After many tests, investigations etc to identify/manage my IBS -D, my NHS gastro consultant arranged a breath test. The nurse administering it said it's often the last attempt at solving issues. Anyhow, I was quite excited to quickly test positive, I felt the cure was in my grasp! I have completed 14 days of Metronidazole , 400mg X3 a day. It's been hard going as they made me extremely nauseous but I persevered. Sadly I feel no different. Two days after completion, my bowel is rolling with wind and I have the usual abdominal cramps.
I'm so disappointed, I really thought a solution was in sight. Has anyone had a successful outcome from Metronidazole?
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Misscrisps
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Sorry you are still feeling bad. I haven't experienced metronidazole, but I know it is an antibiotic. So, it has hopefully knocked out your problem bacteria, but will also have cleared your 'good' bugs too, which may be why you are still having symptoms. Have you been given any advice about pre & probiotics to help replace your good guys? It may take time for them to re-establish.
Metronidazole is brutal. I once took a course for something else and I had two weeks of liquid stools with it and daren’t go out. It will have completely stripped all your bacteria and is like a complete reset. You now need probiotics.
They’re expensive but after years of taking probiotics ‘off Amazon’ I’ve just tried ‘Epetome’. The results have been staggering for me in just two weeks. I’m feeling so much better after years of problems.
I had a positive breath test but didn't have SIBO. Unfortunately the tests aren't accurate. In the end I had dysbiosis (dominance of a bad bug in the colon/large intestine, rather than in the small intestine) which is common for IBS sufferers. Alflorex probiotic helped me greatly with this. If the dominance is in the large intestine (which is more likely), then probiotics are far better to take and safer than antibiotics (but not all probiotics are the same when it comes to IBS). They help to take control of the bad bugs (which we all have), improving food tolerance, so that you can take in more prebiotic foods to help the good bugs to grow. If you take prebiotics before probiotics, you may be feeding the bad bugs causing symptoms. In fact, if you take antibiotics for dysbiosis of the large intestine, they can make intestinal imbalances worse, since your gut bacteria may grow back even more out of balance since it kills good bugs too. Also bad bugs can grow back meaning taking anitbiotics is futile for large intestine imbalances.
If a 3 month trial of Alforex helps rather than hinders, you would have been suffering from IBS/dybiosis rather than SIBO, since if you'd had SIBO your symptoms would get gradually worse and worse over time (after the bedding in period), as you are adding bacteria on top of bacteria in the small intestine. This may also be used as a crude test for SIBO.
You also won't have SIBO unless you have one of its root causes and these need treating first. You may want to read this:
I too have a large bowel dysbiosis suggested by repeated courses of antibiotics, no small bowel symptoms and good bile flow/gall bladder function on a ketogenic diet. I've had a good response to Elixa probiotics, and then further improvement taking a post biotic, tributyrin. I use Taubiotic but Healthy Gut also produce it. It is reported to be effective for IBS-C as well as IBS-D. Just wondering whether it's something that you'd tried? frontiersin.org/journals/mi...
Good that you have found things that work for you.
Regarding Elixa probiotics - I looked them up and they have 1/2 trillion CFUs and lots of different strains. I've done very badly on multi-strain high CFU probiotics in past. I've read research that people with IBS tend to do better on lower CFU products (<10 billion) and sometimes multi-strain probiotics can compete with one another. Great it works for you, though.
I haven't looked into tributyrin. I'll do more research into that. I'm hoping to launch my non-commercial, information only website on all the research I've done into IBS soon. I have a section on SCFAs, so I'll review tributyrin as part of that. Thanks for the info. I haven't tried it myself. At the moment my IBS is relatively stable (apart from some remaining food intolerances, particularly some vegetables and foods containing mannitol). It might be something I could consider for future.
Are you on ketogenic diet now or was it something temporary? I have a whole web page about low carb/fibre, high protein, high fat diets not being good for the microbiome.
Interesting re probiotics and IBS. I guess it depends on how imbalanced the microbiome is, and the underlying cause. It's so multifactorial, and research still lacking, unsurprising really given how relatively recently the importance of the microbiome has been acknowledged.
So pleased to read of you launching a website with all the information that you've collated. I look forward to looking at it, and I'm sure that it'll be a valuable resource for many on here.
I understand that tributyrin has advantages compared with say sodium butyrate (as it's released in the colon where it should be, rather than more proximally, and it doesn't have the odour issue). I didn't use it whilst in ketosis as the state of ketosis itself results in SCFAs, an excess of which in the gut can cause issues.
Good to hear that your IBS is behaving. I'm similar with mannitol (and possibly sorbitol too) I think...noticeable gas with cauliflower, mushrooms, fennel and apples!
I've been on a ketogenic diet for a few years, with short breaks, to decrease systemic inflammation to good effect, but felt that it was possibly worsening my dysbiosis (likely originally caused by repeated rounds of antibiotics over the years). I think it was also causing gut/mast cell issues due to the production/release of too much bile, so I changed back to a carbohydrate based diet a little while ago.
I totally agree re such diets adversely affecting the microbiome and am working towards replenishing bifidobacteria (amongst others) and crowding out the undesirable (histamine producing) citrobacter, hence my being drawn to Elixa's very high dose of bifidobacteria/lactobacilli.
Secondly, this YouTube video about thiamine/vitamin B1 (Better Health Guy and Elliot Overton). It's long (two hours) but can be speeded up. They discuss, amongst other things, the significance of vagal nerve dysfunction in gut disorders, and further to that, the importance of thiamine/vitamin B1 sufficiency for vagal nerve functioning. B1 is so easily depleted, it begs the question, how many IBS sufferers might be 'deficient'?
I’m really sorry this didn’t work out for you. I wish you luck for the future. Anyone with IBS I feel for. It’s a dreadful thing and the impact it has on your life is immeasurably.
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