AIM： To comparatively evaluate the long term efficacy of Rifaximin and dietary fibers in reducing symptoms and/or complication frequency in symptomatic, uncomplicated diverticular disease,METHODS： 307 patients （118...AIM： To comparatively evaluate the long term efficacy of Rifaximin and dietary fibers in reducing symptoms and/or complication frequency in symptomatic, uncomplicated diverticular disease,METHODS： 307 patients （118 males, 189 females, age range： 40-80 years） were enrolled in the study and randomly assigned to： Rifaximin （400 mg bid for 7 d every month） plus dietary fiber supplementation （at least 20 gr/d） or dietary fiber supplementation alone. The study duration was 24 mo; both clinical examination and symptoms＇ questionnaire were performed every two months. RESULTS： Both treatments reduced symptom frequency, but Rifaximin at a greater extent, when compared to basal values. Symptomatic score declined during both treatments, but a greater reduction was evident in the Rifaximin group （6.4±2.8 and 6.2 ± 2.6 at enrollment, P = NS, 1.0 ±0.7 and 2.4±1.7 after 24 mo, P 〈 0.001, respectively）. Probability of symptom reduction was higher and complication frequency lower （Kaplan-Meyer method） in the Rifaximin group （P 〈 0.0001 and 0.028, respectively）.CONCLUSION： In patients with symptomatic, uncomplicated diverticular disease, cyclic administration of RJfaximin plus dietary fiber supplementation is more effective in reducing both symptom and complication frequency than simple dietary fiber supplementation.Long term administration of the poorly absorbed antibiotic Rifaximin is safe and well tolerated by the patients,confirming the usefulness of this therapeutic strategy in the overall management of diverticular disease.展开更多
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...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.展开更多
文摘AIM： To comparatively evaluate the long term efficacy of Rifaximin and dietary fibers in reducing symptoms and/or complication frequency in symptomatic, uncomplicated diverticular disease,METHODS： 307 patients （118 males, 189 females, age range： 40-80 years） were enrolled in the study and randomly assigned to： Rifaximin （400 mg bid for 7 d every month） plus dietary fiber supplementation （at least 20 gr/d） or dietary fiber supplementation alone. The study duration was 24 mo; both clinical examination and symptoms＇ questionnaire were performed every two months. RESULTS： Both treatments reduced symptom frequency, but Rifaximin at a greater extent, when compared to basal values. Symptomatic score declined during both treatments, but a greater reduction was evident in the Rifaximin group （6.4±2.8 and 6.2 ± 2.6 at enrollment, P = NS, 1.0 ±0.7 and 2.4±1.7 after 24 mo, P 〈 0.001, respectively）. Probability of symptom reduction was higher and complication frequency lower （Kaplan-Meyer method） in the Rifaximin group （P 〈 0.0001 and 0.028, respectively）.CONCLUSION： In patients with symptomatic, uncomplicated diverticular disease, cyclic administration of RJfaximin plus dietary fiber supplementation is more effective in reducing both symptom and complication frequency than simple dietary fiber supplementation.Long term administration of the poorly absorbed antibiotic Rifaximin is safe and well tolerated by the patients,confirming the usefulness of this therapeutic strategy in the overall management of diverticular disease.
文摘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.
