Presenter: Leonard B. Weinstock, MD

Original Date: June 9, 2018

Small intestinal bacterial overgrowth (SIBO) is a syndrome in that it has multiple causes. Motility disorders are most often the underlying factors to predispose for the development of SIBO. Postural orthostatic tachycardia syndrome (POTS) leads to an imbalanced autonomic nervous system because excessive sympathetic activity overrides vagal tone. Peristalsis is reduced and SIBO may be promoted. Mast cell activation syndrome (MCAS) is a leading factor in 33% of POTS. It is also conceivable that MCAS could directly impact motility via one of 200 mediators that may reduce neuromuscular activity.

It is important to recognize POTS which has a prevalence of 500,000-1,000,000 in the US. Understanding this disease and the more prevalent MCAS (1 – 17% of the population) is critical to help many patients who otherwise suffer for decades without a diagnosis and/or effective therapy.

Specific pharmaceutical medications to be discussed in both the overview and outline: rifaximin and naltrexone..

0.5 Pharmacology, 0.5 General (Total 1.0 CEUs) approved by OBNM