The answer is small intestinal bacterial overgrowth (SIBO)
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Dr. Bharat Mehta
The answer is small intestinal bacterial overgrowth (SIBO)
Small intestinal bacterial overgrowth (SIBO) caused the condition. An overgrowth of bacteria that feed on carbohydrates in foods containing high fructose corn syrup, the lactose in dairy products and the fiber in green vegetables; the result can be diarrhea, bloating and, in severe cases, nutritional deficiencies and even malnutrition. Rohlf underwent a breath test to measure hydrogen and methane in the digestive system. Elevated levels of hydrogen confirmed the diagnosis. She had a two-week course of rifaximin, an antibiotic not absorbed by the body that kills excess bacteria. Since then she has had several recurrences - one severe enough to require a second course of the drug - but none as serious as previous attacks. Recently, with the help of a nutritionist she has embarked on a special diet designed to eliminate high fructose corn syrup and lactose, to which, it turns out, she is intolerant; these are among the substances that cause bacterial overgrowth and trigger diarrhea.

Case Facts
Rohlf said she never had GI problems until her second pregnancy in 1967, when milk and milk products caused diarrhea. After her son was born, the problem disappeared. Two years later, while pregnant with her third child, the episodes of violent diarrhea recurred. But this time it didn’t disappear when the baby was born and seemed to be triggered by more foods, including broccoli, Brussels sprouts and sauerkraut. In 1985, she suffered a bout of both vomiting and diarrhea so severe that she had to be hospitalized for a week. She had been diagnosed with psoriatic arthritis, a serious autoimmune disorder that involves both psoriasis, a scaly skin condition, and joint-destroying arthritis. A year earlier on a trip to India, where she mostly lived on rice and bread, Rohlf had eaten some fresh vegetables. She came home with a roaring intestinal infection that required a course of antibiotics. In previous years she had been beset by attacks of diarrhea in Vienna, Rome, and Paris, where water quality isn’t an issue. What was causing the condition?

Option 1: Shigella infection

Option 2: Celiac disease

Option 3: ulcerative colitis

Option 4: Small intestinal bacterial overgrowth (SIBO)
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