A New IBS Solution by Mark Pimentel, MD
#350123 - 09/20/09 10:48 AM
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I read this book and thought that there was a solution to IBS by going on a course of antiobiotics. I was excited to read it, but then I went on our site and found that alot of the people who undertook this actually developed the overload of bacteria again. And I also see that the nightime treatment of zelnorm has be recalled so that cant be good. Anyway, has anyone had success with this kind of treatment??? I see its been a while since the last post of this, so Im hopeful that maybe by now something has changed.
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SIBO (small intesting bacterial overgrowth) which is what Dr Pimentel is talking in his 2005 book about is usually diagnosed using the lactulose breath test.
Recently there have been some research articles published showing that the lactulose breath test (LBT) he uses to diagnose SIBO is unreliable. A recent study Lactulose Breath Testing Does Not Discriminate Patients With Irritable Bowel Syndrome From Healthy Controls shows the test for diagnosing SIBO is questionable. They say "The utility of LBT, in its current form as a diagnostic tool in IBS requires critical reappraisal."
A recent editoral in the American Journal of Gastorenterology titled The Lactulose Breath Test for Diagnosing SIBO in IBS Patients: Another Nail in the Coffin says "The findings of the lactulose breath test in irritable bowel syndrome patients have been used to suggest that most patients have small intestinal bacterial overgrowth (SIBO), and this association has spawned the widespread use of antibiotics in IBS. The study by Bratten and colleagues demonstrates that this test does not discriminate between IBS patients and healthy controls when criteria from recent clinical IBS studies are applied. When the findings from this large study are combined with previous smaller studies, they challenge the hypothesis that SIBO underlies the symptoms of IBS and undermine the current rationale for the use of antibiotics in IBS."
It seems SIBO is a contentious issue with GI docs and it role in IBS may be questionable.
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STABLE: ♂, IBS-D 50+ years - Science of IBS
The FODMAP Approach to Managing IBS Symptoms
Evidence-based Dietary Management of Functional GI Symptoms: The FODMAP Approach
FODMAP Chart & Cheatsheet
The Role of Food & Dietary Intervention in IBS
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Back in August I had a colonoscopy and am happy to say there was no sign of polyps, masses, Crohn's disease or ulcerative colitis. However, there was "some mild increase in eosinophils" (allergic type white cells)... due to "a reaction to a medication or a allergic type response". The the gastroenterologist wanted to put me on Xifaxan but with a co-pay of $142 (over $300 without insurance), I declined. He then put me on Tetracycline 500mgm four times a day for five days.
Any comments would be appreciated.
Nora
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