SIBO - Small Intestine Bacterial Overgrowth - Brian's Story
I had the SIBO breath test under Dr Jervoise Andreyev at the Marsden in October. It confirmed small bowel bacterial overgrowth. A short course of antibiotics (Ciprofloxacin – no side effects suffered) almost immediately cleared all the debilitating symptoms I had suffered in the 18 months since my Ivor Lewis operation and adjuvant chemotherapy. I entered into a brave new world, free of abdominal pain, bloating, absence of appetite, irregular bowel movement and persistent weight loss. Seven weeks later, I remain free of symptoms: should they recur, they should again be readily treatable.
The reversal is remarkable. My weight had fallen from 92 kilos to 58 kilos. Appetite collapsed. Malnutrition was severe enough for enteral feeding and a stay as an in-patient to be necessary. I had a bout of pneumonia and chest infections, and persistent abdominal pain. I am now eating hungrily, and am pain-free with normal bowel movements.
What may, perhaps, also be of interest is that the recommendation to see Dr Andreyev came from a consultant in a quite different field (a cardiologist, in fact) at a different hospital. It may be that my case is exceptional. But the SIBO test is so simple, and the result can be so life-enhancing, that it seems remarkable that such gastroenterology is not better known.
SIBO Follow up - from the Chairman
This is wonderful news for you, Brian, and thank you for sharing it with us.
In fact, two of the OPA’s committee (both oesophagectomy patients) have recently been battling similar symptoms and both of us have been diagnosed with SIBO. I started with prolonged severe diarrhoea episodes in November 2012, accompanied by bloating, vigorous churning and gaseousness in all directions – my wife described my abdomen at night as like the Olympic stadium while Mo Farrah was running!
Yet another Committee member, another oesophagectomy patient, had had similar symptoms ten or more years ago and his had been sorted (without this diagnosis) by the antibiotic Ciprofloxacin. My Doctor agreed to my suggestion that we try it too, and it worked, but not for long. Over a few months I became antibiotic dependant, with symptoms returning very quickly at the end of each two week antibiotic course.
In the end, after it was agreed that SIBO was the cause, it was sorted by an aggressive campaign of three different antibiotics, continually over three months, Ciprofloxacin, followed by Doxycycline and then Erythromycin, the latter to be accompanied by the prescription probiotic, VSL3. After that I was encouraged to undertake the (rather onerous – but successful, in my case!) FODMAP diet, to remove any foods that would ferment if the bacterial imbalance persists.
I personally believe that there is another factor at play here. There is some evidence out there, I believe, that it is the long term heavy use of PPIs such as Lansoprazole and Omeprazole that may contribute to, or even cause, the bacterial imbalance in the first place, by subduing stomach acid to the extent that there is no control on those bad bacteria! There is no way I could stop using PPIs, nor would I want, but I have settled down, comfortably, to one Omeprazole MUPS 20mg tablet each afternoon.
So now, since August 2013, I have regained digestive stability and I am just crossing my fingers that this will continue!