Is systemic bacterial overgrowth a thing?
July 9, 2014 11:15 AM   Subscribe

In the past I was diagnosed with bacterial overgrowth of the gut and was treated with pretty intense antibiotics, but the symptoms came back. I was subsequently diagnosed with IBS. I've also suffered from recurrent yeast infections. I ALSO suffer from chronic joint pain (with arthritis in my hands, feet, and ankles) and fatigue. I've started taking a low dose of immunosuppresants (on top of plaquenil), but I'm worried that if I do have bacterial overgrowth, my immune system may be less able to defend against it because my gut symptoms have gotten worse. Ah!

All of my diagnoses and treatments were from regular GI doctors and rheumatologists. No woo here, but I don't know how woo systemic overgrowth is. I've heard of the "candida diet" but same thing there.

A subsequent question: could systemic bacterial overgrowth cause any of my fatigue and joint pain? I also experience the "brain fog" and headaches that the candida diet website mentions.

Lay the truth on me! Thanks!
posted by anonymous to Health & Fitness (15 answers total) 9 users marked this as a favorite
I know this isn't your question, but have you been tested for celiac disease? Everything you've mentioned here (GI symptoms, yeast infections, joint pain, brain fog, headaches) can be symptoms.
posted by obfuscation at 11:28 AM on July 9, 2014 [3 favorites]

Joint pain and gi issues can also point to inflammatory bowel disorders (chron's or UC) in addition to celiac. Seems like checking back into the gi for further testing is in order. (I'm also in the process of figuring out similar problems. Scopes are my next step.)
posted by Crystalinne at 11:55 AM on July 9, 2014 [1 favorite]

Oh and I assume that by yeast infections you mean vaginal infections and that you're a woman. The first birth control I was on gave me a yeast (the food) intolerance and I would get severe migraines and chronic yeast infections. (That was a bad year.) so if you're on hormonal birth control it can mess with those things. The yeast intolerance and infections went away within 2 weeks on new pills.
posted by Crystalinne at 12:07 PM on July 9, 2014

Get tested for Celiac but even if you test negative you might try going gluten free - might help. Do get tested first because if you stop eating gluten the test won't give you a valid result.
posted by leslies at 12:13 PM on July 9, 2014

I went to med school and I learned nothing about systemic bacterial overgrowth there. I also just searched PubMed about it and there were zero articles with the term "systemic bacterial overgrowth" in them in the past 1.5 years - this includes most global scientific literature. Take that for whatever it's worth.
posted by treehorn+bunny at 12:15 PM on July 9, 2014 [7 favorites]

Sorry this is terribly anecdotal, but a few months ago I had a gut infection that caused a lot of joint pain and inflammation (the best my doctor could tell was that it was food poisoning gone wild, then led to an auto-immune attack on my system once the infection was cleared). I tested negative for anything you can possibly think of that might cause joint pain, either viral or systemic.

I decided to experiment with my diet as a result, and I feel best when I avoid corn (in all forms), wheat products, and unfermented dairy. I tried eliminating them all in turn to see in isolation what was better or worse. I'm doing a lot of fermented foods (homemade kefir & sourkraut, etc). My brain fog has cleared and my sleep is much better, and the residual joint pain is better. I'm not sure if it's the elim or less sugar in general (meaning a lot of corn and wheat products quickly convert to sugar), but now if I ain't broke, I am sticking with this kind of not-super-religious paleo-like diet.

I see a lot of candida websites and I would like to know if it's woo too, because people say they are diagnosed with this by a medical doctor, and other people say it's a myth. I half-assedly search for studies sometimes, but nothing seems conclusive to me. I wish someone who is not named Dr. Oz would say, eat this, or take this probiotic. It's never that simple, though, is it?

Good luck feeling better.
posted by Lardmitten at 1:18 PM on July 9, 2014

You might look up the term "Small bowel bacterial overgrowth".

If you throw that term into PubMed, you will get a ton of hits:

Small bowel bacterial overgrowth

including: Estimation of small intestinal bacterial overgrowth in patients with constipation and diarrhea irritable bowel syndrome [PMID: 24964506]

Please note, that this is quite recent (May 2014).

This is indeed recognized enough, that it has its own acronym and test (SIBO test).

Bacterial overgrowth interaction is one of the hypothesis of what the mechanism is behind some IBS:

"While the cause of IBS is unknown, a disruption of the brain-gut axis and small intestinal bacterial overgrowth are thought to be important factors.[27][28] The risk of developing IBS increases sixfold after acute gastrointestinal infection."

Based on that, there have been some successful IBS treatments with antibiotics:

"There is research to support IBS being caused by an as-yet undiscovered active infection. Studies have shown that the nonabsorbed antibiotic rifaximin can provide sustained relief for some IBS patients.[36] While some researchers see this as evidence that IBS is related to an undiscovered agent, others believe IBS patients suffer from overgrowth of intestinal flora and the antibiotics are effective in reducing the overgrowth (known as "small intestinal bacterial overgrowth").[37]

Other researchers have focused on a possible unrecognized protozoal infection such as blastocystosis as a cause of IBS[10] as certain protozoal infections occur more frequently in IBS patients.[38][39] Dientamoeba fragilis has also been considered a possible organism to study, though it is also found in people without IBS.[40]"
posted by VikingSword at 1:32 PM on July 9, 2014 [1 favorite]

Small intestine bacterial overgrowth, as mentioned upthread (SIBO) is a real thing and strongly associated with IBS. Antibiotic therapy is only OK at treating it -- I've heard of cases that were refractory to antibiotic treatment, or that only improved while actively taking antibiotics, that responded more permanently to a low-FODMAP diet.

That said, the yeast infections, or any fungal infection, are most likely the result of taking heavy duty antibiotics. I would consider that a sequela, not a symptom of the original issue. Sorry that happened to you -- I myself took heavy duty antibiotics for a similar issue and ended up with recurring fungal infections as a result, so I feel your pain.

You may need an upgrade in your GI or rheumatologist to someone who is more interested in treating your entire autoimmune oeuvre, as it were, instead of prescribing individual treatments for individual symptoms. Inflammatory arthritis is often fed by inflammation elsewhere in the body -- could be finding a way to treat the SIBO would improve your IBS and your joint pain, for example. I think a good starting point would be an academic clinician whose research interests include autoimmune diseases.
posted by telegraph at 1:51 PM on July 9, 2014

Your gut constitutes about 60%-70% of your immune system. So when something goes very, very wrong with your gut, you should not be surprised if you just cannot seem to get well thereafter.

I have a very serious condition which significantly impacts gut function. I have read a lot about recalcitrant infections, gut issues, yeast, you name it. I hesitate to post because I don't know where the dividing line is between "official/accepted" science and "woo/controversial" explanations (and, thus, a lot of my comments on this sort of issue get deleted -- I guess for being too woo or something). I just know I have gotten better after being told that could not happen and a lot of what you are saying sounds extremely familiar to me.

You might look up the term "biofilm." When infection gets really rooted in your system, it basically starts terraforming your body. Once your chronic infections are so bad that you have biofilm, it tends to become increasingly antibiotic resistant. After that, it is simply not enough to keep throwing more antibiotics at it. As far as I know, most doctors do not know that much about effectively reversing antibiotic resistance in biofilm. There is some research out there. I am not currently finding anything very enlightening. At one time, I had a link to research on biofilm in people with my condition which contained information consistent with my experience that high acidity goes hand-in-hand with biofilm and, thus, eating a more alkaline diet (or using certain drugs, like quinine) can help reverse antibiotic resistance in biofilms.

FWIW: In alternative med circles, yeast is believed to feed on detritus from other kinds of infections. In my experience and, anecdotally from being on various health lists over the years, yeast overgrowth and chronic infection seem to go hand in hand. Of course, correlation does not prove causation.

I have spent a lot of years getting well. I am much more clear headed these days, my chronic joint problems are mostly cleared up, my chronic fatigue is cleared up, my headaches are getting less frequent as well as less severe and shorter in duration, and my chronic yeast infections are gone. In my experience, joints heal slowly. If you can figure this out, other things will improve long before you notice improvement in your joints. Cartilage is fed/cleaned up via osmosis. It does not have a direct blood supply. So it seems to me your general overall health has to improve first before your joints can improve.

Best of luck.
posted by Michele in California at 2:35 PM on July 9, 2014 [1 favorite]

Response by poster: I haven't heard of massive doses of antibiotics resulting in bacterial overgrowth, but I have heard of them in the context of chronic yeast infections and "overgrowth". Looking up systemic yeast or fungal infections brings a lot of results on Pubmed. Have you been treated with a long course of oral antifungals?
posted by Anonymous at 2:35 PM on July 9, 2014

My partner has SIBO. She's been helped by heavy-duty probiotics. VLS3 is the one she's been taking; she seems to think it helps.
posted by mudpuppie at 3:40 PM on July 9, 2014

Anecdata: I have had arthritis in my hands and feet for quite some time, it was getting worse, and had a bunch of other weird autoimmune symptoms. Plus chronic fatigue. I realized I didn't digest dairy well, started using lactase pills some, but mostly giving up dairy. My arthritis is vastly improved. The fatigue is better at times. I try to eat foods that have anti-inflammatory properties, what the heck, I've learned to love salmon.

I'm not aware of a downside to probiotics, so I would consider them unless your doc says not to.
posted by theora55 at 4:00 PM on July 9, 2014

It sounds almost like a bacterial undergrowth--all of the antibiotics could/would wipe out the good bacteria that colonize your gut and vagina, leading to an imbalance and overgrowth of less-desirable yeasts and such. Antifungals and/or probiotics might be useful, too?
posted by stillmoving at 7:02 PM on July 9, 2014

I really like Prescript Assist soil based probiotics. It's expensive but it's not meant to be taken continuously (twice a day for a month, then once a week after that).
As with any strong probiotics, you might have to start at a low dose then work your way up.

Conserning the auto-immune issues, look up the auto-immune protocol on the Paleo Mom's website. And yes, get checked for celiac. And start a food journal: write down absolutely everything you eat. You might find a connection with some random food or spice you don't suspect.
posted by Neekee at 5:57 PM on July 10, 2014

A lot of those symptoms are cited on various MTHFR forums. But I agree with starting with diet - gluten and dairy particularly. Then sugars (which yeast feeds on). When I did a similar elimination diet, I ate a lot of tacos and stir-fry.
posted by vignettist at 5:46 AM on July 12, 2014

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