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A New IBS Solution offers a revolutionary look at the way Irritable Bowel Syndrome is currently being treated. Today, over 60 million people of all ages across the country are suffering from Irritable Bowel Syndrom(IBS), which is characterized by abdominal pain, bloating, and altered bowel habits. But because patients may find it difficult to discuss their bowel problems with their physicians, they often suffer in silence or even worse, "learn to live it". According to Dr. Mark Pimentel, Director of the Gastrointestinal Motility Program at Cedars-Sinai Medical Center, the majority of IBS cases can be treated successfully. Dr. Pimentel believes that the "missing link" or root cause of most IBS symtoms can be attributed to an overgrowth of bacteria in the small intestine. A New IBS Solution takes you through the historical evolution of conventional medicine's view on IBS in a way that can be easily understood. In addition, Dr. Pimentel presents a simple treatment protocol that will not only help you resolve your IBS symptoms, but will also prevent their recurrence.
- Sales Rank: #32483 in Books
- Published on: 2006-05-15
- Original language: English
- Number of items: 1
- Dimensions: 9.12" h x .46" w x 6.06" l, .62 pounds
- Binding: Paperback
- 156 pages
About the Author
Dr. Mark Pimentel was born in Thunder Bay, Ontario, Canada. He obtained his medical degree at the University of Manitoba in Winnipeg, Canada. He did his residency in Internal Medicine at the University of Manitoba as well. He is now assistant Professor of Medicine at the UCLA Geffen School of Medicine and is the Director of the Gastrointestinal Motility Program at Cedars-Sinai Medical Center.
Most helpful customer reviews
50 of 51 people found the following review helpful.
Important Information for IBS Sufferers, but the Treatment Plan Is a Little Lacking.
By mirasreviews
"A New IBS Solution" was written in 2006 by Dr. Mark Pimentel, at the time Director of the Gastrointestinal Motility Program at Cedars-Sinai Medical Center, to explain his understanding that many cases of irritable bowel syndrome (IBS) are caused by small intestinal bacterial overgrowth (SIBO) and his protocol for successfully treating the condition. He begins by taking the reader through the history of theories and treatment for IBS, which is currently the most common chronic medical condition in the United States. Dr. Pimentel explains the sometimes-confusing labeling and categorization of IBS, why IBS has so often been attributed to psychological causes, comments on drugs that have been used to treat symptoms, what is known about post-infectious IBS (food poisoning), which seems to constitute 20-30% of cases, before he concludes with an exposition of how and why he and his colleagues came to believe that IBS is caused by SIBO in many cases.
Then Dr. Pimentel presents his treatment plan, described clearly and in enough detail that both laypeople and physicians can understand and follow it. The Cedars-Sinai Program for Treating IBS is essentially this: Several screening tests are recommended, among them a hydrogen breath test for SIBO. If a patient tests positive, he or she is given a 10-day course of the antibiotics Xifaxan and neomycin. If, after that, the patient is still positive for SIBO, a second course of antibiotics is given. The patient is to follow a low-carbohydrate diet in order to help the antibiotics along by starving the pathogenic bacteria. The diet restricts carbs that are absorbed low in the intestines while allowing some carbs -monosaccharides, starches, white wheat bread and pasta- that are absorbed high in the intestines. If, after 2 courses of antibiotics and diet, SIBO is still present, Dr. Pimentel recommends the patient consume only Vivonex elemental diet and water for 2 weeks to starve the bacteria. Once cured, he has patients take Zelnorm or erythromycin for 3 months in order to enhance small bowel cleansing waves. (Note that Zelnorm has since been taken off the market.)
Dr. Pimentel's work on SIBO as a cause of IBS is important. I'm sure he and his colleagues have helped many people, and I hope that everyone with IBS will read this book. I find his treatment plan lacking in a couple of areas, however, probably insufficient for a long-term cure, and Dr. Pimentel's understanding of what is causing the symptoms of IBS is poor, which results in his giving some bad advice. Dr. Pimentel relies solely on a hydrogen breath test for diagnosis and claims that 76% of IBS sufferers in one study and 84% in another study tested positive for SIBO. That's impressive, but I wish that he had addressed the accuracy of hydrogen breath tests for SIBO, because their results are subject to interpretation, and a couple of studies have called their accuracy into question. Dr. Pimentel also places a lot of emphasis on small bowel cleansing waves in the small intestine, the lack of which he believes predisposes people to SIBO, without any evidence that it is a major factor.
One shortcoming of the Cedar-Sinai treatment plan is that is has no protocol for restoring normal flora to the intestines. Dr. Pimentel's diet for long-term maintenance is good, but it may not be enough to restore the normal flora and keep the bacteria at bay. Many of Dr. Pimentel's patients suffer recurrences. Wiping out the pathogenic overgrowth without restoring the flora is like throwing chips in the air and letting them fall where they may. It won't last. Dr. Pimentel doesn't seem to care for probiotics, but he needs to learn. People have to restore the flora somehow. It seems that only alternative practitioners and "functional" MDs emphasize a restoration of normal flora, which can take years. I don't endorse them, as I have not used these diets for this purpose, but, if you want to design your own protocol for restoring the flora, you may want to consult the Specific Carbohydrate Diet (SCD) or the GAPS diet for ideas. You can also find recommendations online as to what type and quantity of probiotics to use.
The other problem with the treatment plan outlined in "A New IBS Solution" -and the one that IBS sufferers will notice first- is that it ignores the many malabsorption issues associated with the condition. The symptoms are the result of malabsorbtion of a variety of short-chain carbohydrates, collectively referred to as FODMAPs. Most IBS sufferers find great relief when they follow a low-FODMAP diet. Though I'm sure it is true that the underlying cause of most IBS is a pathogenic overgrowth, patients can get immediate relief of even the most debilitating symptoms by following a low-FODMAP diet and should do so until the overgrowth has been successfully treated. For an explanation and advice about the low-FODMAP diet, see the book "The Complete Low-FODMAP Diet" by Sue Shepherd, PhD and Peter Gibson, MD. As "A New IBS Solution" was published 8 years ago, it is possible that Dr. Pimentel has since integrated some of this information into his treatment program.
"A New IBS Solution" is short (132 pages of text), easy to read, and provides the public with information about SIBO, IBS, and successful treatment in a format that is easy to digest. A little too easy; there are no footnotes or endnotes for the studies that are referenced. Dr. Pimentel does not mention that, though SIBO is probably more common, some IBS is caused by fungal overgrowth rather than bacterial. I know. I had a rather bad case. Dr. Pimentel downplays the neurological and psychiatric symptoms of IBS, claiming that no more IBS patients suffer from depression than the general population. He probably thinks that he is dispelling the myth that IBS is psychosomatic, but depression is more prevalent among IBS sufferers. It is caused by the IBS, not the other way around. Pimentel does not mention "brain fog" as a symptom until the end of the book, where he speculates that it is caused by endotoxins. There is no mention at all of inflammatory disease associated with IBS. He's a gastroenterologist. He shies away from systemic implications of GI disease.
3 of 3 people found the following review helpful.
Great, detailed story about IBS/SIBO, not absolutely flawless though
By Andrew
This one is a very comprehensive book on IBS/SIBO. It really helps to piece together various pieces of the puzzle for someone who's been bothered by an "IBS" of sorts.
I myself am more on the constipation side of things with occasional manifestations of extra flatulance, gurgling stomach etc. (but not anything like frequent diarrhea or severe bloating). I'm definitely sensitive to fast carbs like white bread and sugar packed stuff like candies and chocolate. I'm actually less sensitive to pastas and also sourdough or non-yeast bread. I've tested for pretty much everything already without much results though. For one, it's not celiac disease. It's also not gluten intolerance per se (I've done genetic testing for that). It's not parasites. I also don't have much "inflammation" or anything like autoimmune effects according to a variety of blood tests. I do have some issues with gut flora according to stool tests, and I might have a lower than necessary stomach acid, though (currently awaiting for the latest test results). I might have some lactose intolerance because of my gut flora issues (basically, it's an excess of E.coli lactose negative). I do have iron, B12 and some folic deficiencies. Supplementing with B vitamins and iron does help with the deficiency, but as soon as I stop, it's back again. I've been taking various probiotics with no long-term effects - as soon as I stop, it's all back in a day or two. I've got a stressful life balancing various family stuff and a rapidly developing international startup. I developed some annoying side-effects to all of the above that really affect my quality of life. As a result, I've been also supplementing with diosmin and stone root, on a permanent basis - to keep the side-effects under control. What's even more annoying is that laxatives actually make it worse (it's a well-known fact, btw, but still annoying). I've switched to Natural Calm magnesium lately, and it appears to be much better than anything else for consistent bowel movements, though. I've been also taking Trimebutine (200mg, 3 times a day with meals) and it really made a difference at the beginning, but now it's much less pronounced, though definitely helps a lot (especially with bread and pasta).
Now about the book.
PROS. After studying various materials for almost 2 years now, I tend to conclude this book is the most detailed story behind IBS/SIBO connection so far. If you've been checking books like "Breaking the Vicious Cycle", "Fiber Menace", "The Good Gut", "The Microbiome Diet", "Why Stomach Acid Is Good for You", and maybe also various "SCD lifestyle" and "FODMAPs" resources on the Web, this book is the very necessary addition to your library. It kinda summarizes everything in a consistent and easy to digest manner, and gives you further direction if you're still stumped. I'd really recommend checking out more books on every particular topic, though (e.g. on stomach acid). What I also liked about this book is that it's got an entire section on "alternative approaches" to mitigate the IBS effects. I can confirm that mindful meditation does help to alleviate the "IBS symptoms" if practiced on a consistent basis - basically, if done every day. There are many great apps already for that, Headspace being particularly useful to me personally.
CONS. It appears the book is already quite outdated. E.g., Zelnorm/Tegaserod appears to be withdrawn from the market since 2007. Still the book sort of advertises it. The book also doesn't mention relatively benign but very effective spasmolytics like Trimebutine (possibly because it's not approved pretty much everywhere but not in the U.S.?). In fact, the book says spasmolytics don't help - but that's probably in regards to two particular medicines mentioned in the text. The antibiotics approach is certainly something worth considering after all the comprehensive tests are done and severe bacterial infection confirmed, however it's more like an atomic bomb to your gut. There are things like bacteriophages that have been used in certain countries for almost a century now as a great alternative to antibiotics..
57 of 62 people found the following review helpful.
Crucial information for anyone with IBS-related symptoms
By B. Ahlen
I had a severe, disabling intestinal pain that went on day in and day out for many months, while I was going through all kinds of tests at a major hospital. The only thing they found was a bunch of diverticuli ("bubbles") on the wall of my small intestine and jujenum, but the specialist I was referred to said that "this couldn't possibly cause the pain."
After exhausting all other possibilities I confronted him with Dr. Pimentel's research results as described in this book (and published more widely in the fall of 2006), but this was promptly described as very unlikely to be valid. Out of options and in a lot of pain, I somehow managed to convince him that it would make sense to at least try it anyway.
Five days later I celebrated the end of my five months of continuous 24/7 suffering!
Two pills morning and evening, a new unique antibiotic that did all the work, and it took two months before the problem came back.
Then it was time for realization #2 from Dr. Pimentel's work as described in the book. I was lactose intolerant, eliminated this from my diet, and haven't had a recurrence since.
Amazingly, it seems very few specialists even know about Dr. Pimentel's research at Cedars-Sinai Hospital on this. Arm yourself with this book, and don't give up until you get good answers from your doctor!
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