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"Antibiotic Improves Irritable Bowel

IBS Linked to Overgrowth of Bacteria in Intestines"

By Fern Garber
WebMD Medical News Reviewed By Michael Smith, MD
on Wednesday, February 26, 2003

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Feb. 26, 2003 -- When it comes to irritable bowel syndrome (IBS), finding a cause -- and a treatment that works -- is foremost in people's minds. And now it seems that researchers may have found an answer to both of these questions.

In a new study, researchers found that 84% of people with IBS had an abnormal breath test that indicated possible overgrowth of bacteria in the intestines. And treatment with an antibiotic significantly improved IBS symptoms. The study is published in the February issue of The American Journal of Gastroenterology.

IBS affects more than 15% of the population -- mostly women -- and causes abdominal pain along with constipation and/or diarrhea. Despite this widespread prevalence, the cause of IBS remains unknown and thus far, there are no standardized diagnostic tests. Treatment options -- which include one drug, Lotronex, with potentially serious side effects -- are somewhat limited as well.

So Mark Pimentel, MD, and colleagues, set out to determine if bacteria in the intestines might be one possible cause of IBS and if antibiotics could improve symptoms. Of the 111 IBS patients, some had IBS consisting of mostly constipation while others suffered mostly from diarrhea.

Of the 111 IBS patients, 84% had an abnormal lactulose breath test -- indicating overgrowth of bacteria in the intestine. This means that these IBS patients exhaled higher concentrations of methane and hydrogen -- gases produced by bacteria.

Amount of bacterial gases differed between people with constipation-predominant vs. diarrhea-predominant IBS. But symptoms -- abdominal pain, constipation, and diarrhea -- improved by 35% overall with treatment with the antibiotic neomycin compared with an 11% improvement with placebo.

In addition, bowel movement frequency improved by 35% with neomycin compared with a 14% improvement with placebo. In those taking the antibiotic, symptoms improved the most in IBS patients who also had a normal breath test after treatment.

Though neomycin did prove to be effective, the researchers note that it only accounted for a 20% success rate in normalizing breath tests -- possibly due to the large numbers and types or bacteria in the intestines.

The researchers add that widespread use of antibiotics may not be wise before more effective antibiotics are tested.

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-Angela
Healed in Jesus' Name

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