[Efficacy of rifaksimin in excessive bacterial growth syndrome after cholecystectomy]

Abstract

Insights

Excessive bacterial growth (EBG) affects 58% of patients post-cholecystectomy and 28% with gallstone disease, often requiring intestinal microflora correction. Rifaksimin therapy shows promise in alleviating symptoms and improving breath test results.

Area of Science:

  • Gastroenterology
  • Microbiology
  • Clinical Medicine

Background:

  • Gallstone disease (GSD) and cholecystectomy are common procedures.
  • Excessive bacterial growth (EBG) in the small intestine can cause significant gastrointestinal symptoms.
  • The role of EBG in patients with GSD and post-cholecystectomy requires further investigation.

Purpose of the Study:

  • To determine the frequency of EBG in patients with GSD and after cholecystectomy.
  • To establish the necessity of intestinal microflora correction in these patient groups.
  • To evaluate the efficacy of rifaksimin for EBG decontamination.

Main Methods:

  • A study involving 35 patients with GSD and 50 patients post-cholecystectomy.
  • Inclusion criteria: characteristic symptoms of EBG.
  • Diagnostic tools: clinical, laboratory, instrumental examinations, and hydrogen breath test.
  • Treatment: rifaksimin 800 mg/day for 7 days.
  • Efficacy assessment: clinical symptoms and hydrogen breath test dynamics at 8 and 30 days.

Main Results:

  • EBG detected in 58% of post-cholecystectomy patients and 28% of GSD patients.
  • Rifaksimin treatment reduced clinical symptom intensity by day 8, correlating with breath test results.
  • By day 30, most patients experienced symptom resolution (56-75%), though some persistent symptoms were noted.
  • Observed symptom changes correlated with hydrogen breath test dynamics.

Conclusions:

  • EBG is prevalent in patients with GSD (28%) and post-cholecystectomy (52%), necessitating corrective therapy.
  • Rifaksimin therapy demonstrated positive effects on clinical symptoms and hydrogen breath test results.
  • Some patients did not achieve complete symptom relief or normalization of breath tests with rifaksimin at 800 mg/day.

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