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[rajiv_gupta]

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I had taken Rifaximin for many years. as long as I took it the diarrhea was manageable.

Seven months back I discontinued it and slowly the diarrhea crept back.

my question is if Rifaximin kills bacteria in the guts, how it differentiates between the good and the bad bacteria.

and if it also kills good bacteria then would it not exacerbate IBS D in the long run.

[mellosphere]

I don't think it really differentiates. It just cuts down on bacteria of all types. This is good for those of us who have some sort of bacterial overgrowth or imbalance. If antibiotics helped you, you probably had an overgrowth or imbalance of bacteria which was minimized by the rifaximin. If you're feeling worse now, it's probably because the bacteria are not being held in check anymore and proliferating without restraint.