SCD and IBS research 2

[Guest guest]

The JAMA article states that Methane gas slows the digestive process and

causes Constipation. It also states that the methane gas is produced by

gut microorganisms that are a result of undigested starches.

Here are other research articles that prove to us that undigested

starches cause IBS.

Here is how to connect the dots between these research articles:

Research paper #5 proves that Methane gas is an indication that a person

has Constipation.

Where does the methane gas come from?

From intestinal bacteria! (Research paper #4)

How do you increase these intestinal bacteria?

Research paper # 1 proves that carbohydrates that are not digested feed

the bacteria

Research paper #2 and #3 also prove that gut bugs are responsible for GI

problems: When antibiotics killed the gut bugs it resulted in the

elimination of the symptoms of

irritable bowel syndrome in many of the subjects. (Long term antibiotic

treatment may result in gut bugs that are resistant to the antibiotic;

so this should not be a permanent solution.)

Research paper #1 proves that bacterial fermentation is caused by

unabsorped starches. Half of the volunteers were fed starches together

with an inhibitor that would make them unable to absorb the starches.

The volunteers that were unable to digest their starches showed signs of

having carbohydrate fermentation in the colon.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstra\

ct&list_uids=3053313&query_hl=11

1: Gastroenterology. 1988 Dec;95(6):1549-55. Related Articles, Links

Effect of starch malabsorption on colonic function and metabolism in

humans.

Scheppach W, Fabian C, Ahrens F, Spengler M, Kasper H.

Department of Medicine, Wuerzburg University, Federal Republic of

Germany.

To study the impact of starch on colonic function and metabolism, 12

healthy volunteers consumed a controlled diet rich in starch for two

4-wk periods. In one of the study periods they received the

glucosidase inhibitor acarbose (BAY g 5421) and placebo in the

other. Stool wet weight increased by 68%, stool dry weight by 57%,

fecal water content by 73%, and the mean transit time by 30% on

acarbose. Breath hydrogen was significantly higher on acarbose,

indicating stimulated carbohydrate fermentation in the colon. Fecal

bacterial mass (+78%), total stool nitrogen (+53%), bacterial

nitrogen (+200%), and stool fat (+56%) were higher in the acarbose

than in the control period. The stimulation of fermentation in the

human large intestine may be important in colonic and possibly other

diseases.

Publication Types:

* Clinical Trial

* Controlled Clinical Trial

PMID: 3053313 [PubMed - indexed for MEDLINE]

Research paper #2 and #3 prove that gut bugs are responsible for GI

problems:

Small intestinal bacterial overgrowth is associated with irritable bowel

syndrome. Eradication of the overgrowth with antibiotics eliminated the

irritable bowel syndrome of many of the subjects. "

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&list_uids=7\

766746&dopt=Abstract

1: Aliment Pharmacol Ther. 1995 Feb;9(1):63-8. Related Articles, Links

The effect of oral vancomycin on chronic idiopathic constipation.

Celik AF, Tomlin J, Read NW.

Gastrointestinal Motility Unit, University of Sheffield, UK.

BACKGROUND: A case study reporting the efficacy of oral vancomycin

in a patient with chronic idiopathic constipation prompted this

prospective trial of oral vancomycin in eight female patients (aged

21-61 years) with severe constipation resistant to the action of

dietary fibre. METHODS: The trial was divided into two consecutive

14-day periods. During the first period, each patient was given

ispaghula, 3.5 g twice a day, and during the subsequent period they

took 250 mg vancomycin t.d.s. per os, as well as the fibre

supplement. During both periods they collected stools and recorded

daily bowel symptoms (stool frequency, straining, stool consistency,

subjective stool volume) in a diary. At the end of each period whole

gut transit time and the breath hydrogen response to a standard

meal, giving oro-caecal transit time, were measured along with

gastrointestinal symptoms which were assessed on visual analogue

scales. RESULTS: Vancomycin caused a significant improvement in

stool frequency, consistency, ease of defecation and the amount of

stool patients felt they produced (all P < 0.05), but objective

measures of daily stool weight and whole gut or oro-caecal transit

time were not significantly different. Basal breath hydrogen levels

were higher after vancomycin treatment in seven out of eight

patients. One patient experienced a complete remission of symptoms

when she took vancomycin and remains in remission after 14 months.

This patient showed no levation in basal breath hydrogen level.

CONCLUSION: Although this study does not support the use of

vancomycin for most patients with constipation, the results suggest

that modification of the intraluminal flora may be of value in the

treatment of the occasional case of idiopathic constipation.

Publication Types:

* Clinical Trial

* Controlled Clinical Trial

PMID: 7766746 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&list_uids=1\

1151884&dopt=Abstract

1: Am J Gastroenterol. 2000 Dec;95(12):3503-6. Related Articles, Links

Comment in:

* Am J Gastroenterol. 2001 Aug;96(8):2505-6.

* Am J Gastroenterol. 2001 Aug;96(8):2506-8.

* Am J Gastroenterol. 2001 Jul;96(7):2281-2.

* Am J Gastroenterol. 2001 Nov;96(11):3204-5.

* Am J Gastroenterol. 2003 Nov;98(11):2572; author reply 2573-4.

Click here to read

Eradication of small intestinal bacterial overgrowth reduces

symptoms of irritable bowel syndrome.

Pimentel M, Chow EJ, Lin HC.

Department of Medicine, Cedars-Sinai Medical Center, CSMC Burns &

Research Institute, and School of Medicine, University of

California, Los Angeles, 90048, USA.

OBJECTIVES: Irritable bowel syndrome is the most common

gastrointestinal diagnosis. The symptoms of irritable bowel syndrome

are similar to those of small intestinal bacterial overgrowth. The

purpose of this study was to test whether overgrowth is associated

with irritable bowel syndrome and whether treatment of overgrowth

reduces their intestinal complaints. METHODS: Two hundred two

subjects in a prospective database of subjects referred from the

community undergoing a lactulose hydrogen breath test for assessment

of overgrowth were Rome I criteria positive for irritable bowel

syndrome. They were treated with open label antibiotics after

positive breath test. Subjects returning for follow-up breath test

to confirm eradication of overgrowth were also assessed. Subjects

with inflammatory bowel disease, abdominal surgery, or subjects

demonstrating rapid transit were excluded. Baseline and after

treatment symptoms were rated on visual analog scales for bloating,

diarrhea, abdominal pain, defecation relief, mucous, sensation of

incomplete evacuation, straining, and urgency. Subjects were blinded

to their breath test results until completion of the questionnaire.

RESULTS: Of 202 irritable bowel syndrome patients, 157 (78%) had

overgrowth. Of these, 47 had follow-up testing. Twenty-five of 47

follow-up subjects had eradication of small intestinal bacterial

overgrowth. Comparison of those that eradicated to those that failed

to eradicate revealed an improvement in irritable bowel syndrome

symptoms with diarrhea and abdominal pain being statistically

significant after Bonferroni correction (p < 0.05). Furthermore, 48%

of eradicated subjects no longer met Rome criteria (chi2 = 12.0, p <

0.001). No difference was seen if eradication was not successful.

CONCLUSIONS: Small intestinal bacterial overgrowth is associated

with irritable bowel syndrome. Eradication of the overgrowth

eliminates irritable bowel syndrome by study criteria in 48% of

subjects.

PMID: 11151884 [PubMed - indexed for MEDLINE]

=======================================================================

Research paper #4 states that " Intestinal bacteria form two gases,

hydrogen (H2) and methane (CH4) " Forget the rest of the article,it is

not relevant to our discussion.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstra\

ct&list_uids=12197533&query_hl=26

1: Life Sci Space Res. 1969;7:102-9. Related Articles, Links

Intestinal hydrogen and methane of men fed space diet.

Calloway DH, EL.

University of California, Berkeley, USA.

Intestinal bacteria form two gases, hydrogen (H2) and methane (CH4),

that could constitute a fire hazard in a closed chamber. So H2 and

CH4 pass from the anus but these gases are also transported by the

blood to the lungs and removed to the atmosphere. Several factors

affect gas formation: 1) amount and kind of fermentable substrate;

2) abundance, types, and location of microflora; and 3) psychic and

somatic conditions that affect the gut. We evaluated the first

factor by studying men fed different diets and have also recorded

influences of uncontrollable factors. One group of 6 men ate

Gemini-type diet (S) and another received a bland formula (F), for

42 days. Breath and rectal gases were analyzed during the first and

final weeks. Flatus gases varied widely within dietary groups but

much more gas was generated with diet S than with F. In the first

12-hour collection, subjects fed S passed 3 to 209 ml (ATAP) of

rectal H2 (avg 52) and 24 to 156 ml (avg 69) from the lungs

(assuming normal pulmonary ventilation). With F, these values were 0

to 3 ml (avg 1) and 6 to 36 ml (avg 20). Subjects were calmer during

the second test. Gas production was lower with S than initially; F

values were unchanged. Methane differed idiosyncratically,

presumably due to differences in flora. Computed from 12-hour

values, maximum potential daily H2 and CH4 are per man: for S, 730

ml and 382 ml; for F, 80 and 222 ml. Volumes would be larger at

reduced spacecraft and suit pressures.

PMID: 12197533 [PubMed - indexed for MEDLINE]

========================================================================

Research paper #5

In conclusion, a methane positive breath test is associated with

constipation as a symptom.

1: Dig Dis Sci. 2003 Jan;48(1):86-92. Related Articles, Links

Click here to read

Methane production during lactulose breath test is associated with

gastrointestinal disease presentation.

Pimentel M, Mayer AG, Park S, Chow EJ, Hasan A, Kong Y.

GI Motility Program, Bums and Research Center, Cedars-Sinai

Medical Center, Los Angeles, California 90048, USA.

It has recently been determined that there is an increased

prevalence of bacterial overgrowth in IBS. Since there are two gases

(hydrogen and methane) measured on lactulose breath testing, we

evaluated whether the different gas patterns on lactulose breath

testing coincide with diarrhea and constipation symptoms in IBS and

IBD. Consecutive patients referred to the gastrointestinal motility

program at Cedars-Sinai Medical Center for lactulose breath testing

were given a questionnaire to evaluate their gastrointestinal

symptoms. Symptoms were graded on a scale of 0-5. Upon completion of

the breath test, the results were divided into normal, hydrogen

only, hydrogen and methane, and methane only positive breath tests.

A comparison of all subjects and IBS subjects was undertaken to

evaluate diarrhea and constipation with regards to the presence or

absence of methane. This was further contrasted to Crohn's and

ulcerative colitis (UC) patients in the database. After exclusion

criteria, 551 subjects from the database were available for

comparison. Of the 551 subjects (P < 0.05, one-way ANOVA) and in a

subgroup of 296 IBS subjects (P < 0.05, one-way ANOVA), there was a

significant association between the severity of reported

constipation and the presence of methane. The opposite was true for

diarrhea (P < 0.001). If a breath test was methane positive, this

was 100% associated with constipation predominant IBS. Furthermore,

IBS had a greater prevalence of methane production than Crohn's or

UC. In fact, methane was almost nonexistent in the predominantly

diarrheal conditions of Crohn's and UC. In conclusion, a methane

positive breath test is associated with constipation as a symptom.

PMID: 12645795 [PubMed - indexed for MEDLINE]

========================================================================

Quick summary:

Research paper #1 proves that bacterial fermentation is caused by

unabsorped starches. Half of the volunteers were fed starches together

with an inhibitor that would make them unable to absorb the starches.

The volunteers that were unable to digest their starches showed signs of

having carbohydrate fermentation in the colon.

Research paper #2 and #3 prove that gut bugs are responsible for GI

problems:

Small intestinal bacterial overgrowth is associated with irritable bowel

syndrome. Eradication of the overgrowth with antibiotics eliminated the

irritable bowel syndrome of many of the subjects. "

Research paper #4 states that " Intestinal bacteria form two gases,

hydrogen (H2) and methane (CH4) "

Research paper #5

In conclusion, a methane positive breath test is associated with

constipation as a symptom.

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