GDD and Digestive System Motility Disorders. Chapter 3. Small Intestine Ileus and Small Intestine Bacterial Overgrowth

Slowing or stopping of the normal movement of bowel is the worst form of effects that Gd has on the digestive system. The stoppage of the normal motion of propulsion (peristalsis) of food material in the digestive system is termed ileus, and if it is completely stopped paralytic ileus. Ileus refers to the fact that there is no internal or external physical obstruction of the bowel.

Small Intestine Bacterial Overgrowth (SIBO) is one of the most worrisome developments in small bowel ileus. This can lead to systemic infection and death.

If ileus arose after GBCA administration, and represents one of the toxicities of GDD, the primary treatment involves removal of Gd with chelation. As mentioned previously, the bowel peristalsis may take a few chelations and a few months t recover. So the ileus has to be addressed with detoxification as well..

Lab testing for electrolyte imbalances is indicated, to examine for findings such as low magnesium as a cause for ileus. Low fiber, and lactose-low diets may be beneficial.

SIBO is frequently managed with antibiotics. I am not fond of this approach for all cases as antibiotics can worsen the overall immune system dysregulation which is at the heart of GDD.

The critical issue is to not consider an aggressive approach to treatment of small bowel ileus, such as small bowel resection, until sufficient chelations have been performed, at least 5 chelations and probably at least 10.

Richard Semelka, MD