Role of gut microflora and probiotic effects in the irritable bowel syndrome.
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.
Fanigliulo
Libera
L
Chair of Gastroenterology, Department of Clinical Sciences, University of Parma , Italy.
Comparato
Giuseppe
G
Aragona
Giovanni
G
Cavallaro
Lucas
L
Iori
Veronica
V
Maino
Marta
M
Cavestro
Giulia Martina
GM
Soliani
Paolo
P
Sianesi
Mario
M
Franzè
Angelo
A
Di Mario
Francesco
F
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
D000890:Anti-Infective Agents; D005765:Gastrointestinal Agents; D012294:Rifamycins; D000078262:Rifaximin