# Why does rifaximin work ?



## Athan (Oct 8, 2015)

Hello everybody.

I've been having IBS-D for more than 30 years now (I'm 46)

A gastroenterologist diagnosed me and suggested Imodium and possibly mild stress-relieving medication.

After reading some latest researches and tests, I decided to try rifaximin and continue with probiotics.

Rifaximin worked for as long as I took it. The problem was that afterwards, I was more or less back to IBS reality (maybe slightly improved).

The first question here is WHY does rifaximin work, since it is basically andibiotic - antibacterial medication ? It suggests that IBS is really caused by "bad" intestine bacteria.

My second question is WHY did IBS return after rifaximin ended ? Didn't it get all the "bad" bacteria ? Was a bigger dose or longer therapy required ?

I'll appreciate any suggestions


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## rajiv_gupta (Jul 16, 2014)

i am also taking rifaximin for more than two years. when i stop taking rifaximin the IBS symptoms come back with vengeance.

i would also keen to know the side effects of long term usage of rifaximin.


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## Athan (Oct 8, 2015)

I'm no doctor, but as far as I know, antibiotics are not supposed to be used for more than a few days, or weeks at the most. I used it for 8 days and then stopped. When you say two years, do you mean continuous use ? I think you should take care with it and consult a doctor. Side effects are usually described in the medication description.


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## rajiv_gupta (Jul 16, 2014)

yep , i have been taking rifaximin for more than two years continuously.


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## acureisoutthere (Jun 28, 2014)

The potential problem with Rifaximin, also called Xifaxan, is that it is an antibiotic. Antibiotics kill bacteria. The trouble is, we have millions of good, helpful bacteria in our intestines, and we shouldn't be killing these off. They play are huge role in maintaining our health.

So, you might kill some bad bacteria that are causing you problems, but you also kill off good, helpful bacteria. Thus, the argument could be made that you risk doing more harm than good.

Physicians prescribing these antibiotics often have little understanding of the human microbiome. When they finally do have a comprehensive understanding, they're going to realize the potential problems of widespread antibiotic use. We are literally destroying our microbiomes, bit by bit. Already, the average American has lost 40 % of the diversity of their microbiome. We've been ignorant, and uninformed, that needs to change. Read the medical research. Become an expert on the Human Microbiome. It's that important to your health.


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## Athan (Oct 8, 2015)

Ok. As far as I understood, rifaximin is not a cure, maybe a temp solution only.

What impresses me more in this forum, is that almost all the people who have this condition, are looking for cures themselves and some of them even even succeed in it! It must be a first, in modern medical history... And I really didn't know how many suffer from this. I thought it was limited, but it seems like the opposite.

@acureisoutthere

I've read your posts about the FMT and I'm really stunned! I didn't know about it and I'll follow your advice on studying the whole thing. Really seems very-very interesting. Thanks for the info !


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## acureisoutthere (Jun 28, 2014)

Thanks Athan,

I really welcome you to research and really understand the human microbiome. When I had IBS I tried the probiotics, which only gave a temporary help at best, no lasting solution which I was determined to find. It might have been a post by the Freeman on this forum that led me to start researching an FMT. Anyhow, I spent a great deal of time researching it. I also found out about the Human Microbiome and once I learned what is was, and how important it is, well I spent a great deal more time reading everything I could find, and watching every video I could. It is important to our health, and sadly we are making some mistakes in how we treat our microbiomes. But, most don't realize it. We need to change this, we need to spread the word.

I wholeheartedly encourage you to learn all you can, to reverse your IBS, and then also come back to this forum to help others. It's the reason I'm here. I learned from others, I'm trying to pay it forward. I find the best info is from medical researchers. I don't like someone trying to sell me something, I want the medical research, the good stuff. You have to dig a little, but it's cutting edge stuff.

When I first told my general practitioner that I reversed my IBS. Well he didn't know what to say ! He had never even heard of the human microbiome, much less an FMT. As I explained it, he caught on, and quickly. I'm confident he looked into it and knows more by now.

There are companies that get it, they understand what this means, how important it is going to be. They are racing to be best in market, or first in market with the best way to provide a microbiome transplant. I understand this. Trouble is, I wasn't going to wait 10 years for clinical trials to compete, all the while suffering with my IBS symptoms. So, I took the leap, and I am so glad I didn't wait. I would do it again, in a heartbeat if I needed to. I'm hoping I never have to take antibiotics or medications again, that may screw up my microbiome. But, at least I know how to fix it, if it if it ever happens.

Best of luck on your journey, and come back here to help others understand, please.


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## Militia99 (Nov 14, 2012)

Hello! Readng this post still leaves me with my concerns. I was just prescribed Rifaximin yesterday at my GI appointment but I haven't yet gotten the script filled. I'm still nervous to take yet another medication (an antibiotic at that) that only serves as a temporary relief and not an overall long-term life change.

If you have taken Rifaximin do you have any unpleasant symptoms (worse than your regular IBS) such as "die-off" like other antibiotic meds/anti-fungals? I've been missing a lot of work due to IBS-D and I can't afford to be any worse then I've been. Are you able to function while on the med? How long have you felt relief after the orginial script was done?

As far as FMT I've been doing a lot of research as well and it shows to be very promising. I think there is definitely a lot of unknowns when it comes to our microbiota. I do know that there are currently FMT trials for IBS patients happening in New York City area and a few other locations. However as of right now to obtain FMT in the United States you have to have been diagnosed with C.Diff and used as a "last option." I don't know that the pharmaceutical companies would allow something like "poop pills" to take over the drug market at a chance they would lose $$ on their other drugs. This opens up a whole different can of worms but I would love to hear any feedback or thoughts!

Age 31 - IBS-D (diagnosed at age 18)


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## acureisoutthere (Jun 28, 2014)

Militia99,

I've read that Johnson and Johnson has started a microbiome unit, and is looking into this subject. I think it was started early this year 2015, if I remember correctly.

Dr. Louie, in Canada, was the first one I heard of trying to encapsulate the microbiome in a pill form. It sounds like others are moving in that direction now. We'll have to see how the success rate turns out in the trials though. If one takes 20 to 30 pills, is that the same as a complete transplant ? The trials will tell.


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## Militia99 (Nov 14, 2012)

Acureisoutthere: I've also learned that there is a company in Medford, MA (openbiome) that is also working on making pill form and clinical grade FMT material (they operate a non-profit, stool-bank). However is can only be obtained by a physician and as of right now in MA there are only a few physicians that will do FMT but strictly for C.Diff patients.


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## IBS2 (Feb 7, 1999)

I agree with Dr. Stefan that only a short course of Rifaximin is warranted. I just saw a TV commercial for Rifaximin as a treatment for IBS-D. I have no doubt the company will make a lot of money from this drug, but also have little doubt, at least from the responses on this forum, that there will be many "cures". The problem I have with anyone making statements about a cure for IBS is, how to you cure something when you can't find any signs of pathology? At this point I would settle for control of my symptoms.


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## Athan (Oct 8, 2015)

Militia99

No unpleasant symptoms for me. On the contrary, my IBS-D symptoms were significantly lessened and I was functioning much better while on the med.

The problem was that after the 8-day period of medication, my old symptoms gradually returned (at a slow rate). I think that there is a slight improvement in my IBS condition, but I cannot be sure, as, even in normal conditions, it comes and goes (and also, simultaneously with rifaximin, I stopped my kefir drinking). So I really cannot say for sure, if my slight long term improvement is a result of med or kefir discontinuation.

Also, no "flare ups" for me after the medication ended.

If I could, I would use it on a longer basis, but I'm sceptical on long term antibiotic usage.

Hope I've helped !


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## acureisoutthere (Jun 28, 2014)

IBS2 said:


> I agree with Dr. Stefan that only a short course of Rifaximin is warranted. I just saw a TV commercial for Rifaximin as a treatment for IBS-D. I have no doubt the company will make a lot of money from this drug, but also have little doubt, at least from the responses on this forum, that there will be many "cures". The problem I have with anyone making statements about a cure for IBS is, how to you cure something when you can't find any signs of pathology? At this point I would settle for control of my symptoms.


I think it would be helpful for you to understand the human microbiome. Please, do this. There are literally millions of bacteria in your large intestine. For one reason or another, they sometimes get out of balance, or the good ones get displaced. Thus when one introduces a healthy microbiome from a healthy person, it restores the flora to a healthy state, thus relieving one of symptoms. Who would have thought that we actually need these bacteria, that we need that diversity, and how much it can affect our health ? But that's what medical researchers are finding.


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## IBS2 (Feb 7, 1999)

acureisoutthere,

What I'm asking is what causes IBS-D? For instance, we know diabetes is caused by a lack on insulin production by the pancreas, but as far as I know the diagnosis of IBS is still based on the exclusion of finding any pathology. If in fact IBS is due to SIBO i.e. pathogens and the treatment is Rifaximin why are we still here? It would be interesting to see how many people who have taken Rifaximin have been "cured". Don't get me wrong I'm glad for any basic research into IBS and would be overjoyed to simply take a poop pill and return to the way I once was. I'm just saying if you can't identify the basic pathophysiology of IBS then we're no where close to a cure and the best we can do is to control the symptoms.


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## an0chick2 (Jan 27, 2015)

I'm 100% positive ibs or at least in my case it is caused by a lack of good bacteria. They are now realizing that bacteria is VERY tied to mood & diseases. It is very important for toxins and even help to keep us healthy giving out immune system a boost. I really believe that there are so many sick people because of lack of good bacteria, overload of bad bacteria AND toxins. Food isn't even real food anymore it's full of toxic additives and hormones or antibiotics. And the food that isn't filled with toxins is SO much more EXPENSIVE. I'm officially making 95% of the food I eat. (Mostly whole foods) i don't buy anything processed. I'm starting to make my own yogurt and my own kefir. When I buy yogurt (I'm still learning to make it) I only buy ORGANIC, GRASSFED,yogurt with live cultures. I only buy organic meats and mostly eat chicken not beef or salmon (salmon is toxic bc I'd the wastes dumped in the water). I've read of people getting better. But it takes GREAT EFFORT and determination. It takes cutting out simple sugars completely. Cutting out most processed foods and eating mostly whole, organic foods. I know I'll eventually get better but I also know it's not going to be easy. But as I feel better I have more energy to cook everything myself.  I've been sick for TWO years. I wasn't eating right. Until now. Its only been 1 or 2 months since I've cut out processed foods, I've been diagnosed with Epstein Bart virus, gluten intolerance, and the doctor thinks I have Chronic Fatigue Syndrome but I feel SO MUCH better. My energy levels are very much improved. Doctors gave me antibiotic after antibiotic for TWO years. Until recently... I'm now trying to take care of myself and not rely on taking care of myself AFTER I get sick. I'm already sick but this is a lesson learned. Guys, try to change your diet. It will make you feel better. Not the first day, or first week. It can take months but I know this is the way.


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## an0chick2 (Jan 27, 2015)

Like they say, nothing that's worth it will be easy. But theres nothing better than working hard for yourself, your own health, and reaping the benefits.


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## Athan (Oct 8, 2015)

an0chick2 said:


> I'm starting to make my own yogurt and my own kefir.


Hi an0chick2

Did you notice any improvement with kefir and what fermentation do you use (1 day, 2 days, more) ?

I'm asking because I stopped my kefir while starting rifaximin and I'm thinking of starting it again.


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## acureisoutthere (Jun 28, 2014)

IBS2,

Perhaps, if you watch this video by Dr. Lawrence Brandt you will start to understand better.

https://www.youtube.com/watch?v=JRZxOU1x71c#action=share

Maybe, it will help you to understand; I reversed my IBS with an FMT, I can eat so many foods now that used to cause me problems. Dr. Thomas Borody is reversing IBS, along with other disease conditions by using FMTs.

Please, you've got to look into the Human Microbiome, and Fecal Microbiome Transplants.

Or perhaps this video by Trevor Marshall will better explain disease pathology and it's relation to the microbiome.






You could also go to ThePowerofPoop website and The Fecal Transplant Foundaiton website. These sites will help you to learn about microbiome transplants also.


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## IBS2 (Feb 7, 1999)

acureisoutthere

Thank you for the reference to Dr. Brandt's You Tube presentation. Unfortunately, the first video did not display. As I mentioned in my prior post I'm all for research in IBS and the development of new treatments. That said, in watching the two other videos by Dr. Brandt, he talks about using stool to cure everything from IBS to obesity to MS. What I'm trying to find out is, if we don't have a cause for IBS and no pathology is found, what is the mechanism for fecal transplant to cure the disease. Dr. Brandt cited his study of 77 patients, but he did not give the break down of what types of conditions he was treating. I'd like to know how many of the 77 were patients with IBS? I surely hope as Dr. Brandt has suggested that the treatment of disease with specific bacteria provides us with a new form of treatment. Do you know of any clinical trials using fecal transplant that replicated Dr. Brandt's success in treating IBS? I know FMT is being used to treat antibiotic resistance c.diff with success, but you have to admit when it comes to IBS all too often on this forum someone comes up with a "cure" for IBS, including the use of Rifaximin only to find out that the cure doesn't live up to the hype. Believe me I hope you're correct and fecal transplant is the answer. At the age of 68, having IBS since the age of 17 I'd like to think that there's still some time to fully enjoy life without IBS.


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## acureisoutthere (Jun 28, 2014)

IBS2,

Was the video by Trevor Marshall helpful ?

I encourage you to check out clinicaltrials.gov from time to time. Do a search for FMT. There is a current trial for IBS using a microbiome transplant in encapsulated pills, though I'm not sure if they have been prepared anaerobically, and this would make a difference. I believe the trial is still recruiting patients, if you are in the area and interested. I hope you find the way to enjoy life without IBS. It must be hard. I'm trying to help.


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## brox914 (Oct 28, 2015)

I am enrolling in that trial mentioned in the previous post. I think that truly is the best hope for a solution. I did the 2 week xifaxan round. Saw immediate positive result when starting, then immediate return within a week.

Like many, I've tried a lot. The fact that I even felt effects from xifaxan and the fact that probiotics make some impact truly support the fact this is bacterial in nature. FMT feels like a chance worth taking. I just wish I didn't have to jump through so many hoops to get it. With this trial, I may not get the real thing till March. Cuz everyday is a struggle for us all, that's tough to stare in the face and wait for...


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## acureisoutthere (Jun 28, 2014)

Brox914,

I am wishing you the best outcome on your trial. I really do, because this could mean so much, for so many people here. Hopefully, Dr. Aroniadis and Dr. Brandt are communicating with Dr. Borody, and with Glen Taylor to find the most effective approach to reversing IBS.

All of us should be so thankful for their efforts. Their desire to help others overcome this nasty disease called IBS, and other diseases associated with the microbiome, deserve our utmost respect and heartfelt thanks.

Please, keep us posted as you continue the trial. It's what we learn from this trial, and the next trials, that will help improve the success rate. Wishing you the best !


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## Athan (Oct 8, 2015)

@Brox914

Good luck and best wishes.

You're lucky to be able to participate in this trial... I just wish I lived in US, so that I could apply too !!

@acureisoutthere

Thanks for your info. I've read a bit into the microbiome and saw the videos. It all agrees with my experience with rifaximin.

I also googled Dr Aroniadis. Let's hope they suceed !


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## IBS2 (Feb 7, 1999)

My hope is that those who are fortunate enough to be in a location to take advantage of this new clinical trial will continue to update this forum on their progress. I have a feeling that modifying the microbiome might be the answer to IBS is due to the link between our GI tract and immunity and that IBS is a disease of the immune system. I'm not sure if this is common, but my IBS is better when I'm sick, that is to say several days before I come down with a cold my IBS is almost non existent and mood wise I experience a feeling of being almost giddy. I surmise that what happens is there is a spike in the immune system response to the cold virus which effect my GI tract. This is not to say I look forward to getting a cold with all its associated misery, but I have to tell you if those few days prior to the onset of the coughing and sneezing is what it's like to be free of IBS then I sure hope this clinical trial works.


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## acureisoutthere (Jun 28, 2014)

Thanks Athan !

When you spend so many hours and days, and ,reading about the microbiome, you really get a picture of it. The discovery of the Human Microbiome is already being called one of the greatest medical discoveries of this century. It's that important, and it's why I encourage others here to learn about it too. When you understand the human microbiome, then you really understand why a microbiome transplant makes sense.


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## poopman (Jul 25, 2015)

Rifaximin is a topical antibiotic as long as I have heard, 
I tried it for 8 days/550mg/thrice/day as the standard prescription goes but then out of the blue someone came up with an idea that it could damage my kidneys if taken for too long, since at that time I wasn't aware that it won't be absorbed into my bloodstream so stopped it asap and now as I'm aware of it that'd mean direct excretion through poop :/ :?

So I may take the course once more provided I don't have to go through that heartburn I had during the last course.
The consistency of stool had changed to hard dark, often Reddish or brownish as well and it felt like it tore through my colon.
My job schedule is random twilight/night shifts so don't exactly know when to eat and when not to !!

Hoping this semi-dead life culminates into a healthy tomorrow !!
Way to go Rifaximin.


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## poopman (Jul 25, 2015)

acureisoutthere said:


> Thanks Athan !
> 
> When you spend so many hours and days, and ,reading about the microbiome, you really get a picture of it. The discovery of the Human Microbiome is already being called one of the greatest medical discoveries of this century. It's that important, and it's why I encourage others here to learn about it too. When you understand the human microbiome, then you really understand why a microbiome transplant makes sense.



Transplant had been done to my uncle by the costliest of the costliest docs out there....

Still no reslut the same crap goes on...if it was worth trying you think I won't??
Its all a ****HOAX**** who ever u saw must be lucky or co-incicental.....


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## poopman (Jul 25, 2015)

poopman said:


> Rifaximin is a topical antibiotic as long as I have heard, I tried it for 8 days/550mg/thrice/day as the standard prescription goes but then out of the blue someone came up with an idea that it could damage my kidneys if taken for too long, since at that time I wasn't aware that it won't be absorbed into my bloodstream so stopped it asap and now as I'm aware of it that'd mean direct excretion through poop :/ :?So I may take the course once more provided I don't have to go through that heartburn I had during the last course.The consistency of stool had changed to hard dark, often Reddish or brownish as well and it felt like it tore through my colon.My job schedule is random twilight/night shifts so don't exactly know when to eat and when not to !!Hoping this semi-dead life culminates into a healthy tomorrow !!Way to go Rifaximin.


to add ++
IBS can't be cured....I know it NOW....just like our heart pounds, our lungs inhale and exhale..similarly some of us unlucky fellas develop this "Genetic mutation" that was written up a li'l time ago by nih reporting such permanent changes that can't be reversed (not being a hope drowner here)

SODIUM CHANNEL MUTATION
^^
http://www.ncbi.nlm.nih.gov/pubmed/19056759


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## Athan (Oct 8, 2015)

poopman

I deny taking my IBSD situation as un-curable. It's a really pessimistic view and will add negativity to our -already negative- psychology.

So, I'll just keep on trying herbs, natural cures and all kind of crazy stuff...

Stay positive !!


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## acureisoutthere (Jun 28, 2014)

poopman said:


> Transplant had been done to my uncle by the costliest of the costliest docs out there....
> 
> Still no reslut the same crap goes on...if it was worth trying you think I won't??
> Its all a ****HOAX**** who ever u saw must be lucky or co-incicental.....


poopman,

I am sorry to hear about your uncle. It must be very frustrating. Doctors are not infallible, no matter how much they are paid. It is quite possible that the doctor followed an old protocol that used a blender to prepare the sample. This is now an outdated protocol, as it is understood that almost all the bacteria we are trying to transplant are anaerobic. Thus incorporating air into the sample as we homogenize it runs the risk of killing many of the good, helpful bacteria we are trying to transplant. It also exposes these tiny bacteria to a spinning metal blade at thousands of rpms. This can't be helpful either. Prominent researchers and doctors are now doing everything they can to eliminate all exposure of the sample to air.

Before I did my procedure myself, I had came to this same conclusion, on my own. I took great pains to limit exposure of my donor's sample to air, as much as I could anyhow. I tried as much as I could to keep these bacteria in a natural state; warm, dark, etc. This may have played a role. My transplant was successful. Truly, IBS is more of a challenge to reverse than C. Diff. Yet, it is being done. Please, read this link :

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3868025/

The author reports that in 70% of the patients with IBS that were given an FMT, improvement was noted. This is substantial.

Either next year, or in 2017, we will have the results of the clinical trial using FMT for IBS that is being done in New York. It's in phase 2 right now, so hopefully the next phase will be a multicenter trial and available to many more individuals on this forum.

So, please don't be discouraged. Have hope. Interest in the Human Microbiome is exploding. Research is beginning for many different disease states and their relation to the microbiome. It's amazing the role that these bacteria play in our health. We are swimming in bacteria. We actually have 100 trillion of these 'friends' that live in, and on our bodies. Bacteria cells outnumber our human cells by 10 to 1. You could say, that we are mostly bacteria, and just 10% human. Understanding and manipulating the microbiome is going to be the hottest topic in medical care for some time. I believe that in the future if we have any unhealthy state in our health, we will first be looking at our microbiome. Perhaps in time researchers will unlock the specific bacteria or groups of bacteria that associate with each different disease state. It's very complex though.


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## IBS2 (Feb 7, 1999)

I would recommend the You Tube presentation "IBS and the Microbiota" given by Dr. Steve Collins. In it he gives a very good presentation of IBS, the role of the microbiome and potential treatments. One of those therapies addressed is fecal transplant including some of the things you should think about when considering this form of treatment. I would mention that the date of the presentation was in 2013 and might be dated in its information. That said, it would appear to me that fecal transplant, at least at this time, is similar to a physician ordering a broad spectrum antibiotic for an infection. That is to say you know the patient has a fever and symptoms of an infection, but you're really not sure just was the infecting organism is so you you take a shotgun approach with a broad spectrum antibiotic. There is some interesting work going on to better identify the specific microbes needed to treat a specific disease entity. In another good You Tube presentation from one of the TED talks titled "Mind altering microbes: how the microbiome affects brain and behavior given by Elaine Hsiao, she gives examples where specific microbes were used to effect changes to specific conditions. Granted the work work was done in mice, but the implications were clear, with time we should be able to identify what microbes to be used for what disease. Interesting stuff!


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## acureisoutthere (Jun 28, 2014)

IBS2,

Thanks for the information about the presentation by Dr. Collins. A bit long but very informative and helpful. Thank you !

Elaine Hsiao gives a good talk too. I enjoy listening to Dr Rob Knight, of course there are many good ones.

I was just reading last night about how they are connecting Rosacea to the intestinal microbiome. I would have thought it would be related to the skin microbiome only.


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## pepgenova (Jun 14, 2017)

Hello @acureisoutthere
Are there any news? Thanks


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## acureisoutthere (Jun 28, 2014)

Hi pepgenova,

As far as my IBS-D, it's been over two years since my successful FMT, and I am still doing fine ( I still have lactose intolerance, however it is not nearly as bad as it used to be) I try to eat a variety of fruits and vegetables. I also try to include fermented foods. I avoid processed foods and am working on avoiding GMO foods. My bowel movements are great. It's nice to have IBS behind me. I just wish everyone here could have the same relief. It's why I encourage everyone to start learning about the human microbiome so they can understand why they have IBS in the first place. When they really understand this, then they will be equipped to help their physician to read about it and learn as well. It is a way forward......... We need to encourage more clinical trials for FMTs, so we can finally get FDA approval of FMTs for IBS, and the millions of people that suffer can find the help they need.

I also encourage people here to submit samples to The American Gut project. This will help researchers isolate and better understand IBS. It's a way forward. It's important. We need to help the researchers, this is the way millions of people are going to be helped.

On a side note; I recently heard about the concept of getting rid of the dissolved oxygen in the saline to be used for an FMT. A very interesting observation ! (Anaerobic FMT)


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## mellosphere (Sep 22, 2015)

Acureisoutthere do you eat gluten free?


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## acureisoutthere (Jun 28, 2014)

Hi Mellowsphere,

No, I don't have to avoid gluten. I used to, when I had IBS-D. I would get a terrible flare from bread, and also dairy. A flare for three days. No fun.

Now, I can eat bread and it's no problem. Dairy is much better, but still gives me a little bit of trouble. Generally I avoid dairy, but take Lactaid when I'm going to have a dairy product.

I do keep trying to avoid GMO foods and this means buying the non GMO frozen bread at the local market. Ever since I found that research paper on the NCBI website showing that glyphosate is killing our good, helpful (commensal) bacteria, I have been trying to avoid GMO products.


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## IBSD2 (Jul 30, 2017)

So Rifaximin works ( by non-descriminatingly killing off bacteria in the small & large intestines )

And Fecal Microbiome Transplant also works ( by non-descriminatingly killing off bacteria in the small & large intestines and replacing it with a 'fecal' load of bacteria from the donor )

My questions are:

1- What PRObiotics are out there now that can be used after a course of Rifaximin to help repopulate the intestines with good flora/ good bacteria?

( I am on VSL-3 which has 112 Billion CFU but only of lactobacillus, so it isn't the answer here)

2- What PREbiotics are out there to promote the growth/health of a healthy microbiome?

3- What diet can help keep the right bacteria?

( I am on a Low FodMapp diet and it works by not supplying fiber/food to bacteria that can ferment food )

I would love to know your thoughts


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## acureisoutthere (Jun 28, 2014)

Well, first it depends on the FMT procedure that is being done. T. Borody uses a cocktail of three different antibiotics prior to an FMT to 'knockdown' the existing population that we want to replace. However, Taylor doesn't use antibiotics. There are competing theories.

From what I read about probiotics, they don't necessarily attach to the epilithium, and therefore establish themselves. it seems that right now they do provide a temporary relief for some people and reduce symptoms (which is helpful to a degree). But as soon as they stop taking the probiotic the symptoms return, which agrees with the understanding that they don't seem to be establishing on the intestinal wall. I've read two different theories on this. One, it is because they lack the proper enzymes that let the body recognize them. The other is that the bacteria in probiotics have lost the ability to 'grab hold of' the intestinal wall. It's a matter of understanding how bacteria live and multiply. Bacteria often multiply quite rapidly. As they do they, they can make changes. It has been theorized that because probiotifc bacteria are grown in stainless steel vats, and that these bacteria when grown in this environment no longer need the ability to 'grab hold of' their environment, that they loose this ability. So, we may be growing probiotic bacteria in the wrong way. I've written some letters to try to encourage a better approach. Time will tell.............

Diet ; I t is a challenge for a person with IBS that is different that from someone without IBS. If you don't have IBS, then eating a large variety of fresh fruits and fresh vegetables is very recommended (there is actually good bacteria on fresh picked produce, the ones we need, if you look into it) . However, for someone with iBS, this can often be a problem as it sometimes happens that these foods cause flare up of symptoms. I believe it is because for those with IBS, they have either lost those bacteria species that help them to normally digest and deal with different foods, or they have such imbalances between their species that their whole ecosystem of bacteria (their microbiome) is out of whack, so to speak, and doesn't behave normally.

Sorry, I'm out of time this morning.......................


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## acureisoutthere (Jun 28, 2014)

Hi again,

If you can handle them, indigestible carbohydrates are excellent food for your gut microbes. Fresh fruits and fresh vegetables are to, if you cahandle them. They are good for your microbiome. The trouble is, for many with IBS, they have are hard time with certain foods. One has to, or should do a food elimination diet to find their problem foods, and then avoid them. But, if there are fruits and vegetables that do not cause problems, you want to have them in your diet, and fresh picked is even better.

You can also try fermented foods. They seem to help the microbiome. However, for some with IBS they can cause problems. So, it's a try it and see approach. If fermented foods don't cause problems then by all means consume them. If they cause issues, then avoid them.


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