280 Efficacy of Rifaximin for Sibo Treatment in Ibs Children

Abstract

Background: Our previous study suggested a significant epidemiologic association between SIBO (Small Intestinal Bacterial Overgrowth) and IBS (Irritable Bowel Syndrome) in childhood. Rifaximin has already been successfully used in adults with SIBO and IBS. Aim: To assess the SIBO prevalence and symptoms improvement in IBS children after treatment with Rifaximin. Study design: 43 (mean age 9,5 ys) consecutive children affected by IBS according to Rome II criteria were enrolled. The control population (n = 28, mean age 10 ys) consisted of healthy subjects without IBS symptoms. All subjects underwent lactulose/methane breath test (LBT) to assess SIBO before and one month after the treatment with Rifaximin 600 mg daily. All IBS pts filled out a Visual Analogic Scale (VAS) score to evaluate symptoms (abdominal pain, constipation, diarrhoea, bloating, flatulence) at time zero and 1 month after the treatment. Results: The prevalence of abnormal LBT result was significantly higher in patients with IBS than controls (65%, 28/43 vs 7%, 2/28, p< 0.05). One month after the treatment 18 pts had a negative LBT while 10 stayed positive (64%, 18/28 vs 36%, 10/28, p< 0.05). In IBS pts VAS score was significantly higher in SIBO positive than SIBO negative children. One month after treatment VAS score was significantly lower in eradicated than non-eradicated pts. Conclusions: Rifaximin is safe and seems to be effective in SIBO eradication and symptoms improvement of IBS pts. Other placebo-controlled interventional studies to treat bacterial overgrowth are warranted to verify the real impact of SIBO on IBS symptoms.