Small intestine bacterial overgrowth and irritable bowel syndrome-related symptoms: Experience with Rifaximin

Peralta, Sergio; Cottone, Claudia; Doveri, Tiziana; Almasio, Piero Luigi; Craxi, Antonio

doi:10.3748/wjg.15.2628

Cited by 88Gastrointestinal motility and disordersGut microbiota and healthMicroscopic Colitis

Small intestine bacterial overgrowth and irritable bowel syndrome-related symptoms: Experience with Rifaximin

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Peralta, Sergio, Cottone, Claudia, Doveri, Tiziana, Almasio, Piero Luigi, Craxi, Antonio·2009·World Journal of Gastroenterology

DOI 10.3748/wjg.15.2628PMC PMC2691494

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Abstract

AIM: To estimate the prevalence of small intestinal bacterial overgrowth (SIBO) in our geographical area (Western Sicily, Italy) by means of an observational study, and to gather information on the use of locally active, non-absorbable antibiotics for treatment of SIBO. METHODS: Our survey included 115 patients fulfilling the Rome II criteria for diagnosis of irritable bowel syndrome (IBS); a total of 97 patients accepted to perform a breath test with lactulose (BTLact), and those who had a positive test, received Rifaximin (Normix, Alfa Wassermann) 1200 mg/d for 7 d; 3 wk after the end of treatment, the BTLact was repeated. RESULTS: Based on the BTLact results, SIBO was present in about 56% of IBS patients, and it was responsible for some IBS-related symptoms, such as abdominal bloating and discomfort, and diarrhoea. 1-wk treatment with Rifaximin turned the BTLact to negative in about 50% of patients and significantly reduced the symptoms, especially in those patients with an alternated constipation/diarrhoea-variant IBS. CONCLUSION: SIBO should be always suspected in patients with IBS, and a differential diagnosis is done by means of a "breath test". Rifaximin may represent a valid approach to the treatment of SIBO.

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Bloating in IBS can be caused by SIBO.
“Bloating in IBS can be caused by SIBO.”
From Thyroid disorders and gastrointestinal dysmotility: an old association (2024) · cites this paper as Peralta et al., 2009
Data from meta-analyses indicating increased prevalence of SIBO in IBS, symptom overlap between the two conditions, and improvement of symptoms with antibiotic treatment support the hypothesis that alterations in the intestinal microbiota may have a role in the pathogenesis of IBS, at least in some patients.
“Nonetheless, the data from meta-analyses indicating increased prevalence of SIBO in IBS, the symptom overlap between the two conditions, and the improvement of symptoms with antibiotic treatment (47, 49, 59, 103, 131, 135, 136, 193) further support the hypothesis that alterations in the intestinal microbiota may have a role in the pathogenesis of IBS, at least in some patients.”
From Intestinal microbiota and immune function in the pathogenesis of irritable bowel syndrome (2013) · cites this paper as [131]
Early studies demonstrated symptom improvement in IBS patients whose SIBO was successfully treated with antibiotics, including neomycin, metronidazole, and rifaximin.
“Early studies demonstrated symptom improvement in IBS patients whose SIBO was successfully treated with antibiotics, including neomycin, metronidazole, and the nonabsorbable antibiotic rifaximin (47, 49, 59, 103, 131, 135, 136, 193).”
From Intestinal microbiota and immune function in the pathogenesis of irritable bowel syndrome (2013) · cites this paper as [131]

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Authors: Peralta, S., Cottone, C., Doveri, T., Almasio, P. L., & Craxi, A.
Affiliations: Bombay Hospital (IN)
ORCID: Peralta, Sergio
Almasio, Piero Luigi
Venue: World Journal of Gastroenterology
Publisher: Baishideng Publishing Group Inc.
Published: 2009
Volume: 15
Issue: 21
Pages: 2628
ISSN: 1007-9327 (ISSN-L)
DOI: 10.3748/wjg.15.2628
PMC: PMC2691494
OpenAlex: W2100507037
Cited by: 88
References: 26
Citations by year: 2026: 4 · 2025: 3 · 2024: 1 · 2023: 2 · 2022: 4 · 2021: 10 · 2020: 5 · 2019: 1 · 2018: 2 · 2017: 7 · 2016: 5 · 2015: 7 · 2014: 12 · 2013: 6 · 2012: 6
FWCI: 6.73
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by-nc
Locations: World Journal of Gastroenterology (publishedVersion, cc-by-nc)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Nova Science Publishers (Nova Science Publishers, Inc.) (submittedVersion)
Topics: Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
Health Sciences › Medicine › Epidemiology › Microscopic Colitis
Keywords: small intestinal bacterial overgrowth, irritable bowel syndrome, rifaximin, lactulose breath test, SIBO prevalence, bloating, non-absorbable antibiotics, western Sicily
MeSH terms: Rifaximin, Adult, Anti-Infective Agents, Bacterial Infections, Breath Tests, Female, Gastrointestinal Agents, Humans, Intestine, Small, Lactulose, Male, Rifamycins, Sicily, Irritable Bowel Syndrome

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Small intestine bacterial overgrowth and irritable bowel syndrome-related symptoms: Experience with Rifaximin

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