A reader asked me to review.. I was disappointed

Gluten

I have never had issues with gluten… yet ubiome suggests that I may…  strange

Inflammation

AKKERMANSIA MUCINIPHILA – Low

• Ubiome: One suggestion,
• http://microbiomeprescription.com/Library/Details?taxon=239935&taxname=Akkermansia%20muciniphila… dozens

ANAEROSTIPES – Low

• Ubiome – 2 suggestions, all prebiotics
• http://microbiomeprescription.com/Library/Details?taxon=207244&taxname=Anaerostipes dozens including foods

FAECALIBACTERIUM PRAUSNITZII – Low

• Ubiome … “exercise”
• http://microbiomeprescription.com/Library/Details?taxon=853&taxname=Faecalibacterium%20prausnitzii dozens

Well, they are doing a token effort so they can claim making recommendations…

Lactose Intolerance

I have zero issue with lactose. Their report suggests that I should be intolerant …hmmm

Bottom Line

This is a quarter-hearted (not even half-hearted) effort to be able to claim giving useful advice. They provide citations — so do I. They have less than 2 dozens, I have about 50 dozen…. so that means they have done a 4% effort… hmmm

A lot of “may help” on their pages…

Long time readers know that I have down on most lactobacillus probiotics for a long time (there are a few exceptions). There was a recent study finding that lactobacillus probiotic use is associated with brain fog.

Probiotic use is a link between brain fogginess, severe bloating

So how do you reduce lactobacillus. I went over to DataPunk and see some easy items to add

• Stevia
• Sucralose (Splenda)
• Iron supplements

Going over to Microbiome Prescription for Lactobacillus, we find also:

• neem
• sulfites food additives
• tea
• These are used with the Jadin Protocol
  • tetracycline antibiotics
  • azithromycin antibiotics
• vitamin d
• cherries
• enterococcus faecium (probiotic)
• carob  – but  cacao increases
• chitosan
• berberine
• salt

A few things to reduce or exclude from your diet are:

• almonds/ almond skins
• gum arabic (prebiotic)
• bacillus probiotics
• lactobacillus probiotics
  • For lactic acid producing probiotics details see Probiotic Mixtures for current information
• barley and oat
• cinnamon
• cacoa
• yogurt
• apple
• blueberry
• pomegranate
• high fiber diet
• inulin (prebiotic)
• pulse / legumes
• oregano (origanum vulgare)
• resveratrol

A more detail analysis is here: A non-antibiotic proposal …

Bottom Line

Brain fog can often been the greatest challenge to improvement. Bad decisions are made,  decisions are confused.

The above excludes other factors that may be part of your health profile.

This post attempts to summarize studies  for IBS. I have often posted on CFS with IBS – this is a post looking at pure IBS. The goal is to update readers to the state of science for treating IBS and to discourage the use of folk-tales and stale medical data. Most MDs do not have time to keep current.

A good start point are these summaries:

A Review of Microbiota and Irritable Bowel Syndrome: Future in Therapies[2018].

• ” the lack of highly predictive diagnostic biomarkers and the complexity and heterogeneity of IBS patients make management difficult and unsatisfactory in many cases, reducing patient health-related quality of life and increasing the sanitary burden. “
• “because bifidobacteria concentrations have been found to be reduced in IBS compared with healthy controls, it seems reasonable, logical and safe to use prebiotics to enhance the growth of bifidobacteria and other beneficial bacteria to improve symptoms in these patients. However, based on available evidence, general use cannot be recommended in patients with IBS [18, 77].
•  Very recent meta-analyses found Saccharomyces cerevisiae CNCM I-3856GI modestly effective in decreasing IBS symptoms in adults only during supplementation [96].
• ” More studies are necessary to understand the effects of low-FODMAP diet in IBS patients.”

Clinical Practice Guidelines for Irritable Bowel Syndrome in Korea, 2017 Revised Edition

• “Five randomized placebo-controlled trials reported that probiotics (Lactobacillus rhamnosus, Lactobacillus plantarum, and VSL#3, which contains a mixture of lactobacilli, bifidobacteria, and a Streptococcus strain) improved some symptoms, mainly bloating and flatulence.^100–104“
• A probiotic mixture (Lactobacillus acidophilus, L. plantarum, L. rhamnosus, Bifidobacterium breve, Bifidobacterium lactis, Bifidobacterium longum, and Streptococcus thermophiles) provided adequate relief of overall IBS symptoms and improved stool consistency in IBS-D patients but had no significant effect on individual symptoms
• There was only ONE item with a strong recommendation: Antispasmodics 
  • Peppermint oil was cited for controlling abdominal pain.

SYMPOSIUM REPORT: An Evidence-Based Approach to IBS and CIC: Applying New Advances to Daily Practice: A Review of an Adjunct Clinical Symposium of the American College of Gastroenterology Meeting October 16, 2016 • Las Vegas, Nevada.

• Strong evidence for:
  • Eluxadoline is superior to placebo for the treatment of IBS-D^e
  • Rifaximin is effective in reducing total IBS symptoms and bloating in IBS-D
  • Lubiprostone is superior to placebo for the treatment of IBS-C
  • Linaclotide is superior to placebo for the treatment of IBS-C
  • Some fiber supplements increase stool frequency in patients with CIC
• “Symptoms associated with viscerosensory perception (abdominal pain/discomfort, bloating, pain at evacuation, and urgency) were more responsive to peppermint oil than motility-related symptoms (constipation, diarrhea, and passage of gas or mucus; “
• “these conclusions do not indicate that probiotics are not effective in individual patients, but rather that the evidence supporting their efficacy is weak.”

IBS Probiotics

See this earlier 2016 post for earlier studies – new studies are shown.

• Prescript Assist – multiple species
• Symbioflor 2 – E.Coli Probiotic
• Mutaflor — E.Coli Nissle 1917
  • Escherichia coli Nissle 1917 restores epithelial permeability alterations induced by irritable bowel syndrome mediators [2018].
• Align – Bifidobacterium infantis 35624
• Florasan B (Bifidobacterium bifidum, Bifidobacterium longum, Bifidobacterium infantis, Lactobacillus rhamnosus) – mixture
  • NOTE: Bifidobacterium infantis, B. breve and B. bifidum is increased by Human Milk Oligosaccharides

Clostridium butyricum probiotics

• ” In conclusion, CB improves overall symptoms, quality of life and stool frequency in IBS-D patients and is considered to be used as a probiotics in treating IBS-D clinically.” [2018]
• Clostridium butyricum regulates visceral hypersensitivity of irritable bowel syndrome by inhibiting colonic mucous low grade inflammation through its action on NLRP6. [2018]
• “The metabolic profile of IBS mice is significantly altered compared to control mice. Supplementation with C. butyricum to IBS mice may provide a considerable benefit by modulating host metabolism.” [2018]

Non-Prescription Substances

• Peppermint oil
• Triphala (TLP):
  • “It has also been shown that the long-term (45 days) treatment with TLP improved the number, frequency and consistency of stools excreted per day and decreased the abdominal pain and bloating in healthy patients vs. control individuals who did not receive TLP [86]. No side effects in the treated group were reported ” [2018]

CFS and other patients can flip between insomnia and hypersomnia within 24 hrs without any apparent cause. My hypothesis is a shift in the bacteria associated with each. My model is that specific symptoms are associated with specific clusters of bacteria. This means that we end up with hundreds of subset of CFS patients 😦 making a standard treatment for CFS becoming a naive hope for many researchers, MD’s and patients.

I have experienced hypersomnia in past relapse, with sleeping 14-16 hrs at a time and waking up very  unrefreshed. My normal healthy sleep pattern is about 6-7 hours.

For CFS, the most probable cause is A brain injury (due to infection) or a neurological disease….  The rapid flipping between insomnia and hypersomnia is better explained by a microbiome shift (Osler’s Principle)

PubMed

• Recurrent hypersomnia is cited with Kleine-Levin syndrome with a positive SIBO results [June 2018]
  • [A young boy with periodic strange behavior and hypersomnia: Kleine-Levin syndrome]. [2017]
  • A variant of the Kleine-Levin syndrome precipitated by both Epstein-Barr and varicella-zoster virus infections. [1993] — Ah, same virus that are associated with CFS
  • Kleine-Levin syndrome following acute non-specific encephalitis.[2002]
  • A case of PANDAS with Kleine-Levin type periodic hypersomnia.[2012] – streptococcal infections
• Circadian disorganization alters intestinal microbiota. [2014] is the closest that I could locate — although it approaches it in the opposite direction.

NS – normal Sleep Pattern,  S – Altered Sleep Pattern, FS – High Fat

Bottom Line

We do not know for sure which bacteria may be associated from the above charts. Looking at contributed samples with symptoms.

Looking at sleep insomnia  http://microbiomeprescription.com/Data/SymptomExplorer?site=gut&filter=79

• Low Actinomycetales, Enterobacteriales (which includes E..Coli), Marvinbryantia, Gammaproteobacteria are very common

And at prolonged sleep,

http://microbiomeprescription.com/Data/SymptomExplorer?site=gut&filter=80

• No one had Actinomycetales
  • 0/10 for prolonged sleep
  • 34/44 had some Actinomycetales with insomnia.
• Enterobacteriales, Marvinbryantia, Gammaproteobacteria was less shifted to the low

A reader passed along a link to this pet product. If you examine the list of bacteria, you will see if matches the original formula.

Cost?  $40 for 50 capsules ($0.80 per capsule) or $499 for 1000 ($0.49 per capsule). Site

On Amazon.com it is 120 capsules for $55 ($0.46 per capsule) — BUT THE LISTED FORMULA is the New Prescript Assist formula. — and strange, I could not find regular Prescript Assist there…