Study: Treatment of the bacterial overgrowth of the small intestine
Study: Treatment of the bacterial overgrowth of the small intestine
Reference
chedid V., Dhalla S., Clarke Jo, et al. The herbal therapy corresponds to rifaximin to treat bacterial overgrowth of the small intestine. Global Adv Health med. 2014; 3 (3): 16-24.
Design
The study was a retrospective study based on an evaluation of the medical stories in a center of tertiary care from 2006 to 2010. The breathing tests were interpreted with regard to the treatment group.
participant
The participants were an evaluable sub-group of 104 people (77 women, 27 men) aged 18 to 85, the symptoms of a bacterial overgrowth of the small intestine (SIO), a positive lactulosis hydrogen/methane breath test and a subsequent lactulose breath test. The participants opted for 7 to 10 days of rifaximin (400 mg 3x/d) or 30 days of 1 of 2 combinations of herbal formula treatments: 2 capsules each from Dysbiocide and FC Cidal from (Biotics Research Lab, Rosenberg, Texas) twice a day or 2 softgels candy-ar and 2 tablets Candibactin BR from (metagenics corporation, Gig Harbor, Washington) twice a day. In addition, a triple antibiotic protocol (Clindamycin 300 mg 3x/d, metronidazole 250 mg 3x/d, neomycin 500 mg 3x/d) or 1 of the same 2 vegetable protocols as "rescue therapy" for 30 days during initialization could not normalize the breath test. There were no significant differences in age, gender, Sibo-risk factors or irritable bowel status between those who decided on herbal therapy and those who chose Rifaximin.
study parameters evaluated
The lactulose breath test (Quintron Instrument Company, Milwaukee, Wisconsin), which measures both the methane and hydrogen gases before and after treatment, was evaluated.
Primary result measurements
A negative breath test after the treatment schemes was the measured result. The improvement in symptoms was not evaluated.
important knowledge
A negative breath test after treatment was observed in 34 % (23/67) of the rifaximin or group compared to 46 % (17/37) of the group treated with herbs ( p =. 24). Of the 44 Rifaximin-Non Responders, 57.1 % (8/14) had a negative breath test after they had undergone herbal therapy, and 60 % (6/10) received a negative breath test with a triple antibiotic treatment ( p =. 89). Although there was no significant difference in the effectiveness between the treatments, the vegetable intervention seems to be just as effective both in advance and in secondary treatment for Rifaximin-Nonresponder as the drug therapies.
practice implications
The implications of the study are clear: herbal treatments are a practical option for patients with Sibo. However, symptom management is just as important for doctors as the objective measurements of the lactulose breath test. Since the study is a retrospective view of the treatments, the objective measurement of results of the hydrogen/methane acle was useful. In future prospectively created studies, symptom relief would be a useful consideration and a useful result for clinicians.
The implications of the study are clear: herbal treatments are a practical option for patients with bacterial overgrowth of the small intestine.
Due to the limited meaning of the study, the summary of some data was a necessity that covers our ability to make differences in treatment results. First, the type of gas - hydrogen or methane - was not delimited. Second, “herbal therapy” consisted of 2 very different formulas of 2 different supplement companies. It is significant that both herbal treatments seemed effective, but a study that focused on a certain herb protocol would be more insightful.
Another restriction is that the drug regime used, although it is still most frequently used by doctors, is not the most effective prescription treatment. Other more effective pharmaceutical treatments could show better effectiveness in future studies.
Apart from these criticisms, this article goes a long way to validate the use of herbal treatments at Sibo. The cost difference is a practical consideration for your use. Rifaxamine is an expensive antibiotic (more than $ 1,000 per treatment), although in many cases it is taken over by the insurance. The herbs used in this study cost about a tenth of the price (less than $ 120 for the treatment cycle) and were equally effective. As the authors mention, future prospective research studies still have to be completed to determine information about symptoms and find out which herbal treatments work best, but at the moment these herbal treatments seem to be safe and effective.
to say it clearly, many of our criticisms are due to the retrospective character of the study and not necessarily to the intention or negligence of the researchers. SIBO research is still in its infancy, so we hope that future studies can build on the fascinating results of these retrospective analysis.
- Pimentel M., Lembo A., Chey Wd, et al.; Target study group. Rifaximin therapy for patients with irritable bowel syndrome without constipation. n Engl. J med. 2011; 364 (1): 22-32.