Internal Medicine Department and Pediatric Department, School of Medicine, Catholic University of the Sacred Heart, Gemelli Hospital, Rome, Italy.
Eur Rev Med Pharmacol Sci. 2013 May;17(10):1314-20.
Aims of the study were to assess the effects of rifaximin treatment on small intestinal bacterial overgrowth (SIBO) prevalence and gastrointestinal symptoms.
Fifty (50) irritable bowel syndrome (IBS) children were consecutively enrolled. All subjects underwent lactulose hydrogen/methane breath test (LBT) to assess SIBO before and one month after the treatment with rifaximin 600 mg daily for one week. All IBS patients filled out a Visual Analogic Scale (VAS) to assess and score gastrointestinal symptoms (abdominal pain, constipation, diarrhoea, bloating, flatulence) at baseline and one month after treatment.
The prevalence of abnormal LBT in patients with IBS was 66% (33/50). LBT normalization rate was 64% (21/33). Compliance was excellent, and no relevant side-effects were observed during treatment. VAS score was significantly higher in IBS patients with abnormal LBT than SIBO negatives, and strongly improved after successful treatment.
Rifaximin was effective and safe in SIBO treatment and IBS symptoms improvement in childhood. Double blind placebo-controlled interventional studies are warranted to verify the real impact of SIBO on gastrointestinal symptoms in children with IBS.
本研究旨在评估利福昔明治疗对小肠细菌过度生长(SIBO)患病率和胃肠道症状的影响。
连续纳入了 50 名肠易激综合征(IBS)患儿。所有受试者均行乳果糖氢/甲烷呼气试验(LBT)以评估 SIBO,然后在接受利福昔明 600mg/d、每日一次、为期一周的治疗前后进行 LBT。所有 IBS 患者均填写视觉模拟量表(VAS)以评估和评分胃肠道症状(腹痛、便秘、腹泻、腹胀、呃逆),在基线和治疗后一个月进行评分。
IBS 患者的异常 LBT 患病率为 66%(33/50)。LBT 正常化率为 64%(21/33)。治疗期间,患者的依从性极好,且未观察到相关不良反应。与 SIBO 阴性者相比,异常 LBT 的 IBS 患者的 VAS 评分明显更高,且在成功治疗后显著改善。
利福昔明在儿童 SIBO 治疗和 IBS 症状改善方面有效且安全。需要进行双盲安慰剂对照的干预性研究,以验证 SIBO 对 IBS 儿童胃肠道症状的实际影响。