# Can h. pylori contribute to ibs?



## babyblue (Aug 5, 2007)

I believe I have ids-d. After reading all the posts i think it may have started after a bad food poisoning episode. I just had endoscopy/colonoscopy. Was found to have inflammation in my esophagus and H. Pylori infection in my stomach. The biopsy's info will be back next week. Is it possible that the infection is causing or contributing to my diarrhea? I have researched and the H. Pylori can be in the duodenum as well as the stomach. I am currently taking rifaximin and then will start the antibiotic triple therapy for the H. Pylori. thanks


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## eric (Jul 8, 1999)

This sounds more like it could be a possible ulcer perhaps.IBS is not an infection.


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## Kathleen M. (Nov 16, 1999)

Hard to say. Most people have IBS symptoms without an H.p. infection so it doesn't need to be there.A variety of GI symptoms are sometimes mentioned with H.p. infection and diarrhea can be one of them. However since both H.p. and IBS are very common you expect a lot of people to have both even if they are completely unrelated. What I mean is just because IBS symptoms are sometimes reported could be just because 10% or so of people with any disease also have IBS and since many are not diganosed diarrhea could be lumped in with the symptoms even when it is from IBS not the H.p.Also a lot of people do not have symptoms with their H.p. infection so it is hard to know what outside of the stomach issues it specifically causes are really related to the bug or not.Being able to colonize the part of the small intestine near the stomach doesn't mean it can colonize the colon and cause problems there. The ecology is very different in those to parts of the GI tract.K.


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## Prudy (Jan 21, 2006)

Because the H-Pylori treatment is quite severe to your system.. but very necessary.. as this can lead to stomach CA if not treated effectively.. I suggest that you eat a good yogurt with active cultures in it or start taking probotics so you don't end up with worse problems.. after the antibotic is completed..This puts back the good bacteria we need in our intestines.. It just may be that once this is treated.. Your D will be improved.. I hope so..


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## bramhendra (Jun 17, 2004)

babyblue said:


> I believe I have ids-d. After reading all the posts i think it may have started after a bad food poisoning episode. I just had endoscopy/colonoscopy. Was found to have inflammation in my esophagus and H. Pylori infection in my stomach. The biopsy's info will be back next week. Is it possible that the infection is causing or contributing to my diarrhea? I have researched and the H. Pylori can be in the duodenum as well as the stomach. I am currently taking rifaximin and then will start the antibiotic triple therapy for the H. Pylori. thanks


I recently took a course of antibiotics for the eradication of HB Pylori. It did not do anything for my IBS-D.


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## 22468 (Aug 21, 2005)

[quote name='bramhendra' date='Aug 5 2007, 11:45 PM' post='684625']I recently took a course of antibiotics for the eradication of HB Pylori. It did not do anything for my IBS-D.I believe my Microscopic colitis/IBS-D all started w/"the cure" for H.P using the Prevpac for the cure. It did cure the hp but the prevacid in the pac contributed to my probs. I now take Prilosec 10mg/daily for GERD, & feel I need to get off that as most PPI's cause GI probs. Most folks on my colitis board contribute having MC to PPI's & the use of anti-inflammatories. I tried every otc antacid, to no avail. And I feel that worsened things also. Hopefully you can get by w/just the use of anti-biotics. And like was mentioned, take yogart & acidophilus for building up your good flora in the intestines. JMHO...Wish you luck...Luv


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## 18491 (Apr 20, 2007)

babyblue said:


> I believe I have ids-d. After reading all the posts i think it may have started after a bad food poisoning episode. I just had endoscopy/colonoscopy. Was found to have inflammation in my esophagus and H. Pylori infection in my stomach. The biopsy's info will be back next week. Is it possible that the infection is causing or contributing to my diarrhea? I have researched and the H. Pylori can be in the duodenum as well as the stomach. I am currently taking rifaximin and then will start the antibiotic triple therapy for the H. Pylori. thanks


Your story sounds a lot like mine: I did not have all these problems until an apparent food poisoning episode in 2004. When my symtoms did not resolve (I had stopped vomiting but had nonstop GERD and diarhhea) I saw a doctor and learned I had H pylori. The PrevPac remedied that, but symptoms returned once I completed that course. Since then I have been pretty miserable for much of the time. I have GERD, had a cholecystectomy, have horrible, horrible bloating, and alternate between D and C. I have also had poor information from my treating physician. However, I recently found a new docotr---a PA, actrually---who talked with me for more than an hour. She told me of a Dr Mark Pimetel who is doing research on people who seem to have aquired IBS in a sudden onset. Dr Pimentel is using the drug usually prescribed for "traveler's diarhhea" to treat such cases. However, since it is being used "off label" it is not approved for people like me. Dr Pimentel has a paper called "A New IBS Solution." My PA was pretty excited about this research.


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## eric (Jul 8, 1999)

Dr Pimentel is investigating the association between IBS and another condition called sibo.They are NOT the same condition, but sibo can mimick some symptoms of IBS.However there is a lot of controversy about the two conditions.The test Pimentel uses is not very accurate. Also in the last study only bloating improved, d and c and d/c did not or pain.FYIIts not bad bacteria, but normal bbacteria in the wrong place in the small bowel, this is called Small Bowel Bacterial Overgrowth. This is a seperate condition then IBS.You should get tested for it, but the most common test is not very accurate.This is a newer study on the associationof IBS and sibo using a better testing method.Bacterial Overgrowth Apparently Not Important in IBSBy David DouglasNEW YORK (Reuters Health) Jun 04 - An abnormally high number of bacteria in the small intestine does not appear to be a major factor underlying symptoms of irritable bowel syndrome (IBS), Swedish researchers report in the June issue of Gut."The data," senior investigator Dr. Magnus Simren told Reuters Health, "do not support an important role for small intestinal bacterial overgrowth, according to commonly used clinical definitions, in IBS."Dr. Simren and colleagues at Sahlgrenska University Hospital, Gothenburg note that a high prevalence of small intestinal bacterial overgrowth has been reported in patients with IBS, but those results were based on indirect determination using hydrogen breath tests.They therefore assessed small intestinal bacterial overgrowth by a direct test -- bacterial culture of small-bowel aspirates -- among 162 patients with IBS and 26 healthy controls. Cultures revealed small intestinal bacterial overgrowth in 4% of patients and 4% of controls.Signs of enteric dysmotility were seen in 86% of patients with overgrowth and in 39% of patients without. Nevertheless, say the investigators, motility alterations could not reliably predict altered small-bowel bacterial flora."However," said Dr. Simren, "mildly increased counts of small-bowel bacteria seem to be more common in IBS," but "its clinical relevance remains unclear."Gut 2007;56:802-808.Sibo is also a different condition then Post Infectious IBS, which is what your mentioning on the sudden onset.One of if not the top researcher on Post Infectious IBS is Dr Robin Spiller.As mentioned abovce also even though the intial infection could be resolved you can still have gi symptoms for a while afterwards if you don't actually develop "clinical" IBS.Post infectious Info you can also do a serch here and on the interent for Dr Spiller.this is in PDFhttp://www.ddw.org/user-assets/documents/P...IBS_Spiller.pdfhttp://www.medscape.com/viewarticle/518355_printThey have found strutural and cellular abnormalities in PI IBS. Some of the same problems they have found in IBS. Two important cells are mast cells and or enterochromaffin (EC) cells. The EC cells are importnat in storing and releasing serotonin, which is very important in gut contractions.People can have different reason they have sibo. You may also have sibo and IBS or just sibo or just IBS or possible some other issues.There is a lot of research that has been done on IBS and none that shows IBS is generated by bad gut flora or any signle pathogen. Hoever there are multiple pathogens that have shown to lead to the development of IBS AFTER the intial infection is resolved. This is called Post Infectious IBS. Transient bacteria or viruses like some bad stuff out of the fridge say or stomach bugs can also trigger it sometimes, without a person being that aware possibly.Just for the info here.I am also not sure they can actually "CURE" SIBO?"Gut Bacteria and Irritable Bowel Syndrome By: Eamonn, M. M. Quigley M.D., Alimentary Pharmabiotic Centre, University College Cork, Cork, IrelandBacteria are present in the normal gut (intestines) and in large numbers the lower parts of the intestine. These "normal" bacteria have important functions in life. A variety of factors may disturb the mutually beneficial relationship between the flora and its host, and disease may result. The possibility that gut bacteria could have a role in irritable bowel syndrome (IBS) may surprise some; there is indeed, now quite substantial evidence to support the idea that disturbances in the bacteria that populate the intestine may have a role in at least some patients with IBS. This article presents a discussion of the possible role of bacteria in IBS and various treatment approaches."Do bacteria play a role in IBS?The possibility that gut bacteria could have a role Irritable Bowel Syndrome (IBS) may surprize some; there is indeed, now quite substantial evidence to support the idea that distrubances in the bacteria that populate the intestines may have a role in at least some patients with IBS. What is this evidence? It can be summarized as follows:1. surveys which found that antibiotic use, well known to distrub flora, may predispose individuals to IBS.2. The observation that some individuals may develop IBS suddenly, and for the first time, following an episode of stomach or intestinal infection (gatroenteritis) caused by a bacterial infection.(The above is post infectious IBS)3. recent evidence that a very low level of inflammation may be present in the bowel wall of some IBS patients, a degree of inflammation that could well have resulted from abnormal interactions with bacteria in the gut.(There is a lot of research that has been done on the above and more being done, but mast cells are important with this and they can be triggered by both foods and the fight or flight stress system as well as some medications)4. The Suggestion that IBS maybe Associated with the abnormal presents, , in the small intestines, of types and numbers; a condition termed small bacterial overgrowth (SIBO)>(This at the moment is highly controversial and not looking to promicing as a cause for IBS at the moment) However a person can have sibo, but at this time IBS and sibo are not the same conditions.5. Accumaliting evidence to indicate that altering the bacteria in the gut, by antibiotics or probiotics, may improve symptoms in IBS.For some time, various studies have suggested the presence of changes in the kind of colonic flora in IBS patients. The most consistent finding is a relative decrease in the population of one species of 'good' bacteria, bifidobacteria.However, the methods employed in these studies have been subject to question and other studies have not always reproduced these finding. Nevertheless, these changes in the flora, maybe primary or secondary, could lead to the increase of bacterial species that produce more gas and other products of their metabolism. These could CONTRIBUTE to symptoms such as gas, bloating and diarrhea.""We still don't know the exact role bacteria has in IBS. More research is needed."http://www.aboutibs.org/Publications/currentParticipate.htmlThis is some indepth expert sibo info. The problem in sibo is not so much bad bacteria but normal bacteria in the wrong place. sorry its in bold type that is how he worte it into the email so I would see it was his answers."IT IS AN OVERSTATEMENT TO SAY THEY ARE "IRRITATING" SUBSTANCES AT LEAST IN THE SENSE OF BEING SOME TYPE OF TOXIN. THEY ARE NATURAL BYPRODUCTS OF DEGRADATION OF FOOD SUBSTANCES BY BACTERIA WHICH DON'T NORMALLY OCCUR IN THE SMALL BOWEL. SO WITH INCREASED BACTERIA IN THE SMALL BOWEL, THE BACTERIA ARE ABLE TO DIGEST SUGARS FOR EXAMPLE PRODUCING H2 AND CO2 FROM THE SUGARS WHICH ARE GASEOUS BUT WHICH ALSO HAVE OSMOTIC PROPERTIES, I.E. INCREASED PARTICLES THAT CAUSE SECRETION OF FLUID INTO THE BOWEL THUS CAUSING DIARRHEA. IT'S THE SAME PRINCIPLE AS USING NON ABSORBABLE SUGARS LIKE LACTULOSE OR SORBITAL TO TREAT CONSIPATION BY INCREASING FLUID IN THE BOWEL. IT'S JUST THAT WITHOUT BACTERIA IN THE SMALL BOWEL, IT DOESN'T HAPPEN AND THE FOOD SUBSTANCES GET ABSORBED. WITH INCREASED BACTERIA IT COMPETES FOR THE FOOD SUBSTANCES AND PRODUCES THE GAS AND DIARRHEA."*This means these are just in the wrong place and not specific or multiple pathogens?*CORRECT. HOWEVER, THERE IS GROWING INTEREST NOT IN THE AMOUNT OF BACTERIA BUT THE TYPE OF BACTERIA. CERTAIN BACTERIA CAN CAUSE SOME MILD INFLAMMATION OF THE BOWEL AND OTHERS PROTECT THE BOWEL FROM THAT POSSIBILITY. SO THERE IS "GOOD" AND "BAD" BACTERIA. POSSIBLY WHEN PEOPLE ARE TREATING PRESUMED SIBO (WHICH MIGHT NOT ACTUALLY BE HAPPENNING, BECAUSE THE TEST MAY BE INACCURATE) ANTIBIOTICS MAY HELP TO GET RID OF THE BAD BACTERIA AND THAT MAY BE WHY THEY ARE GETTING BETTER. THIS IS WHY SOME PEOPLE GET BETTER AFTER ANTIBIOTIC TREATMENT. BUT IT CAN ALSO GO THE OTHER WAY, I.E., ANTIBIOTICS HAVE BEEN SHOWN TO MAKE IBS WORSE AS WELL. THE OTHER IDEA IS TO USE PROBIOTICS WHICH CONTAIN "GOOD" BACTERIA (E.G., LACTOBACILLUS OR BIFIDOBACTERIA) WHICH REPLACE THE BAD BACTERIA, POSSIBLY REDUCE THE INFLAMMATION AND IMPROVE SYMPTOMS. SO THE ISSUE OF BACTERIA IN THE BOWEL IS MUCH MORE COMPLICATED THAN SIMPLE SIBO, BUT SIBO CAN BE A PART OF THE WHOLE PICTURE (THOUGH NOT THE WHOLE PICTURE FOR IBS).DR Drossman http://www.med.unc.edu/wrkunits/2depts/med...dc/drossman.htmhttp://www.med.unc.edu/wrkunits/2depts/med...n_materials.htmhttp://www.ibsgroup.org/forums/index.php?showtopic=68397The inflammation seen in IBS, and its not clear all IBSers, is macroscopic of specific cells and sites. There has been a lot of research already done on inflammation and IBS, although bacteria is an important part of the research right now as well as other reasons. This is not the overt inflammation seen in ulcers or IBD diseases. IBS is also not infectious.There is also very good research on why there is d and c and d/c and brain gut axis communications.http://www.ibsgroup.org/forums/index.php?showtopic=80198FYIThe History of Functional Bowel Disorders"PRESENT PATHOPHYSIOLOGICAL OBSERVATIONSDespite differences among the functional gastrointestinal disorders, in location and symptomfeatures, common characteristics are shared with regard to motor and sensory physiology,o central nervous system relationships,o approach to patient care.What follows are the general observations and guidelines.MOTILITYIn healthy subjects, stress can increase motility in the esophagus, stomach, small and largeintestine and colon. Abnormal motility can generate a variety of GI symptoms includingvomiting, diarrhea, constipation, acute abdominal pain, and fecal incontinence. Functional GIpatients have even greater increased motility in response to stressors in comparison to normalsubjects. While abnormal motility plays a vital role in understanding many of the functional GIdisorders and their symptoms, it is not sufficient to explain reports of chronic or recurrentabdominal pain.VISCERAL HYPERSENSITIVITYVisceral hypersensitivity helps to account for disorders associated with chronic or recurrent pain,which are not well correlated with changes in gastrointestinal motility, and in some cases, wheremotility disturbances do not exist. Patients suffering from visceral hypersensitivity have a lowerpain threshold with balloon distension of the bowel or have increased sensitivity to even normalintestinal function. Additionally, there may be an increased or unusual area of somatic referral ofvisceral pain. Recently it has been concluded that visceral hypersensitivity may be induced inresponse to rectal or colonic distension in normal subjects, and to a greater degree, in personswith IBS. Therefore, it is possible that the pain of functional GI disorders may relate tosensitization resulting from chronic abnormal motor hyperactivity, GI infection, or trauma/injuryto the viscera.5BRAIN-GUT AXISThe concept of brain-gut interactions brings together observations relating to motility andvisceral hypersensitivity and their modulation by psychosocial factors. By integrating intestinaland CNS central nervous system activity, the brain-gut axis explains the symptoms relating tofunctional GI disorders. In other words, senses such as vision and smell, as well as enteroceptiveinformation (i.e. emotion and thought) have the capability to affect gastrointestinal sensation,motility, secretion, and inflammation. Conversely, viscerotopic effects reciprocally affect centralpain perception, mood, and behavior. For example, spontaneously induced contractions of thecolon in rats leads to activation of the locus coeruleus in the pons, an area closely connected topain and emotional centers in the brain. Jointly, the increased arousal or anxiety is associatedwith a decrease in the frequency of MMC activity of the small bowel possibly mediated by stresshormones in the brain. Based on these observations, it is no longer rational to try to discriminatewhether physiological or psychological factors produce pain or other bowel symptoms. Instead,the Functional GI disorders are understood in terms of dysregulation of brain-gut function, andthe task is to determine to what degree each is remediable. Therefore, a treatment approachconsistent with the concept of brain-gut dysfunction may focus on the neuropeptides andreceptors that are present in both enteric and central nervous systems.http://www.ibsgroup.org/forums/index.php?s...&hl=history"Small intestinal bacterial overgrowth (SIBO) is indicated by a positive lactulose breath test "That is not a very accurate test for sibo.People without IBS can have sibo.


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## babyblue (Aug 5, 2007)

I appreciate all the feedback. I just received a call from my dr. telling me I DON'T have the H. Pylori infection. Misread lab results!!! (How on earth can we get better if they can't even do their job right??" I was happy for the news, though. Now I'm just suffering from the rifaximin. Been on it for 7 days now and I feel awful. Super bloated, wicked cramps, horrible D every day. Its like I'm taking the prep for a colonoscopy, every day! Thats what the past week has been. All day misery. Like I said before, I remember a food poisoning incident in 2004 and I've not been the same since. I panic on a daily basis about eating and being near a bathroom. If I wasn't such a positive person I think the depression would swallow me up. I fight it every day.


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