Small intestine bacterial overgrowth and irritable bowel syndrome-related symptoms:Experience with Rifaximin

AIM:To estimate the prevalence of small intestinal bacterial overgrowth(SIBO) in our geographical area(Western Sicily,Italy) by means of an observational study,and to gather information on the use of locally active,non-absorbable antibiotics for treatment of SIBO.METHODS:Our survey included 115 patients fulfilling the Rome □ criteria for diagnosis of irritable bowel syndrome(IBS);a total of 97 patients accepted to perform a breath test with lactulose(BTLact),and those who had a positive test,received Rifaximin(Normix,Alfa Wassermann) 1200 mg/d for 7 d;3 wk after the end of treatment,the BTLact was repeated.RESULTS:Based on the BTLact results,SIBO was present in about 56% of IBS patients,and it was responsible for some IBS-related symptoms,such as abdominal bloating and discomfort,and diarrhoea.1-wk treatment with Rifaximin turned the BTLact to negative in about 50% of patients and significantly reduced the symptoms,especially in those patients with an alternated constipation/diarrhoea-variant IBS.CONCLUSION:SIBO should be always suspected in patients with IBS,and a differential diagnosis is done by means of a "breath test".Rifaximin may represent a valid approach to the treatment of SIBO.