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I have suggested to my GP that, after 2 weeks or so of unexplained diarrhoea, bacterial overgrowth be investigated, since there is some evidence, in research** & anecdotally, that it is common in treated coeliacs. While I wait for other standard tests to be done, I have been offered a week of the antibiotic Flagyl (metronidazole) as a trial. 

I have read the useful previous postings on bacterial overgrowth but would be interested to hear of anyone who has taken Flagyl (does it work without Cipro?) - or other antibiotics for this, especially anyone who has taken Rifaximin, which has been used recently in Europe for diarrhoea**and is now licensed in the US (though not in the UK so this is an option for me at present). 

Most of the "evidence" on SIBO* and CD is from coeliacs with continuing symptoms in the months immediately after diagnosis. This is not quite my situation since I have been mainly well the last 7 years. Has anyone been OK and then "developed" diagnosed SIBO some years later?

I should mention that I am a healthy middle-aged woman, with CD/GF diet well-controlled. The onset of diarrhoea was sudden and I do not normally suffer from this or any IBS type symptoms nor do I get this reaction from gluten contamination.  The standard gut bugs (food poisoning etc) have been ruled out and I have no pain or other symptoms of illness (though some signs of malabsorption). My appetite is good and I have been advised to continue eating normally since trying limited changes in diet (eg avoiding dairy) do not seem to make a difference.  

I will of course be investigated further if it continues (but i feel malignancy is unlikely). My hunch about bacterial overgrowth is based really on ruling other things out.

Charlotte, Oxford

*(small) intestinal (bowel) bacterial overgrowth (aka SIBO, IBO, SBBO)

**High prevalence of small intestinal bacterial overgrowth in celiac patients with persistence of gastrointestinal symptoms after gluten withdrawal.

Tursi A, Brandimarte G, Giorgetti G. Department of Emergency, "L. Bonomo" Hospital, Andria (BA), Italy.

Am J Gastroenterol. 2003 Apr;98(4):839-43

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12738465

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