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[Efficacy of rifaksimin in excessive bacterial growth syndrome after cholecystectomy]
Unlabelled:
OBJECTIVE. To determine the frequency of the syndrome of excessive bacterial growth in patients with cholecystectomy and PL, justify the need for correction of intestinal microflora and to assess the effectiveness of rifaksimin decontamination.
Material And Methods:
The study involved 35 patients with gallstone disease (GSD) (3 men, 32 women, average age--59 +/- 9 years) and 50 patients who underwent cholecystectomy at the cholecystolithiasis (4 men, 46 women, average age--60 +/- 9 years). Inclusion criteria were the complaints that are characteristic for the syndrome of excessive bacterial growth in the small intestine (EBG). All the patients underwent clinical, laboratory and instrumental examinations and hydrogen breath test. In identifying the EBG was a rifaksimin treatment at a dose of 800 mg/day for 7 days. Treatment efficacy was determined by the dynamics of clinical symptoms and indicators of the hydrogen breath test at the 8 th and 30th day of observation.
Results And Discussion:
Patients who was underwent cholecystectomy, EBG was detected in 58%, and among patients with gallstone disease--in 28%. The rifaksimin treatment to 8 th day was declining intensity of clinical symptoms correlated with the dynamics of the hydrogen breath test. On day 30 the majority of patients clinical symptoms of EBD disappeared (from 56 to 75% depending on the symptoms), but in some patients it persisted, despite the reduction in their severity. These data also correlated with the dynamics of the hydrogen breath test.
Conclusion:
At cholecystolithiasis and in patients with removal of the gallbladder detected EBG in 28 and 52% respectively, which requires corrective therapy. The rifaksimin therapy have positive dynamics in relieving clinical symptoms and the decline in the hydrogen breath test. However, some patients with therapy at a dose of 800 mg/day uncropped pain and dyspeptic symptoms and hadn't accompanied by normalization of pH test.
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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