Rifaximin in Canada and FODMAP items
#369927 - 08/05/13 08:39 PM
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JBI
Reged: 01/25/04
Posts: 579
Loc: BC, Canada
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Hi!
It's been quite a while since I've been on these boards. I first had IBS systems about 10 years ago when I was working as a pilot of small planes (read: no bathroom!) in Northern Canada. Made for a challenging job!
The information, advice and support I received from Heather's products, this website, and most of all, the other posters really helped me get to a position where I could cope with IBS. I did change careers, but it's been for the better. I'm truly thankful for these boards and this website.
Throughout the past 5-8 years my symptoms have come and gone. I'd have stretches where things were worse, but other times I could eat a whole lot of 'forbidden' foods on a regular basis. I was strictly dairy free and generally ensured that I'd have sufficient amounts of soluble fibre. I'd also take immodium strategically and sometimes proactively (not necessary a good thing, but provided comfort when in a work meeting or when traveling).
The past month or so, my symptoms have been significantly worse. I've had a couple days where I felt I couldn't even go into the office (though I was able to work from home). So I started looking into any sort of IBS Help. I was pleasantly surprised to see that there's been a lot of research done on the subject since I last frequented the boards.
I've searched the boards and read lots of posts, but any insight on the following information would be greatly appreciated.
I read about the Rifaximin study and thought that it might be a good start to try a course of this. I spoke with my doctor, he hadn't heard of the study, but after reviewing a couple items including the article from the New England Journal of Medicine, he gave me a prescription. Only problem is (as the Canadians on this board probably know) Rifaximin isn't approved in Canada!
I called a pharmacy in Washington State and because the prescription was written by a British Columbia doctor, they would be able to fill it. However, for the 550mg course x 2 weeks x 3 times per day - it would be $1,512 and not likely covered by my health insurance as it's not approved in Canada.
--> For those who have tried Rifaximin - what was your dose? (I'm wondering if 550mg x 2 weeks x 3x's a day is necessary, or if less will still work).
--> Have any Canadians been able to try Rifaximin? (How so?)
--> Are there any other similar antibiotics that are available in Canada that provide the same results?
The FODMAP diet is also something that is completely new to me. There are a few items in there that made me think 'Ah Ha!' that makes perfect sense - i.e. why beer will bother me WAY more than other alcohol. I'm going to keep reading about it and my wife is excited to try the diet with me. But:
--> Does anyone know where to get the breath tests done in Vancouver, BC? Life Labs seems to only do the lactose intolerance breath test.
--> From my searches on the board, it seems that most people who have found success with FODMAP tend to mix the EFI and FODMAP diets. I've been reading past posts and SYL's reference articles have been very helpful. Any tips on how to best integrate the diet into a busy 50+ hour work week?
--> Also, any tips for meals at lunch would be helpful. I'm planning to try and bring more meals from home instead of heading to subway or freshii all the time, but sometimes that's not always an option.
Thanks for any input! (Sorry for the long post)
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Rifaximin is not available in Canada according to my GI doc. Unfortunately last year the FDA did not approve the drug for use with IBS in the US as the target organism(s) have not been identified and usually individuals require many courses of treatment but even so the IBS symptoms usually continue to return. You may find this editorial in the New England Journal of Medicine titled Antibiotic Therapy for the Irritable Bowel Syndrome of interest. Neomycin has had similar results but unlike Rifaximin is it absorbable with other systemic effects. It is rarely used these days.
The FODMAP diet is very easy to integrate into the EFI diet. Check the first three links in my signature and in particular the 3rd one. If you are familiar with the EFI diet then just eliminate those foods on the list from the EFI diet. Once these foods have been eliminate for 2 weeks or so then you can slowly introduce foods from one of five FODMAP groups to see if you can tolerate them. There are a number of dietitians in Vancouver that are familiar with the FODMAP diet that you could contact for help. For example here is one and you should be able to find others using Google.
Lactose breath tests are common in Canada but there does appear to be a shortage of places that do fructose breath tests. However, sensitivity to foods with excess fructose can usually be determine by either (1) eliminating foods with excess fructose such as honey, apples, etc or (2) eat some foods with a large amount of excess fructose such as high fructose corn syrup and see if give you a significant increase in symptoms. Personally I would do the former rather than the later 
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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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We have assisted many people who have the same difficulties as you receive up to $40,000 in tax refunds from the Canadian government. We may be able to assist you receive a refund as well. You can call us at 1-888-298-2721 for a free consultation or feel free to visit our website for more information www.canadiandisabilityadvocates.com
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