IBS not psychological! - Treatable with antibiotic - Science Daily article

Discussion in 'Fibromyalgia Main Forum' started by KerryK, May 8, 2010.

  1. KerryK

    KerryK Member

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    Antibiotic Prevents Irritable Bowel Syndrome Symptoms for Weeks After Final Dose
    ScienceDaily (May 8, 2010) — A targeted antibiotic provides effective and long-lasting relief of Irritable Bowel Syndrome symptoms, according to the results of two multisite Phase III clinical trials designed by Cedars-Sinai researchers. Rifaximin is the first drug treatment for IBS that relieves symptoms while it's being administered and continues to benefit patients after they stop taking the drug.

    Researchers found that patients who took rifaximin not only experienced relief of their IBS symptoms, including specific symptoms of bloating, abdominal pain and stool consistency, while they were taking the antibiotic, but also that their relief was sustained over the 10 week follow-up period when no antibiotic was administered.

    The results of the studies were presented at the Digestive Disease Week conference in New Orleans on May 3.

    "These studies validate the role of altered gut bacteria in IBS," said Mark Pimentel, M.D., GI Motility Program director at Cedars-Sinai and the principal investigator of the clinical trail at Cedars. "These findings show that targeted antibiotics provide safe and long-lasting improvement for IBS patients."

    IBS is the most common gastrointestinal disorder in the United States, affecting more than 20 percent of the population. Traditionally, patients with IBS have been described as having "constipation predominant," "diarrhea-predominant" or an alternating pattern of diarrhea and constipation. In addition to these symptoms, IBS patients often experience abdominal pain or cramps, excess gas or bloating, harder or looser stools than normal and visible abdominal distension.

    Because the cause of IBS has been elusive, treatments for the disease have historically focused on relieving its symptoms through medications that either slow or speed up the digestive process. Earlier research conducted by Pimentel and colleagues documents a possible link between bloating, the most common IBS symptom, and bacterial fermentation by giving participants lactulose breath tests. The test monitors the level of hydrogen and methane -- the gases emitted by fermented bacteria -- on the breath. Those tests show elevated levels of those gases, indicating that small intestine bacterial overgrowth, or SIBO, may be a cause of IBS.

    More than 1,200 patients participated in the Phase III, double-blind, multi-center studies of rifaximin, a nonabsorbable antibiotic that stays in the gut and is currently FDA-approved to treat traveler's diarrhea and hepatic encephalopathy. IBS patients with mild to moderate diarrhea and bloating were randomized to receive 550 milligrams of rifaximin or placebo for two weeks. Patients were then followed for an additional 10 weeks. Phase III trials are randomized studies on large patient groups to definitively demonstrate the safety and effectiveness of a new drug.

    The findings support previous research by Pimentel indicating that IBS is caused by an overgrowth of bacteria in the gut.

    "Even after you stop the antibiotic, the patients continue to feel better, which indicates that we did something to strike at what causes the condition," Pimentel said.

    In addition to Cedars-Sinai, other centers participating in the clinical trials included Beth Israel Deaconess Medical Center in Boston, University of Michigan Medical Center in Ann Arbor, University of North Carolina at Chapel Hill, Connecticut Gastroenterology Institute in Bristol, Conn.

    Rifaximin is marketed by Salix Pharmaceuticals, Inc. Salix also provided funding for the studies. Pimentel discovered the use of rifaximin for IBS, and Cedars-Sinai holds patent rights to this discovery and has licensed rights to the invention to Salix. Dr. Pimentel is a consultant to Salix, Inc, and serves on its scientific advisory board.

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    Adapted from materials provided by Cedars-Sinai Medical Center, via EurekAlert!, a service of AAAS.


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  2. KerryK

    KerryK Member

    The problem with your statement is that the medical establishment has come up with this remedy and clear proof of bacterial involvment. In fact, the study was, I believe, funded by the pharmaceutical manufacterer of the antibiotic mentioned. So, the profit motive has produced yet another advancement in medical knowledge and treatment. I am not aware of anything more than minor improvements with probiotics at best. So the alternative industry has not provided any real such proof, even if they may have generally accepted the hypothesis of bacterial causation. Frankly, the alternative industry has provided few real remedies while the "medical establishment" has, albeit frustratingly slowly. Go Big Pharma!
  3. SnooZQ

    SnooZQ New Member

    In fact, I will dare to say that the majority are NOT.

    I was interested in this post, as a former IBS sufferer. A friend of mine who also had severe IBS was tried on rifaximin ... without success. So I was interested in what was being said.



    I am not entirely sure that this is precisely the same study as Kerry mentions, however, it appears to be a placebo-controlled study, so let's look at the data.

    The first thing I noticed is that the subjects chosen for the Rifaximin study were nonconstipated IBS subjects.

    IBS is considered to have three different types (IBS-C, IBS-D and alternating). So, at best it would be fair to say that the study's results would be applicable only to one of those groups, those with IBS-D.

    From the data, it appears that Rifaximin improved IBS significantly in roughly 40% of the IBS patients in the study, compared to sig improvement in 30% with placebo.

    So, the differential improvement with Rifaximin, over placebo, is improvement in 10% of one of three patient subsets with IBS.

    I'm underwhelmed.

    Kerry said: >>Frankly, the alternative industry has provided few real remedies while the "medical establishment" has, albeit frustratingly slowly. >>

    For myself, I suffered for 5 decades -- since infancy, with severe IBS (called other things in decades past). I endured numerous medical procedures during 3 hospitalizations for this beast, and was tried on numerous medications, none of which were remotely helpful.

    For the past 6 years, I have been IBS free while following a faithful gluten-free diet. My gastroenterologist was stunned. Under his care for 20 yrs., no mention was made of the possibility that a food intolerance can be a cause of IBS.

    So, while some feel frustration with alt med., my experience leads me to deep disappointment with modern medicine and Big Pharma.

    I no longer suffer from IBS. My life has turned around. And I owe my thanks to alternative medicine.

    For those with IBS who find long-term success with Rifaximin, I'm happy. However, Rifaximin treatment does come with potential for these side-effects: bloating, gas, stomach pain; feeling like you need to empty your bowel urgently; feeling like your bowel is not completely empty; nausea, vomiting, constipation; headache; fever; vaginal itching or discharge; mild itching or skin rash, allergic reaction including anaphylaxis. (Read more: http://www.drugs.com/mtm/rifaximin.html#ixzz0nlE1eTsi)

    [This Message was Edited on 05/12/2010]
  4. SnooZQ

    SnooZQ New Member

    I don't believe there is just one cause of IBS (in all its forms) any more than I believe that there is just one possible cause of FMS.

    If all IBS were caused by bacteria, where's the study showing Rifaximin (or other antibiotic of choice) besting placebo by say 65-70% rather than just besting placebo by 10%.

    It's fairly reasonable IMO, on the basis of the research evidence available, to say that SOME IBS-D is rifaximin responsive, and that therefore probably some IBS is a result of bacteria, or bacterial overgrowth in the gut (which is actually more of an alt-med concept).

    However, over decades with IBS, I've met many people who have found root causes for their IBS other than bacteria. Anecdotal,yes, but possibly related to the relatively modest showing of rifaximin in this study.[This Message was Edited on 05/12/2010]
  5. gapsych

    gapsych New Member

    I will have to run this by my doctor. It does sound counterintuitive that an antibiotic would help but antibiotics can also clear up an ulcer.

    I think to get the same effect from probiotics, you would have to take a lot and this medication is probably cheaper in the long run and targeted to help IBS. That is if it does.

    Probiotics do help me a bit but they are so expensive, compared to the relief I get. I take miralax which is OTC. It is not cheap either but I just found out that you can have your doctor prescribe it so I would only have a copay. You also can't take it everyday. Yogurt also helps but again I don't get enough bang for my buck.

    Thanks Kerry.

    [This Message was Edited on 05/13/2010]
  6. TigerLilea

    TigerLilea Active Member

    Some people are mistakenly diagnosed as having IBS when in fact they actually have Celiac Disease or gluten intollerance.
  7. SnooZQ

    SnooZQ New Member

    Yes, I am quite aware of that. Now.

    You know there are still many gastroenterologists who are not aware. Celiac disease is coming onto the radar, but most gastros do not acknowledge nonceliac gluten intolerance. Mine does, now.

    Yeah, my "mistaken diagnosis" was given by umpteen docs over FIVE DECADES. I do not have any of the four primary antibody types associated with celiac disease, nor do I have antibodies associated with IgE/IgG gluten intolerance.

    This thread started out RAH RAH conventional med & Big Pharma.

    Well, that route did not work for me -- while alt med DID.

    Best wishes.