Bacterial Flora in Digestive Disease: Focus on Rifaximin by C. Scarpignato, A. Lanas

By C. Scarpignato, A. Lanas

Reprint of: Digestion 2006, Vol. seventy three, Suppl. 1 1000's of bacterial species make up human intestine vegetation. The gut has a minimum of four hundred various species of micro organism totaling over 1012 organisms. of those, ninety nine% are anaerobic micro organism. The gastrointestinal tract is then uncovered to 1000s of bacterial species and international antigens and has embedded a special and intricate community of immunological and non-immunological mechanisms to guard the host from most likely destructive pathogens. fit everyone is ordinarily tolerant to their very own microbiota, yet such tolerance is impaired in sufferers with either natural and useful gastrointestinal illnesses. The development of the information on microbial-gut interactions in wellbeing and fitness and illness has allowed a extra pathophysiologically-oriented method of a number of demanding medical stipulations. There are at the moment how one can manage enteric vegetation. Antibiotics can selectively lessen tissue invasion and dispose of competitive bacterial species or globally reduce luminal and mucosal bacterial concentrations, counting on their spectrum of job. however, management of valuable bacterial species (probiotics), poorly absorbed nutritional oligosaccharides (prebiotics), or mixed probiotics and prebiotics (synbiotics) can fix a predominance of worthy commensal flowers. those healing techniques should not, in fact, jointly particular. Rifaximin, a poorly absorbed antibiotic designated on the gastrointestinal tract, has been lengthy utilized in Italy for the remedy of infectious diarrhea in either adults and youngsters. in the past few years the appreciation of the pathogenic position of intestine micro organism in different natural and useful gastrointestinal ailments has more and more broadened its medical use, which now covers hepatic encephalopathy, small gut bacterial overgrowth, inflammatory bowel affliction and colonic diverticular ailment. different power medical symptoms are being explored and glance promising. during this factor, top scientists (both Spanish and Italian) speak about - in a sequence of state of the art reports - the present prestige of the current wisdom on Microbial plant life in Digestive ailments and determine the function of rifaximin in numerous gut-related natural and useful gastrointestinal problems. because it contains a lot info tricky to assemble from different scattered resources, this quantity can be of curiosity to infectiologists, gastroenterologists and digestive surgeons alike.

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Extra info for Bacterial Flora in Digestive Disease: Focus on Rifaximin (Digestion)

Example text

It comprises a group of FBDs which are dominated by a feeling of abdominal fullness or bloating, without sufficient criteria for another functional gastrointestinal disorder. Diagnosis of functional abdominal bloating requires the presence during 12 or more weeks in the past 12 months of: (1) feeling of abdominal fullness, bloating, or visible distension, and (2) insufficient criteria for a diagnosis of functional dyspepsia, IBS or other functional disorder. Functional Constipation. It comprises a group of functional disorders which present as persistent difficult, infrequent or seemingly incomplete defecation.

Lactulose was then given per os and hydrogen excretion was monitored in expired air to detect the increase of hydrogen breath excretion indicating the beginning of colonic fermentation. At this point in time, a second evaluation of sensitivity thresholds was performed to test whether colonic fermentation may induce visceral hypersensitivity. On a separate day, the test was repeated with the administration of a non-fermentable, non-absorbable electrolyte solution to serve as a control. A small amount of barium was added to this solution and the timing of the second series of distensions was selected on the basis of an X-ray monitoring.

1a). On the contrary, both lactulose and methylcellulose caused Digestion 2006;73(suppl 1):38–46 39 Table 1. Perception and discomfort thresholds to rectal distension after administration of lactulose or a control iso-osmotic electrolyte solution in healthy volunteers and patients with functional bloating (from Di Stefano et al. 586 an increase in abdominal bloating scores (fig. 1b). This finding could be explained on the basis of the increased fecal bulk by methylcellulose and on the enhanced gas production by lactulose.

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