Rifaximin Bests Placebo for Irritable Bowel Syndrome By John Gever, Senior Editor, MedPage TodayPublished: May 06, 2010NEW ORLEANS -- The antibiotic rifaximin (Xifaxan) met its primary endpoint in two phase III trials in nonconstipational irritable bowel syndrome (IBS), though the improvement over placebo was only modest, researchers said here. Pooled data on a total of 1,260 patients indicated that 40.7% had "adequate relief" of their symptoms following a two-week course of rifaximin, compared with 31.7% of patients taking placebo (
P=0.0008), reported Mark Pimentel, MD, of Cedars-Sinai Medical Center in Los Angeles.....But another prominent IBS researcher, in an interview with MedPage Today, sounded a note of skepticism. Brennan Spiegel, MD, of the University of California Los Angeles, who was not involved with the study, said he was unconvinced that bacterial overgrowth is a cause of IBS.He said he believed it's "an epiphenomenon" -- a consequence of a more fundamental pathology in IBS that remains unknown. Although antibiotic treatment may normalize the intestinal flora for a period of time, Spiegel said, it is likely to recur if the real cause isn't treated.
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