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Non‐absorbable antibiotics for managing intestinal gas production and gas‐related symptoms
Author(s) -
Di Stefano M.,
Strocchi A.,
Malservisi S.,
Veneto G.,
Ferrieri A.,
Corazza G. R.
Publication year - 2000
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1046/j.1365-2036.2000.00808.x
Subject(s) - rifaximin , medicine , lactulose , activated charcoal , gastroenterology , breath test , excretion , small intestinal bacterial overgrowth , flatulence , bloating , irritable bowel syndrome , antibiotics , abdominal pain , surgery , microbiology and biotechnology , chemistry , organic chemistry , adsorption , biology , helicobacter pylori
Background: Simethicone, activated charcoal and antimicrobial drugs have been used to treat gas‐related symptoms with conflicting results. Aim: To study the relationship between gaseous symptoms and colonic gas production and to test the efficacy of rifaximin, a new non‐absorbable antimicrobial agent, on these symptoms. Methods: Intestinal gas production was measured by hydrogen (H 2 ) and methane (CH 4 ) breath testing after lactulose in 21 healthy volunteers and 34 functional patients. Only the 34 functional patients took part in a double‐blind, double‐dummy controlled trial, receiving, at random, rifaximin (400 mg b.d per 7 days), or activated charcoal (400 mg b.d per 7 days). The following parameters were evaluated at the start of the study and 1 and 10 days after therapy: bloating, abdominal pain, number of flatus episodes, abdominal girth, and cumulative breath H 2 excretion. Results: Hydrogen excretion was greater in functional patients than in healthy volunteers. Rifaximin, but not activated charcoal, led to a significant reduction in H 2 excretion and overall severity of symptoms. In particular, in patients treated with rifaximin, a significant reduction in the mean number of flatus episodes and of mean abdominal girth was evident. Conclusions: In patients with gas‐related symptoms the colonic production of H 2 is increased. Rifaximin significantly reduces this production and the excessive number of flatus episodes.