Irritable Bowel Syndrome and bacterial overgrowth

Irritable Bowel Syndrome is a condition that affects more
than twenty percent of Americans and is in the top 10 most
common chronic medical condition in USA. Sufferers with
Irritable Bowel Syndrome have abdominal pain often eased by
defaecation. In addition there is associated bloating and
altered bowel habits and form. Constipation and/or
diarrhoea are common.

At present no one knows the exact cause, no one treatment
is effective in a large group of patients and there is no
cure. In fact medical treatment has fallen well below
patients' expectation.

Although no one can give you a specific cause for Irritable
Bowel Syndrome, there are various suggestions. There is a
higher incidence of abuse in IBS patients (Talley et al
1994: 50% of IBS patients reported abuse). In addition at
least 20% of severe gastroenteritis (especially bacterial)
develops Irritable Bowel Syndrome.

Recently trials on a poorly absorbed antibiotic raises the
possibility of another cause. Researchers at Cedars-Sinai
Medical Centre, Los Angeles studied Rifaximin and found it
to be very effective in controlling symptoms of Irritable
Bowel Syndrome. Working on the theory that IBS is caused by
bacterial overgrowth, they used Rifaximin, a non-absorbed
antibiotic. This drug stays in the gut and is not absorbed
into the blood stream.

Mark Pimental, MD at Cedars-Sinai linked bloating to
bacterial fermentation by using Lactulose breath test to
diagnose Small Intestine bacterial overgrowth (SIBO). This
test monitors levels of hydrogen and methane on the breath.
These two gases are released following bacterial
fermentation. Rifaximin was shown to reduce the bacterial
level and significantly reduce Irritable Bowel Syndrome
symptoms in these patients.

The Lactulose test plus the significant benefits of
Rifaximin suggests that small Intestine bacterial
overgrowth may be a causative factor in Irritable Bowel
Syndrome.

Leonard Weinstock, MD at Washington University tested 254
Irritable Bowel Syndrome sufferers that met the Rome 11
Criteria by using the Lactulose test and found Small
Intestine bacterial overgrowth in 161. The patients tested
positive for SIBO showed significant improvement of IBS
symptoms following Rifaximin treatment.

It seems that Small Intestinal bacterial overgrowth is a
possible cause of Irritable Bowel Syndrome and when
recognised by a positive Lactulose breath test, a very
effective treatment is Rifaximin.

This gives strength to the argument that Irritable Bowel
Syndrome is caused by bad bacteria. More trials are needed.
In addition not all patients have a positive Lactulose
breath test. It is, however, an exiting and encouraging new
avenue to pursue. At present Rifaximin is approved by the
FDA for use in traveller's diarrhoea.


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Dr.Phil Hariram is a retired General Practitioner. He has
treated IBS patients for 27 years. He understands why
hypnotherapy is an effective treatment for IBS. His ebook,
"Irritable Bowel Syndrome. You take control." gives a
unique insight into how IBS is viewed by the Subconscious
Mind and how it can be altered for better and lasting
control of IBS. http://www.healingibs.com