title: [Variation of intestinal fermentative profile after sequential therapy with rifaximin/probiotics].
abstract: BACKGROUND
  There is evidence suggesting that intestinal microbiota plays a role in the development of irritable bowel syndrome. Its activity can be indirectly assessed using the lactulose breath test. Antibiotics like rifaximin or probiotics can be used as therapeutic options for patients with irritable bowel syndrome. Our purpose was to evaluate the efficacy of a sequential treatment with rifaximin and probiotics in these patients.
  
  
  METHODS
  We prospectively evaluated patients with diagnosis of irritable bowel syndrome according to Rome III criteria. Included patients had to fill in a questionnaire in order to assess their symptoms severity. A lactulose breath test was also performed in each case and a curve with the results of hydrogen concentration and time was elaborated. Then, the area under the curve was calculated After initial evaluation, patients received a seven-day treatment with rifaximin, followed by a ten-day course of probiotics. Thirty days after completion of treatment a new lactulose breath test along with a questionnaire were performed.
  
  
  RESULTS
  We included 15 patients and 93% experienced a significant improvement of their symptoms as well as a significant reduction of the lactulose breath test values.
  
  
  CONCLUSIONS
  Sequential treatment with rifaximin/probiotics seems to be effective for symptom and fermentative profile improvement in irritable bowel syndrome patients.
authors.affiliation: Servicio de Gastroenterología, Departamento de Medicina Interna, CEMIC Citiudad Autónoma de Buenos Aires, Argentina.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Dima
authors.forename: Daniel
authors.initials: D
authors.lastname: Peralta
authors.forename: Abel
authors.initials: A
authors.lastname: Novillo
authors.forename: Juan
authors.initials: J
authors.lastname: Lasa
authors.forename: Horacio
authors.initials: H
authors.lastname: Besasso
authors.forename: Luis
authors.initials: L
authors.lastname: Soifer
mesh_terms: D001944:Breath Tests / Q000379:methods; D005260:Female; D005285:Fermentation / Q000187:drug effects* / Q000502:physiology; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D019936:Probiotics / Q000627:therapeutic use*; D011446:Prospective Studies; D012294:Rifamycins / Q000627:therapeutic use*; D000078262:Rifaximin; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D005765:Gastrointestinal Agents; D012294:Rifamycins; D000078262:Rifaximin