May 9, 2017
In this episode Dr Nirala Jacobi continues the conversation with
Dr Bradley Bush, with a focus on case presentations around chronic
SIBO cases and inflammatory concepts.
Dr Bush received his Naturopathic Doctorate degree from the
National College of Naturopathic Medicine. He is co-owner and
clinic director of Natural Medicine of
Stillwater and its online consumer direct website for
practitioners, neurovanna.com.
The Bush practice focuses on fatigue, insomnia, GI disorders,
mood disorders, and lyme disease. Dr Bush has over 16 years of
industry experience. He is the owner of Natural Health Insights,
providing consulting services to the naturopathic products and
laboratory testing industry.
Dr Bush speaks nationally and regularly publishes on the topics
of neuroimmunology, brain-gut connections, neuroendocrinology, and
lyme disease. Dr Bush sits on two non profit boards, The
Naturopathic Education and
Research Consortium, and Compass Centre for
Health.
The format of this episode is slightly different. In it Dr Bush
discusses three different SIBO cases, diving into the variability
and complexity of each presentation.
Case 1 - SIBO with associated fibromyalgia and chronic
fatigue - 65y/o female.
- Incremental approaches with complex cases.
- The gut being the epicentre of health, without which SIBO
associated presentations will not rectify.
- Polypharmacy approach and the compounding effect of this on the
patient.
- Analysis of basic chemistry.
- Myeloperoxidase (MPO), the enzyme secreted by neutrophils, and
the indications for testing and tracking this in treatments. (MPO
elevation has associations with lipopolysaccharides (LPS), chronic
infections, irritable bowel disease (IBD), and immune induced leaky
gut)
- The neurotransmitter imbalances that can be sustained by
chronic inflammation (hint - upregulated indoleamine dioxygenase
enzyme, precipitating downregulated synthesis of serotonin, among
others)
- Yeast association with SIBO.
- Weaning off polypharmacy.
- Metronidazol for rifaximin resistant SIBO, and C. diff.
- An indication on how many rounds of rifaximin are required to
attend to chronic versus acute SIBO.
- Eating disorders prompted by therapeutic diets taken on for too
long.
- Botanicals vs conventional medicine for SIBO treatment, or a
combination use approach?
- Probiotic use as immunological modulators rather than massive
impactors for floral diversity in the GI microbiome.
- Botanicals that Dr Bush uses in SIBO treatment.
- Mediherb gut flora complex - immune regulating capability, IBD
modulation, mucosal affinity.
- Dr Nirala Jacobi’s therapeutic recommendation - Mediherb
Bacto-Cand GI.
Case 2 - SIBO with associated constipation, acne,
halitosis - 20y/o male
- Traumatic brain injury due to sporting event.
- Tricyclic antidepressant therapy introduced in his recovery
plan and his subsequent experience of anxiety and spacey
feelings.
- Naturopathic neurotransmitter production therapy alongside
conventional antidepressant use.
- Serotonin syndrome and the potential for it to be induced by
dual therapy use.
- Methane Protocol - rifaximin and neomycin combination for
methane dominant SIBO treatment.
- Anxiety caused by SIBO, key indications being:
- Treatment resistant anxiety
- Treatment resistant insomnia
- Anxiety as a manifestation resultant of SIBO chemicals
interrupting neurotransmitter signalling.
Case 3 - Lyme and SIBO - 25y/o female
- Chronic fatigue, constipation, bloating, neuralgia, catatonic
staring episodes.
- Lyme testing.
- The effectiveness of the paleo diet for symptomatic control,
noting that the issue still exists, even though the bugs are simply
not being fed and therefore symptoms abating.
- SIBO as a concomitant condition with Lyme, and/or as a
condition that can mimic the various presentations of Lyme.
- The Lyme/SIBO overlap as discussed by Dr Farshid Rahbar at the 2017
SIBO
Integrative Conference, and the methane association.
- The clinically noted neuralgia and methane dominance link.
- Methane endotoxins produced by SIBO bacteria theorised to
contribute to neuralgia.
- Constipation and methane dominance perpetuating each
other.
- Methane dominant SIBO moving from constipation to diarrhoea
during treatment and why this can occur.
Resources