Small intestine bacterial overgrowth and irritable bowel syndrome-related symptoms: experience with Rifaximin.
OBJECTIVE
To estimate the prevalence of small intestinal bacterial overgrowth (SIBO) in our geographical area (Western Sicily, Italy) by means of an observational study, and to gather information on the use of locally active, non-absorbable antibiotics for treatment of SIBO.


METHODS
Our survey included 115 patients fulfilling the Rome II criteria for diagnosis of irritable bowel syndrome (IBS); a total of 97 patients accepted to perform a breath test with lactulose (BTLact), and those who had a positive test, received Rifaximin (Normix, Alfa Wassermann) 1200 mg/d for 7 d; 3 wk after the end of treatment, the BTLact was repeated.


RESULTS
Based on the BTLact results, SIBO was present in about 56% of IBS patients, and it was responsible for some IBS-related symptoms, such as abdominal bloating and discomfort, and diarrhoea. 1-wk treatment with Rifaximin turned the BTLact to negative in about 50% of patients and significantly reduced the symptoms, especially in those patients with an alternated constipation/diarrhoea-variant IBS.


CONCLUSIONS
SIBO should be always suspected in patients with IBS, and a differential diagnosis is done by means of a "breath test". Rifaximin may represent a valid approach to the treatment of SIBO.
Peralta
Sergio
S
Operative Unit of Gastroenterology and Hepatology, Di.Bi.M.I.S, Piazza delle Cliniche 2, Palermo 90127, Italy. peralta.sergio@yahoo.it
Cottone
Claudia
C
Doveri
Tiziana
T
Almasio
Piero Luigi
PL
Craxi
Antonio
A
D000328:Adult; D000890:Anti-Infective Agents / Q000627:therapeutic use*; D001424:Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D001944:Breath Tests; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D007421:Intestine, Small / Q000382:microbiology*; D043183:Irritable Bowel Syndrome / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology* / Q000503:physiopathology; D007792:Lactulose / Q000378:metabolism; D008297:Male; D012294:Rifamycins / Q000627:therapeutic use*; D000078262:Rifaximin; D012802:Sicily / Q000453:epidemiology
D000890:Anti-Infective Agents; D005765:Gastrointestinal Agents; D012294:Rifamycins; D007792:Lactulose; D000078262:Rifaximin