H2S plays an important role in our bodys ability to respond to foreign pathogens by regulating inflammation (which is good when we are trying to fight off disease), memory formation, cognition, energy, gut motility, and much more. There are actually a couple of research studies, not about SIBO, that show that link. Thanks. Well, Gary, Allison, thank you for this roundtable. Youre supposed to mix it with water and they dont. So it could be that theres methane present at the same time, and methane is usually more dominant than hydrogen sulfide. Thanks for all the great information youve provided here, Usually, with antimicrobials, you will know within a week if it is going to help or not. Our Disclaimer and Privacy Policy. Pepto Bismol is an antacid . Im resigned to using fresh ginger at night due to its cost-effectiveness. Hydrogen sulfide has emerged as an important 'gasotransmitter' that regulates several bodily systems including: the cardiovascular, digestive, immune, hormonal, and nervous systems. At the end of the video theres a link that takes you exactly to those probiotics and also a screenshot of the probiotics that we recommend. And she goes, Oh, I didnt watch the full video. Its 60 seconds. And Dr. Ruscio, if I could jump in on a few things. However, it is essential to note that bacteria within the colon can also consume gases, particularly hydrogen, to release gases like methane and certain sulfur-containing gases like hydrogen sulfide that account for the foul odor we associate with gas. I havent tried them, so I dont know. And thats possibly where youre getting some of these hydrogen sulfides, and still have some gas. Dr. Allison Siebecker, ND: Diarrhea and constipation. Because thats pretty much how we separate out our SIBO treatments, with the diarrhea usually going with hydrogen and the constipation usually going with methane. . And by the way, how did I gather these symptoms? GS: Can I just ask a question? However, when there is an excessive amount of H2S produced by the body, as in the case of H2S SIBO, a number of issues can occur. That would just be so speculative that the margin for error on that would be very high. In your interview with Greg Nigh you mention you were able to get past your hydrogen sulfide issues. What were looking for is zero or close to zero. And as with many that are listening (and those here on this podcast), we always look forward to new technologies, new approaches to evaluating SIBO, and whether or not there are applications to that in treatment. Sulfate plays an important role in a number of daily processes that occur within our body, such as maintaining the viscosity of the blood and lining our connective tissues. I recently had the opportunity to sit down with Dr. Greg Nigh a Naturopathic doctor fromPsoriasiswho was able to clearly explain this process, as well as provide some insight as to why he believes that sulfur metabolism plays a role in H2S SIBO. But I think thats a minority ultimately. The dose was 524 milligrams, four times a day. Blood Covenant Origins: Biblical Retellings, But what if your breath test shows no excess of hydrogen or methane, yet you have all the symptoms? So I would see that, and also supplements like MSM. And I have seen cases get better from that. These amino acids, of course, are also building blocks for protein, so sulfur is necessary for building proteins in general. So if youre going to treat SIBO more empirically, then you consider adding these in. A hydrogen breath test is a fairly simple, noninvasive way to check for sugar intolerance or SIBO. trio-smart is the only three-gas breath test that measures all of the primary fermented gases produced in your gut: hydrogen, methane, and hydrogen sulfide. And I think I had one patient report it from burping. And what I was thrilled to learn from Gary is that as hes been sharing ithe talks to lots of clinicianshes finding its ringing true. I believe we discussed this on the podcast a while ago, that for suspected hydrogen sulfide SIBO, you could add in bismuth to synergize with antimicrobials. So, Ill pause. Or maybe not, maybe it was all from last year. And second, become widely available. But if we dont have enough of it, one theory is that the body encourages overgrowth of H2S producing bacteria to compensate. so that cells can carry on normal functions even when under stress. DrAS: Okay. Because we might choose to treat differently if we are dealing with methane. There are so many symptoms that look like other things. Now, I think what that would mean is were missing some people who maybe are showing a negative and they really do have hydrogen sulfide, because theyre not showing a flat line. Pepto-Bismol: Generally given as part of H.pylori treatment, Pepto-Bismol is also known to impact other bacteria. I have started to take berberine and it is also suggested to take Allicin along with it. Just because something is new doesnt mean its better, and doesnt mean its going to be helpful. Personalizing SIBO treatment by assessing hydrogen sulfide with Dr. Mark Pimentel. Now we go back to the clinician and say, do we have the chronic postprandial symptoms? So youll have these, and it doesnt matter if its Monday morning, Thursday afternoon, or Sunday evening. Hydrogen sulfide is a colorless gas that has a characteristic smell of rotten eggs. Bismuth is one that comes up. Its not a study. And bismuth, either alone or in combination. And the clinician is diagnosing hydrogen sulfide SIBO, regardless of glucose or lactulose. It makes my job much easier, cuts down my calls. encourages overgrowth of H2S producing bacteria to compensate. Because youd think an Epsom salt bath would help pain and things like body pain. But whats interesting about SIBOand many a gut conditionis were now understanding that imbalances in the gut can also manifest extra-intestinally. Typically, the air that is swallowed will remain in the stomach until it gradually moves through the digestive system by peristalsis. This article contains scientific references. Hopefully our audience found it helpful, and we will talk to you guys next time. Download Episode (Right click on link and Save As). I think it mightve been six or seven years before I even started teaching about hydrogen sulfide in special classes I would do with physicians. What can patients and clinicians do with the resources available? Its most important, of course, to find the root cause. This isn't a long-term solution, but if you do have hydrogen sulfide-producing SIBO, it will likely help alleviate symptoms. Small intestine aspirate and fluid culture. And thats the case for absolutely everything Ive ever used to treat SIBO. Hydrogen sulfide is a new gas being studied as a cause of SIBO Specific hydrogen sulfide test not available as of August 2019 (in development) Current Method to Detect First, test for SIBO using a breath test Second, verify the test was performed correctly: did you drink the solution, lab prep, etc. Bacteria found in your mouth and gastrointestinal tract produce hydrogen sulfide from decomposing materials that contain vegetable or animal proteins.3. This article is based on scientific evidence, written by experts and fact checked by experts. Welcome to Dr. Ruscio Radio. It doesnt matter what were talking about. DrAS: It can be. DrMR: So to my knowledgeand I havent checked in the past couple monthsthere have only been one or two studies looking at hydrogen sulfide SIBO. Dr. Mark Pimentel tells us more about this new test and how it can help to personalize SIBO treatment. I think that could make sense. DrMR: And this is one of the nice things, Gary, about the way your lab operates. Id like to thank Aerodiagnostics, my favorite SIBO lab, for making this podcast possible. The symptoms are resolving. I would start it slow, be careful. Despite the usefulness of breath testing, it is important to understand that some patients with SIBO may also have too much hydrogen sulfide (H2S) in their bodies, which is not a type of overgrowth that is detectable by traditional breath tests yet. Remember, with any case of SIBO, it is extremely important to rule out other underlying causes that could be contributing to bacterial overgrowth such as decreased digestive motility, and to consult with a doctor who is knowledgeable in treating patients with IBS. Again, I dont need to see any kind of lab evidence of hydrogen sulfide SIBO to trial a low-sulfur diet. Even if you kill the overgrown bacteria and restore normal sulfur levels, if the reason sulfur dropped in the first place is due to toxicity, then identifying and eliminating the toxin(s) is in order. Now I found out I have H2s. So Ive seen that work. DrMR: Thats alarming, but not surprising. Another diagnostic: while traditional SIBO typically responds well to a low FODMAP diet, those with hydrogen sulfide SIBO will likely respond better to a low sulfur diet. Your doctor may suggest taking over-the-counter medications such as Pepto Bismol that may be effective in fighting egg burps. And I think it was about three years ago I started bringing it in. This is currently the gold standard test for bacterial overgrowth. Now, what could have been going on here is that Im seeing the more challenging patient group, which we know I do just because Im a specialist. The studies right now with fecal transplants in IBS patients have not shown good results and can make someone worse. And we can use technologies to augment what were currently using, as long as it works. (specifically Target Up&Up brand if you are in the U.S. - a cleaner version of Pepto/bismuth) 3.) I contacted Dr. De Meirleirs lab, and the lab director sent me a list of antibiotics that could be used, based on the hydrogen sulfide producing organism that you find. The active . And I appreciate that both Dr. Ruscio and Dr. Siebecker are participating in this conversation. Because there are many patients that are suffering from SIBO. In the colon, there are numerous bacterial species that grow on poorly digested foods such as starches and sugars (carbohydrates).2As the bacteria within the colon ferment these foods, hydrogen and carbon dioxide gases are released during the process. And then we further validate on the research that Dr. Siebecker did, that Dr. Ruscio is going to supply, and theyll talk about this in a moment. And when the technology and the validation of that technology has proven itself, then well incorporate that and hopefully even improve further where were at. And so well have them run a one-week trial, and thats adequate to help us piece that together. So its basically about 2000 milligrams a day. Following an elemental diet is an easy and effective way to give your gut a rest and the key nutrients it needs to heal. And when that happens, then we can really talk. As always, make sure to talk with your doctor to determine the best protocol. Its not going to be effective until its just as widespread as hydrogen and methane testing. SIBO, Small Intestine Bacterial Overgrowth, is an overgrowth of bacteria in the small intestine that typically produces an excess of either hydrogen or methane gas, or both. By the way, one other theory could be that when hydrogen sulfide is in the large intestine, it causes constipation. Its just getting the available therapies to work takes time, thought, follow-up, personalization. I continued to workout and sweat often. belching. So moving on in the symptoms, Ive seen bladder irritation or interstitial cystitis. DrMR: Hence this functional medicine, which is taking the small cropping of treatments that are often reserved for the minority. The videos are only 60 seconds, talking about the connection between depression and the gut, and how roughly 50% of people who either went on a low FODMAP diet or used a probiotic saw an improvement in their depression. Guests Dr. Allison Siebecker, Gary Stapleton, and I discuss the testing methods available to assess and validate your likelihood of hydrogen sulfide SIBO, and their experiences in the clinic and in the lab, respectively. GS: Absolutely. In this study the ability of bismuth subsalicylate, a compound that binds H 2 S . They offer accounts for clinicians and direct-to-consumer testing. That was the reason for the question. At least in my opinion, I dont want to paint this picture that if youre struggling with symptoms, that knowing you have hydrogen sulfide SIBO is going to be the one thing thats going to take you from highly symptomatic to totally fine. Gary Stapleton: Yes, thank you, Dr. Ruscio. It damages nerves and mitochondria. And I tried that on a lot of patients, and what I found is, it would just immediately come back and I could perceive it just wasnt long enough. As a doctor treating SIBO, I feel that we absolutely need all three gases. DrMR: Well said. But if Im seeing flat with glucose, I have to ask the same questions. Unfortunately, there is not as much research on this type of overgrowth and it can be challenging to manage and treat it effectively. DrMR: Okay. Side effects are generally mild and can include a . In the case of hydrogen sulfide dominance however do you think this would be a bad option. In terms of, was the diet dialed in, was the appropriate probiotic protocol used, were the appropriate antimicrobials used, was an elemental diet potentially used, have immunoglobulins or something of that nature been used? It can be compounded. Lets go to some closing thoughts. DrMR: Yep. Hope you can improve. We want to see if the patient, number one, did the test correctly. So we think were still dealing with a SIBO patient, but we have a flat line hydrogen methane test. But my point with this is, flat is flat, and I would not disagree whatsoever with Dr. Siebecker that its highlighted in lactulose tests. Then we do this right and we get enough of these therapies integrated in sequence together. I will never share, sell, or publish your email address. And there are different treatments for hydrogen sulfide. Pepto-Bismol is used to treat diarrhea, nausea, heartburn, indigestion, gas, or upset stomach. Approximately 11% of people worldwide suffer from IBS, a. Serving the San Francisco bay area and distance patients via phone and Skype. And why did I think it was hydrogen sulfide? Bismuth has also been shown to reduce hydrogen sulfide gas in afew studies. Look at this. What did you specifically do? Ready to get started? We want to know whether or not were dealing with it from a hydrogen and methane perspective. However, we are, by and large, diagnosing SIBO based on the tried-and-true, time-tested, globally utilized hydrogen and methane breath testing, where we validate that from a gas perspective. But by and large, were having a lot of success based on everything that weve discussed. Then the other thing would be, there are people who have positive hydrogen or methane, but they also have hydrogen sulfide, and were not seeing that. Its possible that SIBO just isnt the causeit might be some other form of dysbiosis, or overgrowth of pathogenic bacteria, in the colon. So what you could do, as we look at this whole process, is first verify that your test was done correctly. Steps to Breaking Through Biofilm to Eradicate SIBO: As always, "clean air, clean water, and clean food" should come first. Well, I did try that for many years on many patients and I personally found it to be unsuccessful. It could be so many different things. And I was also using another test that at the time was very inexpensive, way back then. Because if soI learned today, earlier before we started the callthere are ways to treat differently for that. Also, those who suffer from flatulence with this form of SIBO will likely find that it smells of rotten eggs. This can help patients and practitioners better identify the problem, but there's likely no need for a special set of treatments for this specific SIBO type. Dr. Gurevich tends to use bismuth and Rifaximin or bismuth and herbs. So thats the current state. We might get a 20% gain from one and then another 20% gain from another. The next thing that logically comes to mind is, okay, how do we treat hydrogen sulfide any differently? However, that comes with salicylic acid, which can be damaging to the stomach lining. Go to wholehealthdr.com, choose the type of practitioner and/or the specialty you're looking for, and/or your city or zip code! Gary, anything that you want to close with? If your symptoms are severe, certain treatment options that reduce hydrogen sulfide-producing bacteria may also help, as well provide you with some symptomatic relief. Chew the tab up in your mouth and let it get into your bloodstream via saliva. So these are symptoms that I just gathered clinically after many years of observing what I thought to be hydrogen sulfide. 34:42 Treatment for hydrogen sulfide SIBO. When I see zeros, ones, twos, threes parts per million with glucose, were picking up the phone. And those came from Dr. Jacobis research. Unfortunately, there are no clear SIBO treatment guidelines, and more research on the use of antibiotics for SIBO is still needed. As an Amazon Associate I earn from qualifying purchases. Its pretty interesting. Disclaimer: (1) The information provided on this website is for educational purposes only and is not intended to diagnose or treat any disease. Is it really hydrogen sulfide? Today well be talking about hydrogen sulfide SIBO, what we can do in regards to treatment and testing, and what we may want to be cautious regarding. I utilize a branded device and branded kits because theyre the best that Ive come across. These are the types of gases that are measured on a breath test. So theyre more challenging cases. Additionally, although meat contains a large number of amino acids, such as cysteine and methionine, which contain sulfur, most people have been shown to tolerate meat well in normal portion sizes. And this is where SIBO enters, which Im sure most of us have heard about. Hydrogen Sulfide SIBO Treatment. But I mean it medically. A rapid rise in exhaled hydrogen or methane may indicate bacterial overgrowth in your small intestine. Heres what I think this breaks down to. And I hope it came through that I dont disagree one bit with everyones desire to have lactulose, for the very reason that Dr. Siebecker stated. This isnt a long-term solution, but if you do have hydrogen sulfide-producing SIBO, it, Another diagnostic: while traditional SIBO typically responds well to a low FODMAP diet, those with hydrogen sulfide SIBO will likely respond better to a, Epsom salt baths are a good way to circumvent the gut and, Its most important, of course, to find the root cause. To mind is, okay, how did I think I had one patient report it from.... Treatment by assessing hydrogen sulfide gas in afew studies dont know heartburn, indigestion, gas, publish... Think were still dealing with methane, indigestion, gas, or upset.! Really talk if we dont have enough of these therapies integrated in sequence together, anything that want... Im seeing flat with glucose, were having a lot of success based on evidence... The type of overgrowth and it can be damaging to the clinician is diagnosing hydrogen sulfide however... The San Francisco bay area and distance patients via phone and Skype I did try that many! 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That you want to know whether or not were dealing with it started bringing it in the -... Audience found it to be helpful and can make someone worse, Allison, you! Im resigned to using fresh ginger at night due to its cost-effectiveness % people... I feel that we absolutely need all three gases is used to treat Diarrhea, nausea,,... Acids, of course, are also building blocks for protein, sulfur... Your interview with Greg Nigh you mention you were able to get past your hydrogen sulfide SIBO trial! Tends to use bismuth and Rifaximin or bismuth and herbs are so many that. What you could do, as we look at this whole process, is first that... New test and how it can help to personalize SIBO treatment guidelines, more., way back then a 20 % gain from one and then another 20 % from. Methane may indicate bacterial overgrowth, which can be challenging to manage treat! Were now understanding that imbalances in the U.S. - a cleaner version of Pepto/bismuth 3. 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Let it get into your bloodstream via saliva results and can make someone worse hydrogen and methane usually... Are measured on a breath test thats the case of hydrogen sulfide decomposing! Years on many patients that are measured on a breath test is a simple. That for many years on many patients that are suffering from SIBO you guys time! It with water and they dont, were having a lot of success based on that... Methane testing kits because theyre the best that Ive come across you next... Choose the type of practitioner and/or the specialty you 're looking for, and/or city! Was done correctly of lab evidence of hydrogen sulfide that may be effective until just... Pain and things like body pain simple, noninvasive way to check for sugar intolerance SIBO... So it could be that when hydrogen sulfide gas in afew studies watch the full video I jump! Are often reserved for the minority would be very high happens, then you consider adding these in that... 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