4. FAQ

Koppling IBS & SIBO

PI-IBS = SIBO (Siebecker)

kontrovers kring kausalitet

Framgångsrik behandling av sibo, men IBS-symptom kvar

Kolhydrater

Gut Health protocol: max 50 g/d i en månad

Bättre resultat med lite mer kolhydrater, jfr. VLC

Hur undvika återfall?

http://www.townsendletter.com/FebMarch2013/ibs0213_2.html


In our practices we have found that the following circumstances increase the chances for an unsatisfactory patient outcome:

• Failure to continue treatment courses until SIBO is eradicated (negative breath test or patient ≥90% better). This crucial process of successive treatment is indicated by the long go-back arrow on the right side of our algorithm (Figure 3).

• Failure to use double antibiotic therapy for methane producers. Methanogenic bacteria need different antibiotic treatment than hydrogen-producing bacteria.

• Failure to utilize breath testing to identify if the patient has SIBO, the type of gas he/she produces, and the overall level of gas. This information is necessary for diagnosis, treatment choice, duration, and prognosis.

• Failure to use a prokinetic immediately following treatment. Prokinetics along with diet are needed to prevent relapse of this commonly recurring condition.

• Failure to use a low-carb preventative diet following treatment. Diet along with prokinetics are needed to prevent relapse of this commonly recurring condition.

• Failure to tailor diet to individual tolerances with personal experimentation. No fixed diet can predict an individual's complex bacterial, digestive, absorptive, immunological, and genetic circumstances; therefore customizing is necessary. • Failure to identify underlying causative conditions. A recent report found the following conditions led to a poor response to antibiotics: anatomical abnormalities, chronic narcotic use, Addison's disease, scleroderma, colonic inertia, inflammatory bowel disease, and NSAID-induced intestinal ulceration.

Statistik om IBS i Sverige/annorstädes

Kostnad IBS: ca 4 mdr/år i Sverige (back of an envelope-kalkyl baserad på antal invånare, % med IBS, totalkostnad i USA).

Adrenal fatigue

Adrenals vs SIBO - vad prioritera?

http://theancestralrds.com/wp-content/uploads/2014/09/Episode-5-Curing-SIBO-with-Adrenal-Fatigue-and-Whether-to-Eliminate-Nightshades.pdf

SIBO + adrenal fatigue: ät 100-150 g kolhydrater för att mata bakterierna i tjocktarmen, men ta antimicrobials. Undvik fodmaps. Gör puree av gröna grönsaker. Begränsa mängden träning. Inte lägre än 10 E% från kolhydrater. Ät var 2-3 timme.


http://www.drlam.com/blog/stealth-infection-and-adrenal-fatigue-syndrome/4714/

Om hur kroniska infektioner kan ge adrenal fatigue.

Histamin

SIBO kan ge histaminintolerans

Histaminintolerans i sig, oavsett ursprung, kan ge IBS-symptom

Se upp med DHwRF (bör vara failsafe, men: kött och spenat)

Kolla pulsen

NAC

Är IBS farligt?

IBS -> IBD

Kronisk inflammation -> Autoimmunitet (Mayers)

Slutsats: gör vad du kan

Resistent stärkelse

http://drbganimalpharm.blogspot.se/2014/10/dont-take-raw-resistant-starch-if-you.html

Låg stärkelse/fodmap tills IBS-symptom har gått över, 4-6 V.

SIYO

http://coolinginflammation.blogspot.se/2012/06/dr-oz-on-gut-flora-repair.html

SIYO: antimicrobials kan vara riktade mot bakterier vilket gör att svamp kan få överväxt.

Fiber

http://chriskresser.com/how-to-restore-healthy-gut-flora-over-the-long-term

Fermentable fiber important for long term restoration of gut flora. Build up slowly. Also, supplements for SIBO

Herbal antibiotics

Sibo saga : Berberine + neem + garlic. High enough doses.

Ska jag behandla utan att först ställa diagnos?

Autoimmune paleo: Testa istället för att chansa på att AIP + SCD ska hjälpa. Diet kanske inte är tillräckligt alla gånger. Hitta de underliggande faktorerna.

Bananer

Enligt the gut health protocol är de inte bra, men enligt sibo specific food guide overview kan de hjälpa mycket mot vätgasdominant SIBO då man har diarre ofta.

Orsaker

Genetic immunodeficiency syndromes (CVID "common variable immune deficiency" or selective IgA, or hypogammaglobulinema, etc.). If you have reoccurring stomach "bugs" or yeast infections (sinus infections, mucosa linings) you might want to ask your doctor to do a simple serum immunoglobulin blood test to rule out low immunoglobulins. Many people with genetic immune deficiency are not diagnosed until they are in adulthood. (Källa)