The efficiency of rifaximin in the correction of the small intestinal bacterial overgrowth syndrome in chronic inflammatory bowel diseases and functional bowel disorders

• Main Authors: Yu.M. Stepanov, N.S. Fedorova, E.V. Zyhalo
• Format: Article
• Language: English
• Published: Publishing House Zaslavsky 2019-11-01
• Series: Gastroenterologìa
• Subjects: ulcerative colitis; crohn’s disease; irritable bowel syndrome; small intestinal bacterial overgrowth syndrome; rifaximin
• Online Access: http://gastro.zaslavsky.com.ua/article/view/182740

Background. The article deals with the problem of small intestinal bacterial overgrowth (SIBO) syndrome in patients with chronic inflammatory bowel diseases (IBD) and irritable bowel syndrome (IBS), and ways to correct it. The purpose was to determine the incidence of SIBO in Crohn’s disease (CD), ulcerative colitis (UC) and IBS with diarrhea and to evaluate the efficiency of rifaximin in the correction of small intestinal microflora in patients with these pathologies. Materials and methods. A study was conducted in 62 patients with chronic IBD and IBS (27 — with UC, 13 — with CD and 22 — with IBS) to detect the presence of SIBO by performing a hydrogen breath test (HBT) with glucose loading. All patients of the study group with SIBO received Alfa Normix at a dose of 1200 mg per day for 10 days as a part of comprehensive therapy. The efficiency of therapy was determined by the dynamics of HBT on day 10 and 30 of observation. Results. SIBO was detected in 39 patients of the general group, of them 24 (61.5 %) patients suffered from chronic IBD, 15 (38.5 %) people had IBS with diarrhea. Patients with UC (15 persons; 62.5 %) were predominant in the group of chronic IBD with SIBO, compared to those with CD (9 persons; 37.5 %). HBT performed 10 days after the start of rifaximin treatment (Alfa Normix) in 24 patients with chronic IBD and 15 persons with IBS with the presence of SIBO was negative in 28 (70.9 %) and remained positive in 11 people (29.1 %). The same result was noted after 30 days: HBT was negative in 26 (66.7 %) patients, and positive — in 13 (33.3 %). So, the elimination of SIBO was achieved in 70.9 % of patients when using Alfa Normix. Conclusions. Most patients in the study group (60 % with chronic IBD and 68.1 % with IBS with diarrhea) had SIBO. The intestinal antiseptic rifaximin (Alfa Normix) has been shown to be highly effective in correcting SIBO in UC, CD and IBS.