# Small intestine biopsy and culture for choice of specific antibiotics?



## zickzack (Jun 10, 2007)

Hi,I'm new in this forum and I think I have SIBO, because of my symptoms and my fructose intolerance test:Fructose-H2-Test: 50gTime PPM0 230 3460 7290 53120 40150 -180 -I will do the breath test with glucose soon.I read a lot about SIBO now and I wonder if it's really necessary to give broad band antibiotics. The problem is obvious: If someone has a good colon flora, but also SIBO, the antibiotics could eradicate SIBO but also the good bacteria in the colon. This could of course enable bad bacteria like clostridium difficile to expand and make you ill. So, how far has research advanced in making cultures from biopsies in the small bowel? Here are my questions:*-From which part of the small bowel should the culture be taken?* Seems to be a difficult question, because not every SIBO is equal. If for example fructose or lactose intolance cause strong bloating in the colon that push the ileocecal valve and enable colon bacteria to move into the small bowel, the biopsy should be taken in the lower part of the small bowel. On the other hand there is more bacteria in the lower part of the bowel and upper parts could possibly tell you more about the specific strain that makes you feel uncomfortable. I don't really know.*-Is it useful at all to trust in the culture, though there may be oxygen-labile bacteria that die when taken out of the bowel and so are not taken into consideration when choosing the specific antibiotic?-Are there studies about cases in that cultures were taken and identified as the bacteria not belonging to this part of the bowel, therefore were eradicated successfully and in the end the SIBO was removed?*I think if you take the antibiotic you should always take probiotics like lactobacillus to replace the afterwards "free areas" in the bowel. Producing lactic acid they could also kill unwanted bacteria.I know that VSL#3 seems to be the best probiotic because of its high germ count. But it could be dangerous for replacing the bad SIBO-causing bacteria, because it contains bifidobacteria. Those are (as far as I know) able to cause bloating and thats exactly what you NOT want in your small bowel. *So, does anyone know a probiotic that ONLY contains lactobacillus in high germ count?*


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