Citizen Scientist

It's sad that the biotech/healthcare industry doesn't understand the gut much. So I've been on this on my own. I should've switched healthcare providers this past Open Enrollment, but I thought I could save some money as Kaiser was the cheapest. However, they're also the worst provider in most cases.

Throughout the years I've stayed up to date with the research in the industry and heard about uBiome, a microbial genomics company based out of San Francisco. They offer testing of poop samples to determine your microbiome. Fortunately their uBiome Clinical offering has covered a lot of the costs (no thanks to Kaiser) for testing as I believe they're still developing their microbiome database and products.

I submitted my first sample in June 2, 2017 - a time where I absolutely knew I had IBS. An excerpt of my results are as follows:

Overall results:

Organisms known to be associated with IBS:

From the results, it seems like I don't have IBS. Those organisms identified that are "Outside Healthy Reference Range" were associated with other GI ailments, and not IBS. *shrug* I didn't learn much from the results.

After I had a bacterial and viral infection from my Southeast Asia trip, I decided to re-sample my poop to see if my microbiome had changed. Unfortunately the results seem worse.

January 19, 2018 results:

Overall:

Associated with IBS:

uBiome had a doctor discuss the 2nd set of results with me - which was a nice service. The doctor recommended that I share this with my regular doctor, and get treated for low Alistipes as it is inversely associated with IBS.

I email my GI doctor at Kaiser and he says...

Christine: I just saw the report you sent me.I agree bacteria plays a strong role in our bodies and probably causes a lot of the GI diseases that we see.A lot of research in GI now is looking into all these bacteria in our intestines.However, we are years away from finding the exact organisms causing the GI diseases.So, with your profile, having a low Alistipe bacteria, may or may not affect your IBS.We have data that lactobacillus and bifidobacteria in the probiotic does help with IBS. However, many patients including my own patients do not get better from taking probiotics with these bacteria in it.Hopefully in the future we will be able to find all the types of bacteria contributing to IBS but not right now.

I'm pretty much back to square one, wondering if I will one day fix my tummy issues. For a temporary period of 2 months (mid-Nov to mid-Jan), I had my old iron stomach and had as much avocado toast as I could. Too bad I didn't get around to Blue Line's deep dish pizza.

For the last 3 or 4 weeks, my stomach seems to have returned to its same IBS conditions. I am bloated everyday and have loose/airy stool everyday. I have to start developing my library of things I can eat, and things that irritate my stomach again. The low FODMAP diet is a start.

Something that I think is important to note is that after I had gotten sick, and taken antibiotics and probiotics, I had temporary relief from IBS conditions. I felt great and very strong. Then that went away and my IBS conditions came back. This is aligned with what I've read in some studies about fecal microbiota transplant (FMT) and/or antibiotic treatment. Some studies show that people have to continue to take treatment/medication (additional FMT or additional antibiotic) to treat IBS. The research is all over the place. Here's a excerpt from a study done with rifaximin, an antibiotic:

What is the likelihood of small intestinal bacterial overgrowth (SIBO) recurrence after completing a course of rifaximin treatment? To help address this question, Lauritano and colleagues treated 80 consecutive patients with IBS and SIBO with rifaximin 400 mg three times daily for 10 days. The presence of SIBO was followed up at 3, 6 and 9 months after the end of treatment. Recurrence of SIBO was documented in 12.6% of patients at 3 months, in 27.5% of patients at 6 months and in 43.7% of patients at 9 months. These results suggest that there is the need for further treatment courses in many patients [Lauritano et al. 2008].

Rifaximin (brand name Xifaxan) was approved for IBS-D in 2015. I think doctors are still weary about prescribing it because in the clinical trial there were relapses in patients needing to be re-treated on additional courses of the antibiotic.

Now I'm thinking about enrolling into a clinical study again, or at least pinging my doctor for other options like rifaximin... I already miss feeling strong and healthy.