[CYCLIC RIFAXIMIN TREATMENT IN UNCOMPLICATED COLONIC DIVERTICULAR DISEASE - AN OPEN LABEL STUDY]
SIMON László, SALAMON Ágnes, FELFÖLDI Ferenc, TAM Beatrix, SÁNTA Judit, VADÁSZ Edit
FEBRUARY 21, 2006
Lege Artis Medicinae - 2006;16(02)
SIMON László, SALAMON Ágnes, FELFÖLDI Ferenc, TAM Beatrix, SÁNTA Judit, VADÁSZ Edit
FEBRUARY 21, 2006
Lege Artis Medicinae - 2006;16(02)
[INTRODUCTION - Aquired diverticular disease of the colon is extremely common in developed countries. Poorly absorbing antibiotics may have beneficial effects on symptoms in long-term treatment. An open study was conducted to evaluate the efficiency of rifaximin in the prevention of complaints and recurrent diverticulitis. PATIENTS AND METHODS - Thirty consecutive patients with proven uncomplicated colonic diverticulosis were selected to receive rifaximin 200 mg bid for the first six days of every month, for six months. They were also advised to consume an high-fibre diet. Patients were reviewed on a monthly basis by clinical examinations; changes in symptom variables (lower abdominal pain, upper abdominal pain, bloating, tenesmus, diarrhoea, abdominal tenderness) were evaluated on a 10-point Visual Analogue Scale (VAS), and the presence of acute diverticulitis (abdominal mass, fever, US) was ruled out at every monthly visit. RESULTS - Twenty-nine of 30 patients completed the study. After six months of cyclic rifaximin treatment the global symptom score decreased in all patients compared to the baseline. Acute diverticulitis, other complications or side effects were not observed. CONCLUSIONS - In this open study cyclic administration of a relatively low dose of rifaximin in uncomplicated colonic diverticular disease resulted in the reduction of abdominal complaints and prevented recurrent diverticulitis. This effect might be explained by a reduced metabolic activity of intestinal bacterial flora.]
Lege Artis Medicinae
Lege Artis Medicinae
Lege Artis Medicinae
Lege Artis Medicinae
Lege Artis Medicinae
[Antibiotic therapy might alter gut microbiome. The consequence of that is dysbiosis with or without immediate overt clinical manifestation. The beneficial effect of rifaximin, a non-absorbable broad spectrum antibiotic, in gastrointestinal and hepatic disorders is known for a long time. According to recent data rifaximin has not only antibiotic but also anti-inflammatory and, within antibiotics, a unique special eubiotic effect as well. It modulates the gut microbiome, restores eubiosis through increasing beneficial species’ count while not disturbing diversity.]
Lege Artis Medicinae
[As acute or chronic liver diseases progress, liver failure and related hepatic encephalopathy may develop. The latter occurs in more than 70% of patients with hepatic cirrhosis. Because of declining cognitive functions, sleep disturbances, memory problems and impaired motion coordination, this condition can - even in mild form - limit the patient's self-sufficiency and activity and can lead to a decreased quality of life and ability to work. Its most advanced stage, hepatic coma is one of the leading causes of liver-related mortality. These conditions generate a substantial healthcare costs. Treatment of hepatic encephalopathy involves dietary restrictions, prevention and treatment of precipitating factors, inhibition of the production and absorption of toxic substances (especially ammonia) and restoration of the amino acid balance. In addition to the traditionally used treatment with disaccharids (lactulose, lactitol), evidence has been accumulating regarding the efficacy and safety of a nonabsorbable antibiotic compound, rifaximin, which targets enteral pathogen bacteria, both in treatment and in prevention of hepatic encephalopathy. Artificial liver support therapies have been also introduced in Hungary. This review summarises the experience regarding treatment of hepatic encephalography for physicians involved in the management of patients with hepatic diseases.]
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