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Dr. Anthony Lembo of Beth Israel Deaconess Medical Center announced that he will present the results of TARGET 3 at the American College of Gastroenterology meeting.  TARGET 3 is a Phase 3 study of the efficacy and safety of repeat treatment with rifaximin in subjects with IBS-D that previously responded to an initial treatment course of rifaximin and subsequently experienced a recurrence of their IBS-D symptoms.  Rifaximin, is widely used to treat small intestinal bacterial overgrowth, but is not currently approved for use in IBS-D and is currently under review by the FDA. The TARGET 3 study was designed with both an open-label and a double-blind phase.

This recently published research studied the benefit of eradicating h. pylori in patients that have been diagnosed with gastro-esophageal reflux disease (GERD).  The study enrolled 29 H. pylori positive patients who also had been diagnosed with GERD.  After administration of triple therapy the H. pylori was successful eradicated in all the patients as confirmed by the urea breath test.  Post eradication, the patients were then evaluated by the DeMeester symptom scoring with 82.8% showing improvement.  While a larger study is needed to confirm these results It may be worthwhile to test GERD patients for H. pylori and treat if positive.

A recent study done at the Boston Children’s Hospital shows that H2-receptor antagonists significantly increases the incidence of small intestinal bacterial overgrowth (SIBO) in children.  In the study group 46% of children taking the antiacids tested positive for SIBO.  Whereas only 18% of children complaining of stomach pain but not being treated were positive for SIBO.  These results support the conclusion that acid-suppression therapy changes the gastric microflora and can introduce new problems.  More study needs to be done to determine what doses of acid –suppression therapy would effectively treat the gastric distress symptoms but not lead to SIBO.

This research focused on the benefits of using probiotic therapy for patients with chronic liver disease, small intestinal bacterial overgrowth (SIBO) and intestinal permeability problems.  The study enrolled 53 patients who consumed for 4 weeks a cocktail of 6 bacterial species. The result was that SIBO was resolved in many of the patients but intestinal permeability was not.  This led the researchers to conclude that in liver disease patients’ probiotics are effective treatment for SIBO.

The cause of autism has confounded medical science.  Recently, research from Caltech has suggested that there may be a link with leaky gut syndrome. This research showed that GI barrier defects (leaky gut) and microbiota alterations in the maternal immune activation (MIA) were found in mice that displayed features of autism. By oral treatment of MIA offspring with the human commensal Bacteroides fragilis the gut permeability was corrected and the behaviors associated with autism were reduced.  This suggests that in autistic patients with leaky gut syndrome healing the leaky gut through pro-biotic therapy might be beneficial.  The researchers cautioned that this is probably only one factor in this complex disease not  a cure and more study needs to be done.

Researchers at Lund University in Sweden have been studying whether leaky gut syndrome is a factor in multiple sclerosis (MS).  What is known about MS is that inflammation develops that effects the central nervous system.  The question is whether the function of the intestines is also compromised by this inflammation.  This effect wouldn’t be unusual because other inflammatory diseases such as Crohns Disease, ulcerous colitis and type 1 diabetes are associated with intestinal permeability problems.  What these researchers found was that MS patients had structural changes in the mucous membranes including an increase in inflammatory T-cells and a reduction in immunosuppressive cells (regulatory T- cells).  Thus the researchers hypothesized that “a damaged intestinal barrier can prevent the body ending an autoimmune reaction in the normal manner, leading to a chronic disease such as MS”.  More work needs to be done on this hypothesis, but there seems to be little downside to testing MS patient for leaking gut syndrome.  Perhaps those MS patients who test positive would benefit from therapy to heal the gut.

Interesting article appeared today on the Huffington Post that provides detailed advice on a homopathic cure for leaky gut.  The article uses as an illustration a young girl whose leaky gut was attributed to the use of Ibuprofen.  Her doctor advised the removal of all gluten and dairy from her diet and then added a few common supplements – curcumin, DGL, zinc and L-glutamine.  The patient was completely healed within a few months.  Obviously, this is a small sample but the simplicity of the treatment merits consideration if you have leaky gut.  If you are not sure whether you have leaky gut consider taking our test leaky gut – /hydrogen-breath-test/leaky-gut-syndrome/

Rifaximin is the antibiotic of choice for treating small intestinal bacterial overgrowth (SIBO).  However, many patients prefer to avoid antibiotic therapy and use natural remedies.  This study looked at the efficacy of using a herbal capsules BID containing following commercial herbal preparations: Dysbiocide^®, FC-Cidal^TM, Candibactin-AR^®, Candibactin-BR^® versus using rifaximin.  Three hundred and ninety six (396) subjects were tested using the lactulose hydrogen breath test.  In this group 104 patients became the focus of the study because they tested positive for SIBO and had a follow-up breath test to determine the outcome of the therapy.  The study group had 37 subjects taking the herbal therapy and 67 elected to use rifaximin.  After a month of therapy the subjects were tested and 46% taking the herbal treatment tested negative whereas only 34% of the rifaximin subjects tested negative.  Adverse side effects for rifaximin affected 6 subjects but only 1 subject had an adverse reaction from the herbal therapy.  More study is necessary to confirm the results but these findings a promising for patients looking for an alternative to antibiotic therapy.

Researchers at Case Western Reserve University School of Medicine have just released a study in PLOS Pathogens that concludes leaky gut syndrome is a problem in HIV positive patients.  What they found is that these patients frequently develop abnormalities in the tight junctions along the epithelial surface of the colon.  This defect allows bacterial to leak through the colon resulting in inflammation.  Why this is so prevalent in HIV positive patients is unknown but it is likely a result of either the antiretroviral drugs or the disease itself, or maybe both.  The research concludes that HIV-positive patients with symptoms should consider testing and treatment alternatives.

Intestinal permeability or more commonly known as leaky guts syndrome, in irritable bowel syndrome (IBS) patients has been studied with conflicting results.  This new study evaluated 91 IBS patients and 94 healthy controls.  All the subjects were given sucrose excretion and lactulose/rhamnose tests to assess gastroduodenal and small intestinal permeability, respectively.  The study result indicated that patients with IBS – D (diarrhea predominate) had a statistically significant higher incidence of leaky gut syndrome as compare to controls.  Metabolic Solutions offers the sucrose breath test for assessing leaking gut syndrome. The breath test is very simple to perform at home.