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Rifaximin treatment for the irritable bowel syndrome with a positive lactulose hydrogen breath test improves symptoms for at least 3 months

  1. P. Meyrat1,*,
  2. E. Safroneeva2,
  3. A. M. Schoepfer3,*

Article first published online: 16 OCT 2012

DOI: 10.1111/apt.12087

Issue

Alimentary Pharmacology & Therapeutics

Alimentary Pharmacology & Therapeutics

Volume 36, Issue 11-12, pages 1084–1093, December 2012

Additional Information

How to Cite

Meyrat, P., Safroneeva, E. and Schoepfer, A. M. (2012), Rifaximin treatment for the irritable bowel syndrome with a positive lactulose hydrogen breath test improves symptoms for at least 3 months. Alimentary Pharmacology & Therapeutics, 36: 1084–1093. doi: 10.1111/apt.12087

Author Information

  1. 1

    Private Practice for Gastroenterology and Hepatology, Solothurn, Switzerland

  2. 2

    Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland

  3. 3

    Division of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois/CHUV, Lausanne, Switzerland

* Correspondence to:
Dr P. Meyrat, Private Practice for Gastroenterology and Hepatology, Dornacherhof 11, CH-4500 Solothurn, Switzerland.
E-mail: gastro.meyrat@hin.ch
Or
Dr A. M. Schoepfer, Division of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois/CHUV, Rue de Bugnon 44, 07/2409, CH-1011 Lausanne, Switzerland.
E-mail: alain.schoepfer@chuv.ch

Publication History

  1. Issue published online: 7 NOV 2012
  2. Article first published online: 16 OCT 2012
  3. Manuscript Accepted: 25 SEP 2012
  4. Manuscript Revised: 24 SEP 2012
  5. Manuscript Received: 8 AUG 2012

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Summary

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.

Aim

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.

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