Bob: FODMAP hypothesis

[Guest guest]

Bob

If you haven't already, you should look into small intestinal

bacterial overgrowth, bacterial translocation and the FODMAP

hypothesis.

I'd come up with a theory that low grade ammonia intoxication could

happen in the absence of liver failure if the blood brain barrier

was compromised. So I tried lactitol (an OTC version of lactulose)

thinking I might feel 10 to 20% better. Within 4 to 6 hours of a

standard dose I was being brutalized. A mild fever was quite

informative. I asked for clues and he cited this beauty:

http://tinyurl.com/2eu72r

It basically says that the modern diet now includes compounds that

we can't absorb but that bacteria can ferment. The main ones seem

to be high fructose corn syrup, guar gum, gum arabic and sorbitol.

Consuming these compounds feeds the commensal bacteria in your gut.

You're supposed to have relatively low numbers of bacteria in your

small intestines. But feeding them can lead to " small intestinal

bacterial overgrowth (SIBO) " and " bacterial translocation " (that is

the overgrown bacteria can compromise the integrity of the small

intestinal lining and then translocate into the tissues/blood. I

suspect that this is why Garth Nicolson found mycoplasma in the

blood of PWCs when he looked for it).

It seems pretty clear that this explains why lactitol had such a bad

effect on me. I suspect that I have intracranial hypertension and

that the resulting activation of sympathetic nerves slows

peristalsis and that this helps promote the SIBO. I also had C diff

which was doing serious damage to my intestines, and which resolved

with treatment. So I can't be sure how much credit to give the

FODMAP dietary changes versus the C diff treatment, but collectively

they have eliminated overt GI problems. I'm going on a year now.

The two times I've had obvious gurgling were when I consumed lots of

corn syrup.

The " die-off " that your wife, and others describe may not be a die

off of pathogens, but of commensals that are overgrown in the small

intestine because of FODMAPs and/or slow peristalsis. If true, then

you can plan on endless " herxing " if you pulse abx since the

commensals grow rapidly and replenish between pulses, IMO. The

obvious solution is to avoid FODMAPs. I even avoid juice due to the

fructose, though I occasionally drink some after adding a tablespoon

of dextrose (i.e., glucose) since the fructose isn't so much a

problem if it is matched on a molar basis by glucose (fructose

undergoes glucose-dependent transport, hence the problem with high

fructose corn syrup unmatched by glucose. Sucrose is not a problem

because it is one part fructose, one part glucose).

Note that " Endogenous lipopolysaccharide (LPS) is continually

absorbed from the gut into intestinal capillaries, and low-grade

portal venous endotoxemia is the status quo " . Quoted from:

http://tinyurl.com/28x8jd

SIBO should aggravate this greatly and it looks like the liver would

be hit hardest.

Given your wife's constraints, restricting dietary FODMAPs is

something that shoud be safe and possibly a bit effective.

Unfortunately, I didn't experience a relief of the fatigue and such

that was aggravated by the lactitol (a FODMAP) but it does seem to

have helped eliminate my GI problems.

As for Ceftin, my wife was give a single, large dose of Omnicef when

she had stitches. She had major GI problems for months afterwards

and then went to the ER for what turned out to be a gall stone.

She's had intolerance to food for many years that now makes sense in

light of gall bladder problems and I think the Omnicef aggravated it

badly. Ceftin and Omnicef are related to Rocephin which is

notoriously hard on the gall bladder. I couldn't find any

definitive statements on Omnicef to match those of rocephin, but it

seems too coincidental.

Matt

>

> She can't tolerate Zithro at all. Strangely, aside from a massive

> cytokine storm, the symptoms are what we associate with

mobilization of

> mercury: dark depression and emotional lability, which in her case

are

> particularly striking because that is so contrary to her

fundamental nature.

>

> Tried mino once, tore her stomach up right away and took months to

> recover. These kinds of atypical responses make abx really

challenging.

>

> Biaxin brings about promising clinical results but is hard on the

> stomach; even so she managed a three week course which for her is

a huge

> accomplishment. And then the doctor tried adding Ceftin.

>

> Ceftin has been tolerated fine in the past by itself, though it

didn't

> produce clinical results one way or the other. But combined with

> Biaxin, Ceftin produced an immediate heavy die off of something.

The

> toxins overwhelmed her liver, liver enzymes went through the roof,

and

> coincidentally or not, she threw a gall stone (completely new

problem --

> whoopee).

>

> At this point one of her doctors is convinced the gall bladder

needs to

> go, that it's a locus of infection and in any case should be

removed

> while it's elective, not wait until it's a crisis. He wants to

> stabilize her for a couple of months and then do the laproscopic

> procedure to take it out. The other doctor is more conservative

and

> doesn't recommend attempting surgery unless she has another

attack. He

> puts the odds of such an attack at 20%.

>

> Unless she has another attack, we are going to move heaven and

earth to

> avoid the knife because with the severe MCS, the combination of a

> hospital stay and anesthesia could well run her into the ground,

if not

> do her in altogether. For now, she is just starting the Biaxin

again by

> itself.

>

> --Bob

>