Dataset Information
Effects of Rifaximin on Transit, Permeability, Fecal Microbiome, and Organic Acid Excretion in Irritable Bowel Syndrome.
Ontology highlight
ABSTRACT: Objectives
Rifaximin relieves irritable bowel syndrome (IBS) symptoms, bloating, abdominal pain, and loose or watery stools. Our objective was to investigate digestive functions in rifaximin-treated IBS patients.Methods
In a randomized, double-blind, placebo-controlled, parallel-group study, we compared the effects of rifaximin, 550?mg t.i.d., and placebo for 14 days in nonconstipated IBS and no evidence of small intestinal bacterial overgrowth (SIBO). All subjects completed baseline and on-treatment evaluation of colonic transit by scintigraphy, mucosal permeability by lactulose-mannitol excretion, and fecal microbiome, bile acids, and short chain fatty acids measured on random stool sample. Overall comparison of primary response measures between treatment groups was assessed using intention-to-treat analysis of covariance (ANCOVA, with baseline value as covariate).Results
There were no significant effects of treatment on bowel symptoms, small bowel or colonic permeability, or colonic transit at 24?h. Rifaximin was associated with acceleration of ascending colon emptying (14.9±2.6?h placebo; 6.9±0.9?h rifaximin; P=0.033) and overall colonic transit at 48?h (geometric center 4.0±0.3?h placebo; 4.7±0.2?h rifaximin; P=0.046); however, rifaximin did not significantly alter total fecal bile acids per g of stool or proportion of individual bile acids or acetate, propionate, or butyrate in stool. Microbiome studies showed strong associations within subjects, modest associations with time across subjects, and a small but significant association of microbial richness with treatment arm (rifaximin vs. treatment).Conclusions
In nonconstipated IBS without documented SIBO, rifaximin treatment is associated with acceleration of colonic transit and changes in microbial richness; the mechanism for reported symptomatic benefit requires further investigation.
SUBMITTER: Acosta A
PROVIDER: S-EPMC4893683 | biostudies-literature | 2016 May
REPOSITORIES: biostudies-literature
Publications
Effects of Rifaximin on Transit, Permeability, Fecal Microbiome, and Organic Acid Excretion in Irritable Bowel Syndrome.
Clinical and translational gastroenterology 20160526
<h4>Objectives</h4>Rifaximin relieves irritable bowel syndrome (IBS) symptoms, bloating, abdominal pain, and loose or watery stools. Our objective was to investigate digestive functions in rifaximin-treated IBS patients.<h4>Methods</h4>In a randomized, double-blind, placebo-controlled, parallel-group study, we compared the effects of rifaximin, 550 mg t.i.d., and placebo for 14 days in nonconstipated IBS and no evidence of small intestinal bacterial overgrowth (SIBO). All subjects completed base ...[more]