Case

Dose of SBI (g/d)

Initial Response and Total Time on Therapy (wks)

Symptom Response

Overall Symptom Improvement

1

5

nd, 10

Significantly decreased symptoms including bloating/distention, and diarrhea

75% - 100 %

2

5

nd, 24

Decreased bloating/distention and abdominal pain

50% - 75%

3

5

nd, 8

Improved abdominal pain, bloating/distention, and diarrhea

50% - 75%

4

5

nd, 4

Significant improvement in bloating and distention

75% - 100%

5

5

nd, 6

Decreased bloating, frequency, and urgency sensation in less than one month on therapy. One watery stool first followed by 2 soft stools per day. Metronidazole 10-day course and dicyclomine as needed were prescribed along with SBI. Now the patient is managed continuously on SBI with loperamide as needed.

75% - 100%

6

5

2, 10

In one week, bloating and diarrhea improved. Continued improvement of bloating, diarrhea, and symptoms of GERD over a 9 week period. When patient stopped SBI for Nissen Fundoplication, symptoms of bloating and diarrhea returned. Re-initiation of SBI therapy resolved symptoms once again after 2-weeks.

75% - 100%

7

5

nd, 12

Significant decrease in bloating and distention

50% - 75%

8

5

nd, 24

Significant decrease in bloating in 8 wks with continued improvement in abdominal pain, bloating/distention and diarrhea thereafter. Patient still has recurrent nausea with vomiting and could not tolerate PPI therapy. Patient was also placed on dicyclomine to manage condition.

50% - 75%

9

5

2, 10

Bowel movements were formed after morning meal with no urgency. Bismuth subsalicylate was discontinued. No abdominal cramping was reported after SBI administration.

75% - 100%

10

5

2, 28

Normally formed bowel movements with notably reduced urgency. Patient self trial off SBI resulted in watery loose stool several times a day. This was resolved with re-initiation of SBI therapy within 2-weeks.

50% - 75%