Premium
Rifaximin treatment for the irritable bowel syndrome with a positive lactulose hydrogen breath test improves symptoms for at least 3 months
Author(s) -
Meyrat P.,
Safroneeva E.,
Schoepfer A. M.
Publication year - 2012
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 - 10.1111/apt.12087
Subject(s) - rifaximin , flatulence , medicine , irritable bowel syndrome , bloating , lactulose , gastroenterology , abdominal pain , small intestinal bacterial overgrowth , hydrogen breath test , breath test , antibiotics , microbiology and biotechnology , biology , helicobacter pylori
Summary Background While rifaximin was able to improve symptoms in patients with irritable bowel syndrome ( IBS ) in phase III trials, these results are yet to be repeated in phase IV studies. Aim To evaluate the treatment response to rifaximin in IBS patients in a phase IV trial. Methods IBS patients underwent lactulose hydrogen breath testing ( LHBT ). LHBT ‐positive patients were treated with rifaximin for 14 days. Prior to treatment as well as at week 4 and 14 following the start of rifaximin treatment, patients completed a questionnaire assessing symptom severity on a Likert scale from 0 to 10. Results One hundred and six of 150 IBS patients (71%) were LHBT ‐positive and treated with rifaximin. As assessed at week 4 following commencement of the therapy, rifaximin provided significant improvement of the following IBS ‐associated symptoms: bloating (5.5±2.6 before the start of the treatment vs. 3.6±2.7 at week 4, P <0.001), flatulence (5.0±2.7 vs. 4.0±2.7, P =0.015), diarrhoea (2.9±2.4 vs. 2.0±2.4, P =0.005) and abdominal pain (4.8±2.7 vs. 3.3±2.5, P <0.001). Overall well‐being also significantly improved (3.9 ± 2.4 vs. 2.7 ± 2.3, P < 0.001). Similar improvements in IBS symptoms were obtained at week 14. Eighty‐six per cent of patients undergoing repetitive LHBT (55/64) tested negative at week 4. Conclusions We found a high percentage of LHBT ‐positive IBS patients. IBS ‐associated symptoms (bloating, flatulence, diarrhoea, pain) were improved for a period of 3 months following 2 weeks of treatment with rifaximin. We conclude that rifaximin treatment alleviates symptoms in LHBT ‐positive IBS patients.