D-Lactic Acidosis in CFS

Avenger

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I'm an ME / CFS patient who has just tested positive for D-Lactate Acidosis. I'm waiting (and may be waiting for some time) for an explanation from my consultant. Does anyone know anything about this?
Hi, me too diagnosed with D-Lactic Acidosis and having treatment. How many more???

D-Lactic acidosis can be treated with antibiotics or diet. Jennifer Brea made a statement in a Times interview that she had been taking antibiotics which would temporarily abate her symptoms for them only to return. I was only diagnosed because I responded to antibiotics.

Many with CFS/ME have been reported to have Bacterial Overgrowth. Luke White an American Gastroenterologist states that anyone with Bacterial Overgrowth is at risk of D-Lactic acidosis. The title of his report is 'D-Lactic acidosis more prevalent than we think'.

Paul.
 

Avenger

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I am a new member, and found these links in relation to CFS, which I think have very important implications. I posted this earlier today, in reply to a member who stated that when he fasted for 3 days, his CFS was hugely improved.

Dla lasts around 3 days, when carbs are stopped. DLA is normally seen by a gastroenterologist, in patients with a shortened bowel. It would be very astounding for them to think of it in a patient with a complete bowel, and I would imagine they would be skeptical, to say the least.

The hospital that tests for d-lactic acidosis is Birmingham Childrens Hospital, UK. They test for adults too. They prefer a gastro to be involved, to interpret the test results, however if the test was positive they would notify the sender by phone to tell them. The test needs to be done in a hospital setting, as the blood needs to be centrifuged within an hour of being taken. The path lab at BCH are very helpful, a really nice bunch.

I get mixed up with micromols and milimoles, the measurements taken, but for example a test of 2.4 would be 2400 with Birmingham Childrens Hospital. Normal dla should be 0-0.25. I enclose some links regarding dla in relation to CFS, and also a link on dla in a short bowel patient, with a good graph of symptoms.

This first one is from another discussion group, where someone with CFS said they had tested postive for dla. The reading of 2.4 would certainly warrant investigation or treatment by a GI, I think they would be astounded to see it though, as they have a very narrow field of vision regarding dla, they almost exclusively see it in short bowel patients. A GP or other dr would not be trained to see that this is a serious condition, or the implications for treatment.

http://www.endfatigue.com/forums/viewtopic.php?f=17&t=1271

This abstract is saying that patients with CFS have bacteria in their stool that are dla producers, and says the symptoms are strikingly similar. I have the full pdf of this, which I have tried to enclose, not sure if it will work as I am a techno-phobe and not good at this sort of thing!

http://www.ncbi.nlm.nih.gov/pubmed/19567398

This is a Newsletter from the Breakspear Hospital (private) regarding CFS and d-lactic acid.

http://www.breakspearmedical.com/files/documents/Issue24Spring2010web_000.pdf

This is the d-lactic in short bowel paper, with a graph of symptoms.

http://hkjpaed.org/details.asp?id=577&show=1234

As I said yesterday, d-lactic lasts up to 80 hours, when you stop eating carbs. It has a circadian rhythm, meaning that it builds up after every meal, peaking in early evening (which I think is why sleep problems are so common in CFS). Maybe cutting carbs out would be a good way of seeing if there are improvements to be had. Also milk sugar counts as a carb, so no milk or soya milk.

Hope this is useful to you, I think it may be the missing link for CFS.

BW

Glynis
Attached Files
2009_Sheedy_In_vi.pdf (252.7 KB, 0 views)
Hi BW,
I have had CFS/ME for 18 years, I have recently been diagnosed with D-Lactic acidosis for the same symptoms without short bowel syndrome. Please follow my thread.

Paul.
 
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I also have a d-Lactat producing Sibo and a Candida. Been on low /or better now carb made some Symptoms disapear and felt really good. Unfortunately after 3 Month (I was still working) my adrenals crashed. After that I became housbound and still am.

Unfortuneately I also have MCAS. So I can´t take good herbs, medicine or even a vegetable based Diet (Salycilates, Fructose etc.). And somehow the energy without carbs isn´t enough. So there is no Way to cure the Sibo. My Doctor is trying autovaccines, but my MCAS isn´t really happy about it.

I´ve read so much about all These Things and it seems, that a) It´s so unbelievably complicated and b) When you are really sick, nearly impossible to solve. That really is a bitter pill to swallow.

Maybe it is necessary to calm down the Mastcells first to lower Inflammation and to get the Immunsytem on track again. I´ve read Something about that in the Forum. So maybe the new medication next year may help with the SIBO and Gut Issues as well. Hopefully.
 
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Avenger

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I also have a d-Lactat producing Sibo and a Candida. Been on low /or better now carb made some Symptoms disapear and felt really good. Unfortunately after 3 Month (I was still working) my adrenals crashed. After that I became housbound and still am.

Unfortuneately I also have MCAS. So I can´t take good herbs, medicine or even a vegetable based Diet (Salycilates, Fructose etc.). And somehow the energy without carbs isn´t enough. So there is no Way to cure the Sibo. My Doctor is trying autovaccines, but my MCAS isn´t really happy about it.

I´ve read so much about all These Things and it seems, that a) It´s so unbelievably complicated and b) When you are really sick, nearly impossible to solve. That really is a bitter pill to swallow.

Maybe it is necessary to calm down the Mastcells first to lower Inflammation and to get the Immunsytem on track again. I´ve read Something about that in the Forum. So maybe the new medication next year may help with the SIBO and Gut Issues as well. Hopefully.
 

Avenger

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Hi, I agree, there is nightmare complexity. But I am sure this will all be simplified in the future.

Interestingly Candida can also produce D-La as well as the Bacteria found by Sheedy et al. I guess that you could also have variants of D-La depending on which Bacteria are involved and whatever other toxins they produce (the toxins may be involved in immune dysfunction after Bacterial Overgrowth causes damage to the Mucosal Lining).

I would try Sarah Myhill, she is good on teasing out the complex and has an extensive knowledge of these Gut problems. She has been light years away from many NHS Doctors understanding of these problems and treats Holistically. I have great faith in her ability and what she is putting online without charge. There must be a chain of dysfunction involved. Immune Dysfunction can be caused by Overgrowth and then cause a negative feedback which spirals into other problems. She may be able to give you some advice.

Your body must have been under extremes for your adrenals to crash. MCAS on top sounds dreadful.

My own understanding of Bacterial Overgrowth is limited and has come purely from survival. I hope you can be helped with such disabling symptoms, my heart go's out to you.
 
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Hey Avenger,

thank you very much for your words. I´ll contact mrs Myhill.

MCAS is the one Thing, that seems to Keep me off helping the others. It is dreadful.

Thank you :)

Unfortunately Dr.Myhill does not take new patients. Not much hope left though.
 
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cigana

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I also have a d-Lactat producing Sibo and a Candida. Been on low /or better now carb made some Symptoms disapear and felt really good. Unfortunately after 3 Month (I was still working) my adrenals crashed. After that I became housbound and still am.

Unfortuneately I also have MCAS. So I can´t take good herbs, medicine or even a vegetable based Diet (Salycilates, Fructose etc.). And somehow the energy without carbs isn´t enough. So there is no Way to cure the Sibo. My Doctor is trying autovaccines, but my MCAS isn´t really happy about it.

I´ve read so much about all These Things and it seems, that a) It´s so unbelievably complicated and b) When you are really sick, nearly impossible to solve. That really is a bitter pill to swallow.

Maybe it is necessary to calm down the Mastcells first to lower Inflammation and to get the Immunsytem on track again. I´ve read Something about that in the Forum. So maybe the new medication next year may help with the SIBO and Gut Issues as well. Hopefully.
Did you consider an elemental diet? That's usually the way to cure SIBO if you have MCAS.
 

anni66

mum to ME daughter
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Hey Avenger,

thank you very much for your words. I´ll contact mrs Myhill.

MCAS is the one Thing, that seems to Keep me off helping the others. It is dreadful.

Thank you :)

Unfortunately Dr.Myhill does not take new patients. Not much hope left though.
Her website is excellent and there is a very good and supportive facebook group " supporters of ..."
I would also email her .. you may have to wait but she may take you on . nothing ventured nothing gained.
 
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Did you consider an elemental diet? That's usually the way to cure SIBO if you have MCAS.
Yes I´ve tried it, I killed some sibo, but I´ve feed the Candida because of the Sugars. I´m blessed with both. The scd diet then afterwards killed my adrenals. Thank you for your idea.

Her website is excellent and there is a very good and supportive facebook group " supporters of ..."
I would also email her .. you may have to wait but she may take you on . nothing ventured nothing gained.
It is! But my case is so complicated, that I´m just not able to do it bye my self. There are to many Things I can´t do due of MCAS and other issues. I really tried for years now, but no Chance. I´ll write her. Maybe a fortune happens.

Thank you :)
 

anni66

mum to ME daughter
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Yes I´ve tried it, I killed some sibo, but I´ve feed the Candida because of the Sugars. I´m blessed with both. The scd diet then afterwards killed my adrenals. Thank you for your idea.



It is! But my case is so complicated, that I´m just not able to do it bye my self. There are to many Things I can´t do due of MCAS and other issues. I really tried for years now, but no Chance. I´ll write her. Maybe a fortune happens.

Thank you :)
Fingers crossed
 

Avenger

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@Avenger what would be the result if you ate a banana and/or a couple of slices of bread?
Hi, nothing would happen at first. It may take 3 days or more before symptoms start up again, but then go from Flu like symptoms exponentially to worsening illness.

You have to remain Carbohydrate and Suagar Free for good to stop the symptoms which can take a further 64 hours to stop after using Carbohydrates. My symptoms have been so bad that I have to take antibiotics because milder symptoms which often feel flu like evolve to more serious ones quickly. I can only guess that I have a severe Overgrowth of D-Lactic Acidosis. It may be that others may have differing levels and combinations of Overgrowth causing the production of D-Lactic as well as other metabolites.

The illness seems to affect everything and cause multiple problems because it is systemic poisoning from D-Lactic acid which is a neurotoxin, but other metabolites may also be involved according to the Australian Research Team that I have previously posted an Abstract of their work.

Paul.
 

Avenger

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Dear All,
I am now trying to get help from Bacteriophage Biotechnology which is regularly used in Georgia and Russia since World War II when Bacteriophages were used to target Dysentry and Gangrene. This involves the use of Phage Virus which are all around us, but can be used to target and destroy certain Bacteria. Phage Virus Research stopped in the West with the use of cheaper and more easy to produce Antibiotics which no one foresaw that Bacteria would eventually become Resistant to all Antibiotics, which is where we are now after the overuse of Antibiotics on Farms and to Wean Piglets early.

The use of Bacteriophages has continued in Russia and Georgia and may well be used to cure D-Lactic acidosis and other forms of Bacterial Overgrowth causing a range of ME/CFS symptoms.

Letter Below to a UK University:

Dear Sir,
thank you for your help and information. I am sending you the abstract promised concerning D-Lactic acidosis due to Bacterial Overgrowth as the most probable cause of ME in a Subset of ME/CFS patients (Abstract from the Australian Microbiology Research Team below).


I have an 'infection' caused by Overgrowth of D-Lactic producing Bacteria and need to get to the right place for Gut Bacteriophage Research. I have D-Lactic acidosis secondary to Bacterial Overgrowth which has caused serious illness and I have developed Antibiotic Resistance. I wish to volunteer for Phage testing and to find a possible Phage to target and eliminate the Overgrowth.

From our conversation this may only be possible at a Phage Research Institute in Georgia.

D-Lactic acidosis had been misdiagnosed as ME/CFS for 18 years in which I remained very unwell and had to research my own problem and obtained a diagnosis last year.

I have sent you a copy of a research Abstract that gives evidence that at least a subset of ME/CFS patients have D-Lactic acidosis and there may be other forms of Overgrowth involved.This means that ME/CFS may well be due to one of a number of different forms of Bacterial Overgrowth. I believe that the Overgrowth itself may be possibly be caused or contributed to by negative Antibiotic properties which can select for Overgrowth due to Resistance and decimation of other Bacterial Colonies.

I cannot stop the return of D-Lactic producing Bacteria and wish to volunteer for Bacteriophage research.
I have become resistant to most Antibiotics and have only one possible Antibiotics left.


Abstract:

2009 Jul-Aug;23(4):621-8.
Increased d-lactic Acid intestinal bacteria in patients with chronic fatigue syndrome.
Sheedy JR1, Wettenhall RE, Scanlon D, Gooley PR, Lewis DP, McGregor N, Stapleton DI, Butt HL, DE Meirleir KL.
Author information

Abstract
Patients with chronic fatigue syndrome (CFS) are affected by symptoms of cognitive dysfunction and neurological impairment, the cause of which has yet to be elucidated. However, these symptoms are strikingly similar to those of patients presented with D-lactic acidosis. A significant increase of Gram positive facultative anaerobic faecal microorganisms in 108 CFS patients as compared to 177 control subjects (p<0.01) is presented in this report. The viable count of D-lactic acid producing Enterococcus and Streptococcus spp. in the faecal samples from the CFS group (3.5 x 10(7) cfu/L and 9.8 x 10(7) cfu/L respectively) were significantly higher than those for the control group (5.0 x 10(6) cfu/L and 8.9 x 10(4) cfu/L respectively). Analysis of exometabolic profiles of Enterococcus faecalis and Streptococcus sanguinis, representatives of Enterococcus and Streptococcus spp. respectively, by NMR and HPLC showed that these organisms produced significantly more lactic acid (p<0.01) from (13)C-labeled glucose, than the Gram negative Escherichia coli. Further, both E. faecalis and S. sanguinis secrete more D-lactic acid than E. coli. This study suggests a probable link between intestinal colonization of Gram positive facultative anaerobic D-lactic acid bacteria and symptom expressions in a subgroup of patients with CFS. Given the fact that this might explain not only neurocognitive dysfunction in CFS patients but also mitochondrial dysfunction, these findings may have important clinical implications.

PMID:
19567398


Yours Sincerely, Paul D. Smith.
 

Avenger

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Thanks Muffin,

I have been looking for a reason for my daughters condition (not CFS) for years, and DLA fits her symptoms. When I read about CFS being implicated, I just had to join here and share the thing's I've found. I have read thread's on here that make me even more convinced that perhaps it is DLA. Things such as reduced carb intake improves CFS, dietary interventions such as gluten free, and milk free diets. These are all part of a DLA treatment. Minimally absorbed antibiotics, an IV of sodium bicarbonate and low carb diets are all successful treatments of DLA. Also some CFS patients do suffer from bowel problems, which include constipation. One dla paper suggests that stagnation of the bowel might be a contributing factor. Some people with constipation are unaware of it, as they have symptoms of diarrhoea, but this might be down to the bowel being blocked and you get an overflow of liquid. You can also have soft stool constipation, where a GI cannot feel the blockage as it is not hard. My daughter had this, no-one realised, including myself, as she went everyday. When we trialled metronidazole, a minimally absorbed antibiotic, we were shocked at how much came out (gross I know, sorry!).

After the recent news article where a viral link was theorised in CFS, I rang ME Research UK and asked them if it was a definate viral link. The person I spoke to said the inflammation they found in CFS patients could just as easily be linked to a bacterial overgrowth.

The thing is even gastroenterologist's would be skeptical that DLA could be involved in CFS. They only see it in short bowel patients. To see it in a person with an intact bowel would be unheard of, and I think that is where the problem lies. They first see their patient as mentally alert, but who have a diseased bowel. It is easy for them to see the effects of dla on that same patient, once their bowel has been shortened. If they were to see a CFS patient, the link would not be made, and also the symptoms themselves are, I think, more subtle than in a short bowel patient. Outside of gastro's, the relevance is being missed. The fact that it does not show up in a routine blood test does not help either. A d-lactate assay kit would be required. There is a private lab in the UK that offer's the test, but a person would need to attend their clinic, or have the blood taken at a hospital, to centrifuge the blood immediately. The only NHS hospital that I know of that does the test is Birmingham Children's Hospital. I do not know how things work in the US and other countries.

I hope that some day someone has the test done, and I can finally let this go.

Hope this is useful.

Best Wishes

Glynis
Dear Glynis,
I have posted a few threads after being diagnosed with D-Lactic acidosis after an 18 year delay in diagnosis in which I was told I ME, CFS and even Fibromialgia.

I have D-La without short bowel. It only takes slowed motility or a faulty valve between colon and Small Intestine to allow Bacterial Overgrowth. D-La is just one of a number of forms of Bacterial Overgrowth that I believe are plaguing at least a subset of ME/CFS (IBS is also a form of Bacterial Ovegrowth). I developed bad Constipation from the point of developing a bowel infection and developed the symptoms of D-Lactic acidosis, but they were not taken seriously even with breathing difficulty and periods of confusion.

But any form of Bacterial Overgrowth in the Small Intestine will develop unwanted toxins which can make you unwell.

Antibiotics which are vastly overused and used to wean and regularly treat farm animals may be one of the causes. Antibiotics can select for different types of Ovetgrowth and then have to be relied on to knock back what I see as an infection which produces toxic metabolites such as D-Lactic acid which is a neurotoxin and causes identical problems to ME.

I sent full details to the ME Association but they told me firmly that ME is caused by and associated with Viral Infections. They were just not interested or in investigating! Viral infections could also be associated with overgrowth because Virus have two means of multiplying which can only be done within host cells and could be involved in overgrowth in the Gut, which if you are very unlucky may be D-Lactic.

Paul D. Smith
 

Avenger

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I am a new member, and found these links in relation to CFS, which I think have very important implications. I posted this earlier today, in reply to a member who stated that when he fasted for 3 days, his CFS was hugely improved.

Dla lasts around 3 days, when carbs are stopped. DLA is normally seen by a gastroenterologist, in patients with a shortened bowel. It would be very astounding for them to think of it in a patient with a complete bowel, and I would imagine they would be skeptical, to say the least.

The hospital that tests for d-lactic acidosis is Birmingham Childrens Hospital, UK. They test for adults too. They prefer a gastro to be involved, to interpret the test results, however if the test was positive they would notify the sender by phone to tell them. The test needs to be done in a hospital setting, as the blood needs to be centrifuged within an hour of being taken. The path lab at BCH are very helpful, a really nice bunch.

I get mixed up with micromols and milimoles, the measurements taken, but for example a test of 2.4 would be 2400 with Birmingham Childrens Hospital. Normal dla should be 0-0.25. I enclose some links regarding dla in relation to CFS, and also a link on dla in a short bowel patient, with a good graph of symptoms.

This first one is from another discussion group, where someone with CFS said they had tested postive for dla. The reading of 2.4 would certainly warrant investigation or treatment by a GI, I think they would be astounded to see it though, as they have a very narrow field of vision regarding dla, they almost exclusively see it in short bowel patients. A GP or other dr would not be trained to see that this is a serious condition, or the implications for treatment.

http://www.endfatigue.com/forums/viewtopic.php?f=17&t=1271

This abstract is saying that patients with CFS have bacteria in their stool that are dla producers, and says the symptoms are strikingly similar. I have the full pdf of this, which I have tried to enclose, not sure if it will work as I am a techno-phobe and not good at this sort of thing!

http://www.ncbi.nlm.nih.gov/pubmed/19567398

This is a Newsletter from the Breakspear Hospital (private) regarding CFS and d-lactic acid.

http://www.breakspearmedical.com/files/documents/Issue24Spring2010web_000.pdf

This is the d-lactic in short bowel paper, with a graph of symptoms.

http://hkjpaed.org/details.asp?id=577&show=1234

As I said yesterday, d-lactic lasts up to 80 hours, when you stop eating carbs. It has a circadian rhythm, meaning that it builds up after every meal, peaking in early evening (which I think is why sleep problems are so common in CFS). Maybe cutting carbs out would be a good way of seeing if there are improvements to be had. Also milk sugar counts as a carb, so no milk or soya milk.

Hope this is useful to you, I think it may be the missing link for CFS.

BW

Glynis
Attached Files
2009_Sheedy_In_vi.pdf (252.7 KB, 0 views)
Dear Glynis,
I have posted a few threads after being diagnosed with D-Lactic acidosis after an 18 year delay in diagnosis in which I was told I ME, CFS and even Fibromialgia.

I have D-La without short bowel. It only takes slowed motility or a faulty valve between colon and Small Intestine to allow Bacterial Overgrowth. D-La is just one of a number of forms of Bacterial Overgrowth that I believe are plaguing at least a subset of ME/CFS (IBS is also a form of Bacterial Ovegrowth). I developed bad Constipation from the point of developing a bowel infection and developed the symptoms of D-Lactic acidosis, but they were not taken seriously even with breathing difficulty and periods of confusion.

But any form of Bacterial Overgrowth in the Small Intestine will develop unwanted toxins which can make you unwell.

Antibiotics which are vastly overused and used to wean and regularly treat farm animals may be one of the causes. Antibiotics can select for different types of Ovetgrowth and then have to be relied on to knock back what I see as an infection which produces toxic metabolites such as D-Lactic acid which is a neurotoxin and causes identical problems to ME.

I sent full details to the ME Association but they told me firmly that ME is caused by and associated with Viral Infections. They were just not interested or in investigating! Viral infections could also be associated with overgrowth because Virus have two means of multiplying which can only be done within host cells and could be involved in overgrowth in the Gut, which if you are very unlucky may be D-Lactic.

Paul D. Smith
 

Avenger

Senior Member
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Dear Glynis,
I forgot, there are many causes of Bacterial Overgrowth, as I had stated earlier D-Lactic acidosis is just one form of Bacterial Overgrowth. There may be a number of different and combined forms Bacterial Overgrowth that give rise to multiple metabolites which are toxic, depending on type and quantity in the Small Intestine. I believe that it may be D-Lactic or similar Bacterial Overgrowth in those suffering ME, because D-Lactic Bacteria produce the Neurotoxin D-Lactic acid. Sheedy et al (Increased D-Lactic acid Bacteria in CFS) later concluded in their 2017 Report that there may be a number of other metabolites involved including D-Lactic acid.

Small intestinal bacterial overgrowth syndrome
Jan Bures, Jiri Cyrany, Darina Kohoutova, Miroslav Förstl, Stanislav Rejchrt, Jaroslav Kvetina, Viktor Vorisek, and Marcela Kopacova
Author information Article notes Copyright and License information Disclaimer
This article has been cited by other articles in PMC.

Go to:
Abstract
Human intestinal microbiota create a complex polymicrobial ecology. This is characterised by its high population density, wide diversity and complexity of interaction. Any dysbalance of this complex intestinal microbiome, both qualitative and quantitative, might have serious health consequence for a macro-organism, including small intestinal bacterial overgrowth syndrome (SIBO). SIBO is defined as an increase in the number and/or alteration in the type of bacteria in the upper gastrointestinal tract. There are several endogenous defence mechanisms for preventing bacterial overgrowth: gastric acid secretion, intestinal motility, intact ileo-caecal valve, immunoglobulins within intestinal secretion and bacteriostatic properties of pancreatic and biliary secretion. Aetiology of SIBO is usually complex, associated with disorders of protective antibacterial mechanisms (e.g. achlorhydria, pancreatic exocrine insufficiency, immunodeficiency syndromes), anatomical abnormalities (e.g. small intestinal obstruction, diverticula, fistulae, surgical blind loop, previous ileo-caecal resections) and/or motility disorders (e.g. scleroderma, autonomic neuropathy in diabetes mellitus, post-radiation enteropathy, small intestinal pseudo-obstruction). In some patients more than one factor may be involved. Symptoms related to SIBO are bloating, diarrhoea, malabsorption, weight loss and malnutrition. The gold standard for diagnosing SIBO is still microbial investigation of jejunal aspirates. Non-invasive hydrogen and methane breath tests are most commonly used for the diagnosis of SIBO using glucose or lactulose. Therapy for SIBO must be complex, addressing all causes, symptoms and complications, and fully individualised. It should include treatment of the underlying disease, nutritional support and cyclical gastro-intestinal selective antibiotics. Prognosis is usually serious, determined mostly by the underlying disease that led to SIBO.

Keywords: Bacterial overgrowth, Breath test, Hydrogen, Methane, Small intestine
Go to:
INTRODUCTION
Human intestinal microbiota create a complex polymicrobial ecology. This is characterised by its high population density, wide diversity and complexity of interaction. The duodenum and proximal jejunum normally contain small numbers of bacteria, usually lactobacilli and enterococci, gram-positive aerobes or facultative anaerobes (< 104 organisms per mL). Coliforms may be transiently present (< 103 bacteria per mL) and anaerobic Bacteroides are not found in the jejunum in healthy people. Up to one third of jejunal aspirates might be sterile in healthy volunteers. The distal ileum is a transition zone between sparse populations of aerobic bacteria of the proximal small intestine and very dense populations of anaerobic micro-organisms in the large bowel[1-3]. The epithelial surface of the small intestine in a healthy human is not colonised. Occasional groups of bacteria can be found in low concentrations within the lumen. Bacteria do not form clusters and spatial structures, and the luminal contents are separated from the mucosa by a mucus layer[4].

Any dysbalance of this complex intestinal microbiome, both qualitative and quantitative, might have serious health consequences for a macro-organism, including small intestinal bacterial overgrowth syndrome (SIBO).

Increased d-lactic Acid intestinal bacteria in patients with chronic fatigue syndrome.
Sheedy JR1, Wettenhall RE, Scanlon D, Gooley PR, Lewis DP, McGregor N, Stapleton DI, Butt HL, DE Meirleir KL.
Author information

Abstract
Patients with chronic fatigue syndrome (CFS) are affected by symptoms of cognitive dysfunction and neurological impairment, the cause of which has yet to be elucidated. However, these symptoms are strikingly similar to those of patients presented with D-lactic acidosis. A significant increase of Gram positive facultative anaerobic faecal microorganisms in 108 CFS patients as compared to 177 control subjects (p<0.01) is presented in this report. The viable count of D-lactic acid producing Enterococcus and Streptococcus spp. in the faecal samples from the CFS group (3.5 x 10(7) cfu/L and 9.8 x 10(7) cfu/L respectively) were significantly higher than those for the control group (5.0 x 10(6) cfu/L and 8.9 x 10(4) cfu/L respectively). Analysis of exometabolic profiles of Enterococcus faecalis and Streptococcus sanguinis, representatives of Enterococcus and Streptococcus spp. respectively, by NMR and HPLC showed that these organisms produced significantly more lactic acid (p<0.01) from (13)C-labeled glucose, than the Gram negative Escherichia coli. Further, both E. faecalis and S. sanguinis secrete more D-lactic acid than E. coli. This study suggests a probable link between intestinal colonization of Gram positive facultative anaerobic D-lactic acid bacteria and symptom expressions in a subgroup of patients with CFS. Given the fact that this might explain not only neurocognitive dysfunction in CFS patients but also mitochondrial dysfunction, these findings may have important clinical implications.

PMID:

19567398
[Indexed for MEDLINE]
Free full text


Another Abstract:

Ovid MEDLINE and PubMed databases were used to search the published literature. For Ovid MEDLINE (1966 to December 2006, English language only) three primary search terms (bacterial overgrowth, small intestine overgrowth, and small intestine bacterial overgrowth) were individually coupled with a larger number of secondary search terms (epidemiology, incidence, prevalence, populations at risk, symptoms, pathogenesis, pathophysiology, inflammation, malabsorption, complications, vitamin deficiency, motility disorders, scleroderma, gastroparesis, chronic intestinal pseudo-obstruction, celiac disease, irritable bowel syndrome, renal failure, cirrhosis, alcohol abuse, elderly, aging, diabetes, hypochlorhydria, surgery, malnutrition, diarrhea, evaluation, diagnosis, breath testing, duodenum, jejunum, aspirates, breath tests, lactulose, treatment, antibiotics, rifaximin, tetracycline, metronidazole, ciprofloxacin, amoxicillin/clavulanate, probiotics, duration, resistance). For PubMed (no time limit), a similar search process was followed. All identified articles were then manually searched for other relevant studies. Only published manuscripts are included in this review; abstracts are not included.