Gut Bacteria and Xifaxan get some press coverage

Written by on April 30, 2010 in What Causes Rosacea? with 5 Comments

The St. Louis-Dispatch has an article today exploring the link between the overgrowth of small intestinal bacteria and rosacea symptoms for some rosacea sufferers.

New way to treat skin disorder

By Cynthia Billhartz Gregorian, ST. LOUIS POST-DISPATCH, 04/29/2010

Weinstock is not a dermatologist. He’s a founding partner of Specialists in Gastroenterology in Creve Coeur.

Nevertheless, word has spread that he’s had success treating the skin disorder, rosacea, with a drug typically used to treat gastrointestinal issues caused by small intestinal bacterial overgrowth commonly known as SIBO.

What’s gaining ground is this theory that irritable bowel syndrome is related to rosacea,” Weinstock said.

Weinstock was studying the link between restless leg syndrome and small intestinal bacterial overgrowth, a couple of years ago, when he read a published study in a medical journal, linking rosacea to small intestinal bacterial overgrowth.

About six months ago, he decided to conduct his own in-office study.

When he noticed signs of the condition on patients that he was treating for gastrointestinal issues, he’d ask them to take a lactulose breathing test which assesses bacterial overload in the small intestines.

Eight of 13 patients tested positive for SIBO. After treating them with Xifaxan for 10 days, five were markedly better, one was slightly improved and two were unchanged.

Dr. Weinstock found that his study matched the findings of the published study from the University of Genoa.

A colleague of Dr. Weinstock, Dr. Anna Glaser, warns that the results are interesting but larger, more comprehensive trials are required to uncover the extent of this discovery. Dr. Weinstock also mentions that Xifaxan (brand name for rifaximin 200mg) won’t work for all cases of rosacea because not all cases are caused by small intestinal bacterial overload.

At the end of the article we are told about a possible source conflict relating to Dr. Weinstock;

Weinstock, an associate professor of clinical medicine and surgery at Washington University, did disclose that he is a member of the speaker’s bureau at Salix Pharmaceuticals, which makes Xifaxan.

For more information about about Xifaxan see the drug information: Nonsystemic Xifaxan. The most common side effects were flatulence, headache and abdominal pain which you would associate with the main intended condition rifaximin targets anyway – traveller’s diarrhea.

This topic has attracted a lot of interest in the online rosacea forums. The link between SIBO and the papules and pustules of rosacea is still a mystery. The researchers responsible for the discovery that has sparked this interest conclude with;

SIBO eradication clears rosacea: are you serious ?

The clearance of cutaneous lesions in almost all rosacea patients after its eradication strongly suggests that SIBO plays a significant pathogenetic role in rosacea, expecially in its papulopustular component. Although the underlying mechanisms linking SIBO to the cutaneous lesions of rosacea need to be elucidated, we believe that our findings represent paramount progress in the clinical management of those frustrated patients.

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About the Author: David Pascoe started the Rosacea Support Group in October 1998. .

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5 Reader Comments

  1. Doug says:

    Wasnt there a study where the treatment for SIBO depended on if you had more hydrogen or methane from the breath test?? So maybe the ones that were treated successfully had more hydrogen and the others had more methane. What is the name of the drug if you have more methane?

  2. Mike T says:

    That’s exactly right Doug.

    In an earlier study those who’s symptoms were not relieved by one type of antibiotic found relief from another type.

    I think it may have been metronidazole (not sure though). The study can be found via google.

    You can either have a breathe test (for excess hydrogen or methane) to see which oral antibiotic to take or you can just try both types, for one week each.

    Mike

  3. Doug says:

    I believe all of this has one common denominator and that is our immune system. I think people with Rosacea have an overactive immune system. So if you suffer from SIBO then our immune system overacts instead of acting normally. I believe that is why different factors affect people with Rosacea. One person could react to SIBO, one could be allergies, one could be hormones, etc… but to me it all comes back to our immune system.

  4. Claire says:

    With regard to conflict for Dr. Weinstock, hey, I don’t care if holds 80% of stock in Xifaxin. IT WORKS, it is the only Rx that worked after I suffered over a decade being dismissed by arrogant, ego-driven GI Specialists who LIED and said there was NO RESEARCH. For most if it is not seen with a scope it is not there, more than 1 author (doctors, a neurogastroenterologist and a gastroenterologist at Cedars-Sinai) called it and “Endoscopic Renaissance” and many people with SIBO suffer horribly, I was virtually housebound and specialist after specialist sent me on my way, gave me harsh Rx that treated only symptoms and treated them only enough to keep me out of ER needing IV for dehydration. Dr. Weinstock is a compassionate, thorough, miracle worker for those of us who suffer from bacterial overgrowth, patients who have been told it’s “just anxiety”. I don’t even see how it is legal for board certified specialists to say something has no research when we all need the type of hope any physician open to this xifaxin protocol which gives people back so much of their lives.

  5. maggy says:

    Hi Claire, i was curious to see how you were feeling? Are you still on Xifaxin if not how long were you on it for?

    I took it for two weeks better but not 100% yet. Did you also use Peppermint capsules, or change your diet? I see they also recommended probitic have you used them as well?

    Appreciate any insight you have on this.

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