Small intestinal bacterial overgrowth in rosacea: clinical effectiveness of its eradication.

Small intestinal bacterial overgrowth in rosacea: clinical effectiveness of its eradication.
Parodi A, Paolino S, Greco A, Drago F, Mansi C, Rebora A, Parodi A, Savarino V.

Department of Internal Medicine, Gastroenterology Unit, University of Genoa, Genoa, Italy.

BACKGROUND & AIMS: To better understand the role of small intestinal bacterial overgrowth (SIBO) in rosacea, we aimed to assess the presence of SIBO in patients with rosacea and the clinical effectiveness of its eradication. METHODS: We enrolled 113 consecutive rosacea ambulatory patients (31 M/82 F; mean age, 52 +/- 15 years) and 60 healthy controls who were sex- and age-matched. Patients and controls underwent lactulose and glucose breath tests (BTs) to assess the presence of SIBO. Patients positive for SIBO were randomized to receive rifaximin therapy (1200 mg/day for 10 days) or placebo. A group of patients with negative BTs were also treated with rifaximin. Eradication was assessed 1 month after the end of therapy. Two dermatologists, unblinded on therapy, evaluated rosacea patients before and after treatment on the basis of an objective scale. RESULTS: The prevalence of SIBO was higher in patients than controls (52/113 vs 3/60, P < .001). After eradication, cutaneous lesions cleared in 20 of 28 and greatly improved in 6 of 28 patients, whereas patients treated with placebo remained unchanged (18/20) or worsened (2/20) (P < .001). Placebo patients were subsequently switched to rifaximin therapy, and SIBO was eradicated in 17 of 20 cases. Fifteen had a complete resolution of rosacea. After antibiotic therapy, 13 of 16 patients with negative BTs for SIBO remained unchanged, and this result differed from SIBO-positive cases (P < .001). CONCLUSIONS: This study demonstrated that rosacea patients have a significantly higher SIBO prevalence than controls. Moreover, eradication of SIBO induced an almost complete regression of their cutaneous lesions and maintained this excellent result for at least 9 months.

Interesting indeed. What is the word on rifaximin?

Yeah I wonder if it would be ok to take it and then just load up on the probiotics during and afterward.

FWIW, I have mild rosacea and I've tried almost everything possible to control the redness.

I do believe the root cause is internal issue just as that study shows.

MMS works great for rosacea.

I would also bet that MMS would work just as well as doxycycline works for MPB. The problem of course is long-term usage of MMS.

Does anyone know the long-term safety of MMS?

jdp710 - Have you tried supplementing with Betaine HCL with meals to see if that reduces your Rosacea?

hapyman, I took it just like in the study, and had no side effects at all. If you read the study close you can see it is only appr. half of the patients who respond to rifaximin (those with digestive symptoms).

Hey CausticSymmetry,

Yeah, Betaine HCL definitely reduces Rosacea symptoms. Also, because I have H Pylori it's definitely a must. I take one or two of these per day http://www.iherb.com/Now-Foods-Betaine-HCI-120-Capsules/398?at=0

Anyway, betaine HCL is definitely one of the better ones to limit the redness. As is LED light therapy.

On a side note, I've been researching everything I can about hypothyroidism and the VERY broad implications it has from fibromyalgia to poor digestion, etc.. I wouldn't be surprised if my "VERY" mild hypothyroid is the cause of Rosacea and my previous problems with H Pylori/peptic ulcer. Right now, I'm taking everything I can think of to try and bring up my temperature. Hopefully, rosacea will clear up 100% at the same time.

CS -

Your opinon after immense research suggests to you that it is gut micrflora, that appear to be growing culprits, does this go some way in explaining early balders?

i ordered from iherb an my vitamin k and niacmide never turned up

DesperateIntellect - Iherb has pretty good customer service, give them a call or email. Gut microflora balance definitely plays a large role. Expect a watershed of information in the coming decades on this.

I'll second CausticSymmetry. I herb has pretty good customer service, IME.

Give them a call up. It wouldn't surprise me if they send you another package for free.

jdp710 - I agree about the hypothyroidism. You've probably already come across this, but in case you didn't hear about it, low thyroid and/or low iodine causes depletion of stomach acid.

Thanks for the info CausticSymmetry.

Here's some interesting info you might be interested in regarding a link between fibromyalgia and hypothryoid

"Thyroid hormone inhibits the production of substance P in the spinal cord.[89][90] When researchers make animals hypothyroid, substance P production is no longer inhibited; the level then rises steeply in the animals’ spinal cords."

"It’s important to note, however, that most patients’ fibromyalgia symptoms caused by thyroid disease are compounded by other metabolism-impeding factors. The most common factors are poor diet, nutritional deficiencies, poor physical fitness, and metabolism-impairing drugs."



more info = http://www.drlowe.com/frf/guttler/addenda.htm#Addendum%201

Here is a good graph