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Aliment Pharmacol Ther ; 45(6): 767-776, 2017 03.
Article in English | MEDLINE | ID: mdl-28112426

ABSTRACT

BACKGROUND: Gut dysbiosis may contribute to pain and bloating in patients with functional gastrointestinal disease. AIMS: To determine if treatment with rifaximin would improve the symptoms of functional dyspepsia in Chinese patients in a double-blinded, randomised, placebo-controlled trial. METHODS: Consecutive subjects with a diagnosis of functional dyspepsia as per the Rome III criteria were randomised to receive rifaximin 400 mg or placebo, all taken three times daily for 2 weeks. The investigators and study subjects were blinded to the treatment allocation. Subjects were followed up for 8 weeks. The primary end point was adequate relief of global dyspeptic symptoms (GDS). Secondary endpoints were relief of individual dyspeptic symptoms. RESULTS: Eighty-six subjects were recruited. At week 8, there were significantly more subjects in the rifaximin than in the placebo group who experienced adequate relief of GDS (78% vs. 52%, P = 0.02). A trend favouring rifaximin group was also noted in the preceding 4 weeks. Rifaximin was also superior to placebo in providing adequate relief of belching and post-prandial fullness/bloating (PPF) in subjects at week 4. Subgroup analysis revealed that female subjects had more significant response to rifaximin treatment (adequate relief of GDS at week 4: 76% vs. 42%, P = 0.006; week 8: 79% vs. 47%, P = 0.008), as well as improvements in their belching and PPF at week 4. The incidences of adverse effects were similar in both groups. CONCLUSIONS: Treatment with 2 weeks of rifaximin led to adequate relief of global dyspeptic symptoms, belching and post-prandial fullness/bloating in subjects with functional dyspepsia. The difference was more marked in females. (clinicaltrials.org NCT01643083).


Subject(s)
Dyspepsia/drug therapy , Dyspepsia/epidemiology , Gastrointestinal Agents/therapeutic use , Rifamycins/therapeutic use , Adult , Aged , Double-Blind Method , Dyspepsia/diagnosis , Eructation/diagnosis , Eructation/drug therapy , Eructation/epidemiology , Female , Gastrointestinal Agents/pharmacology , Hong Kong/epidemiology , Humans , Male , Middle Aged , Pain/diagnosis , Pain/drug therapy , Pain/epidemiology , Placebo Effect , Postprandial Period/drug effects , Postprandial Period/physiology , Rifamycins/pharmacology , Rifaximin , Treatment Outcome
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