Efficacy of Rifaximin in Diarrhoea Predominant Irritable Bowel Syndrome: A Placebo Controlled Clinical Trial

Abstract

Introduction: Irritable bowel syndrome is a common chronic functional gastrointestinal disorder characterized by abdominal pain associated with altered bowel habit of either diarrhoea, constipation or both. Its pathogenesis is multifactorial and incompletely understood.The role of gut microbiota in the pathophysiology of IBS is supported by various evidences.These are differences in mucosal and faecal microbiota between patients with IBS and healthy individuals,development of post-infectious IBS and the efficacy of some probiotics and nonsystemic antibiotics such as Rifaximin. Previous study showed resetting microbial diversity via Rifaximin use may lead to a decrease in bacterial fermentation and a reduction in the clinical symptoms of IBS. This study is designed to assess efficacy of Rifaximin in diarrhoea predominant irritable bowel syndrome. Objective: This study was conducted to assess the effectiveness of Rifaximin in diarrhoea predominant irritable bowel syndrome patient. Materials and Methods: This quasi experimental study was conducted on patients aged 18-55 years with IBS-D in department of Gastroenterology, BSMMU during the period of September, 2020 to August, 2021. Results: There was significant improvement on abdominal pain(p <0.001), abdominal bloating(p =0.001) and satisfaction with bowel movement( p<0.001) in Rifaximin group at 4th week from baseline and most of which sustained upto 12th week of study. The total IBS-SSS at baseline (328.7 ±13.7) decreased to (231.5±14.2) at 12th week of study in Rifaximin group which was significant (p

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利福昔明治疗腹泻为主的肠易激综合征的疗效:一项安慰剂对照临床试验

肠易激综合征是一种常见的慢性功能性胃肠道疾病，其特征是腹痛与腹泻、便秘或两者兼而有之的排便习惯改变有关。其发病机制是多因素的，尚不完全清楚。肠道菌群在肠易激综合征病理生理中的作用得到了各种证据的支持。这些差异包括肠易激综合征患者与健康个体之间粘膜和粪便微生物群的差异、感染后肠易激综合征的发展以及一些益生菌和非全身性抗生素(如利福昔明)的疗效。先前的研究表明，通过使用利福昔明重置微生物多样性可能导致细菌发酵减少，并减轻IBS的临床症状。本研究旨在评估利福昔明对腹泻为主的肠易激综合征的疗效。目的:评价利福昔明治疗腹泻型肠易激综合征的疗效。材料与方法:本准实验研究于2020年9月至2021年8月在BSMMU消化内科对18-55岁IBS-D患者进行研究。结果:利福昔明组患者第4周腹痛(p <0.001)、腹胀(p =0.001)和排便满意度(p <0.001)均有显著改善，且大部分改善持续至研究第12周。利福昔明组IBS-SSS总分在治疗12周时(328.7±13.7)降至(231.5±14.2)，差异有统计学意义(p < 0.01)。安慰剂组IBS-SSS也从基线(323.4±17.29)逐渐下降至第12周(269.3±16.2)，但无统计学意义。利福昔明组IBS-QOL基线评分为64±5.2，安慰剂组为63.4±5.1。利福昔明组和安慰剂组IBS-QOL总分均随时间增加，但无显著性差异。结论:研究12周后，利福昔明在控制腹痛、腹胀和排便不满意方面优于安慰剂。两组患者的IBS生活质量评分均有所提高。医学今日2023卷35(1):44-48

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