Moodle at CCNM

In continuing the discussion of the principle of treating underlying causes of SIBO rather than simply focusing therapy on reduction of bacterial overgrowth, we cannot overlook the thyroid gland’s role in motility. Evidence has emerged for thyroid disorders as one of SIBO’s etiologies. This presentation explores SIBO’s intersections with dysthyroidsm, and points to implications in developing effective treatment plans and strategies for prevention of recurrence.  The presentation will include a brief overview of thyroid prescribing, both clinically and sub-clinically, including use of Levothyroxin, Tri-iodothyronine, dessicated Thyroid USP, and compound prescribing.

In the last decade, the understanding of clinical breath testing in the evaluation of SIBO has evolved. We have come to know that methane on breath testing is highly associated with constipation and requires a different approach to treatment. Hydrogen on the other hand is not related to any specific symptom. The missing gas has been hydrogen sulfide and this gas is of great importance to the symptom diarrhea. Not having this gas in the breath test profile leaves a missing piece of the puzzle out. In this presentation we will examine the interaction of all three gases and the importance they play in the evolving microbiome story of SIBO. Rifaximin will be discussed which is FDA approved, neomycin a drug not yet approved for SIBO and SYN-010 which is not yet approved by FDA for methane.