Thank you Mark Pimentel MD and Adam Rinde ND


My time stamp notes:

1:22 Highlights from the last 5 years of Dr. Pimentel’s work.
11:05 Defines SIBO – a few key players E.coli and Klebsiella take over when the gut is slowed down. The higher they are the more they destroy the community. At DDW2023 we will tell you the exact organisms.
13:17 Methanogens are recruiting more organisms. More diversity of the wrong things.
14:04 Patients are either methane or they’re not. You get stuck in your bucket.
18:20 The two families are Ruminococcus and Christensenella. They are intense hydrogen producers and carbohydrate feeders. People tend to be heavier or more obese when they are methane producers.
20:44 Acid-containing foods like fermented foods. Betaine HCL might be encouraging methane. Methane can use hydrogen in many forms; acid, ammonium, acetate, and hydrogen gas itself. Lowering acid might lower methane.
22:34 Trio Smart Breath test measures all 3 gases. Hydrogen – mostly bloating some bowel changes. Methane – constipation. Hydrogen sulfide bloating and more diarrhea.
23:55 Stool testing -We still don’t understand all the nuts and bolts of it. Some M. Smithi is good. Some patients drop their methane so low they start having diarrhea and that’s not good. That’s an artifact of treatment, not SIBO. We need some methane. We have to know what we are doing.
26:06 There is no such thing as good and bad bacteria. It’s about balance.
27:10 MMC lack of migrating motor complex equals SIBO, not IMO. Prokinetics.
29:00 Bile acids. Guar gum. Bile salt diarrhea.
32:00 IBS Smart Test and Antibodies.
34:00 Post Infectious IBS.
39:42 Low thyroid is not the cause of constipation.
40:33 What makes a good gastroenterologist?
43:32 Mastprogram at Cedars Sinai Medical Center Los Angeles. Dr. Mark Pimentel’s new book
( The Microbiome Connection)
Every dollar counts. The Neomycin story.