Evidence map›Paper›PMID 39641896›Full record

ArticleDigestive diseases and sciences2025

Rifaximin-Alpha Increases Lactase Activity in Patients with Irritable Bowel Syndrome Without Constipation and Small Intestinal Bacterial Overgrowth.

María Fernanda García-Cedillo, Federico Ulises Villegas-García, Josealberto Sebastiano Arenas-Martinez, Victoria Jaqueline Ornelas-Arroyo, Jesús Kazuo Yamamoto-Furusho, Luis Alberto Estrella-Sato, Enrique Coss-Adame

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Article in Digestive diseases and sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

María Fernanda García-CedilloPrograma de Maestría y Doctorado en Ciencias Médicas, Odontológicas y de la Salud, Universidad Nacional Autónoma de México, Mexico City, Mexico.
Federico Ulises Villegas-GarcíaDepartment of Gastroenterology, Centro Médico Nacional la Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico.
Josealberto Sebastiano Arenas-MartinezGastrointestinal Motility Laboratory, Department of Gastroenterology, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico D.F., Mexico.
Victoria Jaqueline Ornelas-ArroyoGastrointestinal Motility Laboratory, Department of Gastroenterology, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico D.F., Mexico.
Jesús Kazuo Yamamoto-FurushoGastrointestinal Motility Laboratory, Department of Gastroenterology, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico D.F., Mexico.
Luis Alberto Estrella-SatoInternal Medicine Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
Enrique Coss-AdameGastrointestinal Motility Laboratory, Department of Gastroenterology, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Mexico D.F., Mexico. enrique.cossa@incmnsz.mx.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIrritable bowel syndrome symptoms are associated with diverse pathophysiological mechanisms including small intestinal bacterial overgrowth and food intolerance. Small intestinal bacterial overgrowth leads to the decreased activity of several digestive enzymes, including lactase.

aimsTo assess the efficacy of rifaximin-alpha on the symptoms and lactase activity of patients with irritable bowel syndrome without constipation.

methodsThis was a prospective, pilot study. The recruited patients had irritable bowel syndrome without constipation (Rome IV criteria), a positive lactulose-Hydrogen Breath Test for small intestinal bacterial overgrowth, low urinary D-Xylose levels measured using the Lactest® test, and self-reported lactose intolerance. In addition, lactose HBT was performed. All patients received 400 mg rifaximin-alpha every 8 h for 2 weeks. Four weeks after the intervention, lactose and lactulose HBT were performed, and the symptoms and urinary D-Xylose levels were evaluated.

resultsAfter treatment with rifaximin-alpha, 60% of the patients reported improvement in abdominal pain, 44% in bloating, 36% in flatulence, 60% in borborygmi, and 72% in stool consistency. A negative lactulose-Hydrogen Breath Test result for SIBO was documented in 32% of patients, and lactose maldigestion by lactose-Hydrogen Breath Test was reduced from 88 to 52% of the studied subjects. The median D-Xylose levels before and after treatment were 7.6 (IQR 4.34-13.7) mg/dL vs. 10.4 (IQR 7.1-17.3) mg/dL, p = 0.002.

conclusionsRifaximin-alpha caused symptomatic improvement, reduced lactose maldigestion, and reduced positive Hydrogen Breath Test results for small intestinal bacterial overgrowth in patients with irritable bowel syndrome without constipation.

Indexed as

Gastrointestinal AgentsIntestine, SmallIrritable Bowel SyndromeLactaseRifamycinsAdultBlind Loop SyndromeBreath TestsFemaleHumansLactuloseMaleMiddle AgedPilot ProjectsProspective StudiesRifaximinGastrointestinal AgentsLactaseLactuloseRifamycinsRifaximinXyloseFODMAPIBSLactase activityLactoseMaldigestionSIBO

Identifiers

PMID39641896

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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.