Xifaxan

So after 4 months of searching for Crohns, my GI has decided to proceed as if my periodic bouts of horrific cramping and D is IBS after all.  Whew. 

Today, he talked to me about trying a 2 week round of Xifaxan, which basically wipes the guts clean of any bacteria.  He said if my problems are coming from bacterial overgrowth then this may help.  Some people get some relief for a few weeks to a few months.  So I'm supposed to take this ASAP and then track everything until I see him again in October. 

Has anyone tried this?  Success?  Any experiences?  Thanks!!

May

Thanks for the tips. I will do my best to hold out until the end of the course. I take Align daily as well.

I will also check out that diet, when I get half a second. I have two young children and a picky husband - I have to be honest that I will have a really hard time following a diet if it's not something that easily translates into use as a whole family. I hate any and all things having to do with food so if I have to do more of that than I already do, it's not likely to happen. I know that sounds horrible, but picky eaters really can ruin your joy of cooking/preparing meals. :)

This is from another bb years ago.

"I am trying to understand somethings in relationship to SIBO. "

Okay altered motlity can cause bacteria to enter the small bowel where it should not be really, at least in high counts, because its a pretty sterile environment. For the moment I am just looking at the altered motility reason for SIBO.

What are small intestinal bacteria overgrowth symptoms?

The symptoms of SIBO include:

excess gas,
abdominal bloating and distension,
diarrhea, and
abdominal pain.

"A small number of patients with SIBO have chronic constipation rather than diarrhea. "

How does small intestinal bacterial overgrowth cause symptoms?

When bacteria digest food in the intestine, they produce gas. The gas can accumulate in the abdomen giving rise to abdominal bloating or distension. Distension can cause abdominal pain. The increased amounts of gas are passed as flatus (flatulence or farts). The bacteria also probably convert food into substances that are irritating or toxic to the cells of the inner lining of the small intestine and colon. These irritating substances produce diarrhea (by causing secretion of water into the intestine). There is some evidence that the production of one gas by the bacteria—methane—causes constipation.

http://www.medicinenet.com/small_intestina...rowth/page2.htm

Any Idea what those irritating substances are?

This means these are just in the wrong place and not specific or multiple pathogens?

A "classic" bacterial infection or a reaction to "all" the bacteria there themselves?


I wrote to Dr Drossman on this and here is the reply.

*Any Idea what those irritating substances are?*

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).

In newer research its looking like SIBO doesn't "cause" IBS but that some people have both conditions.

In IBS gas puts pressure on the bowel and the bowel is pressure sensitive which is how it actually works. So the anitbiotic if you don't have sibo might help just by reliving gas pressure on the bowel, which in IBS is overly sensitive to all stimulis.

One thin about sibo and not ibs is absorbtion, in IBS absorbtion is normal.

You might ask for the test just to be sure that is what it really is and they use a hydrogen breath test. You don't want a lactulose breat test for it and they are not very accurate.

Even with sibo itself, without IBS the sibo can come back, because the sibo is not the actual probvlem but a consequence of another problem.

In IBS and sibo, they don't know yet how long to keep people on antibiotics and this is a real problem long term.

On the IBS research side they are still cautious of microscopic colitus a type of inflammatory bowel disease. But a good doctor can pretty much diagnose IBS with a 95 to 98% accuracy using the rome criteria for functional disorders, even though there is not a specific test for IBS yet.

There are some newer stool tests that might help and they use to seperate IBS from inflammatory bowel conditions.

Foods and stress don't cause IBS and the triggers can be different with foods.

On the stress side that is a different story, for one you might not feel under staress, but the symptoms themselves and the worry they can come on make a difference. There is an important aspect here called the fight or flight responce directly connected to gut function.

You should read these two excellent articles.

http://www.ahealthyme.com/article/primer/101186767

http://www.ibs.med.ucla.edu/Articles/PatientArticle003.htm

It doesn't have to be "stress' but just emotions themselves. Not to mention living with these conditions are stressfull and emotional.

But these have a direct and close impact on the gut, that a lot of people don't really know about or understand very well.

Sleep is very important to IBSers and they have found that quite a few IBSers have problems with rem sleep.

Do you have insomnia?

 

 

Mayok, watch the video I posted on IBS its not all in your head, its an excellent presentation on everything here we talked about.

One thing that can really help is Gut directed Hypnotherapy. I use to have insomina and I did a home coruse for IBS and it helped everything, all the symptoms of my severe IBS and took out my insomnia as well. It help bloating, pain, incomplete evacuation, anxiety, relaxed the gut muscle and brain gut axis and more.

There is a lot of research showing the effectiveness of HT on IBS.

Out of curisoity what are the hang ups? There are a lot of major misconceptions about it.

If you have sibo the Xifaxan may help. But one problem again is what is causing the sibo, it is a consequence of abnormal functioning to begin with due to motility issues.

It may help IBS as well just by killing all the bacteria in the gut. But for IBS it is not all that successful. It may reduce some symptoms somewhat.

However, you can't stay on them forever. You also will want to replenish the bacteria in the gut again.

Mayok, I understand, however that is one of the major misconceptions about it. Its a natural state like people can get when reading, watching a movie or whats called highway hypnosis.


This is clinical hypnotherapy used just for IBS. Nothing to do with religion, spirituality or anything like that at all. In fact the person who created the ones I used is a christian.

Some peope think incorrectly that hypnotherapy can alter your consciousness, or you can be made to do things you don't want to do or view it from what they have seen on TV with stage hypnosis, but its not like that at all. What it's really is like is deep meditation or very deep relaxation. It's a highly focused state.

spasman a doctor gave you the Rifaximin?

Xifaxan550 550mg is an awesome and unique Antibiotic. It will soon be approved for IBS (March 2011) This is the most effective and safe non systemic Antibiotics available. It is Gut specific and Placebo shows higher side effects. This will soon be a very populsr IBS drug not only with GI's but with Family Practice. It is currently indicated for Travelers Diarreha (sp) and HE.

I know this is an old thread, but as I am the OP, I figure I have rights to resurrect it. :) I have taken Xifaxan twice now, and been nearly problem free since January. I feel that is well worth it.

Wonder why that guy said I should fire my GI? I have no complaints from taking the Xifaxan, only happiness that I've been trouble free for so many months.

I'm willing to bet that if you stop taking the Align in conjunction with the Xifaxan, you'll no longer have the problems with constipation. Align, if taken for long periods of time, can cause constipation. It's been my go-to probiotic for several years, but it's a balancing act. If I'm not experiencing active ISBD, I don't take Align every day.

Regarding the FODMAP diet, it saved my life. Picky eater? Who gives a rip? I was so sick with a bowel disorder I was missing work every few weeks before I started the diet!! Dr. Mark Pi
mentel of Cedars-Sinai has cited research that traces IBS and these disorders to an episode of food poisoning at some time in your life (exposure to e-coli or salmonella ) that screws up your bowel's motility. He put out a wonderful article in 2015 where I first learned about the FODMAP diet--that wheat, onions, milk, and other fermentable sugars were making me deathly sick. Couldn't care less that I'm now a picky eater. I'm finally well. Recently I had a really bad episode of IBS-D because I was taking expectorant "cough" syrup for chest congestion & mucus--and the inactive ingredients contained three top offenders on the fermentable sugars list!! Now I'm going to try Air Power, a natural form of guifenisen with none of that junk. I plan to try the Xifaxan in the near future as well because I still have attacks of IBS-D after times of very high stress, physical or mental. (and particularly heat stress) I have this idea it will help my immune system.