• 2016 SIBO Symposium, all presentations

    Original Date: June 4-5, 2016

    Small intestine bacterial overgrowth (SIBO) is a chronic bacterial colonization of the small intestine. These bacteria normally live in the gastrointestinal tract, however, in SIBO they have overgrown in a location not meant for so many bacteria. The bacteria interfere with our normal digestion and absorption of food and are associated with damage to the lining or membrane of the small intestine. These mechanisms in turn lead to myriad other disorders—gastrointestinal, systemic, and neurological.

    The 3rd Annual SIBO Symposium features the nation’s leading experts on the topic to present an evidence-based educational program on managing small intestine bacterial overgrowth. For more information, visit www.sibosymposium.com

    Presentations include:
    • Top 10 Highlights of SIBO 2014 & 2015
    • Pharmacologic Treatment of SIBO
    • Biofilm Degrading Agents As Synergists; Atrantil in Treating SIBO; Methods for Patient Research
    • LDN – Updates in Rx
    • Underlying Causes – PPIs and Hypochlorohydria
    • Are Generic Formulations Really Bioequivalent to Branded Drugs? The Case for Rifaximin
    • Dysbiosis in Syndromes and Diseases
    • Phased Diet & Herbal Antimicrobials
    • GI Manifestations and Pattern Recognition in Lyme and Common Tick-Borne Illnesses
    • The Intersection of SIBO and IBD
    • Rifaximin for the Treatment of SIBO: A Systematic Review and Meta-analysis
    • Updated Diet Guidelines
    • Adhesions – The "Missing Link" for Unresolved SIBO?
    • Clinical Pearls Presentations and Open Forum

    12.5 CEUs (including 3.0 pharmacy and 9.5 general) for NDs approved by OBNM
  • Top 10 Highlights of SIBO 2014 & 2015

    Presenter: Lisa Shaver, ND, MSOM, LAc
    Original Date: June 4, 2016

    Dr. Shaver reviews the top ten highlights from the SIBO Symposiums of 2014 and 2015. We look at the underlying causes of SIBO and the resultant carbohydrate malabsorption. We glance at the approval of Rifaximin for IBS-D and the new test for IBS: IBSchek. The various herbal antibiotic protocols and the Johns Hopkins herbal study will be explored. We examine the basic antibiotic protocols and prokinetics commonly used. Finally we study the associated diseases and syndromes and briefly review the elusive hydrogen sulfide.

    1.0 general CEUs approved by OBNM
  • Pharmacologic Treatment of SIBO

    Presenter: Carmelo Scarpignato, MD, DSc, PharmD, MPH
    Original Date: June 4, 2016

    SIBO is a challenging clinical condition. Its etiology is usually complex and multifactorial and the syndrome is often misdiagnosed and generally under-diagnosed. Clinical symptoms may be subtle and non-specific, which makes diagnosis difficult without objective testing. The availability of poorly absorbed antimicrobials (i.e. rifaximin) has been an advance in treatment, which needs to be refined to identify the best dose and duration to maximize eradication and prevent recurrence. The global management of patients with SIBO will be, however, multifactorial (including nutritional support and dealing with the underlying abnormalities) and long-term care.

    1.0 pharmacy CEUs approved by OBNM
  • Biofilm Degrading Agents As Synergists; Atrantil in Treating SIBO; Methods for Patient Research

    Presenter: Michael Ruscio, DC
    Original Date: June 4, 2016

    Biofilms are protective films that can form over bacteria and fungus and contribute to treatment resistance. The utility of co-administration of biofilm degrading agents with antimicrobials or antibiotics in SIBO is unclear. This presentation examines the available literature and outlines observations from our clinical research in attempts to provide practical recommendations regarding biofilms.

    1.25 general CEUs approved by OBNM
  • This course requires an enrollment key
    Cost: US$ 30.00
    LDN – Updates in Rx

    Presenter: Leonard B. Weinstock, MD, FACG
    Original Date: June 4, 2016

    Low dose naltrexone (LDN) is a remarkable compound that increases endorphins which modulate inflammation and decreases pain by interacting with microglia. Many diseases and syndromes have been treated with LDN although there are few good studies in the literature. Published articles on 4 different diseases are discussed.

    Includes a case presentation by Steven Sandberg-Lewis, ND, DHANP

    0.75 CEUs (including 0.5 pharmacy and .25 general) approved by OBNM
  • Underlying Causes – PPIs and Hypochlorohydria

    Presenter: Allison Siebecker, ND, MSOM, LAc
    Original Date: June 4, 2016

    This presentation discusses both the structural and functional underlying causes of SIBO and common risk factors which can cause these underlying causes. The underlying causes of SIBO occur when the normal protective factors fail. These include HCL, Bile, Enzymes, Immune System, ICV, Motility and Normal Anatomy. The risk factors that can lead to SIBO include many Diseases, Lifestyle/Drugs, Trauma/Surgery and Genetics. Common risk factors are covered including hypochlorhydria and Proton Pump Inhibitors.

    0.5 pharmacy CEUs approved by OBNM
  • Are Generic Formulations Really Bioequivalent to Branded Drugs? The Case for Rifaximin

    Presenter: Carmelo Scarpignato, MD, DSc, PharmD, MPH
    Original Date: June 4, 2016

    A “generic drug” has been designated by the World Health Organization as a medicinal product, which is interchangeable with the “original drug”, covered by patent (designated also as “branded drug”), in terms of both formulation (pharmaceutical interchangeability/ equivalence) and utilization in the clinical practice (therapeutic interchangeability/equivalence). Although the development and approval process of generic medicinal products is driven by specific and very detailed guidelines, some uncertainties do exist, stemming from the issue that the procedures, dictated by guidelines to get license for producing and marketing generic drugs, do not enforce the performance of efficacy clinical trials for the intended therapeutic indications. Rifaximin is an antibiotic, locally acting in the gastrointestinal tract, which may exist in different crystal as well as amorphous forms. The branded rifaximin formulation contains the polymorph rifaximin-α, whose systemic bioavailability is very limited. Recent studies demonstrate different systemic bioavailability of generic and branded formulations of rifaximin. As a consequence, the therapeutic results obtained with rifaximin-α should not be translated sic et simpliciter to the generic formulations of rifaximin, which do not claim containing only rifaximin-α and will display significantly higher systemic absorption in both health and disease.

    1.0 CEUs (including 0.5 pharmacy and 0.5 general) approved by OBNM
  • Dysbiosis in Syndromes and Diseases

    Presenter: Leonard B. Weinstock, MD, FACG
    Original Date: June 4, 2016

    The colon has 13 trillion bacteria which play many roles including protection of the colon layer and immune balance. This presentation describes the basic principles of dysbiosis. It also teaches viewers to appreciate the wide spread application of fecal microbiome studies in different diseases. Studies that try to rebalance bacteria are examined.

    Includes a case presentation by Lisa Shaver, ND, MSOM, LAc.

    0.75 general CEUs approved by OBNM
  • Phased Diet & Herbal Antimicrobials

    Presenter: Nirala Jacobi, ND
    Original Date: June 4, 2016

    The effective treatment of SIBO requires certain dietary restrictions that are based on the low FODMAP diet. In this talk, Dr. Jacobi reviews her Bi-phasic diet that focuses specifically on timed pre-treatment and treatment diet strategies to maximize patient outcomes. Practitioners in Australia use the Bi-Phasic Diet successfully in conjunction with conventional and/or herbal treatments.
    Additionally, she discusses novel herbal approaches for the treatment of SIBO and SIFO.

    0.75 general CEUs approved by OBNM
  • GI Manifestations and Pattern Recognition in Lyme and Common Tick-Borne Illnesses

    Presenter: Farshid Sam Rahbar, MD, FACP, ABIHM
    Original Date: June 5, 2016

    There is significant controversy as whether Lyme and other co-infections can present as chronic persistent infections. In addition, there is little written as whether these “persistent infections” can present primarily with digestive manifestations and SIBO. Our experience in a Los Angeles gastroenterology practice speaks strongly of the observations that these infections can indeed present predominantly with GI manifestations. Several specific patterns of SIBO, with or without presence of vinculin/CDTb antibodies, suggest immune suppression and may be part of these manifestations. Clinicians may consider expanding their differential diagnosis to include these stealth infections when dealing with patients with recalcitrant or inflammatory type symptoms.

    0.5 general CEUs approved by OBNM
  • The Intersection of SIBO and IBD

    Presenter: Illana Gurevich, ND, LAc; Gary Weiner, ND, LAc; Steven Sandberg-Lewis, ND
    Original Date: June 5, 2016

    Lymphocytic colitis, the most common form of microscopic colitis, is a cause of inflammatory non-bloody diarrhea. This presentation briefly discusses the condition and presents a theory of its association with SIBO. A demonstrative case is detailed.

    1.25 general CEUs approved by OBNM
  • Rifaximin for the Treatment of SIBO: A Systematic Review and Meta-analysis

    Presenter: Carmelo Scarpignato, MD, DSc, PharmD, MPH
    Original Date: June 5, 2016

    Over the past decades, the poorly absorbed antibiotic rifaximin has gained popularity for SIBO eradication, despite that its use is not evidence based. To bridge this gap, a systematic review and meta-analysis of randomized and non-randomized studies was performed to evaluate the clinical efficacy and safety of rifaximin to eradicate SIBO in adult patients. 32 studies involving 1321 patients were included. The overall eradication rate according to intention to treat analysis was 67.8% (95% CI: 59.2 to 75.7). Meta-regression identified three covariates (namely the drug dose, the study design and co-therapy) independently associated with an increased eradication rate. The overall rate of adverse events was low (i.e. 5.6%). These data show that rifaximin therapy is effective and safe for the treatment of SIBO. However, since the quality of the available studies is generally poor, well-designed RCTs are needed to substantiate these findings and to establish the optimal regimen (i.e. daily dose and duration of rifaximin) for the treatment of this increasingly common condition.

    Includes case presentation by Megan Taylor, ND and Allison Siebecker, ND, MSOM, LAc.

    1.0 CEUs (including 0.5 pharmacy and 0.5 general) approved by OBNM
  • Updated Diet Guidelines

    Presenter: Allison Siebecker, ND
    Original Date: June 5, 2016

    Two common SIBO diets, the Specific Carbohydrate Diet and the Low Fodmap Diet, are opposite in many ways, both in their carbohydrate targets and philosophical approach. The SIBO Specific Food Guide was created to combine the best of both diets. This class describes these 3 diets and include a discussion of carbohydrate and fiber types and presents a new version of the SIBO Specific Food Guide.

    Includes a case presentation by Melanie Keller, ND.

    0.75 general CEUs approved by OBNM
  • Adhesions – The "Missing Link" for Unresolved SIBO?

    Presenter: Larry Wurn, LMT
    Original Date: June 5, 2016

    Adhesions are the internal scars that commonly form whenever and wherever the body heals from surgery, infection,
    inflammation or trauma. When they form in the abdomen or pelvis, adhesions can act like internal straitjackets, slowing or totally
    stopping intestinal motility.

    In the case of bowel strictures or obstructions, adhesions can be threaten life as they prevent food from passing through the
    digestive tract. In this presentation Larry Wurn looks at research in this area, then moves on to the effect of bowel adhesions on SIBO.
    Recent clinical data indicates that adhesions in the bowel can decrease the effectiveness of medications or cause SIBO to
    recur, because treated bacteria cannot exit the digestive tract.

    This lecture looks at the mechanical properties of adhesions, research in this area, how they form and whether they can be
    deformed without surgery. It also examines new data about diagnosing and treating adhesions in cases of recurring SIBO

    1.0 general CEUs approved by OBNM
  • Clinical Pearls Presentations and Open Forum

    Presenter: Mona Morstein, ND & Erica Peirson, ND
    Original Date: June 5, 2016

    Presentation of cases and clinical pearls from various clinicians. Also includes an open forum for attendees to share clinical and patient experience.

    1.0 general CEUs approved by OBNM