Restless legs syndrome in patients with irritable bowel syndrome: response to small intestinal bacterial overgrowth therapy.
BACKGROUND
Small intestinal bacterial overgrowth (SIBO) occurs in irritable bowel syndrome (IBS) and fibromyalgia. Since restless legs syndrome (RLS) occurs with fibromyalgia, a link between IBS, SIBO, and RLS was studied.


METHODS
BS patients with abnormal lactulose breath tests received rifaximin 1,200 mg day(-1) for 10 days, followed by tegaserod 3 mg, long-term, and 1 month of zinc 220 mg day(-1) and once-daily probiotic (N = 11) or rifaximin monotherapy (N = 2). IBS symptom improvement was assessed after rifaximin. RLS symptoms, IBS symptoms, and overall IBS global improvement were assessed at last posttreatment visit: 8/10 patients were followed long-term (mean, 139 days; range, 54-450 days).


RESULTS
Ten of 13 patients exhibited > or =80% improvement from baseline in RLS symptoms. Five maintained complete resolution of RLS symptoms. Global gastrointestinal symptom improvement was great (n = 6), moderate (n = 5), or mild (n = 2).


CONCLUSIONS
This study suggests that SIBO associated with IBS may be a factor in some RLS patients and SIBO therapy provides long-term RLS improvement.
Weinstock
Leonard B
LB
Washington University School of Medicine, St Louis, MO 63141, USA, lw@gidoctor.net
Fern
Steve E
SE
Duntley
Stephen P
SP
D000328:Adult; D001944:Breath Tests; D004359:Drug Therapy, Combination; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D006801:Humans; D007211:Indoles / Q000627:therapeutic use; D007421:Intestine, Small / Q000382:microbiology*; D043183:Irritable Bowel Syndrome / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012148:Restless Legs Syndrome / Q000150:complications*; D012294:Rifamycins / Q000627:therapeutic use; D000078262:Rifaximin; D017366:Serotonin Receptor Agonists; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D005765:Gastrointestinal Agents; D007211:Indoles; D012294:Rifamycins; D017366:Serotonin Receptor Agonists; C105050:tegaserod; D000078262:Rifaximin