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Definite IBS link to bacteria supports treatment with antibiotic

Kathleen Blanchard's picture
IBS and bacteria definitively linked.

Irritable bowel syndrome treatment (IBS) historically has been directed at relieving symptoms. Now researchers have definitively linked IBS to a bacterial cause, adding support to treatment of the condition with the antibiotic rifaximin.

One-third of patients with IBS have overgrowth of intestinal bacteria

Researchers found small intestine bacterial overgrowth (SIBO) in one-third of patients tested who were diagnosed with irritable bowel syndrome.

Mark Pimentel, MD, director of the Cedars-Sinai GI Motility Program and an author of the study said in a news release, “This clear evidence of the role bacteria play in the disease underscores our clinical trial findings, which show that antibiotics are a successful treatment for IBS.”

IBS affects 30 million people in the United States. The condition is painful and causes bloating, cramping, either diarrhea or constipation and sometimes both intermittently. It’s sometimes difficult for patients with IBS to manage symptoms.

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Pimentel is the researcher who found the antibiotic rifaximin alleviates symptoms of IBS, even after patients stop the medication. The effect lasted up to 10 weeks in clinical trials; 40.7 percent of 600 patients in trials experienced symptom relief. The results were published in January 6, 2011, in the New England Journal of Medicine.

Rifaximin specifically targets the gut where it stays. Very little is absorbed into the bloodstream.

The study is the first to use cultures to directly identify bacteria in the gut in patients with irritable bowel syndrome. Past studies relied on breath tests that measured methane that occurs when bacteria ferment.

Pimentel explains that bacterial cultures are the “gold standard” of diagnosis. He began exploring the notion that irritable bowel syndrome and bacteria were linked more than a decade ago. The study supports treating IBS with the antibiotic rifaximin.

May 25, 2012

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