Question for IBS-C folks: relief w/o fiber or probiotics?
#179793 - 05/18/05 08:40 AM
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I've been dealing with post-infectious IBS since a horrific episode of dysentary and giardia six years ago. I have tried many of the dietary and nutritional strategies on this board, and a million others, with limited or no success.
Last week I went to the Cedars-Sinai GI Motility Clinic in Los Angeles. I had come across research they've done correlating IBS to bacterial overgrowth in the small intestine. They have achieved the most dramatic and successful improvements with their treatments of any published research on IBS treatment.
They tested me and sure enough I was positive. The treatment was 10 days of two antibiotics that are "gut-specific", meaning they don't get absorbed into the bloodstream and are thus less toxic. They then prescribe Zelnorm at 6mg before bedtime following the drugs.
The antibiotics almost completely eliminated the gas, bloating and pain that was so crippling before. Yea! However, the constipation is far, far worse. I have not had a BM without an enema for several days. I am not taking fiber or probiotics, because the clinic's research and anecdotal experience indicates that fiber and probiotics make things WORSE for people with IBS caused by small bowell bacterial overgrowth (SIBO).
I seem to be one of those men that Zelnorm has absolutely no effect on, other than making me feel drugged. Are there any other options for increasing regularity that aren't habit-forming laxatives? Unfortunately the doctor at the clinic is away until May 31 and no one there is able to help.
In desperation I tried some probiotics and fiber for a few days, even though I was told not to. The bloating, gas and cramps came back almost right away. Any ideas?
BDB
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Hi badlydrawnboy,
My GI had heard about the research being done in LA and put me on antibiotics, too (although I was only on one - Xifanin/Xifaxin - what other one were you on?). I believe that I am at least 50% better since then... well, since I finally got rid of all the C that had built up that entire 10 days I was on the antibiotic. The week I was on it and the week afterwards was one of the worst few weeks I've had in a while, but after a huge amount of miralax, I'm feeling GREAT. Not perfect, but do we ever really feel perfect?
I had not heard that probiotics and fiber were bad for SIBO, and they seem to help me, actually. I will ask my GI about it when I go back in 2 weeks.
As for the C, there are a few things I've been doing that really help me:
1) Eating a lot of vegetables at night, right before I go to bed. Like a big salad, vegetable soup, etc. I do get somewhat bloated, but I'm just going to sleep and it's gone by the next morning... and I'm able to "go" almost every morning like clockwork. Something to think about.
2) Magnesium supplements. Our bodies don't absorb magnesium very well, which is why it acts as a "safe" stool softener. I either take 1500-2000mg or Miralax (my doctor believes it is not habit-forming) daily and I'm doing great.
3) Psyllium husks right before bed (but I guess that doesn't apply to you since you aren't doing fiber).
HTH!
--------------------
Elizabeth
all those years it wasn't IBS - it was celiac!
send me an email: liz@dopple.net
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Welcome back, although I'm sorry it's for such an unfortunate reason.
Here's a post of mine referencing a green apple juice treatment. I've dragged this out several times over the last few weeks (you'd think I was getting royalties for recommending it) and no one has reported anything about it: trying it, problems, success, zip, zilch, nada. So I'd say take a careful look at the old posts on it that I'm sending you to (by a somewhat circuitous route) and if it looks like something that might help, approach cautiously.
I'm glad the targeted antibiotic treatment helped with some of your symptoms. I'm sure it must be frustrating to have another worsen as an apparent result. I hope this helps and good luck. Keep us posted - so to speak. 
--------------------
[Research tells us fourteen out of any ten individuals likes chocolate. - Sandra Boynton]
Edited by Sand (05/18/05 09:17 AM)
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Hello Elizabeth,
I was on Xifanin (Rifaximin) and Neomycin. The doc said that this combo has a 90-95% effective rate in their research. But it's my understanding that Xifanin is the more important of the two.
I just started Natural Calm (magnesium fomula) this morning. I pulled it out of my-cupboard-of-remedies-that-haven't-worked-in-the-past-but-I-still-have. We'll see how it works this time around.
Perhaps I will try fiber again, but I want to check with my doc first. In the past everything except flax seed meal has caused intolerable bloating and gas, and sometimes made the constipaton worse (yes, this includes Acacia). But perhaps now, post-antibiotics, things will be different.
I've been at Zelnorm 6mg 2x day and it has done NOTHING.
The green apple juice is interesting. Time consuming though. I'll give it a try if these other things don't work.
Someone mentioned DGL (deglycyrrhizinated licorice) can help constipation. Anyone have experience with this?
Chris
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Forgot to mention a few things that may be relevant.
One, the kind of constipation I've got going is incomplete, infrequent BMs. Stools are thin and kind of pasty. Never dry, unless it's been a REALLY long time. Stool softeners like aloe are not effective. I need something that stimulates peristalsis.
Two, the reason this clinic doesn't think probiotics are good for those with SIBO is that there is already a tendency for overgrowth of bacteria, so introducing large amounts of bacteria (whether good or bad) can make that worse. I'm not totally clear on why they don't recommend fiber.
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This is my very first post. Please bear with me. I am trying to find the best message board for IBS w/chronic constipation. Can someone help me?
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There isn't a specific message board here for those with constipation. But if you post a question on this board and put IBS-C in the title of the post many folks out there will respond.
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only work for people who got IBS from some type of infection or dysentary or something like that and not fom unknown cause?
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This surprises me as probiotics are really recommended for IBS. Research says how good this friendly bacteria is for IBS. I would think good bacteria would definately help with IBS from dysentary. But, what do I know.
I'm just sort of worried now to take my probiotic. I'm so confused about what is helping and what is hurting me. 
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I too cannot take a Soluble fiber supplement either and would really be interested in responses to this fiber dilemma.
How much flax do you take everyday? Does it still work without the bloating and gas? I may need to try this because I am in need of some constipation relief. 
I would recommend taking the magnesium. It's worth a try. I am trying it now, but not sure it is doing anything for me. I am still in pain and constipated, but I can have a BM once in a while. Better than never.
Zelnorm did NOTHING for me either.  Very disappointing.
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