EFFICACY OF RIFAXIMIN IN DIARRHEA PREDOMINANT IRRITABLE BOWEL SYNDROME

ABSTRACT
Background: It has been shown in multiple studies that gut micro biota plays a major role in diarrhea predominant
irritable bowel syndrome. Here we evaluated the efficacy of rifaximin in irritable bowel syndrome.
Objective: To determine the efficacy of rifaximin in diarrhea predominant irritable bowel syndrome.
Study design: Comparative study.
Place and Duration: A Multicenter study from January 2016 to December 2016.
Material and Methods: In a double-blind, placebo-controlled study, patients who had IBS without constipation were
randomly assigned to either rifaximin at a dose of 550 mg or placebo, three times daily for 2 weeks, and were followed
for an additional 4 weeks. The primary end point was the proportion of patients who had adequate relief of global IBS
symptoms, and the key secondary end point was the proportion of patients who had adequate relief of IBS-related
bloating, were assessed weekly. Adequate relief was defined as self-reported relief of symptoms for at least 2 of the 4
weeks after treatment. Other secondary end points included the percentage of patients who had a response to treatment
as assessed by daily self-ratings of global IBS symptoms and individual symptoms of bloating, abdominal pain,
and stool consistency during the 4 weeks after treatment.
Results: Significantly more patients in the rifaximin group than in the placebo group had adequate relief of global IBS
symptoms like bloating, stool frequency and stool consistency during the first 4 weeks after treatment (62% vs. 20%,
P = 0.01). In addition, significantly more patients in the rifaximin group had a response to treatment as assessed by
daily ratings of IBS symptoms, bloating, abdominal pain, and stool consistency. The incidence of adverse events was
similar in the two groups.
Conclusions: Among patients who had IBS without constipation, treatment with rifaximin for 2 weeks provided significant
relief of IBS symptoms, bloating, abdominal pain, and loose or watery stools.
Key Words: Irritable bowel syndrome, rifaximin, diarrhea