Rifaximin versus Other Antibiotics in the Primary Treatment and Retreatment of Bacterial Overgrowth in IBS

Yang, Jae Hyuk; Lee, Hyo-Rang; Low, Kimberly; Chatterjee, Soumya; Pimentel, Mark

doi:10.1007/s10620-007-9839-8

Cited by 115 publications

(84 citation statements)

References 31 publications

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“…Nonetheless, the data from meta-analyses indicating increased prevalence of SIBO in IBS, the symptom overlap between the two conditions, and the improvement of symptoms with antibiotic treatment (47,49,59,103,131,135,136,193) further support the hypothesis that alterations in the intestinal microbiota may have a role in the pathogenesis of IBS, at least in some patients.…”

Section: Small Intestinal Bacterial Overgrowthmentioning

confidence: 83%

“…The possible role of the altered intestinal microbiota, immune function, and the abnormal interaction between the two systems in the pathogenesis of IBS has led to the increased interest in targeting the intestinal microbiota and immune system in the treatment of this disorder. Early studies demonstrated symptom improvement in IBS patients whose SIBO was successfully treated with antibiotics, including neomycin, metronidazole, and the nonabsorbable antibiotic rifaximin (47,49,59,103,131,135,136,193). Other studies have demonstrated beneficial effect of antibiotics in patients with IBS regardless of either the diagnosis of SIBO or the effect of antibiotics on HBT (95,100,114,134,(137)(138)(139)160).…”

Section: Discussionmentioning

confidence: 99%

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Intestinal microbiota and immune function in the pathogenesis of irritable bowel syndrome

Ringel

Maharshak

2013

American Journal of Physiology-Gastrointestinal and Liver Physi

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Ringel Y, Maharshak N.Intestinal microbiota and immune function in the pathogenesis of irritable bowel syndrome. Am J Physiol Gastrointest Liver Physiol 305: G529-G541, 2013. First published July 25, 2013; doi:10.1152/ajpgi.00207.2012.-The pathophysiology of irritable bowel syndrome (IBS) is believed to involve alterations in the brain-gut axis; however, the etiological triggers and mechanisms by which these changes lead to symptoms of IBS remain poorly understood. Although IBS is often considered a condition without an identified "organic" etiology, emerging evidence suggests that alterations in the gastrointestinal microbiota and altered immune function may play a role in the pathogenesis of the disorder. These recent data suggest a plausible model in which changes in the intestinal microbiota and activation of the enteric immune system may impinge upon the brain-gut axis, causing the alterations in gastrointestinal function and the clinical symptoms observed in patients with IBS. This review summarizes the current evidence for altered intestinal microbiota and immune function in IBS. It discusses the potential etiological role of these factors, suggests an updated conceptual model for the pathogenesis of the disorder, and identifies areas for future research.inflammation; gastrointestinal; microbiota IRRITABLE BOWEL SYNDROME (IBS) is the most common and best studied condition of a larger group of functional gastrointestinal (GI) disorders. Functional GI disorders refer to the presence of a variable combination of chronic or recurrent GI symptoms not explained by structural or biochemical abnormalities (130,159). IBS is characterized by chronic or recurring abdominal pain or discomfort that is associated with altered bowel habits (53, 99). The condition is often associated with other GI symptoms (e.g., bloating, distention, and gas), other functional GI disorders (e.g., functional dyspepsia), other non-GI disorders (e.g., fibromyalgia, interstitial cystitis, migraine headache), and psychological disorders (e.g., depression, anxiety, somatization) (96,146,167). Traditionally, IBS has been subtyped on the basis of the patient's predominant symptom/stool pattern (99). These subtypes include diarrhea predominant (IBS-D), constipation predominant (IBS-C), and mixed type (IBS-M), in which patients experience alternating periods of diarrhea and constipation. Unlike other conditions that can be associated with abdominal pain and abnormal bowel patterns such as inflammatory bowel diseases (IBD), IBS is not associated with any overt histopathology, structural, or biochemical abnormalities. IBS has been generally considered to be caused by alterations in the brain-gut axis (the bidirectional communication network involving the enteric nervous system, the autonomic nervous system, and the central nervous system) (60,108,125), and the pathophysiological mechanisms behind this condition remain unclear. Traditionally, IBS is considered to be a multifactorial condition in which multiple environmental, genetic, physiological, ...

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Section: Small Intestinal Bacterial Overgrowthmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Intestinal microbiota and immune function in the pathogenesis of irritable bowel syndrome

Ringel

Maharshak

2013

American Journal of Physiology-Gastrointestinal and Liver Physi

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“…Notably, one previous study has demonstrated a gradual recurrence of both IBS symptoms and SIBO (as judged by serial hydrogen breath testing at 3, 6, and 9 months) following rifaximin [Lauritano et al 2008], suggesting that any beneficial effect arising as a consequence of the eradication of SIBO may not be maintained in the longer term. However, one group of investigators has demonstrated that recurrence of SIBO does appear to respond to retreatment with rifaximin [Yang et al 2008].…”

Section: Antibioticsmentioning

confidence: 99%

Treatment of irritable bowel syndrome: beyond fiber and antispasmodic agents

Sainsbury

Ford

2010

Therap Adv Gastroenterol

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Irritable bowel syndrome (IBS) is a chronic functional disorder of the gastrointestinal tract of unknown etiology. The diagnosis of IBS is made clinically, using symptom-based criteria such as the Manning or Rome criteria. Medical therapy for this condition has traditionally been directed towards symptom relief, using fiber or antispasmodic agents. In recent years, emerging data have confirmed the efficacy of antidepressants, psychological therapies, 5-HT 3 antagonists, 5-HT 4 agonists, and probiotics in the short-term treatment of IBS, although whether these therapies influence the long-term course of the disease is unknown. Increasing knowledge regarding the pathophysiological mechanisms underlying IBS has resulted in a number of novel molecular treatments, which show promise. These include therapies targeting gastrointestinal mucosal chloride channels and guanylate cyclase-C receptors, as well as highly selective agents influencing serotonergic transmission that, at the time of writing, do not appear to have any severe deleterious effects. In this article we provide a summary of current and emerging therapies in this field.

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“…[85][86][87] Finally, in 2015, rifaximin became the first Food and Drug Administration-approved antibiotic for the treatment of IBS-D. Rifaximin is a rifamycin-based oral nonabsorbable antibiotic that has a strong in vitro antimicrobial effect against aerobic and anaerobic gram-positive and gram-negative bacteria. 88 Rifaximin has high solubility in the presence of bile acids, and poorly systemic absorption.…”

Section: Antibiotics In Functional Bowel Disordersmentioning

confidence: 99%

“…In previous studies, normalization of the results of the breath test in IBS patients after antibiotic therapy has been shown to be correlated with a successful response to antibiotic therapy. 86,92,93,96 The predictive value of a positive lactulose breath test has been disappointing, however, in selecting patients who will respond. [97][98][99] In a recent prospective study that used upper-gut aspiration culture for diagnosing SIBO, IBS patients with SIBO had greater symptom alleviation than patients without SIBO (87.5% vs 25%) 1 month after the administration of antibiotics.…”

Section: Antibiotics In Functional Bowel Disordersmentioning

confidence: 99%

Therapeutic Modulation of Gut Microbiota in Functional Bowel Disorders

Lee

Choi

Ryu

et al. 2017

J Neurogastroenterol Motil

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Functional bowel disorders (FBDs) are functional gastrointestinal disorders with symptoms attributable to the middle or lower gastrointestinal tract. These include irritable bowel syndrome, functional bloating, functional constipation, functional diarrhea, and unspecified FBD. Increasing evidence has emerged of late that intestinal microbiota is involved in the pathogenesis of FBDs. In this review, the therapeutic benefits and future perspectives of the currently available strategies for modifying the gut microbiota in FBDs are described, focusing primarily on irritable bowel syndrome and functional constipation.

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Rifaximin versus Other Antibiotics in the Primary Treatment and Retreatment of Bacterial Overgrowth in IBS

Abstract: Rifaximin is more effective than other antibiotics in the treatment and retreatment of IBS.

Cited by 115 publications

References 31 publications

Intestinal microbiota and immune function in the pathogenesis of irritable bowel syndrome

Intestinal microbiota and immune function in the pathogenesis of irritable bowel syndrome

Treatment of irritable bowel syndrome: beyond fiber and antispasmodic agents

Therapeutic Modulation of Gut Microbiota in Functional Bowel Disorders

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