Rifaximin improves symptoms of acquired uncomplicated diverticular disease of the colon.

Abstract

BACKGROUND AND AIMS:

We examined the efficacy of cyclic long-term administration of rifaximin, a broad spectrum, poorly absorbable antibiotic, in obtaining symptom relief in a large series of patients with uncomplicated diverticular disease, and compared the incidence of episodes of diverticulitis in the group treated with rifaximin to that in a group receiving fiber supplementation only.

PATIENTS AND METHODS:

In a multicenter, prospective, open trial, 968 outpatients with uncomplicated symptomatic diverticular disease were randomized to either fiber supplementation with 4 g/day glucomannan plus 400 mg rifaximin twice daily for 7 days every month ( n=558) or 4 g/day glucomannan alone ( n=346). Clinical evaluation was performed on admission and at 4-month intervals for 12 months.

RESULTS:

After 12 months the group treated with glucomannan + rifaximin showed fewer symptoms (abdominal pain/discomfort, bloating, tenesmus, diarrhea, abdominal tenderness) and a lower global symptomatic score. Overall 56.5% of the patients treated with glucomannan + rifaximin and 29.2% of those treated with glucomannan alone were asymptomatic at 12 months ( P<0.001). The rate of complications (diverticulitis and rectal bleeding) was 1.34% in the rifaximin + glucomannan group and 3.22% in the glucomannan alone group ( P<0.05).

CONCLUSION:

Cyclic administration of rifaximin is effective in obtaining symptom relief in uncomplicated diverticular disease of the colon. The incidence of episodes of diverticulitis in the group treated with rifaximin was lower than that in the group treated with glucomannan alone.

• Authors: Giovanni Latella, Maria Teresa Pimpo, Sandra Sottili, Maddalena Zippi, Angelo Viscido, Maria Chiaramonte, Giuseppe Frieri
• Journal: International journal of colorectal disease (Int J Colorectal Dis) Vol. 18 Issue 1 Pg. 55-62 (Jan 2003) ISSN: 0179-1958 [Print] Germany
• PMID: 12458383 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Cathartics
• Gastrointestinal Agents
• Mannans
• Rifamycins
• (1-6)-alpha-glucomannan
• Rifaximin

Topics

• Adult
• Aged
• Aged, 80 and over
• Cathartics (adverse effects, therapeutic use)
• Diverticulum, Colon (pathology)
• Drug Evaluation
• Female
• Follow-Up Studies
• Gastrointestinal Agents (adverse effects, therapeutic use)
• Humans
• Italy
• Male
• Mannans (adverse effects, therapeutic use)
• Middle Aged
• Patient Compliance
• Prospective Studies
• Rifamycins (adverse effects, therapeutic use)
• Rifaximin
• Severity of Illness Index
• Time Factors
• Treatment Outcome