Abstract

COMPARATIVE EVALUATION OF RIFAXIMIN AND VSL#3 IN THE PATIENTS OF IRRITABLE BOWEL SYNDROME WITH DIARRHEA

Dr. Sarita Goyal, *Dr. Himani Deswal, Dr. Sandeep Goyal and Dr. M. C. Gupta

Abstract

Introduction: Abdominal pain and frequent loose stools are the most characteristic features of IBS-D which relates to disturbance in gut microbiota. Both rifaximin, a non-systemic antibiotic which acts by suppressing bacterial gene expression and probiotics (VSL#3) by modulating the gut microbiota were found in amelioration of disease symptoms during literature search. Aim: This study was carried out to compare effects of probiotics and rifaximin when given in IBS-D patients. Methodology: It was an open-label, parallel group, prospective, randomized and comparative study, in 88 patients diagnosed with IBS-D using ROME IV criteria, who were divided into two groups with either tab rifaximin 550 mg BD or tab VSL#3 BD for 14 days. Assessment was done by using NRS scale for pain intensity, IBS-SSS for pain frequency, BSFS for stool character and stool frequency at baseline, 2weeks, 4weeks and 6weeks after treatment. Results: Both rifaximin and VSL#3 were found to be effective in reducing pain and stool parameters after treatment. Reduction in NRS score was seen in 63% and 45%(p=0.014) of patients at 6 weeks, in IBS-SSS score was seen in 63% and 54%(p=0.147) of patients at 6 weeks, in Likert scale was seen in 49% and 47%(p=0.138) of patients at 6 weeks, in BSFS for stool character was seen in 28% and 26%(p=0.418) of patients at 6 weeks and for stool frequency was seen in 71% and 57%(p=0.078) of patients at 6 weeks, in rifaximin and VSL#3 respectively. Conclusion: VSL#3 was found to be noninferior with rifaximin in the patients of IBS-D.

Keywords: VSL#3, Rifaximin, BSFS, IBS-SSS, NRS.