title: Role of gut microflora and probiotic effects in the irritable bowel syndrome.
abstract: BACKGROUND
  Even though the cause of irritable bowel sindrome (IBS) is not yet known, alterations of the intestinal microflora may be important in its pathogenesis.
  
  
  OBJECTIVE
  To evaluate the efficacy of rifaximine alone or in association with the probiotic strain of Bifidobacterium longum W11 in reducing symptoms in patients with IBS.
  
  
  METHODS
  We performed a monocentric, prospective, randomized open trial including 70 patients randomized in to two groups: Group A (41 patients) receiving rifaximin 200 (2 cp bid for ten days in a month) followed by a formulation of the probiotic strain of Bifidobacterium longum W11(one granulated suspension for 6 days on alternate weeks ) and Group B (29 patients) receiving only rifaximin 200 (2 cp bid for ten days in a month). The clinical evaluation was performed at admission and after 2-months, taking into account the method of visual analogous.
  
  
  RESULTS
  At the 2-month follow-up, Group A patients reported a greater improvement of symptoms compared to patients in group B (p = 0.010) even if the physician's opinion at T1 did not confirm these results (p = 0.07).
  
  
  CONCLUSIONS
  The increased colonisation by Bifi-dobacterium longum W11, after the cyclic administration of rifaximin, which eradicates the bacterial overgrowth of the small intestine, may reduce symptoms, especially those related to bowel habit and stool frequency in patients with IBS. The abnormalities observed in the colonic flora of IBS suggest, in fact, that a probiotic approach will ultimately be justified.
authors.affiliation: Chair of Gastroenterology, Department of Clinical Sciences, University of Parma , Italy.
authors.forename: Libera
authors.initials: L
authors.lastname: Fanigliulo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Comparato
authors.forename: Giovanni
authors.initials: G
authors.lastname: Aragona
authors.forename: Lucas
authors.initials: L
authors.lastname: Cavallaro
authors.forename: Veronica
authors.initials: V
authors.lastname: Iori
authors.forename: Marta
authors.initials: M
authors.lastname: Maino
authors.forename: Giulia Martina
authors.initials: GM
authors.lastname: Cavestro
authors.forename: Paolo
authors.initials: P
authors.lastname: Soliani
authors.forename: Mario
authors.initials: M
authors.lastname: Sianesi
authors.forename: Angelo
authors.initials: A
authors.lastname: Franzè
authors.forename: Francesco
authors.initials: F
authors.lastname: Di Mario
mesh_terms: D000328:Adult; D000368:Aged; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001644:Bifidobacterium; D003627:Data Interpretation, Statistical; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D005765:Gastrointestinal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000175:diagnosis / Q000382:microbiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D019936:Probiotics / Q000627:therapeutic use*; D011446:Prospective Studies; D012294:Rifamycins / Q000008:administration & dosage / Q000627:therapeutic use*; D000078262:Rifaximin; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000890:Anti-Infective Agents; D005765:Gastrointestinal Agents; D012294:Rifamycins; D000078262:Rifaximin