Determination of Rifaximin Treatment Period According to Lactulose Breath Test Values in Nonconstipated Irritable Bowel Syndrome Subjects

Bae, Su-Hyun; Lee, Kwang Jae; Kim, Young-Sang; Kim, Kyunam

doi:10.3346/jkms.2015.30.6.757

Cited by 21 publications

(11 citation statements)

References 22 publications

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“…A recent retrospective study investigated the association between rifaximin therapy and LHBT changes in nonconstipated patients with IBS who showed normalized LHBT values after treatment. 65 Patients with IBS symptoms and similar LHBT values prior to therapy received rifaximin 1200 mg daily for treatment periods of 4, 8, or 12 weeks. The differences in LHBT values were statistically significant in the 3 treatment groups, with higher values occurring in patients who were treated for longer periods.…”

Section: Clinical Profile Of Rifaximinmentioning

confidence: 99%

Review of Rifaximin: Latest Treatment Frontier for Irritable Bowel Syndrome Mechanism of Action and Clinical Profile

Gupta¹,

Ghuman

Handa³

2017

Clin Med Insights Gastroenterol

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Background:Irritable bowel syndrome is classified as a functional gastrointestinal disorder with the primary symptom of abdominal pain in conjunction with bloating and bowel movement disorder. It affects up to 15% of the world’s population. Among its subtypes, the most common is diarrhoea predominant. However, the current treatment options for diarrhoea-predominant irritable bowel syndrome have had not very promising results; most, such as antispasmodics, only provide partial symptomatic relief. Treatment with antidepressants and alosetron (a 5HT3 antagonist) has shown the most promise to date. The latest drug to be approved for the treatment of irritable bowel syndrome-diarrhoea is rifaximin, which was approved in May 2015. It is a minimally absorbed antibiotic that is used to change the gut microbiota. Small intestinal bacterial overgrowth is one of the causes suggested for irritable bowel syndrome, particularly for the diarrhoea-predominant type. There are various methods for detecting bacterial overgrowth, the simplest of which is breath tests. Rifaximin has been shown to be of benefit to these patients.Purpose:The purpose of the study is to discuss the potential mechanism of action of rifaximin, a minimally absorbed antibiotic. In addition, we evaluate the various clinical trials undertaken to study the efficacy and safety profile of rifaximin.

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Section: Clinical Profile Of Rifaximinmentioning

confidence: 99%

Review of Rifaximin: Latest Treatment Frontier for Irritable Bowel Syndrome Mechanism of Action and Clinical Profile

Gupta¹,

Ghuman

Handa³

2017

Clin Med Insights Gastroenterol

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“…The frequency of SIBO among IBS patients ranges between 4% and 78%, and the variations in prevalence of SIBO in previous studies might be attributable to differences in the geographical origins of the studied populations, different criteria for the diagnosis of IBS and methods for the diagnosis of SIBO using different breath tests [15,32]. The response to rifaximin treatment in IBS-D patients has been shown to correlate with the normalization of the LHBT results [33][34][35]. In our study, 57.7% of the included patients had a positive LHBT, and 20 showed LHBT normalization after 2 weeks of rifaximin treatment, with a SIBO eradication rate of 44.4%.…”

Section: Discussionmentioning

confidence: 99%

Short-course Rifaximin therapy is effective and safe in patients with Diarrhea-Predominant Irritable Bowel Syndrome

Zhuang

Tian

Luo

et al. 2020

Preprint

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Background and Aim Gut dysbiosis has been implicated in the pathogenesis of irritable bowel syndrome (IBS). Small intestinal bacterial overgrowth (SIBO), a manifestation of gut dysbiosis, is associated with diarrhea-predominant IBS (IBS-D). Rifaximin could effectively and safely improve IBS symptoms. The aim of this study was to investigate the effect of rifaximin on Chinese IBS-D patients.Methods This study included 78 IBS-D patients defined by the Rome IV criteria. Patients received 400 mg rifaximin twice daily for 2 weeks and participated in a 10-week follow-up. Gastrointestinal (GI) symptoms, quality of life (QOL) and lactulose hydrogen breath test (LHBT) results were assessed before and after treatment. Results All participants showed significant improvements in all GI symptom subdomains after rifaximin treatment (all P < 0.05), which were maintained for at least 10 weeks of follow-up. Additionally, QOL scores were increased with concomitant improvement of clinical symptoms (all P < 0.05). The 45 rifaximin-responsive patients (57.7%) achieved significantly greater GI-symptom improvement than non-responders (all P < 0.05). No GI symptoms were associated with the presence of SIBO (all P > 0.05). SIBO normalization after rifaximin treatment measured by LHBT was found in 44.4% (20/45) of patients with SIBO before treatment. Conclusion A short course (2 weeks) of rifaximin effectively and safely improved GI symptoms and QOL in Chinese patients with IBS-D. However, it did not eradicate SIBO completely, indicating that rifaximin might not be closely associated with LHBT normalization and that an additional therapeutic mechanism of rifaximin is urgently needed.

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“…The frequency of SIBO among IBS patients ranges between 4 and 78%, and the variations in prevalence of SIBO in previous studies might be attributable to differences in the geographical origins of the studied populations, different criteria for the diagnosis of IBS and methods for the diagnosis of SIBO using different breath tests [33][34][35]. The response to rifaximin treatment in IBS-D patients has been shown to correlate with the normalization of the LHBT results [32,36,37]. In our study, 57.7% of the included patients had a positive LHBT, and 20 showed LHBT normalization after 2 weeks of rifaximin treatment, with a SIBO eradication rate of 44.4%.…”

Section: Discussionmentioning

confidence: 99%

Short-course Rifaximin therapy efficacy and lactulose hydrogen breath test in Chinese patients with diarrhea-predominant irritable bowel syndrome

et al. 2020

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Background: Gut microbiota alterations including small intestinal bacterial overgrowth (SIBO) might play a role in pathogenesis of irritable bowel syndrome (IBS). Rifaximin could effectively and safely improve IBS symptoms. The aim of this study was to investigate the effect of rifaximin on Gastrointestinal (GI) symptoms, quality of life (QOL) and SIBO eradication in Chinese IBS-D patients. Methods: This study included 78 IBS-D patients defined by the Rome IV criteria. Patients received 400 mg rifaximin twice daily for 2 weeks and 10-week follow-up. GI symptoms were assessed at week 0, 2, 4, 8 and 12. QOL and lactulose hydrogen breath test (LHBT) results were estimated at week 0 and 4. Results: All participants showed significant improvements in GI symptom subdomains after rifaximin treatment (all P < 0.05), which could maintain at least 10 weeks of follow-up. Additionally, QOL scores were increased with concomitant improvement of clinical symptoms (all P < 0.05). The 45 rifaximin-responsive patients (57.7%) achieved significantly greater GI-symptom improvement than non-responders (all P < 0.05). No GI symptoms were associated with SIBO (all P > 0.05). SIBO normalization after rifaximin treatment measured by LHBT was found in 44.4% (20/45) of patients with SIBO before treatment. Conclusion: A short course (2 weeks) of rifaximin improved GI symptoms and QOL in Chinese IBS-D patients whether they had SIBO or not. However, the efficacy of rifaximin could not be explained by the successful eradication of SIBO. Further studies on the therapeutic mechanisms of rifaximin in IBS are urgently needed.

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Determination of Rifaximin Treatment Period According to Lactulose Breath Test Values in Nonconstipated Irritable Bowel Syndrome Subjects

Cited by 21 publications

References 22 publications

Review of Rifaximin: Latest Treatment Frontier for Irritable Bowel Syndrome Mechanism of Action and Clinical Profile

Review of Rifaximin: Latest Treatment Frontier for Irritable Bowel Syndrome Mechanism of Action and Clinical Profile

Short-course Rifaximin therapy is effective and safe in patients with Diarrhea-Predominant Irritable Bowel Syndrome

Short-course Rifaximin therapy efficacy and lactulose hydrogen breath test in Chinese patients with diarrhea-predominant irritable bowel syndrome

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