Interaction between rifaximin and dietary fibre in patients with diverticular disease.
BACKGROUND
Cyclic administration of rifaximin in association with dietary fibre achieves symptomatic relief in uncomplicated diverticular disease (DD) by means of a still undefined mechanism.


OBJECTIVE
To investigate the effects of a combination of rifaximin and fibre on both hydrogen production by intestinal microflora and oro-anal transit time.


METHODS
In a controlled, double-blind crossover trial, 64 patients with uncomplicated DD were given bran (20 g/day) and randomly treated with rifaximin (1200 mg/day) or a placebo for 14 days. Evaluation was based on clinical status, breath test, oro-anal transit time and faecal weight.


RESULTS
The global symptomatic score was significantly reduced after rifaximin (7.1 +/- 4.1 to 4.1 +/- 3.3; P < 0.005) but not after placebo (6.8 +/- 3.8 to 6.1 +/- 3.5). Hydrogen production significantly increased after placebo from 198 +/- 134 to 267 +/- 161 ppm/min, while Rifaximin reduced it from 222 +/- 187 to 166 +/- 131 ppm/min (P = 0.05). The total oro-anal transit time decreased from 56.1 +/- 28.2 to 51.3 +/- 28.0 h in placebo and from 54.4 +/- 31.9 to 45.1 +/- 32.4 h (P < 0.05) in rifaximin-treated patients.


CONCLUSIONS
The administration of rifamixin improves the benefits of dietary fibre in uncomplicated DD by preventing its bacterial degradation.
D'Incà
R
R
Department of Surgical and Gastroenterological Sciences, University of Padua, Padua, Italy. dinca@unipd.it
Pomerri
F
F
Vettorato
M G
MG
Dal Pont
E
E
Di Leo
V
V
Ferronato
A
A
Medici
V
V
Sturniolo
G C
GC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001944:Breath Tests; D018592:Cross-Over Studies; D004043:Dietary Fiber / Q000008:administration & dosage*; D004240:Diverticulum / Q000188:drug therapy* / Q000209:etiology; D004311:Double-Blind Method; D004347:Drug Interactions; D005260:Female; D005500:Follow-Up Studies; D005772:Gastrointestinal Transit / Q000187:drug effects; D006801:Humans; D006859:Hydrogen / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D012294:Rifamycins / Q000494:pharmacology / Q000627:therapeutic use*; D000078262:Rifaximin
D000890:Anti-Infective Agents; D004043:Dietary Fiber; D012294:Rifamycins; D006859:Hydrogen; D000078262:Rifaximin