Abstract

Concomitant Irritable Bowel Syndrome Does Not Influence the Response to Antimicrobial Therapy in Patients with Functional Dyspepsia

Dig Dis Sci. 2022 Jun;67(6):2299-2309. doi: 10.1007/s10620-021-07149-1. Epub 2021 Aug 14.

 

Ayesha Shah 1 2 3 4 5Saravana Ruban Gurusamy 1 2Teressa Hansen 2Gavin Callaghan 2 6Nicholas J Talley 3 4 5 7Natasha Koloski 1 2 3 4 5 7 8Marjorie M Walker 3 4 5 7Michael P Jones 3 4 5 9Mark Morrison 1 3 4 5 10Gerald J Holtmann 11 12 13 14 15 16

 
     

Author information

1Faculty of Medicine, University of Queensland, St. Lucia, QLD, Australia.

2Department of Gastroenterology and Hepatology, University of Queensland, Princess Alexandra Hospital, Ipswich Road, Brisbane, Woolloongabba, QLD, Australia.

3Australian Gastrointestinal Research Alliance, Brisbane, Australia.

4Australian Gastrointestinal Research Alliance, Newcastle, Australia.

5Australian Gastrointestinal Research Alliance, Sydney, Australia.

6Department of Pharmacy, Princess Alexandra Hospital, Brisbane, QLD, Australia.

7Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, Australia.

8Faculty of Health and Behavioural Sciences, University of Queensland, Herston, QLD, Australia.

9Department of Psychology, Macquarie University, Sydney, NSW, Australia.

10Faculty of Medicine, University of Queensland Diamantina Institute, Woolloongabba, QLD, Australia.

11Faculty of Medicine, University of Queensland, St. Lucia, QLD, Australia. g.holtmann@uq.edu.au.

12Department of Gastroenterology and Hepatology, University of Queensland, Princess Alexandra Hospital, Ipswich Road, Brisbane, Woolloongabba, QLD, Australia. g.holtmann@uq.edu.au.

13Australian Gastrointestinal Research Alliance, Brisbane, Australia. g.holtmann@uq.edu.au.

14Australian Gastrointestinal Research Alliance, Newcastle, Australia. g.holtmann@uq.edu.au.

15Australian Gastrointestinal Research Alliance, Sydney, Australia. g.holtmann@uq.edu.au.

16Faculty of Health and Behavioural Sciences, University of Queensland, Herston, QLD, Australia. g.holtmann@uq.edu.au.

Abstract

Background and aims: Antimicrobial therapy improves symptoms in patients with irritable bowel syndrome (IBS), but the efficacy in functional dyspepsia (FD) is largely unknown. While FD and IBS frequently overlap, it is unknown if concomitant IBS in FD alters the response to antimicrobial therapy in FD. Thus, we aimed to assess and compare the effect of antimicrobial therapy on visceral sensory function and symptom improvement in FD patients with and without IBS.

Methods: Adult patients with FD with or without IBS received rifaximin 550 mg BD for 10 days, followed by a 6-week follow-up period. The total gastrointestinal symptom score as measured by the SAGIS (Structured Assessment of Gastrointestinal Symptoms) questionnaire and subscores (dyspepsia, diarrhea, and constipation), symptom response to a standardized nutrient challenge and normalization of the glucose breath tests were measured.

Results: Twenty-one consecutive adult patients with FD and 14/21 with concomitant IBS were recruited. Treatment with rifaximin resulted in a significant (p = 0.017) improvement in the total SAGIS score from 34.7 (± 15.4) at baseline to 26.0 (± 16.8) at 2 weeks and 25.6 (± 17.8) at 6 weeks post-treatment. Similarly, compared to baseline there was a statistically significant improvement in SAGIS subscores for dyspepsia and diarrhea (all p < 0.05) and effects persisted for 6 weeks post-treatment. Similarly, the symptom score (and subscores) following a standardized nutrient challenge improved significantly (p < 0.001) 2 weeks post-treatment. The presence of concomitant IBS did not significantly influence the improvement of symptoms after antibiotic therapy (all p > 0.5).

Conclusions: In FD patients, the response to antimicrobial therapy with rifaximin is not influenced by concomitant IBS symptoms.

 

 

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