The Changes Of Intestinal Microlfora In Paitents With Irritable Bowel Syndrome And The Effects Of Antibiotic Rifaximin

Objective To investigate the changes of irritable bowel syndrome(IBS) intestinalmicroflora in patients, and explored the significances of the changes.Methods Fifty Rome Ⅲ criteria IBS patients and twenty-five healthy subjects wereenrolled, fresh faecal samples were collected and the method established by Mit-suokawas used to quantitatively and qualitatively culture the fecal three kinds of anaerobes(Bifidobacterium, Lactobacillus, Bacteroides) and two kinds of aerobes(Enterobacteriaceae, Enterococcus), we also calculated the ratio of Bifidobacterium toEnterobacteriaceae (B/E value).Results Compared with healthy subjects, the number of fecal Enterobacteriaceaewas significantly increased(8.71±1.08vs8.20±0.73, P＜0.05), Bifidobacteriu,Lactobacillus and B/E value were significantly decreased in IBS patients8.41±0.98vs8.92±0.88，6.32±1.02vs7.07±1.14,0.98±0.17vs1.09±0.13, P＜0.05), but the numbleof Bacteroides and Enterococcus were not significantly. Different types of IBS havedifferent changes of intestinal microflora, the number of fecal Enterobacteriaceae wassignificantly increased(8.80±1.11vs8.20±0.73，P＜0.05), the number of fecalBifidobacteriu, Lactobacillus and B/E value were significantly decreased indiarrhea-predominant IBS patients versus healthy subjects(8.28±0.98vs8.92±0.88,6.34±1.08vs7.07±1.14，0.96±0.17vs1.09±0.13，P＜0.05),the level of fecalBacteroides was significantly increased in constipation-predominant IBS versus healthy subjects(9.22±0.54vs8.43±0.53，P＜0.05), others were not significantly; the levelof fecal Enterobacteriaceae was significantly increased(8.82±1.12vs8.20±0.73，P＜0.05), Lactobacillus and B/E value were significantly decreased inalterlated-predominant IBS patients versus healthy subjects(6.18±1.07vs7.07±1.14，0.99±0.15vs1.09±0.13，P＜0.05).Conclution There were intestinal microflora disorders in IBS patients, that wasmanifests in a decrease of beneficial Bifidobacterium and Lactobacillus, a increase ofpotentially pathogenic Enterobacteriaceae and a damage of CR. Different types of IBShave different changes of intestinal flora, diarrhea-predominant irritable bowelsyndrome and alternated-predominant irritable bowel syndrome were similar with thechanges of intestinal microflora of all IBS patients, constipation-predominant irritablebowel syndrome had only then a increase of Bacteroides. Objective To study the changes of intestinal microflora of Diarrhea-predominant IBSpatients after taking rifaximin, to evaluate the efficacy and safety of rifaximin in IBS-Dpatients.Methods Twenty-five Rome Ⅲ criteriaIBS-D subjects and twenty-five healthysubjects were enrolled, to quantitatively and qualitatively incubate Enterobacteriaceae,Enterococcus, Bifidobacterium, Lactobacillus and Bacteroides in two groups, wo alsocalculated the ratio of Bifidobacterium to Enterobacteriaceae(B/E value), compare withchanges of intestinal microflora in two groups. IBS-D subjects were received Rifaximin800mg/day for10days, to contrast the changes of intestinal microflora after takingrifaximin, to score the abdominal pain time(hour/day) abdominal painfrequency(day/week)、ratio of abnormal shape of stool、ratio of abnormal passage ofdefecation、ratio of mucous stool and distention when defecation, to observe theside-effects of Rifaximin.Resutls Compared with healthy subjects, the number of fecal Enterobacteriaceae wassignificantly increased(8.92±0.91vs8.20±0.73， P＜0.05), Bifidobacteriu,Lactobacillus and B/E value were significantly decreased in IBS patients(8.21±1.08vs8.92±0.88，6.23±1.03vs7.07±1.14，0.93±0.14vs1.09±0.13，P＜0.05). After treatment of rifaximin, the number of fecal Enterobacteriaceae wassignificantly decreased(8.15±0.65vs8.92±0.91，P＜0.05), Lactobacillus and B/E value were significantly increased(7.13±0.88vs6.23±1.03，1.05±0.15vs0.93±0.14,P＜0.05). The score of singal enteric symptom and global enteric symptomshad a decent; the ratio of global symptom improvement was72%, six singal symptomswere obviously relieved, especially mucous stool and ratio of abnormal passage ofdefecation, for up to four weeks after completion of therapy.Conclutions There were intestinal dysbacteriosis in IBS-D subjects, that wasmanifests in a decrease of Lactobacillus and Bifidobacterium, a increase ofEnterobacteriaceae and a damage of CR. Rifaximin may adjust intestinal microflora,the number of potentially pathogenic reduced and the number of beneficial bacteriaraised after taking rifaximin. Rifaximin may improve enteric symptoms of IBS-Dpatients, especially mucous stool and ratio of abnormal passage of defecation, theefficacy could sustain four weeks after completion of therapy and lower side-effects.