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  • Jefferson Adams
    Jefferson Adams

    The Restless Leg Syndrome, SIBO, Celiac Connection

    Reviewed and edited by a celiac disease expert.

    Celiac.com 09/03/2009 - Every night thousands of people lose sleep because of a gnawing, tingling urge to move their legs, disturbing their sleep and are often causing chronic pain. These people wake feeling unrested, with aching muscles.

    In addition to lost sleep and discomfort, these people often suffer chronic pain. Often, these symptoms baffle both patients and primary care doctors. Little do these people and their doctors know that the pain and restlessness is due to Restless Legs Syndrome (RLS) and is likely caused by a problem with the digestive tract.

    RLS affects 7% to 15% of the population, especially older adults and pregnant women. RLS symptoms can have a major impact on quality of life, and the syndrome often stymies the medical community. In recent years a number of drugs have been introduced to help the symptoms of RLS, but until now the cause has remained unknown.

    Small intestinal bacterial overgrowth (SIBO) is a condition where abnormally large numbers of bacteria exist in the small intestine. Symptoms often include diarrhea, bloating, excess gas and abdominal pain. SIBO has strong ties to IBS, diabetes, celiac disease and Crohn’s disease.

    St. Louis-based Gastroenterologist Dr. Leonard Weinstock has led research that has recently established a link between RLS and SIBO. Dr. Weinstock's clinical trials have shown that treating SIBO often sends the RLS into remission.

    “When a patient was diagnosed with SIBO, given a course of treatment that included rifaximin, an antibiotic that is not absorbed by the bloodstream, we found that the patient showed quick, dramatic and continuing relief of RLS symptoms,” explains Weinstock.

    This discovery promises a new lease on life for many RLS sufferers. Weinstock discovered the association while treating a patient for Irritable Bowel Syndrome (IBS) who also suffered from RLS. Treatment of the IBS, also seemed to send the patient’s RLS into remission. This discovery led to a number of trials, all of which produced the same overall result.

    “While many new drugs help treat the symptoms of RLS. This research shows us the cause of the disease and in turn allows us to treat the RLS rather than just helping the symptoms,” says Weinstock.

    Based on a standard RLS severity scale, all Weinstock’s patients have shown substantial improvement. In the most recent trial, severity scores for 9 of 14 patients dropped an average of 65% after one course of antibiotics. After an initial lack of response, two patients received a second round of antibiotics and no longer had any symptoms. A third patient was cured after discovering that she had celiac disease and beginning on a gluten-free diet.

    The link between non-responsive celiac disease and SIBO has also been documented. The fact that such a link exists between SIBO and RLS, and other conditions such as celiac disease, IBS and Crohn’s disease clearly warrants further study, and should give anyone suffering from RLS some information to share with their clinician in approaching the issue.



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    I just KNEW there had to be a link between gut/gluten problems & RLS. Wish you had a link for Dr. Leonard Weinstock, tho' I can Google his site. Needless to say, there are other natural ways to properly restore flora balance. As he's using antibiotics, leads me to think that there's a problem with H-pylori as well.

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    I was recently diagnosed with ulcers in my small bowel and which caused iron deficient anemia. Since taking iron pills I have not had RLS which was getting really, really bad.

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    I'd like to see more research on this and on the particular antibiotic rifaximin. No doc has ever prescribed that for me. I have had Rx for h-pylori (prevpak) and I can't say that I noticed any relief from rls at the times I have taken it.

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    I was in Dr. Weinstock's study and I agree that SIBO can be responsible for many problems associated with celiac, Crohn's and other autoimmune diseases which may create a spectrum of nervous system disorders.


    What I dislike, however, is the lack of mention of the Specific Carbohydrate Diet. It's obvious that Xifaxim is only a temporary solution, and should at least be followed up by a strict Specific Carbohydrate Diet. Elimination of SIBO, for most people, just isn't going to happen without it.

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    My son alerted me to this site and as I have had RLS all my life I never ever thought about diet, other than coffee, etc. I will look into this more and will try Probiotics.

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  • About Me

    Jefferson Adams is Celiac.com's senior writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,000 articles on celiac disease. His coursework includes studies in biology, anatomy, medicine, science, and advanced research, and scientific methods. He previously served as SF Health News Examiner for Examiner.com, and devised health and medical content for Sharecare.com. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.

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