Dr. Todd LePine

So there is a subclass of these patients that it is fungal, but it's smaller than some would like to believe, but larger than those who are naysayers, as you've probably heard. And so it is there, it's real, but it's a little more challenging to identify. There's no breath test for it. You got to go in and chase it. And that's the challenge.

chase it by doing stool cultures or well chase it it could be by stool but if you want to find small intestinal fungal overgrowth you got to get into the small intestine and that's that's really sampling you have to have endoscopy and all that that's how dr rao identifies it yeah and and any particular species of fungus or is it sort of a broad array

chase it by doing stool cultures or well chase it it could be by stool but if you want to find small intestinal fungal overgrowth you got to get into the small intestine and that's that's really sampling you have to have endoscopy and all that that's how dr rao identifies it yeah and and any particular species of fungus or is it sort of a broad array

chase it by doing stool cultures or well chase it it could be by stool but if you want to find small intestinal fungal overgrowth you got to get into the small intestine and that's that's really sampling you have to have endoscopy and all that that's how dr rao identifies it yeah and and any particular species of fungus or is it sort of a broad array

So what we found in this, quote, shotgun sequencing is candida albicans is a big part and a little bit of candida glabrata. And there's a few other, malassezia and all these other organisms that are very minor, but they generally aren't at a high number that we think are as consequential as the first two I mentioned.

So what we found in this, quote, shotgun sequencing is candida albicans is a big part and a little bit of candida glabrata. And there's a few other, malassezia and all these other organisms that are very minor, but they generally aren't at a high number that we think are as consequential as the first two I mentioned.

So what we found in this, quote, shotgun sequencing is candida albicans is a big part and a little bit of candida glabrata. And there's a few other, malassezia and all these other organisms that are very minor, but they generally aren't at a high number that we think are as consequential as the first two I mentioned.

Well, generally in... allopathic medicine, we try an antifungal. There are natural antifungals as well. And you're probably better versed in those than I am, but we do use fluconazole. We do use nystatin. Occasionally we use more radical, more advanced antifungals, but those are the typical first two choices.

Well, generally in... allopathic medicine, we try an antifungal. There are natural antifungals as well. And you're probably better versed in those than I am, but we do use fluconazole. We do use nystatin. Occasionally we use more radical, more advanced antifungals, but those are the typical first two choices.

Well, generally in... allopathic medicine, we try an antifungal. There are natural antifungals as well. And you're probably better versed in those than I am, but we do use fluconazole. We do use nystatin. Occasionally we use more radical, more advanced antifungals, but those are the typical first two choices.

Yeah. So first of all, we helped develop the first three gas breath tests. So just full disclosure, but it's changed my practice because there are patients who fell through the cracks without knowing hydrogen sulfide. So unpacking each, the hydrogen positive breath test patients are generally, we actually just published this paper, it came out literally yesterday. There are two bugs, that's it.

Yeah. So first of all, we helped develop the first three gas breath tests. So just full disclosure, but it's changed my practice because there are patients who fell through the cracks without knowing hydrogen sulfide. So unpacking each, the hydrogen positive breath test patients are generally, we actually just published this paper, it came out literally yesterday. There are two bugs, that's it.

Yeah. So first of all, we helped develop the first three gas breath tests. So just full disclosure, but it's changed my practice because there are patients who fell through the cracks without knowing hydrogen sulfide. So unpacking each, the hydrogen positive breath test patients are generally, we actually just published this paper, it came out literally yesterday. There are two bugs, that's it.

That caused the hydrogen overgrowth. It's Escherichia coli, the non-pathogenic one, and Klebsiella pneumoniae. Those two characters, when they come into town, everybody leaves because they're so opportunistic and bullies. And we think they produce even toxins to the other bacteria around them to try and get rid of the bacteria.

That caused the hydrogen overgrowth. It's Escherichia coli, the non-pathogenic one, and Klebsiella pneumoniae. Those two characters, when they come into town, everybody leaves because they're so opportunistic and bullies. And we think they produce even toxins to the other bacteria around them to try and get rid of the bacteria.

That caused the hydrogen overgrowth. It's Escherichia coli, the non-pathogenic one, and Klebsiella pneumoniae. Those two characters, when they come into town, everybody leaves because they're so opportunistic and bullies. And we think they produce even toxins to the other bacteria around them to try and get rid of the bacteria.

So it's like you've got a gang that comes into the small town and everybody leaves. So it's a disruptor of the microbiome and then they rise very high in number. So that's the hydrogen one. The second category is the methane or methanogens. And those characters live both in the colon and the small bowel.

So it's like you've got a gang that comes into the small town and everybody leaves. So it's a disruptor of the microbiome and then they rise very high in number. So that's the hydrogen one. The second category is the methane or methanogens. And those characters live both in the colon and the small bowel.

So it's like you've got a gang that comes into the small town and everybody leaves. So it's a disruptor of the microbiome and then they rise very high in number. So that's the hydrogen one. The second category is the methane or methanogens. And those characters live both in the colon and the small bowel.

And we have a paper coming out showing exactly where they're living and it's pretty universal in a lot of these patients. So hence we call it intestinal methanogen overgrowth and not SIBO methane, because it's not just the small bowel, it's colon also. And when they produce methane, it gives you a lot of constipation, a lot of gas, and you can't pass the gas. And these people are quite miserable.