Exciting Gut Health Updates: Butyrate, Rifixamin, and More - Dr. Michael Ruscio, DC

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Exciting Gut Health Updates: Butyrate, Rifixamin, and More

Revelations About Fecal Microbiota Transplantation, Fiber, Vitamin D, 5-HTP, Butyrate, and Low FODMAP for SIBO, IBS, IBD, and More

Another podcast episode dedicated to gut health updates is here, providing a unique opportunity to hear about new findings and if they can help you better your health. While the featured studies shine the spotlight on how gut health conditions like SIBO, IBS, IBD, and travelers’ diarrhea respond to various treatments, they also show what we’ve known for a while: your gut bacteria speaks volumes about your mood, fatigue, and other non-digestive symptoms. Tune in to hear if Rifaximin, sodium butyrate, 5-HTP, vitamin D, the low FODMAP diet, and fecal microbiota transplantation at reducing symptoms for a wide range of health conditions.

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➕ Dr. Ruscio’s Notes

Which Conditions the New Gut Health Studies Cover

Irritable Bowel Syndrome (IBS)

A meta-analysis was conducted to evaluate the associations between vitamin D and IBS. 

The parameters: 

  • The meta-analysis included 12 studies with 1,331 IBS patients. 


The results:

  • Vitamin D deficiency was associated with a 1.8X increased risk of IBS, and treatment with vitamin D led to: 
    • Improved quality of life
    • No change in IBS symptoms severity 


A study aimed to determine the microbial difference between IBS-Diarrhea (IBS-D) overlapping with/without Small Intestinal Bacterial Overgrowth (SIBO), and to analyze the underlying mechanism of its sensitivity to Rifaximin.


The parameters: 

  • A total of 176 participants were enrolled in the study. 
    • 127 were IBS-D patients.
    • 49 were healthy controls. 
  • The 127 IBS-D patients all performed a lactulose SIBO breath test.
    • Both SIBO-positive and negative IBS-D patients were treated with Rifaximin (400mg BID). 


The results: 

  • Compared to the IBS-D negative breath test patients, the IBS-D positive breath test patients treated with Rifaximin led to greater improvements in: 
    • Abdominal pain
    • Bowel movement satisfaction
    • Diarrhea 
    • Bristol stool form


Children’s GI Conditions 

A systematic review and meta-analysis aimed to understand the global incidence of the adverse events associated with fecal microbiota transplantation (FMT) in children over the past 20 years.


The parameters: 

  • The systematic review and meta-analysis included 18 studies featuring 681 children


The results: 

  • FMT led to:
    • 86% overall efficacy in children with GI symptoms
    • 91% efficacy in children with C. diff infections
    • 27.7% mild to moderate side effects (abdominal pain, diarrhea, bloating, etc) 
    • 0.9% severe side effects

Inflammatory Bowel Disease (IBD)

This study further explored the effect of 5-hydroxytryptophan (5-HTP) supplementation on fatigue in patients with inactive IBD.

The parameters:

  • 166 IBD patients experiencing fatigue were randomized to placebo or 5-HTP (precursor to serotonin. 


The results: 

  • After 2 months, the 5-HTP group had: 
    • Increased serum 5-HTP and serotonin
    • No improvement in fatigue, anxiety, or depression 


Chronic Constipation 

A systematic review and meta-analysis investigated the efficacy of fiber supplementation at improving chronic constipation. 


The parameters: 

  • The systematic review and meta-analysis included 16 randomized controlled trials with 1,251 participants with chronic constipation, randomized to: 
    • Control group (maltodextrin, yogurt, milk, apple juice) 
    • Fiber (psyllium, pectin, inulin, guar gum, galactooligosaccharides, wheat bran)


The results: 

  • Compared to control, fiber supplementation led to: 
    • Greater response rate 
    • Increased stool frequency 
    • Worse flatulence 
    • Improved stool consistency
  • Constipation was most improved with: 
    • Psyllium and pectin 
    • Fiber doses >10 g/day
    • ≥4 weeks of treatment 


Travelers’ Diarrhea

A systematic review and network meta-analysis were performed to clarify if probiotics or Rifaximin are more effective in the prevention of travelers’ diarrhea.

The parameters:

  • The systematic review and network meta-analysis included 17 randomized controlled trials featuring healthy participants traveling to other countries. 
  • These participants were randomized to: 
    • Placebo or no treatment
    • Rifaximin 
    • Probiotics/prebiotics (e.g. Strep thermophilus, galactooligosaccharides (GOS), S. boulardii, and sodium butyrate) 


The results: 

  • Compared to placebo, both interventions reduced the risk for traveler’s diarrhea. 
  • Of the probiotic/prebiotic therapies, the following, listed from most to least superior, provided the greatest reduction for travelers’ diarrhea: 
    • Sodium butyrate 
    • Lacto/bifido + Strep thermophilus 
    • GOS
    • S. boulardii


Celiac Disease

A study assessed the efficacy of a moderately low FODMAP diet on persistent symptoms in treated celiac patients.


The parameters: 

  • 70 celiac-disease patients in remission with persistent GI symptoms, currently on a gluten-free diet were randomized to: 
    • Usual gluten-free diet
    • Low FODMAP + gluten-free diet


The results: 

  • After 1 month, the addition of a low FODMAP diet led to greater reductions in: 
    • GI symptom score 
    • Abdominal pain  
    • Bloating 
    • Diarrhea


Small Intestinal Bacterial Overgrowth (SIBO)

A study analyzed the mental state and gastrointestinal complaints of patients with SIBO in relation to tryptophan metabolism and Rifaximin treatment.

The parameters: 

  • The study assessed 120 participants with anxiety and depression with SIBO and IBS-Diarrhea (IBS-D) and SIBO and IBS-Constipation (IBS-C). 
    • All 120 participants were treated with Rifaximin (1,200 milligrams per day for 10 days for 3 months). 


The results: 

  • After 3 rounds, treatment with Rifaximin led to improvements in: 
    • Anxiety
    • Depression
    • Diarrhea
    • Constipation


Intestinal permeability 

A study tested the associations between intestinal permeability biomarkers and food-specific IgG antibodies. 


The parameters: 

  • 111 adults, with and without gastrointestinal symptoms had biomarkers and food-specific IgG antibodies measured via ELISA. 


The results: 

    • Common food IgG antibodies, including eggs, wheat, and dairy, were: 
      • Associated with increased intestinal permeability markers (anti-lipopolysaccharide (LPS) and anti-occludin IgG and IgA antibodies) 
  • Not associated with anti-vinculin or anti-CdtB antibodies
  • There was no difference in IgG food antibody levels or intestinal permeability markers when comparing symptomatic and asymptomatic participants


Hypermobile Ehlers-Danlos syndrome

A systematic review assessed the frequency of gastrointestinal symptoms in patients with hypermobile Ehlers-Danlos syndrome (hEDS) and hypermobility spectrum disorders (HSD). 


The parameters: 

  • Literature relevant to the gastrointestinal system and hypermobile Ehlers–Danlos syndrome was systematically searched, critically appraised, and summarized.


The results: 

  • Compared to those without hEDS/HSD, those with hEDS/HSD have a higher prevalence of: 
    • Constipation 
    • Abdominal pain 
    • Diarrhea
    • Postprandial fullness 


Acute and Recurrent Gout 

A pilot study aimed to evaluate the effects of washed microbiota transplantation (WMT) on serum uric acid levels, symptoms, and the intestinal barrier function in patients with acute and recurrent gout.


The parameters: 

  • The study featured 11 patients with gout who were treated with WMT. 


The results: 

  • WMT led to reductions in: 
    • Frequency and duration of gout flares
    • Uric acid
    • Serum endotoxins

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