Integrative Medicine : Lubiprostone for SIBO and Chronic Constipation.

A recent 2016 study for 29 female patients with chronic constipation and Small Intestinal Bacteria Growth (SIBO) used 24 mcg twice per day of Lubiprostone (a prescriptive intestinal secretagogue). 41% of those people who tested positive for SIBO were SIBO negative after 2 weeks. This well designed (but albeit small) study also measured gastric emptying time, small bowel transit time, colon transit time (CTT), combined small and large bowel transit time (SLBTT) and whole gut transit time were measured using wireless motility capsule and showed improvement in those parameters. Stooling increased from 2x per week to 4x per week. As someone who treats a lot of SIBO and Chronic Constipation this is a promising new integrative treatment that may even have better results combined with natural therapies and even other conventional therapies. I am investigating more about the reported low side effects of Lubiprostone. The most exciting thing is that it helps us understand more of the mechanism of chronic constipation and the importance of intestinal fluid interchange in regulating motility. More on Small Intestinal Bacterial Overgrowth Here.

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Plateauing

Plateauing in the process of change. I have experienced and you have experienced it. Things are going well and then we hit a flat point of progress. The typical response to the plateau that I have seen is to "do more" ,"add more", and "be more". It makes sense,right? Or does it? You're climbing a mountain after learning, growing, acquiring skills, and carrying more responsibility, motivation, and discipline. It seems worth it because you're seeing your health improve, relationships improve, mental health improve, and spiritual health improve. Then you suddenly you're at a flat point. Things are not quite where they need to be and you have acquired new things, skills, tools that require maintenance and nurturing. If you don't continue them you would... well....fall back down the mountain. Or would you? So we add more stuff, more noise, more ideas, more skills, and suddenly we look like a pack mule climbing to our asc...

You have SIBO: Take these antibiotics and call me in two weeks. Can we do better?

The antibiotic approach to SIBO... A reasonable approach to Small Intestinal Bacterial Overgrowth (SIBO) treatment? Perhaps. Effective long term? Probably not. So the question is not “should I take Rifaximin or Neomycin/Rifaximin or plant antimicrobials?” Which I go into detail on this blog post . The question is what should I do after I take them? Because we all know of the infamous likelihood of a SIBO relapse. Too dive into this question we should look at the factors that lead to SIBO: Intrinsic factors that prevent bacterial overgrowth (Ghoshal, Shukla, & Ghoshal, 2017): 1. Secretion of gastric juice and bile which have antibacterial effects. Basically proper stomach acid and gallbladder function. 2. Peristaltic movement preventing adherence into the intestinal mucosa. Basically regular bowel movement. 3. Normal gut defense including humoral and cellular mechanisms. Basically adequate immune defenses in the gut such as proper Secretory IgA levels ...

HPA Management: How to decrease anxiety?

This post is about Hypothalamic Pituitary Adrenal gland Axis (HPA) management. Specifically how to decrease anxiety. How do we decrease anxiety? Ask people to be clear of what is expected of us. And upon hearing what's expected be honest with ourselves and others about what is possible. If we you have expectations from others and for ourselves that have no boundaries; then we are likely going to experience an arousal state in the brain. This trickles down to anxiety related symptoms. Vice versa by not setting expectations we can reak havoc on our inner self relationships and outer self relationships. Of course I could write all day about lifestyle changes and herbal interventions that might help but the inner game of anxiety is so much more.

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