Bacterial Flora in Digestive Disease: Focus on Rifaximin by C. Scarpignato, A. Lanas

By C. Scarpignato, A. Lanas

Reprint of: Digestion 2006, Vol. seventy three, Suppl. 1 countless numbers of bacterial species make up human intestine plants. The gut has not less than four hundred varied species of micro organism totaling over 1012 organisms. of those, ninety nine% are anaerobic micro organism. The gastrointestinal tract is then uncovered to thousands of bacterial species and overseas antigens and has embedded a different and intricate community of immunological and non-immunological mechanisms to guard the host from very likely damaging pathogens. fit people are quite often tolerant to their very own microbiota, yet such tolerance is impaired in sufferers with either natural and useful gastrointestinal illnesses. The development of the information on microbial-gut interactions in overall healthiness and ailment has allowed a extra pathophysiologically-oriented method of numerous hard medical stipulations. There are at the moment how one can control enteric plants. Antibiotics can selectively reduce tissue invasion and get rid of competitive bacterial species or globally reduce luminal and mucosal bacterial concentrations, reckoning on their spectrum of job. on the other hand, management of worthwhile bacterial species (probiotics), poorly absorbed nutritional oligosaccharides (prebiotics), or mixed probiotics and prebiotics (synbiotics) can fix a predominance of necessary commensal vegetation. those healing ways aren't, after all, collectively unique. Rifaximin, a poorly absorbed antibiotic distinctive on the gastrointestinal tract, has been lengthy utilized in Italy for the remedy of infectious diarrhea in either adults and kids. prior to now few years the appreciation of the pathogenic function of intestine micro organism in different natural and practical gastrointestinal ailments has more and more broadened its medical use, which now covers hepatic encephalopathy, small gut bacterial overgrowth, inflammatory bowel ailment and colonic diverticular ailment. different strength medical symptoms are being explored and glance promising. during this factor, prime scientists (both Spanish and Italian) speak about - in a chain of state of the art reports - the present prestige of the current wisdom on Microbial plant life in Digestive ailments and investigate the function of rifaximin in different gut-related natural and useful gastrointestinal issues. because it contains a lot details tough to gather from different scattered resources, this quantity could be of curiosity to infectiologists, gastroenterologists and digestive surgeons alike.

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F. 7 Favours placebo cebo-controlled randomized study using neomycin leading to a significant reduction in IBS symptoms: 75% of patients when the antibiotic was successful in eliminating the overgrowth [53]. Rifaximin could be an interesting treatment option in cases of bacterial overgrowth associated to IBS due to its excellent efficacy/safety profile [54]. Probiotics Several probiotics have been tried in the treatment of IBS but most trials have included few patients and had methodological pitfalls; results have been inconsistent [55].

A small amount of barium was added to this solution and the timing of the second series of distensions was selected on the basis of an X-ray monitoring. In healthy volunteers neither lactulose nor the control solution induced any modification of sensitivity thresholds. On the contrary, only in the patient group was a reduction of perception and discomfort thresholds evident after lactulose but not after the control solution (table 1). This finding is consistent with the idea that a subgroup of patients may have a heightened visceral sensation (induced or unmasked by colonic fermentation), which allows even low amounts of fermentation products to trigger the symptoms.

87 Yuan R, Flockhart DA, Balian JD: Pharmacokinetic and pharmacodynamic consequences of metabolism-based drug interactions with alprazolam, midazolam, and triazolam. J Clin Pharmacol 1999;39:1109–1125. 88 King A, Laurie R, Connolly M, Kamm A, Boxenbaum H, Kastrissios H, Trapnell C: The effect of rifaximin on the pharmacokinetics of single doses of intravenous and oral midazolam in healthy volunteers. Clin Pharmacol Ther 2004;75:P66. 89 Husebye E: The pathogenesis of gastrointestinal bacterial overgrowth.

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