title: Determination of rifaximin treatment period according to lactulose breath test values in nonconstipated irritable bowel syndrome subjects.
abstract: Small intestinal bacterial overgrowth (SIBO) can partly explain irritable bowel syndrome (IBS), and rifaximin has been observed to improve abdominal symptoms in nonconstipated IBS patients. However, there are few reports on the association of the rifaximin treatment periods with the results of a lactulose breath test (LBT). Therefore, we performed a retrospective review of patient charts to investigate the relation between the rifaximin treatment periods with LBT results in nonconstipated IBS patients. We also evaluated the time to achieve a symptomatic improvement in the IBS patients as compared to the changes in the LBT. We reviewed the charts for patients who showed IBS symptoms with documented positive results for LBT during their initial visit and who had a follow-up LBT after treatment with rifaximin. The LBT values were compared to the subjects' symptom scores. A total of 102 subjects had a follow-up LBT to assess LBT normalization. The subjects were divided into groups according to treatment periods of 4 weeks (n = 36), 8 weeks (n = 43), and 12 weeks (n = 23). The groups with a longer treatment exhibited an increase in the hydrogen gas value at 90 min and its sum during 90 min at the initial LBT. There were significant differences in hydrogen gas value at 90 min and in its sum during 90 min at the initial LBT between the groups treated for 4 and 12 weeks. The most significant treatment response was observed during the first 4 weeks for all treatment groups. Symptomatic improvement occurred earlier than LBT normalization in the treatment period over 4 weeks. The results indicate that different rifaximin treatment periods are needed in accordance with LBT levels to effectively eradicate SIBO.
authors.affiliation: Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Suhyun
authors.identifier: 0000-0003-3289-6596
authors.initials: S
authors.lastname: Bae
authors.affiliation: Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Kwang Jae
authors.identifier: 0000-0002-8534-0850
authors.initials: KJ
authors.lastname: Lee
authors.affiliation: Department of Family Medicine, Cha University, Cha Bundang Medical Centre, Seongnam, Korea.
authors.forename: Young-Sang
authors.identifier: 0000-0002-7397-5410
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Kyu-Nam
authors.identifier: 0000-0002-1213-5004
authors.initials: KN
authors.lastname: Kim
mesh_terms: D015415:Biomarkers / Q000032:analysis; D001944:Breath Tests / Q000379:methods*; D003248:Constipation; D004334:Drug Administration Schedule; D016903:Drug Monitoring / Q000379:methods*; D005260:Female; D005765:Gastrointestinal Agents / Q000008:administration & dosage; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000175:diagnosis* / Q000188:drug therapy*; D007792:Lactulose / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012294:Rifamycins / Q000008:administration & dosage*; D000078262:Rifaximin; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D005765:Gastrointestinal Agents; D012294:Rifamycins; D007792:Lactulose; D000078262:Rifaximin
keywords: Irritable Bowel Syndrome; Lactulose Breath Test; Rifaximin; Small Intestinal Bacterial Overgrowth