Join us on Facebook in the SIBO SOS Community
FREE Virtual Trainings
Search
0
Log in
0
Free Virtual Trainings with SIBO Researcher, Dr. Mark Pimentel
1:29:09
Watch the QA with Dr. Ali Rezaie - recorded March 2024
Watch the Q&A with Dr. Mark Pimentel - recorded March 2024
1:35:30
Digestive Disease Week 2023 Research Update by Dr. Mark Pimentel (May 2023)
52:26
Digestive Disease Week 2023 Research Update by Dr. Ali Rezaie (June 2023)
1:34:25
Research Update for SIBO, IMO, and IBS (November 2022) with Dr. Mark Pimentel
0:02
Allison Siebecker, doctor Alison Sebecker and doctor Mark Pimentel will be talking to us about the developments revealed at the American College of Gastroenterology 2022 research updates to share with us today.
3:58
Sarna: We now know that IBS, SIBO, and food poisoning are linked. Sarna: Food poisoning is the trip the trip wire or the trigger for the development of these problems in most cases of SIBO.
8:00
Sarna: We can't food poison humans because that's unethical, so we had to use animal studies. In 2008, we gave campylobacter, which is the most common bacterial food poisoning agent in the United States, 2 33 rats, and the other 33 got nothing. In contrast to the control rats, 27% of these rats got SIBO.
11:45
In a study, the antibodies to CDTB are tricked into binding to your nerves of your gut, causing changes in those nerves. If you gave rats campylobacter and they developed SIBO, the number of these special cells that conduct the electricity for the cleaning wave are markedly markedly reduced.
15:47
Sarna: We've known that cleaning waves are important in IBS CBOW connection for a while. If you don't have cleaning waves, you get overgrowth, because you're not cleaning your small bowel properly.
20:03
In the blood of these rats, and they have all sorts of cytokine changes, in particular, these 4, IL 2, IL 5, IL 18, TNF alpha. If the direction of change of these 4 happened in a human, it would be because the human was seeing too much lipopolysaccharide.
24:04
This is the one that's validated with the, what we call epitope optimization to give you a better separation between IBS d in red and other people with diarrhea. So this is really important. When you develop a blood test for IBS, and people have, some of these blood tests were, well, it's up in IBS but not up and healthy. Well, if you have a normal bowel movement, you're not seeing me. If you have diarrhea, I need to figure out what's causing your diarrhea.
27:53
Breathalyser test findings are correct that IBS has more SIBO by breath testing. But SIBO is complicated. In 1996, when we first started doing research in this, all we had was data on hydrogen. All we know is if hydrogen's elevated, you have SIBO. But if the hydrogen's a 100 or 50, both are abnormal.
31:51
Bacteria are taking up 45% of everything in the gut. 40% of every you have 500 to a 1000 species in the small bowel, and 40% are just a couple. It's almost like an infection. The more you have, the worse it is for you.
35:53
Shivan: Hydrogen sulfide is really the new kid on the block. Fusobacterium is one of the key hydrogen sulfide producers of the gut. We do believe E. Coli lines up with this and that these 2 are working in partnership.
39:37
Rifaximin and neomycin have an effect on constipation. Bismuth could be used to treat hydrogen sulfide.
43:27
Methanobrevibacter smithii is the source of methane on breath test. Methane is lower than even non SIBO patients because the methane is eating the hydrogen. Eating more hydrogen means less hydrogen on your breath test, and and all of that just continues to line up. It's not E. Coli and klebsiella when it comes to methane.
47:29
Most experts around the world now agree of the importance of SIBO and how to diagnose it. Most agree how to dose the substrate, and most of them agree thatSIBO and IBS are interlinked and interrelated.
51:16
If they're constipated, I don't measure routinely those antibodies because they're only present about 25%. But for the methane positive, I give rifaximin plus neomycin based on that randomized controlled trial. Methane negative, you need to figure out why they'reconstipated.
55:00
Rifaximin should work on E. Coli klebsiella and Christian senesenaliciae. It's not water soluble. So it can't penetrate some of the deeper parts of the small bowel fluid, that where these bugs are sort of hiding, including the mucus.
58:58
In almost all bugs that make methane, they use f 420 as the final step. So if you wanna get rid of methane and make sure that it's not, you know, if it just happens to be you don't have Smithy eye, you have one of the other ones, f 420 is still there. And so lovastatin, we showed in a paper a number of years ago, sticks in the socket of that protein and blocks the protein doing what it's supposed to do.
1:02:35
I think the challenge with IBS is IBS, has always been a clinical diagnosis. Anybody with any diarrhea should have a breath test. If it's positive, then don't apply the Rome criteria. That that's gonna be hard to convince people.
1:06:15
The diversity in the microbiome, whether they're talking small or large, is is is too is too diminished, and we need to build it back up. If you slow the gut down, you have more time for diversity.
1:09:37
When we treat with rifaximin and we get rid of the SIBO, we have data on this, You look at the small bowel again, all the diversity came back. It's sort of like a gang moved into your neighborhood, and all the neighbors just say, I'm out.
1:13:06
IBS patients do have weird inflections of blood sugar that are difficult to explain. We're trying to sort out that, but, we haven't made a lot of progress there. There's something connecting the microbiome to diabetes and high blood sugar.
1:16:49
In younger people, we see a more hypo, especially if we do a a sugar to glucose tolerance test. If they're older people, then they tend to go high. So it's this is the challenge with diabetes is because it changes in time.
1:20:45
Roxanne Jones: I just wanted to ask a clinical question about it. How often you might have seen tinnitus develop? And, like, how how common is that for you to see? And when and if you've seen it, was it temporary or not? Jones: You can imagine how many people I've given rifaximin and neomycin to. It's it's over a 1,000.
1:24:22
There's no randomized controlled trial, none, of treating bile acids in diarrhea IBS. There are open label 20, 30 patient studies that say, hey. This might do something. Overall, the bile acid story is a bit complicated.
1:28:04
Sarna: I feel like there might be a changing landscape because now we know methanogen overgrowth can be, you know, in the large intestine, so can hydrogen sulfide. What's normal? What's abnormal? We're still trying to figure that out.
1:32:01
You know, so it's it's all sorts of things that we're learning just as we continue to look. It's the wild west, in there. And then last this really is the last one. Any relationship? Do you ever see any? Haven't looked.
Show more
Show less
36:51
Digestive Disease Week Updates 2022 with Dr. Satish Rao
1:47:01
Digestive Disease Week 2022 Update for SIBO, IMO, and IBS by Dr. Mark Pimentel (July 11, 2022)
5:24
Dr. Pimentel’s New Book Has Been Released! (April 13, 2022)
1:26:00
The Latest on SIBO/IMO/IBS with Dr. Mark Pimentel (Feb. 14, 2022)
1:08:55
SIBO, IBS, and the New 3-Gas SIBO Breath Test with Dr. Mark Pimentel and Shivan Sarna (recorded Mar 15, 2021)
28:47
Podcast
1:31:40
SIBO Research Breakthroughs Q&A with Dr. Mark Pimentel - Watch and Download the Material
56:39
Cutting-Edge Developments in Post-Infectious IBS, Methane, and SIBO Masterclass with Dr. Mark Pimentel
1:21:28
The Q&A Recording for Cutting-Edge Developments in Post-Infectious IBS, Methane, and SIBO Masterclass with Dr. Mark Pimentel
1:05:48
Post Infectious IBS and SIBO and Research Update With Dr. Mark Pimentel
1:01:11
Research Update and QA with Dr. Mark Pimentel 2020 Part 1
1:05:07
Research Update and QA with Dr. Mark Pimentel 2020 Part 2
48:54
SIBO Research Update Masterclass Lecture with Dr. Mark Pimentel
1:31:40
SIBO Research Update Masterclass Q&A Part 2 with Dr. Mark Pimentel
1:05:51
Part 1 Q&A with Dr. Mark Pimentel & Dr. Allison Siebecker
1:17:22
Part 2 Q&A with Dr. Mark Pimentel & Dr. Allison Siebecker
