# xifaxan availability in Australia and SIBO doctors?



## Jackson1980

Has anyone from Australia been able to obtain xifaxan?My preference is to get it legally and would only use it under doctors guidence! Also if there are any australians here - can you let me know of any doctors - gastro specialist that have a good knowledge / interest in SIBO and conducting the breath tests etc.Thanks


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## Kathleen M.

One thing to remember is that isn't the only antibiotic that can be used (it is usually the first one Pimentel tries on a patient) and lots of other very common antibiotics were used for decades before that came on the market. http://www.medicinenet.com/small_intestina...rowth/page6.htm has a list of the typical antibiotics used and the doses that usually work.So there are alternatives if you can't get that one.Whatever agency approves drugs in Australia (the FDA is the one in the USA) should have information about what drugs are approved, you might check their website.


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## Common Response

Where do you live?You can have the gas tests done at Box Hill Hospital Gastro department as an outpatient.I had this done about a year ago.They perform three tests.
Lactose intolerance
Fructose intolerance.
Baseline test.
Apparently if you fail all three it's indicative of SIBO.I failed the lactose test only, by producing Hydrogen.Personally I don't think it's conclusive if this test doesn't confirm SIBO.I suspect there are unknown factors.The gas tests are well worth doing, especially if you do have an intolerance & not aware of it.Although far from cured my symptoms did drop once I eliminated dairy & wheat products (things which are found in just about all Australian processed food).Apparently patients with intolerance either produce hydrogen or methane.Get a referral from your GP to the gastro department of your local public hospital & take it from there.From memory the tests set me back $55.00.


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## Jackson1980

Thankyou bothYes I have had a lactulose and fructose breath test. Only got assayed for hydrogen.Interestingly both sugars gave me the worst D ever. It was aweful. Lucky I was able to do the test at home. For the lactulose my hydrogen levels were normal but for the fructose they were very high. I would have liked to be tested for methane as well.I am convinced I have a bacterial problem - so much trapped gas in my system ALL the time. I have tried a fructose free diet but it did not helpWill check out the local hospital to see if they perform the methane test as well OR ask at least what antibitotics might help.kinda going nuts here, hope to get some relief soonishMark


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## Common Response

Hi Jackson.Apparently if we're intolerant of lactose or fructose we'll either produce hydrogen or methane.The gas test determines which gas we produce.Now that you've learned you're intolerant to these sugars it's important to remove them from your diet.I've found that fructose & lactose is present in many tinned & packaged process foods & its very easy to ingest it without realising.Also your gut can remain destabilized even days after eating problem food.I'm also convinced that I have some kind of bad bacterial &/or yeast infestation which produces gas with high odor.Perhaps some kind of anti biotic followed by probiotics might be the go.Before doing the anti biotics I recommend you try Huang Lian.It's a Chinese preparation which acts as a mild anti biotic but also has many other properties including repair of the intestinal lining, digestion, & diarrhea.I've been on it for 2 weeks & although I'm not claiming a cure, I've never felt better in a very long time.My symptoms have also reduced by about 80% & my confidence is coming back.http://alternativehealing.org/huang_lian.htmhttp://medical-dictionary.thefreedictionary.com/huang+lianYou can buy it from Chinese Medicine outlets for around $15 which will last you 3 weeks.This is the brand I bought.http://www.orientalpharmacy.com/hulisutak.htmlGive it a go.I plan to follow it up with a good probiotic after 4 weeks.


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## Kathleen M.

_Apparently if we're intolerant of lactose or fructose we'll either produce hydrogen or methane._Every human has bacteria that produce gases like hydrogen and methane.These are not produced from every single indigestible carbohydrate and all humans eat indigestible carbohydrates (this is why every human farts and two of the most abundant gases in farts are methane and hydrogen)Now if you can't digest lactose or absorb fructose and they give you a bunch of it you produce more than someone that digested/absorbed it.But these are not abnormal gases for people to produce. They are very normal gases (some people have methanogenic bacteria and others do not but neither gas is only produced in an abnormal state)._I'm also convinced that I have some kind of bad bacterial &/or yeast infestation which produces gas with high odor._Not bad bacteria (as in pathogenic or dangerous in anyway). One of the other very normal groups of bacteria you find in totally healthy normal people are the sulfur-reducing bacteria. Typically people either have methanogenic or sulfur-reducing bacteria in large numbers but not both at the same time. (some people at any given time may have neither)There are some other odors (why every humans stool smells) but usually when people have a lot of smelly gas it is because the sulfur-reducing bacteria are in the ecological niche rather than methane-producing bacteria. Some people will go back and forth between the two as the ecology inside changes over time. That being said.People who have intolerances to certain foods generally feel better if they avoid them especially with IBS as IBSers often do not handle even normal increases in gas level from any of the other myriad foods that cause gas that have no lactose or fructose. Some people who have no symptoms are intolerant of those two sugars, but they just have a system that handles the gas increases well.Glad that particular chinese herb helped you.


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## Common Response

Kathleen M. said:


> Not bad bacteria (as in pathogenic or dangerous in anyway). One of the other very normal groups of bacteria you find in totally healthy normal people are the sulfur-reducing bacteria. Typically people either have methanogenic or sulfur-reducing bacteria in large numbers but not both at the same time. (some people at any given time may have neither)There are some other odors (why every humans stool smells) but usually when people have a lot of smelly gas it is because the sulfur-reducing bacteria are in the ecological niche rather than methane-producing bacteria. Some people will go back and forth between the two as the ecology inside changes over time. That being said. People who have intolerances to certain foods generally feel better if they avoid them especially with IBS as IBSers often do not handle even normal increases in gas level from any of the other myriad foods that cause gas that have no lactose or fructose. Some people who have no symptoms are intolerant of those two sugars, but they just have a system that handles the gas increases well.


I think it's my poor terminology.By bad bacteria I mean bacteria which result in high odor &/or poor stool formation.I'd imagine we are drawn together under the IBS banner but many of our symptoms will have common causes & whilst others may have totally different causes.I suspect my gut flora is populated with the undesirable bacteria which either produce high odor waste &/or result in considerable food passing undigested.I don't know what the Huang Lian is doing but I'm hoping it's controlling the population of the undesirables or is producing an environment which allows the friendly bacteria to thrive.The Huang Lian continues to stabilise my system.Last night I attended a dinner spending the evening symptom free.I keep thinking this will end but continue to do well.My next plan of action will be to introduce desirable bacteria with some quality Probiotics.Just hope these don't have an element of undesirability.


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## Kathleen M.

_Following from this would you say that lactose & fructose intolerant people with unmodified diets may end up with a greater volume of undigested food remaining in their gut._Probably doesn't affect total volume much. I mean it isn't like it takes several cups of the offending carb, but couple of tablespoons.It should NOT cause all other food to somehow get dumped into the colon in amounts that is different from anyone else._Does having undigested food passing through the system contribute to messy stools & FBO?_If it did EVERY human being on the planet would have messy stools and FBO. All humans have some undigested food in their stools._Would you then say the presence of this gas in high volumes is an indicator of poor diet &/or food intolerance rather than a problem in itself?_Normal humans have a lot of gas, so every diet leads to an average of 14 farts a day. Gas is not abnormal.Healthy diets tend to have more indigestible carbs (even the ones no human on the planet digests) than the high fat all processed food unhealthy diets._Also would high gas volumes result in excessive bloating & abdominal pains as well as gas leakage?_Probably only if you don't handle gas volume well. Many people with intolerances have ZERO symptoms, none at all, don't know they have a problem.IBSers generally don't have abnormally high gas volumes and don't handle normal gas volumes well.


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## Common Response

Kathleen M. said:


> _Does having undigested food passing through the system contribute to messy stools & FBO?_If it did EVERY human being on the planet would have messy stools and FBO. All humans have some undigested food in their stools.Probably only if you don't handle gas volume well. Many people with intolerances have ZERO symptoms, none at all, don't know they have a problem.IBSers generally don't have abnormally high gas volumes and don't handle normal gas volumes well.


Would you say that consuming food for which one has an intolerance can exacerbate symptoms? Couldn't the action or waste of some undesirable bacteria destabilize the gut & putrefy its content even if its percentage volume is relatively low?Would you agree that although a different environment & specifics, a typical garden compost can illustrate the possible result of undesirable bacteria._Anaerobic piles will tend to have more likelihood to have an overabundance of nitrogen causing the dark slimy feel due to the fact that the organisms in such a pile have less of a need for nitrogen and high energy. They work slower, and the nitrogen will tend to convert to ammonia resulting in a smelly mess. _


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## Kathleen M.

_Could the specific characteristics of some undesirable bacteria, sufferers may carry, destabilize the gut & lead to FBO & messy stools?_Not that I know of.If you have sulfur reducing bacteria filling up the ecological niche that methane producing and sulfur reducing bacteria compete for your farts will have more odor than people who have methane producing (or neither) bacteria filling this niche.This does not seem to cause leaky fecal odors all the time regardless of hygeine. It just makes the farts stink. FWIW many if not most of those who have FBO problems do not see any reduction in odor from anything proven to reduce the levels of sulfurous gases from the sulfur reducing bacteria. Some do.Bacteria alone probably doesn't have a huge effect on stool consistency. I'd bet on IBS which can disrupt the progressions of stool through the colon so it only gets to the end when it is the perfect consistency. A lot of that seems to be in the control system of the gut (nervous system and some immune system cells) and I doubt any bacteria by itself can do way more to you than you do to yourself. They can participate at bit, but I doubt you could inoculate a healthy person one with one or a few species of bacteria and have that by itself cause messy stools._Although low in percentage terms wouldn't the quantity of undigested food (due to intolerance) hitting the large intestine feed these problem bacteria leading to a worsening of any symptoms?_IF and only IF your symptoms are effected by gas volume. People with carbohydrate intolerances when they eat the carb they cannot digest will have a bit more carbs (in addition to all the carbs no human on the planet digests that always in every human feed the colon bacteria) for the bacteria.I know of no evidence to suggest it only feeds the bacteria you don't like. All the bacteria food is pretty generic bacteria food and doesn't specifically effect only one or two species.If I took 100 totally normal people who have no FBO, no excessive farting, no symptoms of anything and test them for carbohydrate intolerance some of them will have it and never, ever have any symptoms as they process that relatively small increase in gas volume over normal from all the bacteria food every human eats every day very well and never notice it.People with IBS often have issues with gas volume, even very normal gas volumes, and sometimes benefit from reducing bacteria food in their diet even when they have NO carbohydrate intolerances.The carb intolerance may make certain foods more problematic but they do not by themselves cause IBS, or FBO or any specific stool consistency._Would you say that consuming food for which one has an intolerance can exacerbate symptoms?_If and ONLY IF you don't tolerate the gas produced (and gases from carbs are not smelly, only sulfur containing foods like protein really contribute to gas odor)_Couldn't the action or waste of some undesirable bacteria destabilize the gut & putrefy its content even if its percentage volume is relatively low?_If you don't tolerate the gas, you may have symptoms, but the odor you are thinking of doesn't come from carbohydrates. You like the smell of bread while it is rising, or beer while it is brewing? Carbs ferment. They do not putrefy._Would you agree that although a different environment & specifics, a typical garden compost can illustrate the possible result of undesirable bacteria._I agree some people do better with certain subsets of the normal bacteria that you find in normal humans with no symptoms of anything. The bacteria aren't doing it to you so much as how your body responds to things like gas levels may cause discomfort. There are some host-bacteria interactions but every species of bacteria you want to give the full blame to is living in other humans and causing them no problems at all.


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## Common Response

Thanks for the detailed response Kathleen.I appreciate your assistance in helping me to understand what is possibly happening.Where do you recommend I look?Does it also mean probiotics might be clutching at straws without knowledge, if that was possible, of ones current flora?The Huang Lian is surprisingly continuing to provide beneficial results.I continue to eliminate well with regularly and my symptoms are well down.FBO is low enough that I've been able to mix freely with people without concern. I'd say down to 10-20% of the levels I was experiencing before commencing this herb.Flatulence, when it happens, isn't inspiring but the constant FBO has dramatically reduced.I keep thinking it won't last but continue to be pleased.


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## Kathleen M.

If the herb is working I wouldn't mess with that.There doesn't seem to be any need to find out your exact flora and only use a specific probiotic that will mingle with that specific flora.Giving a few good brands a trial of 2-3 weeks before trying something else should give you a good idea if they work for you or not. After all the people in clinical trials where they work for enough of them to be significant weren't prescreened in any way for a specific type of internal flora. Just IBS symptoms.If that brand establishes in you (and I do well with all the good brands, I don't need one specific on, although some people do better with one brand vs another) it will not generate gas from the carbs you eat regardless of what other bacteria are in there.


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## Common Response

Kathleen M. said:


> There doesn't seem to be any need to find out your exact flora and only use a specific probiotic that will mingle with that specific flora.Giving a few good brands a trial of 2-3 weeks before trying something else should give you a good idea if they work for you or not. After all the people in clinical trials where they work for enough of them to be significant weren't pre screened in any way for a specific type of internal flora. Just IBS symptoms.If that brand establishes in you (and I do well with all the good brands, I don't need one specific on, although some people do better with one brand vs another) it will not generate gas from the carbs you eat regardless of what other bacteria are in there.


That's very good information Kathleen.It means I can experiment with Inner Health Plus, a probiotic product stocked by many Chemists & at reasonable prices. If it doesn't work I can start to experiment with the more expensive formulations.


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## Common Response

Kathleen M. said:


> If the herb is working I wouldn't mess with that.


Having been on Huang Lian for about a month I can say it's not the total answer.This herb has stabilized my condition.Before using it I suffered from poor stool formation ranging from diarrhea to constipation, incomplete evacuation & considerable FBO. With no sign of relief my psychological state was taking a battering.Since Huang Lian (Coptidis Ryzoma) I'm regular with normal stool formation & a feeling of complete evacuation.I still continue to have FBO but it's severity is considerably less.For me any level of FBO is unacceptable.My next course of action is:1. Continue to take Huang Lian.2. See a surgeon regarding sphincter (Investigate if closed position isn't slightly open).3. Commence Probiotics.4. See dietitian to fine tune diet & eliminate major problem foods.Atleast I have options to investigate.Whilst there are options there's hope.


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## chetverto

You can buy Xifaxan for Australia here

http://trustedrxsolutions.com/buy-xifaxan-au.html


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