Rifaximin eases bloating in patients with functional GI disorder

Treatment with rifaximin appears effective in reducing bloating and distension, as well as the subjective severity of these symptoms, in patients with functional gastrointestinal disorder (FGID), results of a systematic review and meta-analysis have shown.

Randomized placebo-controlled trials using rifaximin in FGID were identified using four databases, namely Medline, Embase, Scopus, and Web of Science. Observational studies were excluded, as well as studies 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.

In total, 1,426 articles were identified, of which 813 were screened after removing duplicates and 34 were selected for full-text review. Of these, 10 trials involving 3,326 patients met the eligibility criteria.

Doses of rifaximin administered ranged from 400 to 1,650 mg/d for 1‒2 weeks. Use of rifaximin resulted in a greater probability of improving symptoms of bloating (44.6 percent vs 34.6 percent; relative risk, 1.22, 95 percent confidence interval [CI], 1.11‒1.35; n=2,401), with no significant heterogeneity. However, daily doses <1,200 mg/d were comparable to placebo (p=0.09).

Seven studies subjectively quantified bloating. Results showed that rifaximin therapy induced greater decrease in bloating scores relative to placebo (standardized mean difference, ‒0.3, 95 percent CI, ‒0.51 to ‒0.1; p=0.04), but there was significant heterogeneity (I², 61.6 percent; p=0.01).

“Abdominal bloating is a common complaint in patients with functional and organic bowel disease,” the authors said. “Rifaximin, a nonabsorbable antibiotic, has been tried for the treatment of this disease.”