Small Bowel Bacterial Overgrowth is found in 71% of IBS patients and associated symptoms respond wel to Rifaximin in a phase IV trial


Serval ID
Inproceedings: an article in a conference proceedings.
Publication sub-type
Abstract (Abstract): shot summary in a article that contain essentials elements presented during a scientific conference, lecture or from a poster.
Small Bowel Bacterial Overgrowth is found in 71% of IBS patients and associated symptoms respond wel to Rifaximin in a phase IV trial
Title of the conference
DDW 2012, Digestive Disease Week
Schoepfer A.M., Meyrat P.
San Diego, California, United-States, May 20-22, 2012
Publication state
Issued date
Background: The prevalence of small intestinal bowel bacterial overgrowth (SIBO) in patients
with irritable bowel syndrome (IBS) ranges from 43% to 78% as determined by the lactulose
hydrogen breath (LHBT) test. Although rifaximine, a non-absorbable antibiotic, has been
able to decrease global IBS symptoms as well as bloating in placebo-controlled randomized
trials, these results were not repeated in phase IV studies in daily clinical practice. Aim: To
assess the prevalence of SIBO in an IBS cohort and to evaluate the treatment response in
the IBS cohort affected by SIBO. Methods: Enrolled patients were diagnosed with IBS using
the following criteria: fulfillment of the Rome III criteria, absence of alarm symptoms (anemia,
weight loss, nocturnal symptoms etc), normal fecal calproectin, normal endoscopic workup
including histology. Celiac disease was excluded by serology and/or duodenal biopsy. All
patients underwent lactulose hydrogen breath testing (LHBT) for SIBO diagnosis. Patients
with SIBO were treated with rifaximine tablets (400mg twice daily for 14 days). Both before
and at week 6 after rifaximin treatment, patients completed a questionnaire, where the
following criteria were assessed individually using 11-point Likert scales: the bloating,
flatulence, abdominal pain, diarrhea, and overall well-being. Results: Hundred-fifty IBS
patients were enrolled (76% female, mean age 44 ± 16 years), of whom 106 (71%) were
diagnosed with SIBO and consequently treated with rifaximine. Rifaximine treatment significantly
reduced the following symptoms as assessed by the symptom questionnaire: bloating
(5.5 ± 2.6 before vs. 3.6 ± 2.7 after treatment, p <0.001), flatulence (5 ± 2.7 vs. 4 ± 2.7,
p = 0.015), diarrhea (2.9 ± 2.4 vs. 2 ± 2.4, p = 0.005), abdominal pain (4.8 ± 2.7 vs. 3.3
± 2.5, p <0.001) and resulted in improved overall well-being (3.9 ± 2.4 vs. 2.7 ± 2.3, p
<0.001). Thirteen of the 106 treated patients were lost to follow-up (12%). The LHBT was
repeated 2-4 weeks after rifaximine treatment in 65/93 (70%) patients. Eradication of SIBO
was documented in 85% of all patients (55/65), whereas 15% of patients (10/65) tested
positive for SIBO as determined by the LHBT testing. Conclusions: The results of our phase
IV trial indicate that a high proportion of IBS patients tested positive for SIBO. IBS symptoms
(bloating, flatulence, diarrhea, pain, overall well-being) were significantly diminished following
a 2-week treatment with rifaximine. These results support the previous findings of
randomized controlled trials that the presence of SIBO is associated with symptom generation
in IBS patients and that reduction and/or elimination of SIBO may help to alleviate IBSassociated
Web of science
Create date
14/02/2013 16:40
Last modification date
20/08/2019 13:09
Usage data