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Profile of rifaximin and its potential in the treatment of irritable bowel syndrome

Authors Iorio N, Malik Z, Schey R

Received 10 February 2015

Accepted for publication 11 May 2015

Published 8 June 2015 Volume 2015:8 Pages 159—167


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 6

Editor who approved publication: Professor Andreas M Kaiser

Natalya Iorio, Zubair Malik, Ron Schey

Section of Gastroenterology, Department of Medicine, Temple University Hospital, Philadelphia, PA, USA

Abstract: Irritable bowel syndrome (IBS) is a chronic functional gastrointestinal disorder characterized by recurrent abdominal pain and abnormal bowel patterns. Alteration in gut flora, visceral hypersensitivity, and abnormal bowel motility are among numerous factors in the complex pathophysiology of IBS. Antibiotics have been used adjunctively to treat IBS for many years but are associated with various systemic side effects. Rifaximin is a nonabsorbable, broad-spectrum antimicrobial that inhibits bacterial RNA synthesis by binding the β-subunit of microbial RNA polymerase. It targets the gastrointestinal tract and works by reducing the quantity of gas-producing bacteria and altering the predominant species of bacteria present. In vivo animal studies suggest additional beneficial mechanisms of rifaximin, including reducing mucosal inflammation and visceral hypersensitivity. Clinical studies have demonstrated that rifaximin improves symptoms associated with IBS, such as bloating, flatulence, stool consistency, and abdominal pain, and has a side-effect profile similar to placebo. Although additional investigation into optimal dosing, treatment duration, and potential resistance is required, rifaximin presents as a safe and beneficial addition to the current management options for IBS.

Keywords: irritable bowel syndrome, rifaximin, small intestinal bacterial overgrowth, mucosal inflammation

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