Gupta Kamesh, Ghuman Harparam Singh, Handa Shivani Vijay
Department of Medicine, Saral Diagnostics, New Delhi, India.
Department of Medicine, Johal Multispeciality Hospital, Jalandhar, India.
Clin Med Insights Gastroenterol. 2017 Aug 31;10:1179552217728905. doi: 10.1177/1179552217728905. eCollection 2017.
Irritable bowel syndrome is classified as a functional gastrointestinal disorder with the primary symptom of abdominal pain in conjunction with bloating and bowel movement disorder. It affects up to 15% of the world's population. Among its subtypes, the most common is diarrhoea predominant. However, the current treatment options for diarrhoea-predominant irritable bowel syndrome have had not very promising results; most, such as antispasmodics, only provide partial symptomatic relief. Treatment with antidepressants and alosetron (a 5HT3 antagonist) has shown the most promise to date. The latest drug to be approved for the treatment of irritable bowel syndrome-diarrhoea is rifaximin, which was approved in May 2015. It is a minimally absorbed antibiotic that is used to change the gut microbiota. Small intestinal bacterial overgrowth is one of the causes suggested for irritable bowel syndrome, particularly for the diarrhoea-predominant type. There are various methods for detecting bacterial overgrowth, the simplest of which is breath tests. Rifaximin has been shown to be of benefit to these patients.
The purpose of the study is to discuss the potential mechanism of action of rifaximin, a minimally absorbed antibiotic. In addition, we evaluate the various clinical trials undertaken to study the efficacy and safety profile of rifaximin.
肠易激综合征被归类为功能性胃肠疾病，主要症状为腹痛，并伴有腹胀和排便紊乱。它影响着全球多达15%的人口。在其亚型中，最常见的是以腹泻为主型。然而，目前针对以腹泻为主型肠易激综合征的治疗方案效果并不十分理想；大多数治疗方法，如抗痉挛药，只能提供部分症状缓解。迄今为止，使用抗抑郁药和阿洛司琼（一种5HT3拮抗剂）治疗显示出了最大的前景。2015年5月被批准用于治疗腹泻型肠易激综合征的最新药物是利福昔明。它是一种吸收极少的抗生素，用于改变肠道微生物群。小肠细菌过度生长是肠易激综合征的病因之一，尤其是以腹泻为主型。检测细菌过度生长有多种方法，其中最简单的是呼气试验。利福昔明已被证明对这些患者有益。
本研究的目的是探讨吸收极少的抗生素利福昔明的潜在作用机制。此外，我们评估了为研究利福昔明的疗效和安全性所进行的各种临床试验。
