Abstract
EFFICACY OF RIFAXIMIN VERSUS PROBIOTICS IN THE PATIENTS OF DIARRHEA PREDOMINANT IRRITABLE BOWEL SYNDROME

Himani Deswal, Sarita Goyal*, Sandeep Goyal and M. C. Gupta

ABSTRACT

Background: IBS-D is chronic functional GI disorder characterized by abdominal pain, diarrhea, bloating and mucus discharge. Along with disturbance in brain gut axis, dysbiosis i.e. imbalance in gut microbiota plays an important role in the development of symptoms. Literature showed that both rifaximin, a non-systemic antibiotic which acts by suppressing bacterial gene expression and probiotics (VSL#3) by modulating the gut microbiota helps in amelioration of disease symptoms. This study was carried out to compare efficacy and safety of rifaximin and probiotics, when given in IBS-D patients. Methodology: It was an open-label, parallel group, prospective, randomized and comparative study, in 138 patients diagnosed with IBS-D using ROME IV criteria, who were divided into two groups with either tab rifaximin 550 mg BD or tab VSL#3 BD for 14 days. Assessment was done by using symptom score scale and pre-prepared adverse drug monitoring performa at 2weeks, 4 weeks and 6 weeks after treatment. Results: Both rifaximin and VSL#3 were found to be effective in improving total relief after treatment. Improvement in total relief rate from baseline was 69.4% and 75% (p=0.578) of patients at 2 weeks in rifaximin and VSL#3 respectively which increased to 86% with rifaximin whereas decreased to 56.25% (p=0.004) with VSL#3 during follow up period at 6 weeks. During 6 weeks of the study, adverse drug events were found comparable in both the groups i.e. 47% in rifaximin and 28% in VSL#3. Conclusion: VSL#3 was found to be non-inferior with rifaximin during treatment period in the patients of IBS-D.

Keywords: IBS-D, Rifaximin, ROME IV, VSL#3.


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