Meds, Mind, Body & Benefits > Questions About Treatment & Side Effects

Digestion issues that won't seem to go away

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decayingsinner:
This may not be the most appealing topic, but I have had diarrhea since February.  At first I thought it was food poisoning, but that wasn't the case.  I have had the stool test, endoscopy, and colonscopy done, and all have come back just fine.  At my recent visit, my ID doctor suggested I cut dairy from my diet, but that has not seemed to work.  Could it be medication?

Jeff G:

--- Quote from: decayingsinner on September 21, 2013, 08:46:10 AM --- Could it be medication?

--- End quote ---

Does the diarrhea coincide with you starting a new med ?

I had an issue once with some tummy bug and lost a staggering amount of weight . My doctors did all the test you mentioned and many more and never found a single thing . It was explained to me that diagnosing a gut problem can be quite a challenge because of the ability for pathogens or the culprit to hide out in the gut undetected .

Yogurt , probiotics and the Brat diet with lots of Imodium helped until it passed , took over two months .         

decayingsinner:
Sorry about that, I did forget to mention I have been on Atripla for about 5 years now and my anti-depressants for about 10. 

Jeff G:
I wouldn't think that the meds is your problem then . I wish there was something helpful for me to add   :-\

sfpvguy41:
The gut mucosa is badly affected by HIV, and as a result our digestion, even after successful ART and undetectable viral loads, is off.  So maybe this is worth looking into and discussing with your doctor.

I've been looking into this a lot lately to address my own problems. A recent study from UCSF showed definitively that our microbiome is off compared to HIV- folks.
http://www.medicalnewstoday.com/releases/263198.php  They concluded:
--- Quote ---The researchers do not believe that there is a single bacterial species responsible for disrupting the integrity of the gut nor do they propose a specific probiotic bacterial treatment to restore a healthy gut. Nonetheless, Lynch said, manipulating microbial populations is a promising idea.
--- End quote ---

The problem is, everyone's microbiome is different and there are many different probiotic bacterial strains available on the market...yet even so there are many more yet to be identified and made available as probiotics.  So which ones you take can be a crap shoot, and they may or may not help your specific problem.

Various studies have been done and are being done to determine whether and what probiotics can help us. As this recent study put it:   
--- Quote ---The articles reviewed demonstrate that probiotic supplementation is safe in HIV patients,
but the evidence is conflicting regarding its efficacy in reducing the incidence of diarrhea in this population.
--- End quote ---
http://digitalcommons.pcom.edu/cgi/viewcontent.cgi?article=1054&context=pa_systematic_reviews  This same study noted that:
--- Quote ---Overall, the adults who received L. rhamnosus and L. reuteri experienced greater resolution of diarrhea than did the children who received B. bifidum and S. thermophilus.
--- End quote ---
  But this well known study of yogurt probiotics in a study that showed improvements in women with HIV in Nigeria focused on a small group of untreated patients.

From what I've read, unless you are currently immunocompromised, probiotic supplementation is generally regarded as safe, so I'm experimenting with different strains of  probiotics. Florastor has helped me a lot in the past and was recommended by my doctor...it's a pretty common post-antibiotic treatment in Europe.  www.florastor.com

Recently my partner (he's negative) and I had traveller's diarrhea, and this probiotic from Pharmaca literally cleared it up in a day (but you need to take the course of it) http://www.pharmaca.com/Pharmaca-Vitamins-Supplements-and-Herbs/Pharmaca-Probiotic-Ultimate-Blend-24-Billion-Live-Cells-60-Vegetarian-Capsules/520943/6077/Product.  This is a great company, and they have a wonderful list of different probiotics and their effects here http://www.pharmaca.com/projectwellness/2013/04/22/snapshot-different-probiotic-species-and-strains/

I'm currently trying a blend of Bifidobacterium (you need to google all these, most can also be bought on Amazon or from iHerb.com online, but it seems the best need to be kept cool and refrigeterated).  There are clinical trials now like these http://clinicaltrials.gov/show/NCT01439841 and I even wrote the good folks at UCSF who said they will do trials.  But all in all, it's a bit of the wild west there now for us in making specific choices.

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