# Article on intestinal bacteria & new IBS study



## badfoot (Oct 5, 1999)

http://news.excite.com/news/r/001213/08/he...-irritablebowelStudy links intestinal bacteria to irritable bowel syndrome Updated 8:00 AM ET December 13, 2000 By Deena Beasley LOS ANGELES (Reuters) - Irritable bowel syndrome, a chronic condition believed to plague 20 percent of the adult population in developed countries, may be caused by too much bacteria in the small intestine, researchers said Wednesday. It was the first time a potential cause for the disease has been identified and could lead to a radical shift in treatment, according to the lead investigator in the study. "This is really exciting because it points to the cause of the disease. Treatments for irritable bowel syndrome (IBS) to this point have been directed at symptoms, not any cause," said Dr. Mark Pimentel, who is also assistant director of the gastrointestinal motility program at Cedars-Sinai Medical Center in Beverly Hills, Calif. Symptoms of IBS, which is diagnosed in twice as many women as men, include gas, bloating, abdominal pain, constipation, diarrhea or both. "We found that 78 percent of IBS patients have bacterial overgrowth in the small intestine. Antibiotics got rid of the disease in half of the patients that got rid of the overgrowth," Pimentel said. Treatments for the gastrointestinal condition currently range from anti-depressants, which are supposed to alter nerve endings in the abdomen, to advice to eat more fiber in order to alleviate constipation. Last month, the IBS drug Lotronex was pulled from the market by its maker Glaxo Wellcome Plc after the U.S. Food and Drug Administration (FDA) voiced concerns about side effects and said three deaths might have been related to the product. Lotronex, marketed as a treatment for women with diarrhea-predominant IBS, was linked to reports of a bowel condition called ischemic colitis, which restricts blood flow to the colon. Some Lotronex users also reported severe complications from constipation. NEW DRUGS AIMED AT SYMPTOMS Zelmac, an experimental drug described as a treatment for women with constipation symptoms of IBS, is expected to be approved by the FDA and launched by its maker Novartis AG by the middle of next year. But Pimentel said pharmaceutical companies may want to redirect their research efforts in IBS to target alternatives for eradicating bacteria in the small intestine. "Once they see this trial, they will really wonder what they're doing," Pimentel said. Cedars-Sinai investigators evaluated 202 patients who underwent a specialized breath test to determine the presence of small intestinal bacterial overgrowth, a condition in which bacteria typically found in the colon makes its way up into the small intestine. "The bacteria produces the bowel symptoms. The fact that we found the overgrowth in almost 80 percent of patients with IBS is quite dramatic," Pimental explained. He noted that there are several mechanisms designed to prevent the build-up of bacteria in the small intestine, but researchers do not know what goes wrong to allow the bacteria to accumulate. Participants in the study were treated for 10 days with antibiotics, which eliminated signs of the disease in 25 of the 47 patients who returned for follow-up exams. Treatment with alternative antibiotics has been effective in about 90 percent of patients at the Cedars-Sinai clinic, Pimental said. Of the 25 study patients in which no small intestine bacteria was detected after treatment with antibiotics, 12 reported no symptoms of IBS and 13 reported significantly reduced symptoms, the researchers said. "We are concerned about overtreatment with antibiotics and potential resistance to antibiotics. We are currently studying other therapies for eliminating the bacteria, but the results so far are not objective," the Cedars-Sinai doctor said. The Cedars-Sinai team, which published its study results in the December issue of The American Journal of Gastroenterology, is currently conducting a double-blind study comparing treatment with antibiotics to placebo in IBS patients. ^ REUTERS### [This message has been edited by Jeffrey Roberts (edited 12-19-2000).]


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## Guest (Dec 14, 2000)

Very interesting. Sounds like not all the participants got great results. Great post, thanks badfood.brian


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## JeanG (Oct 20, 1999)

Thanks for posting this, badfoot.







JeanG


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## Jeffrey Roberts (Apr 15, 1987)

http://www.nytimes.com/2000/12/19/science/19TREA.html The New York Times December 19, 2000 VITAL SIGNS Treatments: Antibiotics, for Irritable Bowel Relief By JOHN O'NEIL esearchers who suspect that irritable bowel syndrome is caused by an overabundance of bacteria in the small intestine report that antibiotics reduced symptoms in a number of patients in a recent experiment. Irritable bowel syndrome, whose symptoms include bloating, diarrhea and abdominal pain, is estimated to affect 20 percent of American adults, and it occurs more commonly among women than men. In an article published in this month's issue of The American Journal of Gastroenterology, researchers from Cedars-Sinai Medical Center in Los Angeles tested 202 people with irritable bowel syndrome and found that 78 percent had a condition known as small intestine bacterial overgrowth. Forty-seven of those who had tested positive for the bacteria were treated with antibiotics and retested after 10 days. There were no signs of overgrowth in 25 of the patients, and levels had dropped significantly among the others, said Dr. Mark Pimentel, the study's lead author. Among the 25 whose excess bacteria had disappeared, half reported no symptoms remaining while the others said their symptoms had decreased. The researchers are now conducting trials to determine how long the course of treatment would need to be to eliminate the overgrowth of bacteria completely in most or all patients.


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## Mike NoLomotil (Jun 6, 2000)

So Many Rhetorical Questions Raised:What were the patient selection criteria for IBS? The results suggest a subpopulation of patients symptomologic and with a finding of bacterial overgrowth, and temporary remission is achived in half the population plus repeat courses of antibiotic are necessary to maintain a remission.Is this actually an IBS patient or is this a similar but separate symptomologic set or is the bacterial overgrowth the chicken or the egg?In the light of the universal abnormal immune reactivity seen in all IBS patients tested by the physicians I work with these are interesting findings and may represent...another piece of a puzzle which, when fully assembled, will reveal multiple etiologies presently lumped under the label of "IBS".It will be interesting to evaluate the granulocytic reactions in a group of IBS patients with confirmed bacterial overgrowth versus a population confirmed to have no overgrowth yet remain symptomatic.Not to mention looking at the effects of repeat-dose antibiotics upon immune response and retained flora.Ohh it goes on and on but another interesting investigation coming from causal angle.MNL______________ www.leapallergy.com


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