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Syl, no problem, I have a ton of sibo information in regards to sibo and IBS. But
SIBO didn't pan out really as a "cause" of IBS, but some people can have sibo and IBS.
Bacterial Overgrowth Apparently Not Important in IBS
By David Douglas
NEW YORK (Reuters Health) Jun 04 - An abnormally high number of bacteria in the small intestine does not appear to be a major factor underlying symptoms of irritable bowel syndrome (IBS), Swedish researchers report in the June issue of Gut.
"The data," senior investigator Dr. Magnus Simren told Reuters Health, "do not support an important role for small intestinal bacterial overgrowth, according to commonly used clinical definitions, in IBS."
Dr. Simren and colleagues at Sahlgrenska University Hospital, Gothenburg note that a high prevalence of small intestinal bacterial overgrowth has been reported in patients with IBS, but those results were based on indirect determination using hydrogen breath tests.
They therefore assessed small intestinal bacterial overgrowth by a direct test -- bacterial culture of small-bowel aspirates -- among 162 patients with IBS and 26 healthy controls. Cultures revealed small intestinal bacterial overgrowth in 4% of patients and 4% of controls.
Signs of enteric dysmotility were seen in 86% of patients with overgrowth and in 39% of patients without. Nevertheless, say the investigators, motility alterations could not reliably predict altered small-bowel bacterial flora.
"However," said Dr. Simren, "mildly increased counts of small-bowel bacteria seem to be more common in IBS," but "its clinical relevance remains unclear."
Gut 2007;56:802-808. also I asked Dr Drossman about the sibo
sorry its in bold type that is how he worte it into the email so I would see it was his answers.
"IT IS AN OVERSTATEMENT TO SAY THEY ARE "IRRITATING" SUBSTANCES AT LEAST IN THE SENSE OF BEING SOME TYPE OF TOXIN. THEY ARE NATURAL BYPRODUCTS OF DEGRADATION OF FOOD SUBSTANCES BY BACTERIA WHICH DON'T NORMALLY OCCUR IN THE SMALL BOWEL. SO WITH INCREASED BACTERIA IN THE SMALL BOWEL, THE BACTERIA ARE ABLE TO DIGEST SUGARS FOR EXAMPLE PRODUCING H2 AND CO2 FROM THE SUGARS WHICH ARE GASEOUS BUT WHICH ALSO HAVE OSMOTIC PROPERTIES, I.E. INCREASED PARTICLES THAT CAUSE SECRETION OF FLUID INTO THE BOWEL THUS CAUSING DIARRHEA. IT'S THE SAME PRINCIPLE AS USING NON ABSORBABLE SUGARS LIKE LACTULOSE OR SORBITAL TO TREAT CONSIPATION BY INCREASING FLUID IN THE BOWEL. IT'S JUST THAT WITHOUT BACTERIA IN THE SMALL BOWEL, IT DOESN'T HAPPEN AND THE FOOD SUBSTANCES GET ABSORBED. WITH INCREASED BACTERIA IT COMPETES FOR THE FOOD SUBSTANCES AND PRODUCES THE GAS AND DIARRHEA."
*This means these are just in the wrong place and not specific or multiple pathogens?*
CORRECT. HOWEVER, THERE IS GROWING INTEREST NOT IN THE AMOUNT OF BACTERIA BUT THE TYPE OF BACTERIA. CERTAIN BACTERIA CAN CAUSE SOME MILD INFLAMMATION OF THE BOWEL AND OTHERS PROTECT THE BOWEL FROM THAT POSSIBILITY. SO THERE IS "GOOD" AND "BAD" BACTERIA. POSSIBLY WHEN PEOPLE ARE TREATING PRESUMED SIBO (WHICH MIGHT NOT ACTUALLY BE HAPPENNING, BECAUSE THE TEST MAY BE INACCURATE) ANTIBIOTICS MAY HELP TO GET RID OF THE BAD BACTERIA AND THAT MAY BE WHY THEY ARE GETTING BETTER. THIS IS WHY SOME PEOPLE GET BETTER AFTER ANTIBIOTIC TREATMENT. BUT IT CAN ALSO GO THE OTHER WAY, I.E., ANTIBIOTICS HAVE BEEN SHOWN TO MAKE IBS WORSE AS WELL. THE OTHER IDEA IS TO USE PROBIOTICS WHICH CONTAIN "GOOD" BACTERIA (E.G., LACTOBACILLUS OR BIFIDOBACTERIA) WHICH REPLACE THE BAD BACTERIA, POSSIBLY REDUCE THE INFLAMMATION AND IMPROVE SYMPTOMS. SO THE ISSUE OF BACTERIA IN THE BOWEL IS MUCH MORE COMPLICATED THAN SIMPLE SIBO, BUT SIBO CAN BE A PART OF THE WHOLE PICTURE (THOUGH NOT THE WHOLE PICTURE FOR IBS).
Dr Drossman
This was at least a year ago and more has been learned on the connections between the two condition. Also people can have sibo without IBS and vise versa.
I have a ton more on all this
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I am gonna look at your questions also here.
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sometimes its the internet itself and speed of the connection. Its working for me at the moement, but will ask them about downloads. It is somewhat annoying it has to load like that really. I will see what I can do on it though, there maybe an issue with protection of the work perhaps, but again will check.
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Thanks for the info on SIBO and IBS. I am going to visit your website. You seem very well informed. You should visit the boards more often, and offer us what info you have. Geri
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Aperson, I would ask Heather about the fennel tea.
I will ask the experts on the BC pill for you.
On the fibercon don't take more then it says on the bottle or ask your doctor about it as well. Don't take more to catch up either and drink with lots of water.
http://www.gicare.com/MEDICATIONS/Medications.aspx?CID=6&ID=84
http://www.drug3k.com/drug/fibercon-14990.htm
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Thanks Gerikat
I use to moderate the HT forum here, but got to busy, but things have calmed down more so I will be around some and try to do my best.
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how can I contact heather directlyt to ask her? I have another question perhaps you would ask about slippery elm for me? I'm not finding answers on my specific questions and concerns...
"When taken, slippery elm is easy on the digestive system. Slippery elm is said to be good for both diarrhea and constipation, as it softens and adds smooth bulk to the stool. Slippery elm also calms irritation as it gently coats the lining of the intestinal system."
Why is it said slippery elm is good for both diarreah and constipation if it softens the stool? WOuldn't that be a problem for d's? What about d that isn't actual diarrea but you go alot everyday and lots of incomplete evacuation? It talks about coating the digestive system,I think my system is well coated with tons of mucus already! sometimes when I release gas or go to the bathroom a glob of mucus comes out!! Will things get more slippery?!
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Re: Thank you
#351491 - 11/02/09 10:05 AM
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Syl
Reged: 03/13/05
Posts: 5499
Loc: SK, CANADA
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Thank you the post. I maintain a large library of research papers FGID. Over the past 2-3 years there have been some very interesting papers published on the topic. In the paper that Drossman and colleagues published (see reference below) they say "more recent reports using jejunal cultures found SIBO in only 4% of the IBS population and detected no differences from a HC (healthy controls)population." This seems to be a fairly good indication that SIBO is not the cause of IBS. But as you say it possible for SIBO and IBS to co-exist.
Reference
Grover, M., Kanazawa, M., Palsson, O., Chitkara, D., Gangarosa, L., Drossman, D., et al. (2008). Small intestinal bacterial overgrowth in irritable bowel syndrome: association with colon motility, bowel symptoms, and psychological distress. Neurogastroenterology Motility, 20
-------------------- 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
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Yea - the bandwidth, speed of media server, Internet congestion and a variety of other factors come into play. The problem is JWPlayer does have fast forward/backward features. The net result is if you loose the connection to a pre-recorded video the player has to start from the beginning. I have a feeling the problem is inherent in the technology they are using to stream the video. Anyway - anything you can find out would be appreciated.
-------------------- 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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Hi - Unless you're having a problem with some of the filler ingredients in the BC pill I don't think the time of day you take them would make a difference. You might ask your ob/gyn about different types of pill formulations as some may be more likely to suit you and cause fewer side effects. That can take some experimentation.
You can contact the manufacturer of Fibercon and ask them how they set the maximum dose. There is really no such thing as an FDA guideline to a maximum daily fiber dose. They just recommend 25-35 grams per day minimum. For most fiber supplements you could take up to 25-35 grams per day as the dietary fiber you're getting on top of that is likely only 10 grams per day if you're an average American. In general, as long as you start at a low dose and increase gradually it's hard to take too much fiber without deliberately abusing a fiber supplement.
Ask the makers of Fibercon this question. They're the only ones who can give you a firm answer about their product.
How much of the fennel are you brewing in the coffee pot? It's meant to be used at about 1-2 tablespoons of fennel per cup of water, and you can have up to 6 cups a day without getting out of the realm of normal consumption. There are no known risks of fennel tea so it shouldn't do anything at all to hurt your body. Having said that, as with anything in the world, including just plain water, if you ingest far more of it than would normally be expected you can cause probems.
Best, Heather
-------------------- Heather is the Administrator of the IBS Message Boards. She is the author of Eating for IBS and The First Year: IBS, and the CEO of Heather's Tummy Care. Join her IBS Newsletter. Meet Heather on Facebook!
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