The drug is used to treat SIBO.
There is a lot of controversy about SIBO and IBS with the researchers right now.
Certain researchers (a few) are promoting SIBO as the cause of IBS. But it is just a theory and speculation at the moment.
Rev Med Chil. 2005 Nov;133(11):1361-70. Epub 2005 Dec 29. Links
[Small intestinal bacterial overgrowth.]
[Article in Spanish]
Quera P R, Quigley EM, Madrid S AM.
Seccion de Gastroenterologia, Departamento de Medicina, Hospital Clinico de la Universidad de ChileChile.
Small intestinal bacterial overgrowth (SIBO) is characterized by nutrient malabsorption, associated with an excessive number of bacteria in the proximal small intestine. Unfortunately, the diagnosis of bacterial overgrowth presents several difficulties and limitations, and as yet there is not a widespread agreement on the best diagnostic test. SIBO occurs when there are alterations in intestinal anatomy, gastrointestinal motility, or a lack of gastric acid secretion. The true association between SIBO and irritable bowel syndrome and celiac disease remains uncertain. The treatment usually consists in the eradication of bacterial overgrowth with repeated courses of antimicrobials, nutritional support and when it is possible, the correction of underlying predisposing conditions.
PMID: 16446861
Small Intestinal Bacterial Overgrowth
(SIBO)
"Although this theory is tantalizing and there is much anecdotal information that supports it, the rigorous scientific studies that are necessary to prove the theory have just begun. Nevertheless, many physicians have already begun to treat patients with irritable bowel syndrome for SIBO. The intriguing issue yet to be elucidated is the reason why individuals who appear normal develop SIBO and IBS. The most popular theory is that patients with irritable bowel syndrome have a subtle abnormality in the function of their intestinal muscles that allows SIBO to occur. "
http://www.medicinenet.com/small_intestinal_bacterial_overgrowth/article.htm
New Updates in Chronic Constipation and Irritable Bowel Syndrome CME/CE
Disclosures
Lin Chang, MD
"Another diagnostic test that has increasingly gained interest in this setting is the breath test to detect small intestinal bacterial overgrowth (SIBO). It has been proposed that many IBS patients have symptoms due to the presence of SIBO, as measured by the lactulose breath test, which has been detected in as much as 78% to 84% of patients.[39,40] Harris and colleagues[41] presented a retrospective chart review assessing the presence of GI symptoms, in particular those associated with IBS, in patients referred for glucose hydrogen breath tests for SIBO. They predicted that lactulose breath testing overpredicted the actual prevalence of SIBO in IBS. Glucose hydrogen breath testing has a sensitivity of 75% for SIBO[42] compared with the sensitivity of 39% with lactulose breath testing for the "double-peak" phenomenon characteristic of SIBO.[43] There has been considerable debate regarding the accuracy of the lactulose breath test compared with small bowel aspirates to detect the number of bacteria, which has been considered the gold standard for diagnosing SIBO.[44] Of the 182 patient charts reviewed, 113 patients (88 women; mean age, 58 years) met the Rome II criteria for IBS (IBS-D, 56%; IBS-C, 32%; and IBS-A, 12%).[41] Only 11% of these patients had a positive breath test for SIBO. The study authors concluded that etiologic factors other than SIBO are likely involved in the pathophysiology of IBS. Despite the standard use of the Rome II diagnostic criteria for IBS, the prevalence of SIBO in these patients appears to vary widely depending on the patient population and type of methodology used."
http://www.medscape.com/viewarticle/517739
I asked Dr Drossman
Dear Shawn,
I do feel that the issue of bacterial overgrowth is an important
considerations in IBS, and these authors have gone a long way to advance
this area of investigation and raise awareness of bacterial overgrowth
as a possible player in IBS. It kind of relates to other work being
done in the area of post-infectious IBS and altered mucosal immunity in
subsets of IBS. However, there is some disagreement within the
community with regard to the prevalence in patients with IBS, these
authors claiming up to 80% and others finding far less by standard
methods. Another issue of concern is that explaining bacterial
overgrowth as the cause of so many other aspects of the condition is
going beyond the available scientific data. Their work should be
considered more in the way of opinion/speculation, rather than accepted
dogma within the medical community, and further confirmation is needed.
You should keep in mind that all scientists will from time to time
try to extend their data into understanding other aspects of a
condition, but the checks and balances within medicine lead to common
acceptance when there is confirmation from other groups and more
conclusive evidence. That has not happenned as of yet but remains an
area of interest in the field.
Doug"
The media seems to be playing a big part in "The Cause" of IBS and "cure" for IBS which are not really true and forward statements as well.
--------------------
My website on IBS is www.ibshealth.com
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