Antibiotic Treatment of Constipation-Predominant Irritable Bowel Syndrome

Pimentel, Mark; Chang, Christopher; Chua, Kathleen Shari; Mirocha, James; DiBaise, John K.; Rao, Satish S.C.; Amichai, Meridythe M.

doi:10.1007/s10620-014-3157-8

Cited by 114 publications

(86 citation statements)

References 16 publications

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“…Rifaximin received regulatory approval for the treatment of IBS-D in May 2015; several studies indicated a favorable efficacy and safety profile for rifaximin in IBS-D (Table 3) [Di Stefano et al 2011;Pimentel et al 2006Pimentel et al , 2011Pimentel et al , 2014. The identically designed, randomized, placebo-controlled, phase III TARGET 1 and 2 studies examined the safety and efficacy of rifaximin 550 mg 3 times daily for 2 weeks in patients with IBS-D [Pimentel et al 2011].…”

Section: Targeting Gut Microbiotamentioning

confidence: 99%

New and emerging therapies for the treatment of irritable bowel syndrome: an update for gastroenterologists

Foxx‐Orenstein

2016

Therap Adv Gastroenterol

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Section: Targeting Gut Microbiotamentioning

confidence: 99%

New and emerging therapies for the treatment of irritable bowel syndrome: an update for gastroenterologists

Foxx‐Orenstein

2016

Therap Adv Gastroenterol

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“…It prevents pathogens from adhering to the bowel mucosa and from invading epithelial cells by binding microbial RNA-polymerase subunit β, thus inhibiting transcription and the synthesis of ribonucleis acid (RNA) (101).…”

Section: Mechanism Of Actionmentioning

confidence: 99%

“…Rifaximin seems to reduce distension, flatulence and abdominal pain in patients with IBS without constipation, according to the relevant studies (90,(101)(102)(103). One study suggests its potential role for patients with IBS-C (104).…”

Section: Efficacymentioning

confidence: 99%

Clinical Practice Guideline: Irritable bowel syndrome with constipation and functional constipation in the adult

Mearin¹,

Ciriza²,

Mínguez³

et al. 2016

Rev Esp Enferm Dig

103

151

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In this Clinical Practice Guideline we discuss the diagnostic and therapeutic approach of adult patients with constipation and abdominal complaints at the confluence of the irritable bowel syndrome spectrum and functional constipation. Both conditions are included among the functional bowel disorders, and have a significant personal, healthcare, and social impact, affecting the quality of life of the patients who suffer from them. The first one is the irritable bowel syndrome subtype, where constipation represents the predominant complaint, in association with recurrent abdominal pain, bloating, and abdominal distension. Constipation is characterized by difficulties with or low frequency of bowel movements, often accompanied by straining during defecation or a feeling of incomplete evacuation. Most cases have no underlying medical cause, and are therefore considered as a functional bowel disorder. There are many clinical and pathophysiological similarities between both disorders, and both respond similarly to commonly used drugs, their primary difference being the presence or absence of pain, albeit not in an "all or nothing" manner. Severity depends not only upon bowel symptom intensity but also upon other biopsychosocial factors (association of gastrointestinal and extraintestinal symptoms, grade of involvement, and perception and behavior variants). Functional bowel disorders are diagnosed using the Rome criteria. This Clinical Practice Guideline has been made consistent with the Rome IV criteria, which were published late in May 2016, and discuss alarm criteria, diagnostic tests, and referral criteria between Primary Care and gastroenterology settings. Furthermore, all the available treatment options (exercise, fluid ingestion, diet with soluble fiber-rich foods, fiber supplementation, other dietary components, osmotic or stimulating laxatives, probiotics, antibiotics, spasmolytics, peppermint essence, prucalopride, linaclotide, lubiprostone, biofeedback, antidepressants, psychological therapy, acupuncture, enemas, sacral root neurostimulation, surgery) are discussed, and practical recommendations are made regarding each of them.

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“…Since eradication of small intestine bacterial overgrowth was shown to reduce symptoms of IBS, 43 double-blind, randomized, placebo-controlled studies using these antibiotics have been conducted (Table 3). 28,[44][45][46] …”

Section: -mentioning

confidence: 99%

Biomarkers of Irritable Bowel Syndrome

Kim

Lin

Pimentel

2017

J Neurogastroenterol Motil

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Traditionally, irritable bowel syndrome (IBS) has not been regarded as an organic disease, and the pathophysiology of IBS is heterogeneous. Currently, the diagnosis of IBS is based upon the Rome diagnostic criteria. The performance of these criteria is only modest in predicting IBS, and moreover their validation is lacking. Additionally, as functional symptoms are common in the general population, healthy controls or volunteers are difficult to define and there is currently no definition of "normal" in the Rome criteria. Due to the weaknesses of the current diagnostic criteria, patients and doctors expect new gold standard diagnostic tools. Various etiologic mechanisms result in potential biomarkers. The focus of this research has been to find non-invasive biomarkers from serum, breath gas, and fecal materials. Though biomarkers should be based on biological and pathogenic processes, most biomarkers for IBS have been developed to identify organic diseases and therefore eliminate IBS. To date, these types of biomarkers for IBS have been disappointing. The purposes of developing biomarkers include improvement of diagnosis, differentiation from other organic diseases, and discrimination of IBS subtypes. A true mechanistic biomarker would make it possible to rule in IBS, rather than to rule out other organic diseases. New serologic biomarkers for diarrhea-predominant IBS have been introduced based on the pathophysiologic findings from a rat model and validation in a large-scale clinical trial. Further investigations of abnormal organic findings from each subtype of IBS would enable the development of new, simple subtype-specific biomarkers.

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Antibiotic Treatment of Constipation-Predominant Irritable Bowel Syndrome

Abstract: Rifaximin plus neomycin is superior to neomycin alone in improving multiple C-IBS symptoms. This effect is predicted by a reduction in breath methane.

Cited by 114 publications

References 16 publications

New and emerging therapies for the treatment of irritable bowel syndrome: an update for gastroenterologists

New and emerging therapies for the treatment of irritable bowel syndrome: an update for gastroenterologists

Clinical Practice Guideline: Irritable bowel syndrome with constipation and functional constipation in the adult

Biomarkers of Irritable Bowel Syndrome

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