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Acosta A, Camilleri M, Shin A, et al. Effects of Rifaximin on Transit, Permeability, Fecal Microbiome, and Organic Acid Excretion in Irritable Bowel Syndrome. Clin Transl Gastroenterol. 2016;7:e173doi: 10.1038/ctg.2016.32.
Acosta, A., Camilleri, M., Shin, A., Linker Nord, S., O'Neill, J., Gray, A. V., Lueke, A. J., Donato, L. J., Burton, D. D., Szarka, L. A., Zinsmeister, A. R., Golden, P. L., & Fodor, A. (2016). Effects of Rifaximin on Transit, Permeability, Fecal Microbiome, and Organic Acid Excretion in Irritable Bowel Syndrome. Clinical and translational gastroenterology, 7e173. https://doi.org/10.1038/ctg.2016.32
Acosta, Andrés, et al. "Effects of Rifaximin on Transit, Permeability, Fecal Microbiome, and Organic Acid Excretion in Irritable Bowel Syndrome." Clinical and translational gastroenterology vol. 7 (2016): e173. doi: https://doi.org/10.1038/ctg.2016.32
Acosta A, Camilleri M, Shin A, Linker Nord S, O'Neill J, Gray AV, Lueke AJ, Donato LJ, Burton DD, Szarka LA, Zinsmeister AR, Golden PL, Fodor A. Effects of Rifaximin on Transit, Permeability, Fecal Microbiome, and Organic Acid Excretion in Irritable Bowel Syndrome. Clin Transl Gastroenterol. 2016 May 26;7:e173. doi: 10.1038/ctg.2016.32. PMID: 27228404; PMCID: PMC4893683.
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Clin Transl Gastroenterol. 2016 May 26;7:e173. doi: 10.1038/ctg.2016.32.

Effects of Rifaximin on Transit, Permeability, Fecal Microbiome, and Organic Acid Excretion in Irritable Bowel Syndrome.

Clinical and translational gastroenterology

Andrés Acosta, Michael Camilleri, Andrea Shin, Sara Linker Nord, Jessica O'Neill, Amber V Gray, Alan J Lueke, Leslie J Donato, Duane D Burton, Lawrence A Szarka, Alan R Zinsmeister, Pamela L Golden, Anthony Fodor

Affiliations

  1. Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Mayo Clinic, Rochester, Minnesota, USA.
  2. Salix Pharmaceuticals, Raleigh, North Carolina, USA.
  3. Bioinformatics/Computer Science, University of North Carolina-Charlotte, Charlotte, North Carolina, USA.

PMID: 27228404 PMCID: PMC4893683 DOI: 10.1038/ctg.2016.32

Abstract

OBJECTIVES: Rifaximin relieves irritable bowel syndrome (IBS) symptoms, bloating, abdominal pain, and loose or watery stools. Our objective was to investigate digestive functions in rifaximin-treated IBS patients.

METHODS: In a randomized, double-blind, placebo-controlled, parallel-group study, we compared the effects of rifaximin, 550 mg t.i.d., and placebo for 14 days in nonconstipated IBS and no evidence of small intestinal bacterial overgrowth (SIBO). All subjects completed baseline and on-treatment evaluation of colonic transit by scintigraphy, mucosal permeability by lactulose-mannitol excretion, and fecal microbiome, bile acids, and short chain fatty acids measured on random stool sample. Overall comparison of primary response measures between treatment groups was assessed using intention-to-treat analysis of covariance (ANCOVA, with baseline value as covariate).

RESULTS: There were no significant effects of treatment on bowel symptoms, small bowel or colonic permeability, or colonic transit at 24 h. Rifaximin was associated with acceleration of ascending colon emptying (14.9±2.6 h placebo; 6.9±0.9 h rifaximin; P=0.033) and overall colonic transit at 48 h (geometric center 4.0±0.3 h placebo; 4.7±0.2 h rifaximin; P=0.046); however, rifaximin did not significantly alter total fecal bile acids per g of stool or proportion of individual bile acids or acetate, propionate, or butyrate in stool. Microbiome studies showed strong associations within subjects, modest associations with time across subjects, and a small but significant association of microbial richness with treatment arm (rifaximin vs. treatment).

CONCLUSIONS: In nonconstipated IBS without documented SIBO, rifaximin treatment is associated with acceleration of colonic transit and changes in microbial richness; the mechanism for reported symptomatic benefit requires further investigation.

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