Abstract

BackgroundRifaximin is a minimally absorbed antibiotic with high luminal activity, used to treat various gastrointestinal diseases. Although rifaximin has been proposed as first line treatment for small intestinal bacterial overgrowth (SIBO), few data are available regarding its efficacy in non-IBS subjects. We aimed to assess the ability of rifaximin to normalize lactulose-H2 breath tests in non-IBS subjects with symptoms suggestive of SIBO.Materials and methodsConsecutive non-IBS patients presenting with bloating and flatulence were prospectively recruited and submitted to lactulose-H2 breath testing (LBT). Patients who had a positive result were offered rifaximin 1200 mg daily for 10 days. Breath testing was repeated two weeks after treatment completion in all patients in order to assess for response.ResultsA total of 19 patients with a positive result received rifaximin and repeated the breath test (7 (36.8%) males, age 56.5 ± 17.6 years). The mean peak hydrogen excretion was 13.7 ± 2.8 and 10.3 ± 7.3 ppm at baseline and following rifaximin treatment, respectively (t = 1.98, p = 0.06). LBT normalized in 8/19 (42.1%) subjects. No patients reported symptom resolution. No adverse events were reported.DiscussionStrengths include the study's prospective design. Limitations include the small sample size and open label design.ConclusionRifaximin was not effective in normalizing LBT in our cohort of non-IBS subjects with symptoms suggestive of SIBO.

Highlights

  • Introduction and backgroundSmall intestinal bacterial overgrowth (SIBO) is a heterogeneous disorder with a clinical presentation ranging from florid malabsorption to minor, non-specific or an absence of symptoms [1]

  • Classically associated with motility disorders and anatomical abnormalities of the upper gastrointestinal tract, small intestinal bacterial overgrowth (SIBO) may be more prevalent than previously thought. This increased prevalence may be due to the availability of noninvasive, inexpensive and applicable alternative diagnostic test to direct assay of a duodenal aspirate, such as the lactulose-hydrogen breath test (LBT) [3]

  • Given the ambiguity surrounding the etiological role of SIBO in IBS patients, and given the fact that rifaximin may be beneficial for the treatment of IBS even in the absence of SIBO [12], it follows that in order to assess the efficacy of rifaximin for the treatment of SIBO, a homogenous cohort of patients without IBS should be used

Read more

Summary

Results

A total of 19 patients with a positive result received rifaximin and repeated the breath test (7 (36.8%) males, age 56.5 ± 17.6 years). The mean peak hydrogen excretion was 13.7 ± 2.8 and 10.3 ± 7.3 ppm at baseline and following rifaximin treatment, respectively (t = 1.98, p = 0.06).

Conclusion
Materials and methods
Discussion

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call

Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.