The third phase (of four) is the biggest sweeping movement and it occurs roughly every 90-120minutes in people. It occurs predominantly in the stomach and small intestine during fasting and is interrupted during feeding. Your MMC is a digestive process which promotes the movement of food and waste products through your gut (including bacteria and archaea!) so they can either be absorbed and utilised or excreted as waste. One is your migrating motor complex (MMC). In terms of diet and lifestyle there are a number of factors to consider. Laxatives may also be prescribed to target the constipation. In some instances a gastroenterologist will prescribe a motility drug such as prucalopride or linaclotide in order to get the gut moving again to prevent a recurrence. There is no antibiotic treatment currently available for IMO which is not systemic as rifaximin alone has been shown to be ineffective in treating IMO. Both Neomycin and metronidazole are systemic antibiotics, meaning they affect other areas of the body as well as just the gut, which could mean there is a higher level of side effects with these. Treatment can be through antibiotics, diet or a combination.Īntibiotics to treat IMO can be Rifaximin with Neomycin, or Metronidazole. Your gastroenterologist may diagnose IMO, based on results and their clinical judgement. It is also difficult to control levels before a test and so the diagnosis of IMO can be challenging. It is difficult to assess whether these methanogens are present in the large intestine or the small intestine. There are multiple factors which affect your body’s methane levels and unlike hydrogen, they are not easily controlled. A diagnosis of IMO should be through an experienced professional as clinical judgement is heavily relied on. Methane levels above 10 during any part of a breath test are considered high. IMO is a more challenging diagnosis as our colonic levels fluctuate and we cannot control levels prior to the test.If we see a rise before 90 minutes, this is suggestive of bacteria in the small intestine (overgrowth), after 90 minutes, the bacteria is within the colon and not an issue. SIBO is a slightly simpler diagnosis, as we can control hydrogen levels before the test and we can monitor at what time we see a rise in hydrogen levels.You will then continue to provide breath samples at intervals up to 90 or 120 minutes. After you have taken a baseline measure you will be given a solution (usually lactulose – a laxative, at a very small dose) which is fermented by bacteria and methanogens, resulting in a rise in hydrogen and/or methane gas. This will be a baseline measure to ensure the diet has worked and if your initial hydrogen reading is not below 16, the results of the test should not be taken as accurate. You will be asked to breathe into a machine for around 20 seconds.The breath test should measure hydrogen, methane and carbon dioxide.Exercise and stress are also taken into consideration.
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