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Related Concept Videos

Drugs for Treatment of Diarrhea-Predominant IBS01:17

Drugs for Treatment of Diarrhea-Predominant IBS

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Diarrhea-predominant irritable bowel syndrome (IBS-D) is a subtype of IBS characterized primarily by frequent, loose, or watery stools, abdominal pain, and abdominal discomfort. Therapeutic approaches to managing IBS-D include dietary changes, stress management techniques, and pharmaceutical interventions.
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
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Drugs for Treatment of Constipation-Predominant IBS01:21

Drugs for Treatment of Constipation-Predominant IBS

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Pharmacological therapies for IBS-C are designed to alleviate abdominal discomfort and enhance bowel function. In patients with IBS-C, fiber supplements may help soften stools and decrease straining, but may also lead to increased gas production and bloating. Osmotic laxatives like milk of magnesia are frequently used to soften stools and increase stool frequency in IBS-C patients. In addition, two drugs approved for use in severe IBS-C adult cases are linaclotide (Linzess) and lubiprostone...
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Drugs Affecting GI Tract Motility: Antimicrobials as Antidiarrheal Agents01:18

Drugs Affecting GI Tract Motility: Antimicrobials as Antidiarrheal Agents

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Acute diarrhea, a common gastrointestinal disturbance, is characterized by the rapid evacuation of fluid stools, leading to an excessive weight in fluid. This condition typically arises from disorders affecting intestinal water and electrolyte transport. It can be triggered by an increased osmotic load within the intestine, excessive secretion of electrolytes and water, mucosal exudation of protein and fluid, or altered intestinal motility. The primary risks of acute diarrhea are dehydration...
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Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation01:30

Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation

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Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation
Irritable Bowel Syndrome (IBS) is classified into subtypes based on the predominant bowel habits as determined by the Bristol Stool Form Scale (BSFS). The subtypes are:
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Drugs for Treatment of Ulcerative Colitis in IBD01:29

Drugs for Treatment of Ulcerative Colitis in IBD

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Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide...
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Irritable Bowel Syndrome III: Medical and Nursing Management01:30

Irritable Bowel Syndrome III: Medical and Nursing Management

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Managing Irritable Bowel Syndrome (IBS) involves a multifaceted approach, including lifestyle modifications, dietary changes, and medication.
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Related Experiment Video

Updated: Mar 1, 2026

A Protocol to Characterize the Morphological Changes of Clostridium difficile in Response to Antibiotic Treatment
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Repeat Rifaximin for Irritable Bowel Syndrome: No Clinically Significant Changes in Stool Microbial Antibiotic

M Pimentel1, B D Cash2, A Lembo3

  • 1GI Motility Program, Division of Gastroenterology, Cedars-Sinai Medical Center, 8730 Alden Drive, Suite 225E, Los Angeles, CA, 90048, USA. Mark.Pimentel@cshs.org.

Digestive Diseases and Sciences
|June 8, 2017
PubMed
Summary

Repeat rifaximin treatment for IBS-D showed no long-term impact on gut bacteria

Keywords:
DiarrheaIrritable bowel syndromeMicrobiologyRifaximin

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Quantitative Polymerase Chain Reaction-based Analyses of Murine Intestinal Microbiota After Oral Antibiotic Treatment
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Area of Science:

  • Gastroenterology
  • Microbiology
  • Pharmacology

Background:

  • Rifaximin is an effective and safe treatment for diarrhea-predominant irritable bowel syndrome (IBS-D).
  • Understanding the impact of repeat rifaximin treatment on gut microbiota antibiotic susceptibility is crucial for long-term therapeutic strategies.

Purpose of the Study:

  • To evaluate the effect of repeat rifaximin treatment courses on the antibiotic susceptibility of fecal bacteria in patients with IBS-D.

Main Methods:

  • Patients responding to initial rifaximin treatment in the TARGET 3 study received repeat courses (rifaximin or placebo) in a double-blind phase.
  • Stool samples were collected at multiple time points for susceptibility testing against 11 antibiotics, including rifaximin and rifampin.
  • Bacterial and yeast isolates were identified, with a focus on common gut bacteria like Bacteroidaceae and Enterobacteriaceae.

Main Results:

  • Clostridium difficile and Staphylococcus isolates remained highly susceptible to rifaximin and rifampin throughout the study.
  • No long-term cross-resistance was observed in key bacterial groups (Bacteroidaceae, Enterobacteriaceae, Enterococcaceae) to rifampin or other tested antibiotics following rifaximin exposure.

Conclusions:

  • Short-term, repeat treatment with rifaximin does not appear to induce long-term changes in the antibiotic susceptibility of the gut microbiota.
  • These findings support the continued use of rifaximin for managing IBS-D without significant concerns for developing antibiotic resistance in the gut microbiome.