[Variation of intestinal fermentative profile after sequential therapy with rifaximin/probiotics]

There is evidence suggesting that intestinal microbiota plays a role in the development of irritable bowel syndrome. Its activity can be indirectly assessed using the lactulose breath test. Antibiotics like rifaximin or probiotics can be used as therapeutic options for patients with irritable bowel syndrome. Our purpose was to evaluate the efficacy of a sequential treatment with rifaximin and probiotics in these patients.

We prospectively evaluated patients with diagnosis of irritable bowel syndrome according to Rome III criteria. Included patients had to fill in a questionnaire in order to assess their symptoms severity. A lactulose breath test was also performed in each case and a curve with the results of hydrogen concentration and time was elaborated. Then, the area under the curve was calculated After initial evaluation, patients received a seven-day treatment with rifaximin, followed by a ten-day course of probiotics. Thirty days after completion of treatment a new lactulose breath test along with a questionnaire were performed.

We included 15 patients and 93% experienced a significant improvement of their symptoms as well as a significant reduction of the lactulose breath test values.

Sequential treatment with rifaximin/probiotics seems to be effective for symptom and fermentative profile improvement in irritable bowel syndrome patients.