Long-term efficacy of rifaximin to manage the symptomatic uncomplicated diverticular disease of the colon

Mario, F. Di; Miraglia, C.; Cambiè, Giulia; Violi, Alessandra; Nouvenne, Antonio; Franceschi, Marilisa; Brandimarte, Giovanni; Elisei, Walter; Picchio, Marcello; Tursi, Antonio

doi:10.1136/jim-2018-000901

Cited by 25 publications

(27 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In addition, rifaximin is also very effective in the treatment of small intestine bacterial overgrowth (SIBO, the most widely detected form of gut dysbiosis) 141 and related (organic and functional) gastrointestinal disorders 142 and safe in clinical practice 143 .…”

Section: [Au: Moved Section On Dica Classification Below For Flow]mentioning

confidence: 99%

Colonic diverticular disease

Tursi

Scarpignato

Strate

et al. 2020

Nat Rev Dis Primers

Self Cite

175

172

View full text Add to dashboard Cite

Queries are meant to draw your attention to edits, inconsistencies or issues that are unclear. If we just ask you to confirm edits are correct, a simple yes/ok between the brackets will do [Au: OK? Is this what you meant? Edits OK? yes]. If questions are asked, please rephrase/update the manuscript text when addressing queries, so that the message is conveyed to the reader (do NOT just type your answer to our query).] [Au: Throughout the manuscript, please use consistent terminology. For example, acute diverticulitis is diverticular disease and in several instances, they are mentioned separately. For clearer understanding, please use consistent terminology and define cleary what diverticular disease refers to. Similarly, there is a slight ambiguity between the terms diverticulosis and asymptomatic diverticulosis. My understanding is that diverticulosis is always asymptomatic. Please refer to them consistently if they are used to refer to the same condition. Is acute uncomplicated diverticulitis as in some instances, its refered to as uncomplicated acute diverticulitis? Please also use the abbreviation, AUD, if this terminology is widely accepted in the field. Just wanted to flag these here to make it easier for you to address.][Au: Important! As I am managing the references for this manuscript, it is essential that changes to references are noted to me in a comment rather than edited manually (as this will likely unlink the references and cause much confusion). If a reference needs to be added, include the full reference details (at a minimum, PMID or DOI are needed) and precise location to be cited. If a reference needs to be deleted, state which reference (author, year) and not just the reference number (as this will change with every change to the references).You can move text around, including the references associated with any given statement, but please don't edit the reference list at the end of the document.

show abstract

Section: [Au: Moved Section On Dica Classification Below For Flow]mentioning

confidence: 99%

Colonic diverticular disease

Tursi

Scarpignato

Strate

et al. 2020

Nat Rev Dis Primers

Self Cite

175

172

View full text Add to dashboard Cite

show abstract

“…This also means that SUDD patients often require recurrent therapeutic courses to control symptoms. In this way, long-term treatment is warranted, and both mesalazine and rifaximin proved to be effective in controlling long-term symptoms [ 18 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

The natural history of symptomatic uncomplicated diverticular disease: a long-term follow-up study

Tursi

Franceschi²,

Elisei

et al. 2020

aog

Self Cite

View full text Add to dashboard Cite

Background Symptomatic uncomplicated diverticular disease (SUDD) affects about 20% of patients who have diverticulosis. However, the natural history of SUDD is not yet completely understood. Our aim was to assess the outcomes of a cohort of SUDD patients during a long-term follow up. Methods One hundred eighty-five patients suffering from SUDD were identified from a large electronic database. Symptoms assessed were abdominal pain, bloating, bowel movement/day, each of which was scored using a visual analogic scale (VAS); the symptom score was calculated by considering the value of the worst symptom present during assessment. Another VAS was used to assess patients’ quality of life (QoL). Patients were treated at the physician’s discretion (with rifaximin, mesalazine, probiotics, spasmolytics) only when symptoms occurred during the follow up. Follow-up visit was performed every year or whenever patients consider it necessary. Results During the follow up (156 months, interquartile range 9-171), 47 patients were lost to follow up. Among these, 9 died from causes not related to SUDD. Acute diverticulitis occurred in 14 patients (7.6% of the overall population): 6 patients (3.2% of the overall population) underwent surgery, and 2 patients (1.1% of the overall population) died because of peritonitis. Both the symptom score and the QoL score were substantially unmodified during the study period. Conclusions SUDD is an important disease able to affect patients significantly in the long term. Acute diverticulitis may sometimes occur in these patients, often leading to surgery with possible severe complications.

show abstract

“…In recent years, new insights have emerged regarding the qualitative and the quantitative changes in microbiota composition and diversity, which appear to be crucial for the occurrence and the persistence of symptoms in patients with colonic diverticulosis [ 11 ]. Consistently, the poorly absorbable drug rifaximin, which favours the growth of bacteria beneficial to the host without altering its overall composition, has been used with success in the prevention of exacerbations of colonic diverticulosis [ 12 , 13 ]. In addition, rifaximin is able to down-regulate the inflammatory response triggered by the gut microbes through inhibition of the activation of the transcription factor nuclear factor-κB and of the induction of inflammatory cytokines, such as Tumor Necrosis Factor and interleukin-1β [ 14 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

Natural History of Ulcerative Colitis with Coexistent Colonic Diverticulosis

Marafini

Salvatori

Rocchetti³

et al. 2021

JCM

View full text Add to dashboard Cite

Ulcerative colitis (UC) and colonic diverticulosis can co-exist in some patients. However, the natural history of UC associated with colonic diverticulosis is not well known. We here compared the disease characteristics and outcome of UC patients with and without concomitant colonic diverticulosis. Medical records of 347 UC patients were included in an observational, retrospective, nested-matched case-control study. Cases were 92 patients with UC and concomitant colonic diverticulosis, while controls were 255 UC patients without concomitant colonic diverticulosis. A propensity score matching (PSM) was used to homogenate cases (n = 92) and controls (n = 153) for age. UC patients with concomitant colonic diverticulosis were less likely to have an extensive disease (25/92, 27.1%) and to experience steroid dependence (8/92, 8.6%) compared to patients without concomitant colonic diverticulosis (70/153, 45.7% and 48/153, 31.3%, respectively; p < 0.001). The use of immunosuppressants (9/92, 9.7% vs. 37/153, 24.1%; p = 0.007) or biologics (3/92, 3.2% vs. 26/153, 16.9%, p < 0.001) was significantly lower in UC patients with concomitant diverticulosis compared to the control group. On multivariate analysis, steroid dependence and extensive colitis were significantly less frequent in UC patients with concomitant colonic diverticulosis compared to UC patients without diverticula. UC patients with coexisting colonic diverticulosis are less likely to have an extensive disease and to be steroid-dependent.

show abstract

Long-term efficacy of rifaximin to manage the symptomatic uncomplicated diverticular disease of the colon

Cited by 25 publications

References 18 publications

Colonic diverticular disease

Colonic diverticular disease

The natural history of symptomatic uncomplicated diverticular disease: a long-term follow-up study

Natural History of Ulcerative Colitis with Coexistent Colonic Diverticulosis

Contact Info

Product

Resources

About