Efficacy of Rifaximin in Patients With Abdominal Bloating or Distension

doi:10.1097/MCG.0000000000001872

Paper

Efficacy of Rifaximin in Patients With Abdominal Bloating or Distension

Published Jun 14, 2023 · U. Arora, Karan Sachdeva, P. Garg

Journal of Clinical Gastroenterology

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Abstract

Background: Abdominal bloating is a common complaint in patients with functional and organic bowel disease. Rifaximin, a nonabsorbable antibiotic, has been tried for the treatment of this disease. We performed a systematic review and meta-analysis to study the efficacy of rifaximin in abdominal bloating and distension in patients with functional gastrointestinal disorders (FGID). Methods: We accessed 4 databases (MEDLINE, Embase, SCOPUS, and Web of Science) to identify randomized placebo-controlled trials that utilized rifaximin in FGID. We excluded observational studies, those including patients with organic bowel disorders such as inflammatory bowel diseases, or those in which rifaximin was given for other indications, such as hepatic encephalopathy. Results: A total of 1426 articles were available, of which 813 articles were screened after removing duplicates and 34 articles were selected for full-text review. Finally, 10 trials (3326 patients) were included. Rifaximin was administered in doses ranging from 400 to 1650 mg per day for 1 to 2 weeks. Rifaximin therapy led to a higher likelihood of improvement in symptoms of bloating (44.6% vs. 34.6%, RR 1.22, 95% CI 1.11, 1.35; n=2401 patients) without significant heterogeneity. However, daily doses less than 1200 mg/day were similar to placebo (P=0.09). Bloating was quantified subjectively in 7 studies, and rifaximin led to a greater reduction in bloating scores compared with placebo (standardized mean difference −0.3, 95% CI −0.51, −0.1, P=0.04) but carried significant heterogeneity (I 2=61.6%, P=0.01). Conclusions: Rifaximin therapy is associated with an increased likelihood of improvement in bloating and distension, as well as reduces the subjective severity of these symptoms in patients with FGID.

Meta-Analysis

Study Snapshot

Rifaximin therapy is associated with an increased likelihood of improvement in bloating and distension symptoms and reduced subjective severity in patients with functional gastrointestinal disorders.

PopulationOlder adults (50-71 years)

Sample size24

MethodsObservational

OutcomesBody Mass Index projections

ResultsSocial networks mitigate obesity in older groups.

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Efficacy of Rifaximin in Patients With Abdominal Bloating or Distension

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References

Management of Chronic Abdominal Distension and Bloating.

Chronic abdominal bloating and distension can be managed through dietary changes, probiotics, antibiotics, and biofeedback, with no single treatment being consistently successful.

Value-based Pricing for Rifaximin Increases Access of Patients With Irritable Bowel Syndrome With Diarrhea to Therapy.

Value-based pricing methods can justify improved payer coverage for rifaximin for patients with irritable bowel syndrome with diarrhea, potentially increasing access to therapy.

Efficacy of pharmacological therapies in patients with IBS with diarrhoea or mixed stool pattern: systematic review and network meta-analysis

Pharmacological therapies are all superior to placebo for treating IBS-D and IBS-M, with alosetron and ramosetron being the most effective.

Double-Blind Placebo-Controlled Study of Rifaximin and Lactulose Hydrogen Breath Test in Gulf War Veterans with Irritable Bowel Syndrome

Rifaximin was not effective in improving IBS symptoms and quality of life in Gulf War Veterans with non-constipated IBS.

Repeat treatment with rifaximin improves irritable bowel syndrome-related quality of life: a secondary analysis of a randomized, double-blind, placebo-controlled trial

Repeat treatment with rifaximin improves irritable bowel syndrome-related quality of life in patients.

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