Small bowel intestinal overgrowth

[Bethsaida]

I have been diagnosed by my gastroenterologist with sibo after a breath test. The treatment prescribed is xifaxan. I’m waiting for approval by insurance. I’m also in treatment for CLL with Zanubrutinib which I began in May last year. I have had stomach issues, sometimes really severe, since beginning treatment. I am pretty sure my long term ppi drugs are involved as they cause less stomach acid. My gastro says there is no interaction with the drugs but I also have sent a message to my oncologist regarding this treatment. Has anyone else had this diagnosis and if so, can you give me any additional information about your experience?

[gardening-girl]

Bethsaida, I have no experience with either zanubrutinib or ppi drugs, but when I did a search for an interaction between zanubrutinib and the 6 ppi drugs with FDA approval, only Omeprazole showed up with an interaction. According to the information on the Lexicomp Drug Interaction site, Zanubrutinib induces the enzyme CYP2C19, an enzyme responsible for omeprazole metabolism, lowering the concentration of Omeprazole. Furthermore, when I checked for interactions with Xifaxan, I found no known interaction between it and Zanubrutinib or any of the 6 FDA approved ppi drugs.

I have not had a diagnosis of small bowel intestinal overgrowth, but when reading about it I found that its symptoms were similar to exocrine pancreatic insufficiency (EPI), a condition that I was diagnosed with several years ago. For me taking a Creon capsule (lipase, amylase & protease) with any food makes up for the EPI and reduces its horrible symptoms.

Please let us know what you discover.

[Bethsaida in reply to gardening-girl]

Thank you for your response. I found it can moderately interfere with ibrutinib but maybe Zanubrutinib is so new, it hasn’t been investigated yet. I’m waiting for my oncologist and oncology pharmacy reply. I think with ibrutinib the dose might have to be decreased.

[Motorman]

I was on Lansoprazole for about 8 years. As I understand things your gut bacterial growth is regulated by acid produced in the stomach. Low acid passing into the bowel can allow Small Intestine Bacterial Overgrowth. I suffered with bad wind ( gas US !) and other bowel problems. I weaned myself off Lansoprazole ( with my Doc's OK) which took over two months. My bowel problems are much improved with less wind and other symptoms. I am not a doctor and I am just giving my experience. Geoff UK

[Bethsaida in reply to Motorman]

Thank you.

[Dragonvrod]

Hello, I do not have CLL (caregiver of CLL patient) I had SIBO for so many years and the pain was horrible. I took the medication they suggested as it doesn’t go into the blood stream, it works directly where it is supposed to. I felt so much better after taking it, and so glad I did. They think I got SIBO from the bacteria in my large intestines and salmonella poisoning. I hipe ypu feel better soon.

[Bethsaida]

thank you for your reply.