Rifaximin improves symptoms of acquired uncomplicated diverticular disease of the colon

Latella, Giovanni; Pimpo, M.T.; Sottili, S.; Zippi, Maddalena; Viscido, Angelo; Chiaramonte, M.; Frieri, Giuseppe

doi:10.1007/s00384-002-0396-5

Cited by 128 publications

(123 citation statements)

References 33 publications

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“…65 Multiple studies have shown that rifaximin can effectively improve symptoms and maintain periods of remission in patients with uncomplicated diverticular disease, while also being well tolerated. [66][67][68][69][70] …”

mentioning

confidence: 99%

Review article: the current and evolving treatment of colonic diverticular disease

Tursi

Papagrigoriadis

2009

Aliment Pharmacol Ther

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mentioning

confidence: 99%

Review article: the current and evolving treatment of colonic diverticular disease

Tursi

Papagrigoriadis

2009

Aliment Pharmacol Ther

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“…RIFax was effective in both acute and chronic hepatic encephalopathy (Loguercio et al, 2003;Mas et al, 2003). Several recent clinical trails have recommended the use of RIFax for prevention of the main complications in patients with diverticular disease (Latella et al, 2003;Pistoia et al, 2004;Papi et al, 2005). In patients with gasrelated symptoms, the colonic production of H 2 is increased, and RIFax significantly reduces this production and the excessive number of flatus episodes (Di Stefano et al, 2000).…”

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confidence: 99%

Rifaximin Is a Gut-Specific Human Pregnane X Receptor Activator

Shah

Guo

et al. 2007

J Pharmacol Exp Ther

113

107

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Rifaximin, a rifamycin analog approved for the treatment of travelers' diarrhea, is also beneficial in the treatment of multiple chronic gastrointestinal disorders. However, the mechanisms contributing to the effects of rifaximin on chronic gastrointestinal disorders are not fully understood. In the current study, rifaximin was investigated for its role in activation of the pregnane X receptor (PXR), a nuclear receptor that regulates genes involved in xenobiotic and limited endobiotic deposition and detoxication. PXR-humanized (hPXR), Pxr-null, and wild-type mice were treated orally with rifaximin, and rifampicin, a well characterized human PXR ligand. Rifaximin was highly concentrated in the intestinal tract compared with rifampicin. Rifaximin treatment resulted in significant induction of PXR target genes in the intestine of hPXR mice, but not in wild-type and Pxr-null mice. However, rifaximin treatment demonstrated no significant effect on hepatic PXR target genes in wild-type, Pxr-null, and hPXR mice. Consistent with the in vivo data, cell-based reporter gene assay revealed rifaximin-mediated activation of human PXR, but not the other xenobiotic nuclear receptors constitutive androstane receptor, peroxisome proliferator-activated receptor (PPAR)␣, PPAR␥, and farnesoid X receptor. Pretreatment with rifaximin did not affect the pharmacokinetics of the CYP3A substrate midazolam, but it increased the C max and decreased T max of 1Ј-hydroxymidazolam. Collectively, the current study identified rifaximin as a gut-specific human PXR ligand, and it provided further evidence for the utility of hPXR mice as a critical tool for the study of human PXR activators. Further human studies are suggested to assess the potential role of rifaximin-mediated gut PXR activation in therapeutics of chronic gastrointestinal disorders.

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“…The RCT found that, at 1 year, dietary fiber supplementation plus rifaximin significantly improved global symptom score compared with dietary fiber supplementation alone [Latella et al 2003]. …”

Section: Rifaximin Plus Dietary Fiber Supplementation Versus Dietary mentioning

confidence: 99%

Management of colonic diverticular disease with poorly absorbed antibiotics and other therapies

Sopeña

Lanas

2011

Therap Adv Gastroenterol

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Colonic diverticular disease is common in Western countries and its prevalence increases with age. The large majority of patients (8085%) will remain entirely asymptomatic throughout their life. In symptomatic cases, most patients will have diverticulosis without inflammation while the remainder will have diverticulitis with or without complications. About 12% will require hospitalization and 0.5% will require surgery. Factors predicting the development of symptoms remain to be identified. However, it is generally recognized that diverticular disease is probably related to complex interactions between colon structure, intestinal motility, diet, and genetic features. Epidemiologic studies have demonstrated an association between diverticulosis and diets that are low in fiber and high in refined carbohydrates. Although the causes of symptom development are still unclear, it is thought that previous episodes of intestinal inflammation may play a role. Changes in intestinal microflora could be one of the putative mechanisms responsible for low-grade inflammation. In patients with uncomplicated diverticulosis, a diet abundant in fruit and vegetables is recommended. The current therapeutic approaches in preventing recurrence of symptoms are based on nonabsorbable antibiotics, mesalazine, and/or probiotics. Cyclic rifaximin administration seems to be an adequate approach to relieving symptoms and preventing acute diverticulitis in patients with symptomatic diverticulosis.

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Rifaximin improves symptoms of acquired uncomplicated diverticular disease of the colon

Abstract: Cyclic administration of rifaximin is effective in obtaining symptom relief in uncomplicated diverticular disease of the colon. The incidence of episodes of diverticulitis in the group treated with rifaximin was lower than that in the group treated with glucomannan alone.

Cited by 128 publications

References 33 publications

Review article: the current and evolving treatment of colonic diverticular disease

Review article: the current and evolving treatment of colonic diverticular disease

Rifaximin Is a Gut-Specific Human Pregnane X Receptor Activator

Management of colonic diverticular disease with poorly absorbed antibiotics and other therapies

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