title: Rifaximin in irritable bowel syndrome: rationale, evidence and clinical use.
abstract: Irritable bowel syndrome (IBS) is the most common functional bowel disease that affects up to 15% of the US population. The majority of patients with IBS have significant bloating and gas. Recent evidence is beginning to suggest that patients with IBS may have an alteration in the gastrointestinal flora. Specifically, findings suggest that patients with IBS have excessive bacteria in the small bowel, referred to as bacterial overgrowth. Therefore there may be benefits of antibiotic-based therapies for IBS. Rifaximin is a nonabsorbable antibiotic that demonstrates no clinically relevant bacterial resistance. Some studies have demonstrated the efficacy and durable improvement of IBS symptoms after treatment with rifaximin. In this review we explore the current data showing the association of small intestinal bacterial overgrowth (SIBO) and IBS as well as review the available data on the clinical use of rifaximin in the treatment of SIBO in patients with IBS.
authors.affiliation: Department of Medicine, Texas Tech University Health Science Center - Paul L. Foster School of Medicine, El Paso, TX, USA.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Saadi
authors.forename: Richard W
authors.initials: RW
authors.lastname: McCallum
keywords: irritable bowel syndrome; lactulose breath test; microbiome; rifaximin; small intestinal bacterial overgrowth
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