Irritable Bowel Syndrome Message Boards

First, in the interests of full disclosure, I haven't read the book. I browsed through what was available on Amazon and I am curious about what Dr. Pimentel's diet and alternative treatment recommendations are.

I would strongly suggest you do some Board searches on this topic. Do these across all Boards with no time limit. You will find information on the Research Library Board, but some of this has also come up on the Diet Board and ShawnEric, in particular, has posted a lot of information. In addition, you'll find posts by BadlyDrawnBoy, who underwent the Cedars-Sinai SIBO treatment.

Do two different Searches, one for "SIBO" and one for "small overgrowth" (don't use the quotes in either Search.

You might also want to do a Search for "Align" (again, no quotes). This is a probiotic that seems to have some decent clinical trials behind it. (I have not tried it.)

There are Websites that explain what SIBO is, how it causes symptoms, what tests are available to diagnose it, and what treatments can be tried. If you do a Google search on "small bacteria" (don't use the quotes), you'll find a lot of them. Two I found particularly helpful were:

MedicineNet - This article is about 6 months old. It has a full clear explanation of SIBO symptoms, diagnosis, and treatments. In particular, it has what seems to be a full discussion of how SIBO can be diagnosed, including how the breath test is done.

http://www.aboutibs.org/Publications/bacteria2.html - This is a review of the Cedars-Sinai research and includes a link to the original Cedars Sinai article. This is interesting because I thought the Cedars-Sinai research was a new, random, double-blind study. It isn't - the population tested was referred because they probably had SIBO and the number of patients followed up on was small. Unless Cedars Sinai has done further testing prior to the book publication, all the cautions the reviewer raises about the Journal article would apply to the book, also.

At the end of this review, the reviewer talks about people with SIBO not really having IBS because IBS means the doctor has excluded all other diagnoses. I think this is an excellent point - I've always believed IBS is really a "bundle" of conditions and that as more of them are identified, the IBS bundle will get smaller.

However, this distinction has little practical significance for patients. If SIBO does turn out to be the cause of symptoms for some people diagnosed with IBS, it would simply mean that those people have been misdiagnosed and that there is one more test - the SIBO test - that should be done before an IBS diagnosis is finalized. (Interestingly, I ran across one Web article that implied SIBO was a result of IBS rather than the cause of it. This says to me that we desperately need long-term follow-up studies of people whose IBS has been "cured" by SIBO treatment.)

If I were not doing well on the EFI Diet, I would definitely be talking to my doctor about getting a SIBO test. However, I would be extremely cautious about undergoing antibiotic treatment and would probably try probiotics alone first.

HTH.

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[Research tells us fourteen out of any ten individuals likes chocolate. - Sandra Boynton]

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