Trial reportDigestive diseases and sciences2019
Double-Blind Placebo-Controlled Study of Rifaximin and Lactulose Hydrogen Breath Test in Gulf War Veterans with Irritable Bowel Syndrome.
Trial report in Digestive diseases and sciences, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 40 citations in OpenAlex.
- Antibiotic therapy for small intestinal bacterial overgrowth: a systematic review of comparative efficacy, clinical-test discordance, and pediatric evidence gaps.Frontiers in pharmacology · 2026Pooled it
- Short-course Rifaximin therapy efficacy and lactulose hydrogen breath test in Chinese patients with diarrhea-predominant irritable bowel syndrome.BMC gastroenterology · 2020Trial
- Targeted antibiotic and dietary approaches in managing small intestinal bacterial overgrowth across irritable bowel syndrome subtypes.Internal and emergency medicine · 2026Review
- Treatment of Small Intestinal Bacterial Overgrowth (SIBO) in Gastrointestinal, Hepatic, Endocrine, Neurological, and Postoperative Diseases: A Comprehensive Narrative Review.Medical sciences (Basel, Switzerland) · 2026Review
- Exploring effectiveness of Metronidazole, Bismuth, and Rifaximin in treating small intestinal bacterial overgrowth and irritable bowel syndrome: A systematic review.World journal of methodology · 2026Article
- Comparative efficacy of diverse therapeutic regimens for small intestinal bacterial overgrowth: a systematic network meta-analysis.Therapeutic advances in gastroenterology · 2025Article
- Crisis in the gut: navigating gastrointestinal challenges in Gulf War Illness with bioengineering.Military Medical Research · 2024Review
- Critical appraisal of the SIBO hypothesis and breath testing: A clinical practice update endorsed by the European society of neurogastroenterology and motility (ESNM) and the American neurogastroenterology and motility society (ANMS).Neurogastroenterology and motility · 2024Review
- Onset of Irritable Bowel Syndrome, Dyspepsia, Diarrhea, Bloating, and Constipation in Deployed Gulf War Veterans.International journal of gastroenterology (New York, N.Y.) · 2024Article
- Emerging role of the gut microbiome in post-infectious irritable bowel syndrome: A literature review.World journal of gastroenterology · 2023Review
- Current and Future Therapeutic Options for Irritable Bowel Syndrome with Diarrhea and Functional Diarrhea.Digestive diseases and sciences · 2023Review
- The Prevalence, Humanistic Burden, and Health Care Impact of Irritable Bowel Syndrome Among United States Veterans.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2023Article
- Berberine and rifaximin effects on small intestinal bacterial overgrowth: Study protocol for an investigator-initiated, double-arm, open-label, randomized clinical trial (BRIEF-SIBO study).Frontiers in pharmacology · 2023Article
- Postinfection Irritable Bowel Syndrome.Gut and liver · 2022Review
- Modulating the gut microenvironment as a treatment strategy for irritable bowel syndrome: a narrative review.Gut microbiome (Cambridge, England) · 2022Review
- Effects of gut microbiota remodeling on the dysbiosis induced by high fat diet in a mouse model of Gulf war illness.Life sciences · 2021Article
- Using Plasma Autoantibodies of Central Nervous System Proteins to Distinguish Veterans with Gulf War Illness from Healthy and Symptomatic Controls.Brain sciences · 2020Article
- Article
- Emerging evidence that irritable bowel syndrome & functional dyspepsia are microbial diseases.The Indian journal of medical research · 2019Article
- Rifaximin for Irritable Bowel Syndrome (IBS) in Gulf War Veterans: Losing the Battle but Winning the War?Digestive diseases and sciences · 2019Article
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundIrritable bowel syndrome (IBS) occurs in up to 33% of Gulf War (GW) Veterans. Alterations in gut microflora including small intestinal bacterial overgrowth (SIBO) during deployment may play a role in development of IBS. Rifaximin is a minimally absorbed antibiotic speculated to improve IBS symptoms, in part, by restoring normal gut microflora. The aim of this study was to compare rifaximin to placebo on IBS symptoms and quality of life (QOL) in GW Veterans with IBS without constipation.
methodsA double-blind, placebo-controlled study was performed. One hundred and twenty-two GW Veterans with IBS (Rome III) from our database and referral to gastroenterology and internal medicine clinics were screened. After a 2-week run-in period, 50 patients were randomized (1:1) to receive either rifaximin 550 gm or placebo twice daily for 2 weeks in a double-blind study. Patients were advised not to change their diet or medications during the study. The symptoms assessed were: (1) stool frequency, (2) stool consistency (Bristol stool scale, 1-7, very hard to watery), (3) urgency (1 = yes/0 = no daily for 7 days), (4) severity of abdominal pain (0-4, none to severe), (5) severity of bloating (1-4, none to severe), and (6) global improvement scale (1-7, substantially worse to substantially improved). These were recorded for 7 consecutive days and then averaged across the 7 days, to generate a continuous variable. The symptom data were compared after 2 weeks of treatment. QOL was assessed using IBS-QOL. The lactulose hydrogen breath test (LHBT) was performed at baseline and after 2 weeks of treatment.
resultsFifty Veterans were randomized to receive treatment; 3 withdrew and 3 were lost to follow-up. Data were analyzed from 44 patients (38 men, 6 women, median age 52, range 33-77 years). Rifaximin was not associated with significant improvement in global symptoms, abdominal pain, bloating, stool urgency, frequency, or consistency (all P ≥ 0.25) or QOL (all P ≥ 0.26). Normalization of SIBO by LHBT was not different between rifaximin- and placebo-treated Veterans (7 vs. 22%, P = 0. 54).
conclusionRifaximin was not effective in improving IBS symptoms and QOL in GW Veterans with non-constipated IBS.
Indexed as
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.