Rifaximin treatment for the irritable bowel syndrome with a positive lactulose hydrogen breath test improves symptoms for at least 3 months.
BACKGROUND
While rifaximin was able to improve symptoms in patients with irritable bowel syndrome (IBS) in phase III trials, these results are yet to be repeated in phase IV studies.


OBJECTIVE
To evaluate the treatment response to rifaximin in IBS patients in a phase IV trial.


METHODS
IBS patients underwent lactulose hydrogen breath testing (LHBT). LHBT-positive patients were treated with rifaximin for 14 days. Prior to treatment as well as at week 4 and 14 following the start of rifaximin treatment, patients completed a questionnaire assessing symptom severity on a Likert scale from 0 to 10.


RESULTS
One hundred and six of 150 IBS patients (71%) were LHBT-positive and treated with rifaximin. As assessed at week 4 following commencement of the therapy, rifaximin provided significant improvement of the following IBS-associated symptoms: bloating (5.5 ± 2.6 before the start of the treatment vs. 3.6 ± 2.7 at week 4, P<0.001), flatulence (5.0 ± 2.7 vs. 4.0 ± 2.7, P=0.015), diarrhoea (2.9 ± 2.4 vs. 2.0 ± 2.4, P=0.005) and abdominal pain (4.8 ± 2.7 vs. 3.3 ± 2.5, P<0.001). Overall well-being also significantly improved (3.9 ± 2.4 vs. 2.7 ± 2.3, P < 0.001). Similar improvements in IBS symptoms were obtained at week 14. Eighty-six per cent of patients undergoing repetitive LHBT (55/64) tested negative at week 4.


CONCLUSIONS
We found a high percentage of LHBT-positive IBS patients. IBS-associated symptoms (bloating, flatulence, diarrhoea, pain) were improved for a period of 3 months following 2 weeks of treatment with rifaximin. We conclude that rifaximin treatment alleviates symptoms in LHBT-positive IBS patients.
Private Practice for Gastroenterology and Hepatology, Solothurn, Switzerland. gastro.meyrat@hin.ch
P
P
Meyrat
E
E
Safroneeva
A M
AM
Schoepfer
D000328:Adult; D001944:Breath Tests / Q000379:methods; D002986:Clinical Trials as Topic; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000188:drug therapy*; D007792:Lactulose; D008297:Male; D008875:Middle Aged; D012294:Rifamycins / Q000627:therapeutic use*; D000078262:Rifaximin; D012720:Severity of Illness Index; D016896:Treatment Outcome
D005765:Gastrointestinal Agents; D012294:Rifamycins; D007792:Lactulose; D000078262:Rifaximin