Fructose breath test/treatment with rifaximin
#327460 - 03/29/08 06:31 PM
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Hi, Has anyone had a fructose breath test to test for small intestine bacterial overgrowth and if you tested positive were you treated with the anitbiotic rifaximin and if so was it with good results and relief of pain?
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The fructose breath test does not test for SIBO it tests for fructose malabsorption which is not treated with rifaximin. The test for SIBO is uses the lactulose hydrogen breath test.
Do you know which of these tests you are having?
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We don't have a test scheduled yet. But another family who has a daughter with Rett syndrome, same as my daughter said they had a fructose breath test done and showed hydrogen content to be very high and doctor said this was due to SIBO and so was treated with rifaximin. This young girl was having significant intestinal pain and is much better now. My daughter's symptoms are very similiar to hers. She said she had done some research regarding all this in the book written by Dr. Pimental who is a GI doctor at Cedar Sinai and the book is about connection between SIBO and IBS. She did not mention the lacutolose test you mentioned.
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Ah - yes. There has been speculation about a link between SIBO and fructose malabsorption. This is discussed in the research paper referenced below. Generally speaking when they do a test for SIBO they use the lactulose breath test and when they do a fructose test they use fructose instead of lactulose. Both test measure the amount of hydrogen produced. From what I have read when SIBO is treated with antibiotics it is not unusual for it to return time and again requiring continued treatment with antibiotics. There has also been some success in treating SIBO with probiotics.
There are links to three research papers on fructose malabsorption in that I posted this message. These are very technical articles. The first one talks a bit about the link between fructose and SIBO although they call it SBBO (small bowel bacterial overgrowth). Generally speaking SIBO is treated through diet by reducing the consumption of foods that contain more fructose than glucose like apples, pears, melons, honey, etc.
I have fructose malabsorption and I control it strickly by diet with no difficulties. From the reports I have read and from the difficulties that antibiotics can cause particularly repeated and long term treatment I am not sure I would try antibiotics - at least repeatedly.
Good luck 
Reference
Lin, H. C., 2004: Small Intestinal Bacterial Overgrowth: A Framework for Understanding Irritable Bowel Syndrome . Jama-Journal of the American Medical Association, 292, 852-858.
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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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