Review article: the role of antibiotics vs. conventional pharmacotherapy in treating symptoms of irritable bowel syndrome

Alimentary Pharmacology and Therapeutics - Tập 25 Số 11 - Trang 1271-1281 - 2007
Christine L. Frissora1, Brooks D. Cash2
1Division of Gastroenterology and Hepatology, Weill Cornell Medical College of Cornell University, New York, NY, USA
2Gastroenterology Department and Colon Health Initiative, National Naval Medical Center, Bethesda, MD, USA

Tóm tắt

summaryBackgroundThe concept of augmenting the management of irritable bowel syndrome with antibiotics is evolving, and many questions remain regarding this therapy relative to known and hypothesized irritable bowel syndrome pathophysiology. The clinical evidence of small intestinal bacterial overgrowth as an important aetiology of irritable bowel syndrome continues to accumulate. Clinical symptoms of bacterial overgrowth and irritable bowel syndrome are similar; however, a definitive cause‐and‐effect relationship remains unproven. It is unclear whether motility dysfunction causes bacterial overgrowth or gas products of enteric bacteria affect intestinal motility in irritable bowel syndrome.AimTo discusses the efficacy and tolerability of current symptom‐directed pharmacotherapies and of antibiotics in the treatment of irritable bowel syndrome.MethodsA computerized search of PubMed was performed with search terms ‘IBS’, ‘pharmacotherapy’ and ‘antibiotics’. Relevant articles were selected, and the reference list of selected articles was reviewed to identify additional references.ResultsAntibiotic treatment benefits a subset of irritable bowel syndrome patients. The non‐absorbed antibiotic rifaximin has a favourable safety and tolerability profile compared with systemic antibiotics and demonstrates a therapeutic efficacy comparable with symptom‐based irritable bowel syndrome pharmacotherapies.ConclusionRifaximin is the only antibiotic with demonstrated sustained benefit beyond therapy cessation in irritable bowel syndrome patients in a placebo‐controlled trial. Whether antibiotics can improve quality of life in patients with irritable bowel syndrome warrants further research.

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Thông tin xuất bản

Alimentary Pharmacology and Therapeutics

Tập 25 Số 11

1271-1281

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