthy person - if the bacteria is absorbing your nutrients then it means your body is not! Remeber the reason we have bacteria in our colon and not our small intestine is that the bacteria feeds on leftovers - it eats what little is left when most of your digestion is complete. When you have bacteria in your small intestine, the bacteria is feeding when your body should be feeding! The bacteria are starving you and you are craving sweets. You could maybe try lucozade (I don't know if its available worldwide, but we have it in the UK... its a fizzy sports drink containing about 300 cal of glucose).... but drink it in small sips not a whole bottle at a time. Dr Pimentel says in his book that glucose is a healthy sugar for SIBO, because although it is the perfect food for bacteria its also the perfect food for your body.... glucose does not require further digestion, glucose is 'carbohydrate' in its purest form as such it can be absorbed in the first few inches of your intestine directly into the blood stream as no more digestion is required. All other carbohydrates (wheat, pasta, potato, rice) are long chains of glucose molecules (polysaccharides) and the digestion process takes time to chop them down to single glucose molecules before they are absorbed, this means that they needs to travel through your intestines for a bit before they are broken down to the extent where they are able to be absorbed, by travelling that far, they reach your SIBO where the bacteria will feed on it, allowing the bacteria to thrive and multiply.... but not with pure glucose it gets absorbed straight away. By drinking lucozade (only a few sips at a time) you will satisfy your body's craving for sugar/glucose, whilst not giving the bacteria any food as hopefully the glucose will be absorbed before it hits the SIBO. A whole tub of ice-cream needs to travel far into your intestines to be broken down and absorbed - and is perfect food for bacteria.N.B: I don't know if Lucozade is an international thing... I know we have it here in the UK. Its basically a fizzy drink that has about 300 calories of pure glucose in it, usually used for sports and stuff. I don't know if its available in the USA although if not I am sure you have something similar..... if anyone knows what the international version is called please reply and let us know!


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## frantic1980

Re: Candida (sweet cravings)Candida is one of the 'ghosts' I chased in my pursuit of SIBO. Yeah sugar cravings are a common "symptom" of "candida"..... so its a good point to raise Ian.Somebody asked about "Candida or SIBO" on a thread on these boards before, and this was my response:---copy---Before I discovered I had SIBO, I thought it was candida. I went to my doctor, he laughed at me and told me that candida infection is only a problem for people who have a serverely compromised immune system, e.g. HIV patients.I didn't believe him and started to take candida remedies from my local health store: garlic, ginger, Cau du parco (or whatever its called - can't remember), grapefruit seed extract, olive extract, coriandor oil, echenacea....) They provided noticable relief and I was sure that this supported my theory that I had candida... Then I got an ear infection (went to spain on holiday and did a lot of swimming) and needed some antibiotics to clear my ear infection, I was terrified about taking antibiotics: after all I believed that candida was overgrowing and causing me diareeha because of a previous course of antibiotics had wiped out my bacterial flora and allowed the candida to flourish: surely antibiotics would make things even worse?!?! In the end I had to take the antibiotics as I was ompletely deaf in one ear, couldn't hear a thing.... I expected my candida to get worse on the antibiotics but something strange happened - my symptoms cleared up completely! But only during the course of antibiotics, my IBS-D came back a day after stopping.I investigated further and found out that antibiotics only act on Bacteria, not fungus. So I found out that my problem had to be caused by bacteria not candida. This is when I researched this and found out about SIBO...Having researched it further, 99% of the professional medical community believe that candida infection of the intestines is a quack-theory. It has never been proved to exist, except in patients with a compromised immune system with HIV/AIDS. The only people who will tell you it does exist are quack-doctors like naturopaths etc etc. The treatments that the quack doctors will give you for candida also act on bacteria - Grapefruit seed extract, oregano oil, ginger, garlic... all kill bacteria Which is why it seems to clear "candida" up.Yes we all know women (and occassionally men) sometimes get Thrush infections when they take antibiotics.... possibly antibiotics might even give you a small thrush infection in your intestines. But 60% of your body's immune system lives in your intestines: it will be kept under control and eradicated by your immune system very quickly. Plus, your intestines are 30 ft long, and bacteria only live in the last 6 feet (the colon), so how could candida cause a problem? Could you really have fungus in all 24 feet of your small intestine - even in HIV patients, they grow in small patches. I adamantly chased this for over a year as a cause for my symtoms but most doctors believe its a quack theory. --- end copy ---- I even changed doctors to try to get one more open-minded who would prescribe me "Nystatin/Fluconazole", and was so frustrated when the new one also said it was cr&p; I didn't believe it, do these doctors no anything?? its so obviously candida (at least it was to me). I just didn't believe them at the time, but now I think it would be difficult to find a GI Doctor who would be willing to consider candida as a cause of digestive problems. I wasted a year chasing 'candida' as a cause for my problems (and a lot of money on 'candida remedies' from my healthfood store..... I was so so so convinced it was the cause, but now I now agree with what my Doctors and the majority of the medical community believe which is that candida overgrowth of the intestines is a total myth).... The 'candida diet' is exactly the same at the SIBO diet.... the natural treaments are the same - Grapefruit, garlic, ginger, coriander, oregano...... no sugars, limited carbs.... exactly the same....


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## uncle-buck

Thanks for your post, frantic. I just started a 2 week course of Nystatin (an anti-fungal drug) for a suspected intestinal yeast overgrowth. The doctor at the IBS Treatment Center in Seattle, WA isn't sure it's yeast, but he has done a fairly extensive workup of my case. We'll see how it goes.


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## IanRamsay

HiCandida is indeed a very difficult condition to effectively diagnose with absolute certainty, and most doctors, even specialists are still sceptical about candida simply because in some people, the levels are incredible but have no symptoms or cause any problems, but in others even a small amount above what is deemed as normal can cause all sorts of problems. it is also a very touchy subject around here and indeed in teh medical profession because it is naturally present in every human being in self pepetuating numbers.in short, its a real sod. and treating it can be even harder, even with pharmaceutical drugs. the key is persistance, strict diet, and attacking it with natural antifungals as well as hard pharmacuticles. in general it can take between 3 and 12 months to effectively bring candida albicans levels under controll, but it is basically impossible to eradicate it from teh body as teh body does need it in one way or another in small amounts.Ian


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## frantic1980

Wow! that was a fast-turn around uncle buck. I am surprised that you found a GI who was willing to entertain the suggestion of Candida in the space of 3 hours! Nystatin is a very old fashioned drug though, I tried to get my doctor to prescribe it to me when I thought I had candida but he wouldn't hear it (actually I begged him!).... he said that if I had advanced HIV/AIDS he might entertain the suggestion intestinal candida but even if this was the case he said wouldn't prescribe Nystatin as it is old fashioned and there are much more effective treatments for Candida now. He explained the whole "holistic doctor" candida thing that its a quack theory to make people buy their remedies, and suggested we take "another stool culture" I cant tell you how frustrating this was as I was totally convinced I had candida.... especially because these stool cultures kept coming back with nothing abnormal!As Ian says though... people who do "battle" with "intestinal candida" have a real struggle treating it; they attack it from many angles, Pharma Antifungals, Natrural Antifungals, Diet, Persistence. Its very stubborn and difficult to get rid of (because it doesn't exist), and then when things stop working they say 'oh no the candida has "built resistance"'. I know this first hand because I "battled with candida" (actually it turned out to be SIBO - the symptoms/natural treatments are the same though) Most GI's would tell you that its so stubborn and resistant because these people are actually chasing a ghost. They think they are fighting candida, but in fact its something else. The immune system is actually very good at keeping candida under control. Even Fluconazole  the thrush remedy that women use works by stopping the thrush from growing, allowing the immune system to bring it under control faster, it doesn't actually kill the yeast, your immune system does.


uncle-buck said:


> Thanks for your post, reach. I just started a 2 week course of Nystatin (an anti-fungal drug) for a suspected intestinal yeast overgrowth. The doctor at the IBS Treatment Center in Seattle, WA isn't sure it's yeast, but he has done a fairly extensive workup of my case. We'll see how it goes.


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## IanRamsay

very true. candida usually gets out of controll (with teh exception of imune disorders) because of an underlying intestinal condition that, in some cases, may be even harder to diagnose and treat. it can be a vicious circle. sadly, candida isnt my specific area, so i cant make any hard reccomendations.just so everyone knows, Candida is a very dodgy word around this board!Ian


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## uncle-buck

frantic, I just finished reading Dr. Pimentel's book, A New IBS Solution. It's very interesting and makes a lot of sense. I also called his office and received a referral to a local GI doc here in Houston who is familiar with the Cedars-Sinai protocol for treating IBS. (That's the approach that helped you so much, isn't it?) I'm going to explore the possibility of getting a lactulose breath test, just in case my symptoms are caused by SIBO - and not a yeast infection.One interesting thing I learned from talking to GI doctors' offices that may be of interest to others on this forum is that many GI docs don't offer breath tests at all - and some of the ones that do offer only the hydrogen breath test vs. the breath test in Pimentel's book that picks up both hydrogen and methane.


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## IanRamsay

hiThere is also a DNA/RNA test for bacterial over growth that is very good. far more reliable than a breath test. cheersIan


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## uncle-buck

Ian, what is it called and where do you have it done?


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## Megyn1

Hi Uncle Buck! Could you please give me the name of the doctor in Houston that Dr. Pimental's office referred you to? I live here in Houston and have SIBO! I have suffered for TWO years. After mulitple GI visits and doctors telling me I am crazy, I figured out that PROBIOTICS were making me MORE CONSTIPATED! I have cut out gluten and taken a round of XIFAXAN with considerable positive results. AFter two years of having to use enemas I have been going on my own for a month now. BUT it is still difficult. Not that I am "constipated" quite the opposite but GI motility is severely slowed. I would like to see a GI who is familiar with the diet and protocol and would run the test for SIBO. My doctor didn't! So if you would like to email me directly that is fine...or post on here let me know.ThankyouMegyn


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## uncle-buck

Megyn, it's Dr. Andrew W. DuPont with UT Physicians, tel. 713-704-5910. Good luck!


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## IanRamsay

BuckYou can get it done online, but the results are often very hard to understand, so ask you specialist for either a referal or a reccomendation of where to get it done. but make sure that your specialist will interperet the results for you so you know where you stand.MegynWhat probiotics where you taking, just out of curiosity?cheersIan


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## Megyn1

Ian I had been on every probiotic under the sun for the past two years. Expensive ones, cheap ones, doctor prescribed! The problem was that at first they thought my GI motility issue was due to a medication I was on. So I was taking pro biotics to try and help and lots of yogurt at times. Anyway they took me off the medication in December and I still couldn't go on my own for months. The doctors were at a loss...I would get Diahrea (from medication or magnesium oxide) but couldn't pass it on my own. Everything just sat in my gutt. Then one day I dropped the probiotic....and woosh! I could go! But that only lasted a week. I then went off Gluten and things improved some more....greatly actually as far as pain, gas, bloat, etc. But transit time was still NOT GOOD! so my colon surgeon gave me the XIFAXAN at my request. It worked immediately. During the period I was on the XIFAXAN I ate yougurt to see what would happen...and everything came to a halt! I WILL NEVER take probiotics again! I have been doing the ginger and started the Grapefruit seed extract since being off the Xifaxan and it seems to be working. But it still takes a lot of effort to go. Things move around now for sure, but i just wonder if I don't have a lazy colon now due to the enemas for two years. So I am going to give it time.


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## Megyn1

Another quick post because I have to run and don't have time to explain everything. You can do your own search online...there is a TON of information. But I think a lot of people on here would benefit GREATLY from following the protocol by Dr. Pimmental and listening to frantic1980 BUT ALSO FOLLOWING A GLUTEN FREE DIET! I think that is part of how my SIBO started! SIBO tends to be hard to treat because they don't always know the underlying disease/cause right? Well Gluten intolerance and/or full on Celiac disease (damage to the villi in the small intestine) both degrade the functioning of the small intestine! I know I wasn't absorbing food properly, couldn't digest it properly, no motility etc. I eliminated gluten from my diet and noticed a HUGE difference immediately. I used to have a chronic sick or collicky feeling in my stomach. Lots of gas and distension. Didn't sleep well, irregular menses, mucos in stool etc. It wasn't hard for me to eliminate it because I didn't eat a whole lot, but it did keep sneaking up on me in different things before I was fully educated. Celiac.com has a wealth of information and it can't hurt to try the gluten free lifestyle for a few weeks and just see what happens! I just want to help...and all I know is you couldn't pay me to eat it again! That is how good I feel off!


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## IanRamsay

Probiotics can cause sever constipation in a VERY small number of people, even when small amounts of probiotic bacteria are taken, but the constipation occours not because of the bacteria but because of another issue in teh Large intestine that is irritated by the bacteria. i am very surprised that your doctor diddnt recognise this instantly when probiotics where introduced. what method was your SIBO diagnosed by?CheersIan


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## Megyn1

NO doctor has ever run a test for SIBO! I want one done. I diagnosed myself essentially! But I would not call what I had Constipation, ie dry hard stools. I have almost the opposite sometimes, with little to sometimes no form. But It wouldn't move around. I had no MOTILITY! I assume that the Gluten intolerance severely inhibited my Small intestines ability to perform correctly ie shutting down so food just sits there. I used to have whole pieces of food come out. This still happens to a much smaller extent. Supposidly staying off the gluten will allow my small intestine to heal, and with time this will get better. But the undegested food sitting there is a prime environment for SIBO to develop. Alot of people with Celiac/gluten intolerance have SIBO! Anyway once I got off the gluten things improved, but the SIBO was still there! So once I took the anti biotics, and STAYED off the gluten I am now going to the bathroom on my own for over a month now! But you are correct...it seems like my Large intestine doesn't function optimally! It takes a long time to move stool through, ie several visits to the bathroom to eliminate completely. Sorry if this is too graphic! But I aslo still have to Strain and push on my tummy to get very soft stool to come out. I assume, but would like to talk to a doctor about this, that this is because my colon became lazy from not having to work for so long, ie the enemas! I've tried adding in some fiber like flax seed but my system is still too sensitive and is makes me sick. I have to stay away from really fibrous foods other wise i get tummy aches. ie broccoli, asparagus, coconut, corn etc.


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## MarcoITA

Hi all and Hi frantic1980, I've given up STARCHES (rice) and things have definetely improved! My stools aren't loose or sticky anymore, but they're SOLID (sorry for this detail...) and I've less (or none) abdominal pain or nausea/bloating. My diet is: meat (any kind), fish (any kind), eggs, ghee, olive oil, some cheese (parmisan and others) and some vegetables (except potatoes) * ABSOLUTELY COOKED*. Apart some raw cherry tomatoes. This fits very well (IMO) with SIBO. I'm wondering whether I've developed a sort of "starch intolerance" after, almost one year ago, I gave up starches to follow a low-carb diet. Perhaps my pancreas and my salivary glands, after some months without starches, stopped to produce AMYLASE (the enzyme for starch digestion) leaving now undigested starches for bacteria fermentation. I don't know, either, if bacteria prefer SIMPLE SUGARS or STARCHES to thrive... it seems to me the answer is: absolutely STARCHES. Anyway... this Saturday I'm doing Lactulose Breath Test (Hydrogen and Methane), and this Sunday I'm picking up results for Celiac Disease. Marco p.s. - Hi frantic1980, I've read from previous messages that you're taking CNP Pro Mass wich contains Maltodextrin. I don't know much about Maltodextrin, but... could bacteria thrive on it or it is absorbable before small intestine? Any idea?


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## uncle-buck

Marco -- Please let us know how your lactulose breath test goes. It sounds like you know a lot about this. Have you read Dr. Pimentel's book?


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## MarcoITA

uncle-buck said:


> Have you read Dr. Pimentel's book?


 No, not yet, but hopefully it'll be here in a couple of day. I hope my Lactulose Breath Test (tomorrow in Rome) won't be invalidated by my NO-STARCH diet...







Marco


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## frantic1980

Hey guys! been off the board for a week or so and see I have a ton of stuff to reply to. I will reply to each of you individually.Megyn - We have had very similar experiences. Although my problem was IBS-D not C like you. I had exactly the same experience with Probiotics/Yoghurt rendering Rifaximin completely useless. For those who didn't notice already I *updated my orginal post with details of my 5 failed attempts at beating this* Attempt 3 on max-dose of Rifaximin I took loads of probiotics and yoghurt along side the rifaximin and it was rendered useless, no improvement whatsoeve. I was interested to see that when you took Yoghurt your progress with rifaximin also halted. I also never got tested for SIBO. The NHS here in the UK is something we as a nation are proud of: free healthcare for every citizen whether its for a sore throat with your local doctor or a heart translplant or emergency surgery in hospital (I hope Obama brings something similar to the USA - its horrifying to think that in the US you could get run over by a bus and wake up to a 6-figure bill).... however for some reason the NHS seem to be slightly behind the times with IBS (not sure if it would be different if I got private halthcare), so I was never offered a test for SIBO and like you Megyn I diagnosed myself.Re: GlutenI was gluten-free for my whole 8 years of IBS. Gluten always made my symptoms worse, but cutting it out never cleared it up (just like lactose). Not sure why this is the case but I always tested NEG for Celiac (and got tested several times). Now that I am cured (hopefully!) I can eat Gluten. Although I did have a chicken burger last week and had a slightly restless night; bit of mucous and felt like things were a little unsettled down there.... next day I had one sticky messy movement but things have been normal since. Weird... I thought I had relapsed again but things are fine now, not sure why, and I had Croissonts for breakfast this morning - no problem! Oh and beer was also a no-go for me (probably since its made from gluten) but i'm on my third Corona as I write this and things are fine with beer now (sorry if the spelling is affected!).Megyn, you say that while you were on Rifaximin things improved completely (till you took the yoghurt). Do you mean your aparent 'lazy colon' went away and you were able to pass fine? If that is the case then your problem is not lazy colon, its the SIBO - get back on Rifaximin, get at least 400mg (preferably 600mg which is the max dose) for at least 14 days - and stay away from probiotics. If you can get your GI to add some Neomycin too then get it - 1000mg 3 times per day. Stick to the grapefruit/ginger and get some Glutamine. You're used to Colon enemas so if you need to repopulate your colon bacteria take some liquid probiotics via enema if your GI is worried about AAD (I have done this a few times - good results) bacteria are only needed in the last few feet of the intestines so why risk making them pass through the first 20ft and causing SIBO! FYI... According to Pimentel's book, the difference between IBS-C and IBS-D is that the bacteria that causes IBS-D produces hydrogen whereas the bacteria that causes IBS-C produces methane - same problem, different bacteria, different gas, different motility issue!


Megyn1 said:


> Ian I had been on every probiotic under the sun for the past two years. Expensive ones, cheap ones, doctor prescribed! The problem was that at first they thought my GI motility issue was due to a medication I was on. So I was taking pro biotics to try and help and lots of yogurt at times. Anyway they took me off the medication in December and I still couldn't go on my own for months. The doctors were at a loss...I would get Diahrea (from medication or magnesium oxide) but couldn't pass it on my own. Everything just sat in my gutt. Then one day I dropped the probiotic....and woosh! I could go! But that only lasted a week. I then went off Gluten and things improved some more....greatly actually as far as pain, gas, bloat, etc. But transit time was still NOT GOOD! so my colon surgeon gave me the XIFAXAN at my request. It worked immediately. During the period I was on the XIFAXAN I ate yougurt to see what would happen...and everything came to a halt! I WILL NEVER take probiotics again! I have been doing the ginger and started the Grapefruit seed extract since being off the Xifaxan and it seems to be working. But it still takes a lot of effort to go. Things move around now for sure, but i just wonder if I don't have a lazy colon now due to the enemas for two years. So I am going to give it time.


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## frantic1980

Ian....I am going to be as polite as I can with this.... Probiotics cause constipation in some people with IBS, because in people who have Small Intestine Bacterial Overgrowth, adding more bacteria to an already-overgrowing population, exacerbates the problem... especially because the problem is occurring in an area of the digestive system that normally contains zero bacteria. According to the Pimentel book, SIBO caused by Methane-producing bacteria causes constipation and SIBO caused by Hydrogen producing bacteria causes diareeha. This is a documented cited issued by Dr Mark Pimentel in his book "A new IBS Solution". "another issue in the large intestine that is irritated by bacteria" - which issue, and why? and where is the citation to prove it?


IanRamsay said:


> Probiotics can cause sever constipation in a VERY small number of people, even when small amounts of probiotic bacteria are taken, but the constipation occours not because of the bacteria but because of another issue in teh Large intestine that is irritated by the bacteria. i am very surprised that your doctor diddnt recognise this instantly when probiotics where introduced. what method was your SIBO diagnosed by?CheersIan


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## uncle-buck

Hey frantic -- With all due respect, some of us here in the states don't want Obama's nationalized health care. Let's stick to the topic and leave politics for another forum.


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## frantic1980

Marco! I am stoked to hear that the low-carbohydrate diet is working for you.....This diet shouldn't interfere with the breath test as Lactulose is food for the SIBO and should trigger a result by causing the bacteria to digest the lactulose and produce hydrogen. If the levels of hydrogen are a bit lower than expected then tell the doctor/technician you've been on a low-carb diet that has improved your symptoms and that your SIBO levels, and therefore your hydrogen levels, might be lower than expected; they should still be present though!Rice does contain starch, but it contains more complex carbohydrates so its more likely that carbs are your problem (food for bacteria!) I would say this is more likely than an intollerance to starches. The diet you described contains no carbs at all.... which is great - you'll be ripped in no time too.... take advantage of this diet and get in the gym and lift some weights... eat tons of meat (or add some egg protein powder) and you'll be ripped and muscled in a matter of months. Its worthy of note that by nature humans are carnivores - evolution intended meat to be our primary food source so by having a diet with lots of meat you will have a very healthy bowel movement and in my experience can use 1 sheet of toilet paper rather than a whole roll like when I had IBS!! hahaha!Re: Pro-mass.... I have asked the same thing about maltodextrin many times. Its described as a semi-complex carb, with a high-glycemic index like glucose but more slowly digested. but the question is.... can bacteria feed on it? I don't know... Wikipediasays "Maltodextrin consists of D-glucose (dextrin) units connected in chains of variable length. The glucose units are linked with α(1→4) bonds. Maltodextrin is typically composed of mixtures of chains that vary from three to nineteen glucose units long.[1] " From reading this....If Maltodextrin is a polysacharide of glucose molecules then when these are broken down to Glucose it is then it is perfect food for bacteria and therfore bad for SIBO. Pro-mass is an awesome mass gain formula (and cheap on ebay ~£38 plus postage for 4.5kg) even when I had SIBO I gained a lot of muscle on pro-mass (although it... sorry for the detail.... came out the same consistency as it went in).... plus its hard to lose fat on it as its so dense in calories, but does make you huge! I would suggest avoiding calorie-dense mass gain formula it until a few months after your SIBO is gone. At the moment I am using 2 large scoops of ultra-fine scottish oats and 1 scoop of egg protein for my muscle building, I stopped using pro-mass as I am trying to build lean ripped muscle right now rather than trying to get as big as possible. You can get the egg protein/oats at www.bulkpowders.co.uk (alternatively get some porridge oats at the supermarket and whizz in a food processor for a few minutes using the curved chopping blades until they are a fine powder, get the egg protein from your local healthfood store) mix with water in a 2/1 60g/30g ratio oats/protein. Whey protein isolate is actually better but does contain a small amount of lactose (3%) so stay off it until your SIBO is gone.Let us know how the breath test goes!



MarcoITA said:


> Hi all and Hi frantic1980, I've given up STARCHES (rice) and things have definetely improved! My stools aren't loose or sticky anymore, but they're SOLID (sorry for this detail...) and I've less (or none) abdominal pain or nausea/bloating. My diet is: meat (any kind), fish (any kind), eggs, ghee, olive oil, some cheese (parmisan and others) and some vegetables (except potatoes) * ABSOLUTELY COOKED*. Apart some raw cherry tomatoes. This fits very well (IMO) with SIBO. I'm wondering whether I've developed a sort of "starch intolerance" after, almost one year ago, I gave up starches to follow a low-carb diet. Perhaps my pancreas and my salivary glands, after some months without starches, stopped to produce AMYLASE (the enzyme for starch digestion) leaving now undigested starches for bacteria fermentation. I don't know, either, if bacteria prefer SIMPLE SUGARS or STARCHES to thrive... it seems to me the answer is: absolutely STARCHES. Anyway... this Saturday I'm doing Lactulose Breath Test (Hydrogen and Methane), and this Sunday I'm picking up results for Celiac Disease. Marco p.s. - Hi frantic I've read from previous messages that you're taking CNP Pro Mass wich contains Maltodextrin. I don't know much about Maltodextrin, but... could bacteria thrive on it or it is absorbable before small intestine? Any idea?


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## frantic1980

Hey uncle buck... yeah the Cedars-Cinai protocol is the one described in the book and the one I followed. Named after the hospital where Pimentel and his colleagues developed it, I believe. Yeah its a very intesting read and it does make perfect sense, doesn't it? The only criticism I would give about "A new IBS solution" is that his advice about probiotics was almost an after-thought. Its only in his "alternative therapies" section where he says that probiotics are bad - therefore I missed it on my first read. I think people would take heed of this point if it had been mentioned earlier in the book in relation to the treatment. I believe that avoidance of probiotics during and after the treatent is pretty fundamental to its success, and given that most people with IBS take probiotics for relief, it goes against their preconceptions.



uncle-buck said:


> frantic, I just finished reading Dr. Pimentel's book, A New IBS Solution. It's very interesting and makes a lot of sense. I also called his office and received a referral to a local GI doc here in Houston who is familiar with the Cedars-Sinai protocol for treating IBS. (That's the approach that helped you so much, isn't it?) I'm going to explore the possibility of getting a lactulose breath test, just in case my symptoms are caused by SIBO - and not a yeast infection.One interesting thing I learned from talking to GI doctors' offices that may be of interest to others on this forum is that many GI docs don't offer breath tests at all - and some of the ones that do offer only the hydrogen breath test vs. the breath test in Pimentel's book that picks up both hydrogen and methane.


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## frantic1980

With all due respect uncle buck; I believe that in every civilized country free healthcare should be a right, rather than a privilige for the wealthy. In the UK, its an optional thing and its not perfect by any means....but it is free, for those of us who need it.I had private healthcare in my previous job and the level of service was outstanding (by far above the National Health Service). However, I got made redundant from my job 4 months ago (damnn recession) and therefore lost my private health insurance that came with the job and I have been dependant on the NHS. Thank god we have it as I would have been unable to get any kind of medical treatment without it.Saying "not everyone wants obama's nationalized health care" is like saying. "people who can't afford food shouldn't be allowed to eat" (except in this case the food costs thousands). Maybe you can afford to pay for an (addmittedly more adanced) private health service; but there are people out there who cannot and require a free service - even if they need to go on a waiting list. Why would you want people to be denied this most basic and essential service?I only raised it because I was pointing out that the NHS isn't perfect (they couldn't help me with IBS) - but its still great and something to be proud of.



uncle-buck said:


> Hey frantic -- With all due respect, some of us here in the states don't want Obama's nationalized health care. Let's stick to the topic and leave politics for another forum.


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## uncle-buck

frantic, I'm not going to engage in a long political debate with you in this forum. But I remind you that there's no such thing as a "free" anything. Every good and service has a price or cost. And while much of western Europe has embraced Socialism, it ultimately leads to less freedom and lower standards of living.So, you keep your Socialism and I'll keep my freedom and prosperity, thank you very much.


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## freakzilla154l

Hey frantic, How long did you wait in-between each time you took the anti-biotics? Thanks!


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## IanRamsay

The "Underlying" problem that i was refering to is a seratonin receptor issue that has yet not been 100% proved but it wont be long as the work has been underway in britain switzerland and america for a while. when it is proven, sadly pimantel will have to review his outlook on D and C. the probiotics attempt to readdress the absorbtion issues but cant do it on thier own without a AO or flavenoid supplimentation as probiotics dont cross teh brain/blood barrier, AO and flavenoids do. when this is teh case probiotics on their own can cause a worsening of D and C, which is why adding probiotics is done on a hit and miss basis for first diagnosis and treatment protocol when probiotic therapy is reccomended untill a DNA\RNA test can reveal teh exact underlying causes of C and D. when teh underlying causes have been identified teh probiotic strains and additional AO/flavenoid suppliments are adjusted. Provex and Cytoplan are two companies that actually offer suppliments to treat the underlying and teh obvious at teh same time. more and more companies are working this out and offering combined targeted therapies in this instance. as eventually bacteria will become resistant to anti biotics, other treatments have to be found that teh bacteria have no tollerance to. again, pimantel dosent have any contingency for this, although it is inevitable at some point in the future. throwing antibiotics at a problem dosent actually fix teh problem it only fixes the symptoms and retards the problem. DONT GET ME WRONG, im glad that it works for some people and gives them some much needed relief from SIBO, i know, living with SIBO is not fun at all, but other treatments without drugs are being developed or have already been developed that do teh same job and last longer, BUT take longer to implement and do require ajustment to get right as they dont wipe out all bacteria, just targeted strains. in the next 2 - 5 years the targeting and delivery of these systems will be As quick as antibiotics and twice as effective. sadly all this stuff just takes time.For the healthcare, as far as i am concerned Obama is possibly the worst thing that has happened to the US in a long time. i believe he will do ireprable damage to teh US in teh coming years.Ian


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## frantic1980

Pimentel actually discusses the 5-HT receptor theory in Chapter 2, Page 23 "The Serotinin Connection""currently there is no serotonin-based class of drugs that has been safe for managing the symptoms of diarrhea predomenant IBS".... he then goes on to talk about Zelnorm for IBS-C however as far as I know this has been withdrawn by the FDA as well as it too wasn't safe.Ian I find it difficult to understand how a DNA test could reveal the exact causes of IBS - if this were true then you could test a new-born baby and determine whether they have or will have IBS or not and what will cause it..... a person's DNA doesn't change throughout their lifetime, does it? and anyway how could IBS possibly change the DNA of every cell in the body - from skin cells to brain cells? The Nucleus of each cell has a copy of your DNA - how can they all be changed?As far as I know the only way DNA can changed is by reverse-transcription.... like the HIV virus uses to overwrite the DNA of the T-helper cell thus scrubbing the T-cells original DNA and replacing it with the HIV code - thus making a copy of itself. I have never heard of a DNA test for IBS - do you have a citation? I really wish you could provide links for stuff like this. Are you sure its not the DNA of the bacteria that is being tested in these tests to determine which strains are present? If this were the case then antibiotics are the solution are they not, since bactera is actually the 'underlying cause'.


IanRamsay said:


> The "Underlying" problem that i was refering to is a seratonin receptor issue that has yet not been 100% proved but it wont be long as the work has been underway in britain switzerland and america for a while. when it is proven, sadly pimantel will have to review his outlook on D and C. the probiotics attempt to readdress the absorbtion issues but cant do it on thier own without a AO or flavenoid supplimentation as probiotics dont cross teh brain/blood barrier, AO and flavenoids do. when this is teh case probiotics on their own can cause a worsening of D and C, which is why adding probiotics is done on a hit and miss basis for first diagnosis and treatment protocol when probiotic therapy is reccomended untill a DNA\RNA test can reveal teh exact underlying causes of C and D. when teh underlying causes have been identified teh probiotic strains and additional AO/flavenoid suppliments are adjusted. Provex and Cytoplan are two companies that actually offer suppliments to treat the underlying and teh obvious at teh same time. more and more companies are working this out and offering combined targeted therapies in this instance. as eventually bacteria will become resistant to anti biotics, other treatments have to be found that teh bacteria have no tollerance to. again, pimantel dosent have any contingency for this, although it is inevitable at some point in the future. throwing antibiotics at a problem dosent actually fix teh problem it only fixes the symptoms and retards the problem. DONT GET ME WRONG, im glad that it works for some people and gives them some much needed relief from SIBO, i know, living with SIBO is not fun at all, but other treatments without drugs are being developed or have already been developed that do teh same job and last longer, BUT take longer to implement and do require ajustment to get right as they dont wipe out all bacteria, just targeted strains. in the next 2 - 5 years the targeting and delivery of these systems will be As quick as antibiotics and twice as effective. sadly all this stuff just takes time.For the healthcare, as far as i am concerned Obama is possibly the worst thing that has happened to the US in a long time. i believe he will do ireprable damage to teh US in teh coming years.Ian


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## IanRamsay

Sorry i didnt make teh post clear in this respect, the DNA/RNA Test is specifically for bacteria. (although it does have alot of other uses). There is some hope of a similar test to determin the probability of gut problems in general (although at the moment it is just theory, but it is an extremely good theory with only a couple of holes in it)CheersIan


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## frantic1980

But if the underlying problem is Bacteria, then surely antibiotics are the solution? You really confuse me - nothing you say makes any sense.


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## Kathleen M.

There are two parts to the equation.1. What kills bacteria vs2. Which bacteria you get recolonized with.Even if you kill off every single intestinal bacteria in your entire body including the back ups you keep in the appendix (the new reason they found for having one) you will very quickly recolonize (and hopefully not with the ones that cause botulism that infants can be paralyzed or even killed by if you feed them the wrong thing before they get enough to keep those really nasty bacteria out).Why let chance decide what you get. What is new may be worse than the ones you had. Probiotics at least make sure you get a good dose of bacteria that reduce gas volume and seem to have some clinical data to help prevent the recurrence of SIBO.I don't know if Pimentel is as strongly anti-probiotic as he was back when he wrote the book seven years ago. I thought someone that saw him in the last couple of years had posted that he can see that sometimes they can help with extending the remission. There has been a lot of research since the book and I wouldn't take it as the unchanging gospel and there is nothing else to be discovered. (and I'm really not motivated to go searching for the post now, but it did stick out as it was different than what the book seemed to suggest)The problem is NO ONE on the planet really has the whole picture of what is going on with the colonic flora or what happens in SIBO.So there really isn't any basis to say someone is completely and totally wrong as both sides have a point and it may be worth agreeing to disagree.If probiotics make you worse DO NOT TAKE THEM. If they make you better TAKE THEM.Surely that is a middle ground we can all agree on? right?We have lots of anecdotal and some clinical evidence that some people are helped by probiotics and some people are not and plenty of anecdotal evidence here a lot of people are much worse after antibiotics even though some people are helped.I'm not going to swap out my probiotics for antibiotics since the probiotics ARE working for me and I want to avoid getting really full up with antibiotic resistant bacteria.


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## IanRamsay

I agree.What works for some people dosent work for others, as i saud earlier in this thread several times. everyone has to try everything untill they fiond something that works. i am biased towards bacteria because its what i do, but i also have to keep an open mind to some degree because i have seen some truely strange things in teh last 12 years doing what i do, and some of them defy explanation simply because sometimes, things dont do the things that they are supposed to. if you have found somethin that works for you that is awsome, power to you, i just think advising people to bin their probiotics because they dont work is wrong. Then again people will make up their own minds in the end anyway, reguardless of what any one else says, because we are human.life is amazing.Ian


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## M&M

This seems like the perfect place to end this particular discussion. Sometimes, once it's clear that no one is going to change their mind on an issue, it's best to just agree to disagree. (Even though we sometimes feel very passionately about something, especially if it worked for us.) Let's all call a truce, and move on to different threads!


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## IanRamsay

Fair enough.Ian


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## MarcoITA

M&M said:


> This seems like the perfect place to end this particular discussion. Sometimes, once it's clear that no one is going to change their mind on an issue, it's best to just agree to disagree. (Even though we sometimes feel very passionately about something, especially if it worked for us.) Let's all call a truce, and move on to different threads!


 I disagree. Purpose of a discussion would be also to give details and find possible explanations... not just trying to change someone's mind. I think a discussion should last until someone has something to say, which would be useful to others. I really find useful the things Ian and frantic1980 have said here. You're the Moderator: with all due respect, it'b be better trying to "moderate" discussions than trying to stopping them...







Kathleen's point is very interesting too ("Why let chance decide what kind of bacteria you get?") and, if you allow, it would be wonderful to know if frantic1980 has an answer to this. So... please, let's keep this thread "alive". It could be very useful to many people. Thanks a lot. Marco


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## Kathleen M.

Well some people never, ever, stop talking and we've had threads that devolve into endless arguments with dozens of pages of nothing but the same thing over and over with just a couple of posters going back and forth.Unfortunately sometimes those get into personal attacks (which are very much against the terms of service of the board) and sometimes become much more upsetting than helpful to most members even if they stay relatively civil. I hate for people to leave the board because they don't like the endless debates and we have lost several from that in the past.http://www.ibsgroup.org/tos Terms of Service LinkSure some people like to pull out the popcorn and watch two people go at it for weeks, months, or years (and trust me, some people never get tired of saying the same thing over and over). However most people are here looking for help and that can get in the way.We generally ask people to agree to disagree and move on (and answer questions rather than mostly debate who has the right approach and why the other person's view just can't work) when we start getting to a point where the thread seems to be getting into a situation that could go into endless debate mode we try to ask people to let it go rather than wait for several more pages of the same sort of thing (and we have a mention of not doing that sort of thing in the posting guidelines)http://www.ibsgroup.org/forums/index.php?showtopic=81175 Link to Posting Guidelines.We've had a few very rabid debaters here that upset a lot of users who come here for help and not to watch a couple of people unable to agree with each other. Often it does devolve into making the other person see you have the only correct view than a discussion of the points and looking for the common ground or even answering questions about one's own view. We have seen this happen a few times over the years. I'm not sure how you want us to moderate the discussion. People generally find a locked thread if people can't end it on their own preferable to us dictating what people should say directly or editing every last post to keep the thread on topic and the discussion productive. That being said, we are happy when people report what works for them, just remember that your answer is not the one and only answer for all people and allow other people to report their experiences as well.


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## MarcoITA

Kathleen M. said:


> Well some people never, ever, stop talking and we've had threads that devolve into endless arguments with dozens of pages of nothing but the same thing over and over with just a couple of posters going back and forth.


 This is not the case. For example I've learnt, one page back and not dozens of page back, that in Pimentel's theory bacteria producing methane are linked to IBS-C and bacteria producing hydrogen are linked to IBS-D. That seems important to me and maybe it's important if you're going to do a Lactulose Breath Test.



Kathleen M. said:


> Sure some people like to pull out the popcorn and watch two people go at it for weeks, months, or years (and trust me, some people never get tired of saying the same thing over and over). However most people are here looking for help and that can get in the way.


 Yes. Some people do and some people don't. I'm here to try to understand and share experience of MY Ibs with other people.



Kathleen M. said:


> I'm not sure how you want us to moderate the discussion. People generally find a locked thread if people can't end it on their own preferable to us dictating what people should say directly or editing every last post to keep the thread on topic and the discussion productive.


 It depends on the meaning you're giving to the word MODERATE. Moderation doesn't mean censorship if YOUR IDEA NOT = MY IDEA. Moderation doesn't mean I'm the Boss here and the thread will stop when I'll say "Stop!".



Kathleen M. said:


> That being said, we are happy when people report what works for them...


Maybe. Or maybe not.Re-reading your first message in this thread (page 1) your tone doesn't seem very happy. It seems to be indeed rather hostile to frantic1980.("That being said, different things work for different people and if this works for you, thank you for sharing.").Kathleen, you probably forgot to say "Adios" to frantic1980, in that sentence...


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## Thai

Some time ago I wrote and complained about this thread as I found it EXTREMEMLY offensive.The language was attrocious and the accusations totally off the wall and disrespectful.I don't come here for this and I would think that most others do not either....there are surely many other places on the net for such vulgarity.Please go there and leave us alone!!!!When I come here, I should not have to open a thread to read the latest posts and be bombarded by this garbage.IMO, locking down this thread should have been done some time ago.Thai


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## frantic1980

I agree that it is time to end the Probiotics/No Probiotics debate. It is getting extremely tiresome. I have asked Ian on many occassions to start another thread in the SIBO Forums about why probiotics work for him for SIBO and to start a discussion on this topic. I have already apologised to Ian for being hostile at one stage, but its been frustrating: I say one thing, he says another. I have also asked for some concrete scientific evidence why probiotics work but none has been provided - just confusing theories, contradicting himself on previous posts and back-tracking to defend his point. Nothing scientific. I don't agree that it is time to end discussion on this thread... aside from the tiresome debate on probiotics thre is still a lot of good stuff coming out of it.... a page back Marco has reported great results based on things he has read on this thread in particular the low-carbohydrate diet and abstaining from probiotics. Megyn has reported that she also found that yohurt nullified the effects of Xifaxan (and is abstaining from probiotics) - people are still learning from this thread, exchanging experiences and giving each other good advice therefore the thread is still producing valuable information. But the probiotics debate needs to end.Most people in this thread are following the Protocol developed by Dr Mark Pimentel; and in this protocol abstaining from probiotics is pretty fundamental to its success (I don't know if he has changed his stance on this since he wrote the book as you say Katherine - but I have no reason to believe so). People keep asking in other threads "why does it keep coming back".... "why do I relapse".... I believe people relapse because like I did 5 times I was putting the bacteria right back in after I killed it all off by taking probiotics.Ian: I respect your passion and enthusiasm for probiotics and bacteria, but we are going to have to agree to disagree on this point, I do think it is time to end the probiotics/no-probiotics debate. You seem like a nice guy, and even after my being very hostile and personal in defending my stance you have done nothing but wish me well and for a lasting recovery, so once again I apologise to you and the other members for being out of line. I do believe your particular case is different to most people on here as you have said you have a leaky IC valve which causes a backwash of bacteria into your small intestine so I am not surprised that antibiotics do not give you lasting relief as you have a physiological problem in your intestines that really needs surgery to be corrected; antibiotics will never provide you with lasting relief as the bacteria will wash back again. So I respect that in your unique case probiotics are probably the only option for you.Almost everyone with IBS uses probiotics at one point - they do give great relief but Pimentel believes that although they provide relief they do prevent a complete cure. This is the only thread I have read on these boards that gives advice about staying away from probiotics to cure SIBO - and I believe that this makes it a valuable contribution to the collective knowledge of the board.


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## Kathleen M.

If it is on topic of what worked for the original poster, or questions about how to do something similar that is OK,If there is jsut going to be more back and forth about who does or doesn't make any sense to the other, that needs to stop and sometimes locking the thread has been the only thing that has stopped it in the past.From what I know of the feedback we get if we at any time ever do anything to anyone's posts that could be considered moderation in any manner it is always seen as censorship. That is why the Moderator team usually resorts to just locking a thread that goes too far. It is less trouble than trying to figure out what edits may or may not be acceptable.Luckily things have calm down a lot lately, and I'd like to see it stay that way I really don't have time to sit on this thread and decide which questions can be asked and who can respond to whom. If everyone is willing to set the debate portion aside and get back on topic also we should end the whole if you do or do not like how this site is or is not moderated that would be great as well. You can send something in private to Jeff if you think there is a better way, or find a site where the moderation suits you. We try to have a very light hand here, but sometimes we do feel we have to step in.


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## M&M

I was not planning on closing this thread, but because of a few comments made since I posted, I'm closing it.When I said politely to move on to other threads it was not a suggestion. If you don't like the way any forum is moderated you are free to post somewhere else Marco. When you joined you agreed to the Terms Of Service. Having moderators is part of the agreement. If you disagree with any of the decisions made by the moderators you may leave at any time.This thread is now closed, and the topic is not up for debate. Now we can move on to other threads.


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