Predicting Response to Rifaximin in Irritable Bowel Syndrome with Diarrhea: Is the Answer Blowing in the Wind?

Abstract

Irritable bowel syndrome (IBS) is one of the most common functional bowel disorder worldwide (Clin Gastroenterol Hepatol 2012;10:712-721). The diagnosis is based on a patient reporting a specific combination of symptoms, as defined by the Rome criteria: abdominal pain, which is related to defecation, associated with a change in stool frequency or form (Gastroenterology 2016;150:1393-1407). IBS is further sub-grouped dependent on predominant stool form, be that diarrhea (IBS-D), constipation (IBS-C), or mixed stool pattern (IBS-M). Patients with IBS-D may be particularly debilitated by urgency and the fear of incontinence, reporting poor quality of life as a result, (Health Qual Life Outcomes 2017;15:35) and may resort to using drugs such as loperamide in an attempt to control their stool frequency. Unfortunately, patients frequently report dissatisfaction with this strategy, for which good quality evidence is lacking (Am J Gastroenterol 2018;113 (Suppl 2):1-18).