Latest news with #Meckel
Los Angeles Times
02-05-2025
- Health
- Los Angeles Times
Small Intestinal Bacterial Overgrowth (SIBO): What You Need to Know
When everything's working right, your small intestine is like a clean, well-organized hallway; nutrients pass through, digestion goes smoothly, and there's not much clutter. But sometimes, bacteria that usually hang out in the colon sneak in and start multiplying where they don't belong: the small intestine. That's where small intestinal bacterial overgrowth, or SIBO, comes into play. It's more than just bloating or discomfort; it's a condition that's increasingly being recognized as a driver behind chronic digestive issues and interconnected digestive diseases, but it remains tricky to pin down and even harder to diagnose definitively. One of the challenges in diagnosing SIBO is the range of gastrointestinal symptoms, such as diarrhea and bloating, that it can cause. At its core, SIBO happens when there's either: Traditionally, the diagnosis hinges on a test called the jejunal aspirate, which involves extracting fluid from the small intestine and checking for bacteria. A count of over 100,000 colony-forming units (CFU) per milliliter has been the benchmark. But more recent studies suggest that even 1,000 to 10,000 CFU/mL might indicate a problem [3], [10]. This variation reveals a big issue: there's no one-size-fits-all definition. The bacterial population in the small intestine plays a crucial role in diagnosing SIBO, as an abnormal increase can lead to symptoms like diarrhea and malnutrition. This is very different from Meckel's Diverticulum as well. People with SIBO often show up in primary care complaining of everyday symptoms like: These symptoms are easy to misattribute to other common issues like food intolerances or irritable bowel syndrome (IBS) [4]. In fact, SIBO may actually cause or worsen IBS and other functional gastrointestinal disorders. That's because the excessive bacteria can disrupt digestion, produce gas, and interfere with nutrient absorption [5]. Weight loss can also occur due to the malabsorption of nutrients. Here's what's happening behind the scenes: Despite its potential impact, SIBO often flies under the radar due to its overlapping symptoms and the challenges involved in making a clear diagnosis. While the jejunal aspirate remains the most direct method, it's invasive and not widely available [7]. More commonly, doctors use breath testing to measure hydrogen or methane gases produced by bacteria. But these tests have limitations—they can be inaccurate or yield inconsistent results. Because different clinics use different criteria to define and test for SIBO, it's hard to say how many people actually have it [3]. This lack of standardization makes it tough to collect reliable prevalence data. Understanding the risk factors associated with SIBO is crucial for identifying specific populations at risk and improving diagnostic accuracy. Exciting developments are on the horizon. Future tests may rely on metagenomics (studying bacterial DNA) and metabolomics (analyzing the chemical products of metabolism) to detect imbalances more precisely [9]. These techniques could provide a clearer picture of what's going on in the gut—and help reduce misdiagnoses. [8] Additionally, understanding the role of intestinal immunity in maintaining gut health could lead to more accurate diagnostic methods in the future. SIBO and intestinal methanogen overgrowth (IMO) are often lumped together, but they're not the same thing. IMO involves an overgrowth of methane-producing microorganisms—mainly Methanobrevibacter smithii—which can cause different symptoms, especially constipation [10]. Though the symptoms overlap with SIBO, the organisms and gases involved are different. That's why IMO requires distinct tests and treatments [6]. SIBO is still a bit of a puzzle. There's growing awareness, but many people remain undiagnosed or misdiagnosed. As science sharpens its tools, we're likely to see: Researchers are starting to think beyond just the number of bacteria in the small intestine and instead looking at the types of bacteria, how they interact with the body, and what chemicals they produce. All of this may eventually help tailor care to each person's gut microbiome. Nutritional support will also be a crucial element in future SIBO management, addressing deficiencies in vitamins and minerals to improve patient outcomes. SIBO is more than a minor gut nuisance—it's a real condition that can significantly affect daily life. But because it mimics other gastrointestinal issues, and because diagnostic methods aren't always consistent or reliable, it often remains overlooked. Recognizing and addressing the underlying cause of SIBO is crucial for effective management and prevention of recurrence. Fortunately, we're entering a new phase of understanding thanks to better research, advanced testing, and a deeper appreciation for how our gut bacteria influence health. As clinicians gain more clarity on what SIBO is—and isn't—patients with chronic GI symptoms may finally get the answers and relief they've been searching for. In severe cases, individuals may experience significant health issues such as night blindness due to vitamin A deficiency, osteomalacia linked to vitamin D deficiency, and various neurological impairments resulting from vitamin B12 deficiency. [1] Pimentel, M., Saad, R. J., Long, M. D., & Rao, S. S. C. (2020). ACG Clinical Guideline: Small Intestinal Bacterial Overgrowth. The American journal of gastroenterology, 115(2), 165–178. [2] Zafar, H., Jimenez, B., & Schneider, A. (2023). Small intestinal bacterial overgrowth: current update. Current opinion in gastroenterology, 39(6), 522–528. [3] Rao, S. S. C., & Bhagatwala, J. (2019). Small Intestinal Bacterial Overgrowth: Clinical Features and Therapeutic Management. Clinical and translational gastroenterology, 10(10), e00078. [4] Krajicek, E. J., & Hansel, S. L. (2016). Small Intestinal Bacterial Overgrowth: A Primary Care Review. Mayo Clinic proceedings, 91(12), 1828–1833. [5] Skrzydło-Radomańska, B., & Cukrowska, B. (2022). How to Recognize and Treat Small Intestinal Bacterial Overgrowth?. Journal of clinical medicine, 11(20), 6017. [6] Rezaie, A., Pimentel, M., & Rao, S. S. (2016). How to Test and Treat Small Intestinal Bacterial Overgrowth: an Evidence-Based Approach. Current gastroenterology reports, 18(2), 8. [7] Quigley E. M. (2014). Small intestinal bacterial overgrowth: what it is and what it is not. Current opinion in gastroenterology, 30(2), 141–146. [8] Bushyhead, D., & Quigley, E. M. (2021). Small Intestinal Bacterial Overgrowth. Gastroenterology clinics of North America, 50(2), 463–474. [9] Ponziani, F. R., Gerardi, V., & Gasbarrini, A. (2016). Diagnosis and treatment of small intestinal bacterial overgrowth. Expert review of gastroenterology & hepatology, 10(2), 215–227. [10] Takakura, W., & Pimentel, M. (2020). Small Intestinal Bacterial Overgrowth and Irritable Bowel Syndrome - An Update. Frontiers in psychiatry, 11, 664.
Yahoo
30-03-2025
- Politics
- Yahoo
‘This is what democracy looks like.' Thousands protest Trump administration at KC march
Thousands gathered to 'March for Democracy' in downtown Kansas City on Saturday, voicing concerns about what several marchers called an overreach by the federal government on citizen's rights. Furrowed brows, smiles, shouts and tears occupied the faces of passionate protesters, who bellowed chants that echoed off the concrete sky-rise buildings. By mid-morning, thousands of marchers lined the sidewalks of 13th Street, wrapping around several blocks from Oak Street to Main Street. The massive crowd walked a little over a mile from downtown to the west side of Union Station, culminating in a huge gathering on the lawn of the National World War I Museum and Memorial. The march brought people together with a collection of causes weighing heavily on their hearts, some deeply personal. Susan Wyssmann, 73, said her daughter works for a federally funded grant program that teaches children about the environment. That program, she said, was slashed among other federal cuts by the Department of Government Efficiency headed by Elon Musk. 'I am sure there are government inefficiencies,' Wyssmann said. 'But to take a sledge hammer and crash agencies, jobs and rights of people without any kind of due process... is truly horrifying and offensive to me.' Kansas Citians are among thousands across the country feeling the effects of a federal workforce reduction. Some have previously spoken to The Star about losing their jobs and feared effects of fewer federal workers. Many in the crowd on Saturday said they shared similar fears. Several picket signs were decorated with messaging against Musk and President Donald Trump. People with megaphones positioned throughout the crowd on Saturday led chants, including, 'This is what democracy looks like,' 'Hey hey, ho ho, Elon Musk has got to go,' and 'Love, not hate, makes America great.' Cars passing by on the street beside them obeyed signs reading 'honk for democracy,' prompting loud cheers. A mother among the crowd said she decided to march because she was deeply concerned about government overreach. Pushing her toddler in a stroller, Michaela Meckel said the federal government was going against her values and that she wanted to raise awareness. 'I'm really concerned about threats to free speech,' Meckel said. Meckel discussed the Trump administration's immigration policy and its attempt to use a wartime law to allow certain deportations. She said using a war law at a time of peace concerned her. 'I think free speech and checks and balances (in) our Constitution are all so foundational to what makes America a place that has been, you know, a world leader for so long,' Meckel said. 'And I think the current policies are really threatening our democracy and our ability to be a leader in the world.' Protestors Kim VanMaren and her husband Roger VanMaren arrived at the march well before it began. Kim VanMuren said she believes she has seen a gradual dismantlement of the democratic system as she once knew it. 'We both see executive power taking way, way too much space, way too much power, way too much word away from the other balancing factors of our of our federal government,' Kim VanMuren said. 'We're frustrated that Congress is not standing up and assuming their responsibilities to balance power.' Drums and voices boomed around them as Kim and her husband spoke to The Star about their concerns. They called on more people to speak up, saying the massive turnout Saturday was encouraging, but that the march itself would not be enough. Roger VanMuren, a former school district superintendent, said he was concerned about the Trump administration's executive order to dismantle the education department. Neither he nor his wife have shown up to an organized protest before. But a laundry list of unknowns prompted them to come Saturday, he said. 'Kids are being told they're of no value when you get rid of the Department of Education, especially the marginalized,' Roger VanMuren said. 'That really makes me angry.' Sitting on a concrete slab near Union Station, Linda Jurkiewicz, 66, criticized the federal government for what she said she feels to be a lack of diplomacy. 'I am shocked that we've gotten to be a country of such ugliness,' Jurkiewicz said. Jurkiewicz said she feels like much of the nation is not well informed on current events and called for younger leaders to get more involved in the democratic process. Partisan politics have driven a wedge between 'real problem solvers,' she said. 'And I will admit, honestly, I mean, I wish I did more,' Jurkiewicz said. 'I wish I called my senators, you know, I wish I did that stuff, wrote them, and I don't do hardly any of that.' Attending the protest with her grandmother on Saturday, Chloe Fischer, 19, said feelings of hurt and hope can live at the same time. A University of Missouri Kansas City student studying journalism, Fischer said she felt compelled to march for freedom of the press and free speech. 'It's important to be able to empathize with other people,' Fischer said. 'When other people are under attack, that's still important to me, even if it doesn't affect me personally. Other people are just as important.'
