Xifaxanta might be unfamiliar to the majority people suffering with IBS as the drug was launched in the UK back in 2011 primarily for the treatment traveller’s diarrhoea associated with non-invasive strains of Escherichia coli (i.e. episodes not associated with fever).
However, some doctors have suggested that patients suffering with IBS should consult their doctor about being prescribed a course of rifaximin for treating their condition, with New York times best-selling author Dr Mark Hyman recommending two 200 mg tablets three times a day for seven to 10 days as one of his ‘5 steps to curing IBS’, describing this as the ‘best way to deal with the chronic bacterial overgrowth that causes bloating and irritable bowel syndrome’.
Interestingly, Medical Specialists® have noticed a burgeoning trend; a growing number of patients that come to them requesting Xifaxanta are now stating in their online consultation that they have been diagnosed with a condition by the name of small intestinal bacterial overgrowth (SIBO), also known as small bowel bacterial overgrowth syndrome (SBBOS).
SIBO occurs when an abnormally excessive amount of bacteria begin to grow within the small intestine. The colon (large intestine) is rich bacteria, but the small intestine is not supposed to be so plentiful with bacteria. In the small intestine there are around less than 10,000 bacteria per millilitre of fluid, in comparison to at least 1,000,000,000 bacteria per millilitre of fluid in the large bowel.
Why does SIBO occur?
The gastrointestinal tract is comprised of a long muscular tube responsible for transporting digesting food to the colon. The coordinated motion of the stomach’s muscles and small intestine propels food from our stomach, then passing through the small intestine and into the colon.
During this muscular function, there is also a clear-out of bacteria from the small intestine and a limit imposed to the amount of bacteria allowed to collate in the small intestine. Unfortunately, conditions can arise that can interfere with the regular actions taking place in the small intestine, and it is this that results in SIBO, with bacteria now able to linger for longer and multiply. Without a normal muscular activity occurring, bacteria can spread backwards from the colon and into the small intestine.
SIBO is not the product of just one single type of bacteria though, but is caused by an excessive growth of numerous kinds of bacteria that are usually present in the colon.
The specific causes of SIBO are often debated, but a number of risk factors have generally been agreed upon, which are: crohn’s disease, celiac disease (long-standing), diabetes mellitus (type I and type II), IBS, low stomach acid, previous bowel surgery, taking multiple courses of antibiotics and organ system dysfunction, such as liver cirrhosis, chronic pancreatitis, or renal failure.
What are the symptoms of SIBO?
The initial symptoms of SIBO are almost identical to those associated with IBS, and include: abdominal pain/discomfort, bloating, constipation, diarrhoea, excessive wind and indigestion.
If the bacterial overgrowth is severe and prolonged, it could be detrimental to the digestion and absorption of food, leading to a deficiency of vitamins and minerals. Weight loss can sometimes then follow as a result of this and symptoms unconnected to the gastrointestinal tract, such as fatigue and body aches. The symptoms are often chronic and a person suffering with SIBO can expect to have symptoms that can drastically vary in severity over the course of months, years or even decades before they are given a diagnosis of small intestinal bacterial overgrowth.
Diagnosing SIBO
As the initial symptoms of SIBO are non-specific and almost identical to irritable bowel syndrome, it may take a long period of time before SIBO is considered as the cause of the symptoms by the doctor or health care professional.
Instead, it is usually health problems linked to a malabsorption of proteins, fats and vitamins that will raise the alarm for any possibility of SIBO, and the patient will probably be made to have blood tests to determine any reasons for anaemia, electrolyte imbalance and vitamin deficiencies.
Next, the patient will usually have to undergo breath-tests which look for the by-products of digestion, in particularly those associated with intestinal bacteria. The common tests include a hydrogen breath test, bile acid and D-xylose. The results can help to determine if the patient’s symptoms are due to SIBO and thus the patient will not have to have a biopsy or endoscopy.
Treating SIBO
To treat SIBO, doctors and health care professionals will usually discuss with the patient ways at managing and treating any possible underlying health problems, as it is not always sufficient merely to target the excess bacterial growth. In addition, effective methods of controlling the symptoms of SIBO will be discussed as it cannot always be ‘cured’.
Antibiotics are typically prescribed to the patient as one method of controlling the excess bacteria, with the most common antibiotic prescribed for this purpose being the previously mentioned Xifaxanta. Whichever antibiotic is prescribed to the patient will not remove all bacteria though, as some are still needed to aid a normal digestive function.
So whether you suffer from IBS, SIBO, or other stomach and bowel problems, click here to go to the stomach and bowel area of the Medical Specialists® website, which is full of helpful information, links and different treatment options.
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