Skip to main content

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.

Comments

Popular posts from this blog

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 ...

Release the Belly Shame

My patients are often surprised when I ask them to release  the belly shame as part of their  IBS  treatment. Why do this? There is  a propensity in this population to “suck in the gut” which physiologically leads to increased nervous tension, abdominal guarding, and probably will be proven one day to be a contributing factor in diarrhea and/or constipation that is chronic.  The second brain (the gut) is being told to “hold”.   I  learned this exercise through Katy Bowman that is helping some of my patients manage their IBS (and SIBO). I combine this with some other things that support releasing tension.   Love your belly ….even if it makes funny sounds and has not been cooperative. Fighting it and  resisting it won’t really support it back to health. Here are some guidelines on Abdominal Release adapted from the great work of Katy Bowman.