IBS 2022 Year in Review with Dr. Mark Pimentel

In this episode I welcome on one of my hero's in medicine, Dr. Mark Pimentel. Without hesitation, he changed my career trajectory for the better when I first came across his work in 2007. Since then he has been a mentor, adviser, and educator of me as I have dedicated myself to helping patients dealing with Irritable Bowel syndrome, Small Intestinal Bacterial Overgrowth, and Intestinal Methanogen Overgrowth.
We covered so many amazing topics in this episode including:

• Highlights from the last 5 years of Dr. Pimentel's research
• His career trajectory from IBS starting as a psychosomatic disorder to know a disorder with a defined pathophysiology
• The latest 2021-22 research that identified the key microbes involved with hydrogen overgrowth sibo intestinal methanogen overgrowth and hydrogen sulfide overgrowth
• The role of bile acids in Irritable Bowel Syndrome
• The role of stomach acid in IBS/SIBO/IMO
• The role of the migrating motor complex in IBS Post-infectious Irritable Bowel Syndrome
• What makes a good GI Doctor
• the Medically Associated Science and Technology Program (MAST) at Cedar Sinai and more.

about Dr. Pimentel:
Mark Pimentel, MD, FRCP (Fellows of the Royal College of Physicians – Canada) Mark Pimentel, MD, is a Professor of Medicine at Cedars-Sinai. Dr. Pimentel is also the Executive Director of the Medically Associated Science and Technology (MAST) program at Cedars-Sinai, an enterprise of physicians and researchers dedicated to the study of the gut microbiome in order to develop effective diagnostic tools and therapies to improve patient care. Dr. Pimentel is also a Professor of Medicine at the Geffen School of Medicine, University of California, Los Angeles (UCLA.) As a physician and researcher, Dr. Pimentel has served as a principal investigator or co-investigator for numerous basic science, translational and clinical investigations of irritable bowel syndrome (IBS) and the relationship between gut flora composition and human disease. This research led to the first ever blood tests for IBS, ibs-smart™, the only licensed and patented serologic diagnostic for irritable bowel syndrome. The test measures the levels of two validated IBS biomarkers, anti-CdtB and anti-vinculin. A pioneering expert in IBS, Dr. Pimentel’s work has been published in the New England Journal of Medicine, Annals of Internal Medicine, American Journal of Physiology, American Journal of Medicine, American Journal of Gastroenterology and Digestive Diseases and Sciences, among others. Dr. Pimentel has presented at national and international medical conferences and advisory boards. He is a diplomate of the American Board of Internal Medicine (Gastroenterology,) a fellow of the Royal College of Physicians and Surgeons of Canada and a member of the American Gastroenterological Association, the American College of Gastroenterology, and the American Neurogastroenterology and Motility Society. Dr. Pimentel completed 3 years of an undergraduate degree in honors microbiology and biochemistry at the University of Manitoba, Canada. This was followed by his medical degree, and his BSc (Med) from the University of Manitoba Health Sciences Center in Winnipeg, Manitoba, Canada, where he also completed a residency in internal medicine. His medical training includes a fellowship in gastroenterology at the UCLA Affiliated Training Program.

papers referenced
#ibs #sibo #imo #irritablebowelsyndrome #dysbiosis

[joec]

Wow, So eye opening!!! I have been seeing a GI doc for a year and have been through multiple diet changes, colonoscopies, endoscopies, blood work, stool samples....yada, yada, yada. My doc never checked for SIBO even though it is a simple office visit breath test but he did, finally, prescribe Rifaximin which seemed to work for a couple months but I am back to the same place I was last year. So frustrating. I have been looking for a good Functional Doc in Florida who thinks outside of the typical GI doc and takes insurance:(

[MrYorickJenkins]

It may sound cheezy, but Mark Pimental is something of a hero in my eyes. His focus on listening to the patient learning from the patient, working hard and focussing on a common disease which causes suffering ona large scale for the simple reason that it is so common, all this shows that he is a doctor who really understands where his responsibility lies. I am taking my SIBO breath test tomorrow. For the first time in forty years of low level but consistent suffering, I am beginning to get cautiously optimistic that significant relief if not cure may be something I might experience in my life time. I am fascinated to know if I test posiitve and strongly suspect that I will

[ash]

I wonder if he sees any overlap or relationship between CFS and SIBO, because I had chronic illness for 5 years before noticing any new symptoms which later intensified then I identified as likely H2S SIBO. I used AIRE 2 and then Biomesight, after doing an anti candida protocol to rule that out, and testing for H Pylori.

[bobsondugnutt]

Around the 31:00 mark, y'all talk about starving bacteria will form spores/membranes to protect themselves while waiting for food. Would this be an example of a "biofilm"? Also, can you point me to more information about biofilms? Because when I take supposed biofilm disruptors such as bismuth subnitrate or NAC, I get reliable, substantial herx reactions.

[marinasmith]

Suffering for 6 years with post infectious IBS after Cdiff. Mixed IBS. Growing list of food intolerances. I am considering SIBO testing but keep hearing there are false positives plus the antibiotics work then SIBO recurs. Do you know cases where SIBO has been cured?

[can.suvari]

Does Dr Pimentel talk about FMT anywhere ? I would love to hear his opinion on that.

[eattrainwalk]

Hi Adam. Thanks for such a great interview. Long time methane sufferer, here. I'm one of the unlucky ones who has developed cardiac symptoms as a result of all of this. Currently in treatment with Rifaximin and neomycin. Hope it will help. One question for you if you don't mind: does a methane dominant breath test with an extremely high starting value with minor tapering off of methane levels as the test progresses indicate anything special? Thanks.

[darlinspaces]

Does IB guard keep the hydrogen one down and high fibre foods like spaghetti squash overpopulate? This seems to be what happened to me for a time

[ginabaughn]

48:08 I’ve never heard about the connection between stomach acid and methanogens. Could a patient with IMO actually exacerbate their symptoms by taking too many digestive enzymes?

[KingsleyOmenyi]

Please sir can you clarify me on what Dr. Mean that fed bacteria is more easy to kill than staffed one
So does it mean that there is no need for SIBO Diet pls am totally confused??😢😢

[manuelaocampo]

I hope you read my question since this video is not recent. If the bacteria “hides” or creates biofilms if they are not being fed in that case the elemental diet is not longer a good idea? From what I understood from the video if I starve them they will get harder to kill right? Would it make sense then another round of antibiotics followed by two weeks of elemental diet? I have IMO since 2022 and took 3 rounds of antibiotics and herbals already and the methane is still high and I feel awful. Thanks 🩵