# Neomycin for eradicating methane-bacteria in IBS-C



## 23770 (Nov 26, 2005)

The following shows that Neomycin improves constipation in IBS when methane is detected in the Breath TestNeomycin Improves Constipation in Ibs: Subanalysis Of a Double Blind Randomized Controlled StudyNeomycin Improves Constipation in Ibs: Subanalysis Of a Double Blind Randomized Controlled StudyAuthors: S. Park, M. PimentelA recently published double blind study revealed that antibiotic treatment of irritable bowel syndrome (IBS) results in symptom improvement, which is further enhanced when their lactulose breath test is normalized. Furthermore, methane presence on breath test is predictive of constipation predominant IBS (C-IBS). However, the effect of antibiotic treatment on constipation has not been reported and the role of methane in this response needs evaluation. Methods: 111 non-tertiary IBS subjects (Rome I) were enrolled in a double blind study. Subjects with a history of recent antibiotic or antidepressant use, inflammatory bowel disease, cirrhosis, autoimmune disease, diabetes, previous bowel resection, or narcotic dependence were excluded. Subjects had a lactulose breath test and were blinded to the result. They were then randomized to receive placebo or neomycin for 10 days in a double blind fashion. Subjects then returned for follow up 1 week after the completion of antibiotic therapy at which point the lactulose breath test was repeated. A questionnaire was completed before and after treatment. Of these patients, those with constipation predominant IBS were sub-selected for analysis. The percent improvement in constipation (0-5 VAS scale) was compared before and after treatment. The response of methane producing subjects was also contrasted to non-methane. Results: Of 111 subjects, 39 (20 placebo, 19 neomycin) had C-IBS. Baseline constipation severity between groups was identical. In the intention-to-treat analysis, neomycin resulted in a 30.5Â±8.3% improvement in constipation compared to 14.7Â±6.8% for placebo (p=0.11). However, when subjects who had an abnormal breath test (n=33) were examined, the improvement in constipation was 31.8Â±10.5% for neomycin compared to 6.5Â±5.3% for placebo (p<0.05). 12 of the 39 C-IBS subjects (31%) were methane positive on LBT. All methane positive subjects receiving neomycin cleared methane on follow up breath test. This elimination of methane resulted in a 58.3Â±11.9% improvement in constipation compared to 12.7Â±11.4% improvement in neomycin treated constipation patients without methane (p<0.01). This accounted for all the improvement in the neomycin treated C-IBS subjects. Conclusion: Neomycin treatment in C-IBS improves the symptom of constipation in a fashion that is dependent on the breath test. Elimination of methane on breath test in C-IBS accounts for all the improvement of constipation as a symptom.


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## SpAsMaN* (May 11, 2002)

Thanks,i'm type C.


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## SpAsMaN* (May 11, 2002)

Carmel,i don't know if you realize that it could explain why Neomycin wasn't that good with the overall IBSers.From what i understand it works only on methane producers.


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## SpAsMaN* (May 11, 2002)

I wonder if your research is from 2003:http://www.docguide.com/news/content.nsf/n...5256CD40031C0FFA DGReview of :"Normalization of lactulose breath testing correlates with symptom improvement in irritable bowel syndrome. a double-blind, randomized, placebo-controlled study."American Journal of Gastroenterology02/26/2003By Elda HauschildtNormalising abnormal lactulose breath testing (LBT) results with neomycin therapy leads to a significant reduction in symptoms among irritable bowel syndrome (IBS) patients, researchers from the United States have found.Investigators from Cedars-Sinai Medical Centre in Los Angeles, California, also say excretion of methane gas seen on LBT is associated 100% with constipation-dominant IBS.Prevalence of abnormal LBTs was compared in 111 IBS patients and a gender-matched control group. The effect of using antibiotics to treat IBS was tested in the IBS consecutive patients, with 55 patients receiving neomycin for seven days and 56 given placebo. Participants returned for repeat LBTs following treatment.Results indicate that 84% of the IBS patients had an abnormal LBT. This compared with 20% of the controls.Neomycin resulted in a 35% improvement in a composite score in intention-to-treat analysis of IBS patients. Placebo resulted in an 11.4% improvement. IBS patients reported 35.3% bowel normalisation after neomycin therapy, compared with 13.9% after placebo.A graded response to treatment was observed, with the best outcome (75% improvement) seen when neomycin was successful in normalising LBT results.LBT gas production results indicate that methane excretion was 100% associated with constipation-dominant IBS. Patients who excreted methane had a mean constipation severity of 4.1. This compared with 2.3 severity in all other participants. American Journal of Gastroenterology, 2003;98:2:412-419. "Normalization of lactulose breath testing correlates with symptom improvement in irritable bowel syndrome. a double-blind, randomized, placebo-controlled study."


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## 23770 (Nov 26, 2005)

Yea, I think we're a different breed.If I'm not mistaken, I think that research is hot off the presses!!Park S, Pimental M. Neomycin improves constipation in IBS: Subanalysis of a double bling randomized controlled study. Gastroenterology. 2005:128:A-258. [Poster T1151]I got the citation above from Clinical Perspectives in Chronic Constipation: An Expert Interview With William D. Chey, MD, FACG, FACP


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