Irritable Bowel Syndrome Responds To Rifaximin

Abdomin v2In a study presented at annual meeting of The American College of Gastroenterology, Anthony Lembo, MD, of the Harvard Medical School and Beth Israel Deaconess Medical Center, presented data that showed that the non-absorbable antibiotic Rifaximin helps control cramping and diarrhea related Irritable Bowel Syndrome (IBS). Irritable bowel cripples individuals by causing abdominal cramping and multiple loose or watery stools per day. These patients have been screened by colonoscopy and imaging studies for more serious diseases such as Crohn’s Disease and ulcerative colitis with testing ruling these entities out. They are left with severe symptoms but no objective findings on available tests.

The study was comprised of 2,579 patients who received either Rifaximin or placebo three times per week. The decision to try an antibiotic was based on the theory that some IBS patients have excessive bacteria in the gut causing the problem. The treatment was successful in a significant number of participants compared to placebo based on a reduction of pain and frequency and number of stools. The patients were then observed for four weeks during which time some patients relapsed. If these patients were treated for another two weeks they showed significant improvement.

Irritable bowel incapacitates millions of individuals. While this data is extremely preliminary, it gives us hope of another treatment regimen, becoming available soon, that is effective and safe.

FDA Approves Coronary Artery Disease Screening Test

FDA - Steven Reznick, MDMedPage Today, the online medical journal of the University of Pennsylvania School of Medicine, announced that the FDA has ” cleared a blood test ” to screen for heart disease known as Lp-PLA2 or lipoprotein associated phospholipase A2. This test is an individual marker of vascular inflammation produced within atherosclerotic plaques. Its use was cleared for screening in all adults with no history of coronary artery disease.

In a National Institute of Health study, known as Reasons for Geographic and Racial Differences in Stroke, it was shown in a review of 4,598 people, aged 45 – 92, that individuals above the threshold level for Lp-PLA2 were more than twice as likely as others to have an event, heart attack or stroke, 7% versus 3.3 %. The study was particularly helpful when looking at black women as a group. An Lp-PLA2 level > 225nmol/min/mL is considered elevated.

This test has been available to patients in our practice through the Cleveland Heart Labs screening panel. It plus the myeloperoxidase level, CRP and other markers have been felt by the Cleveland Clinic cardiology division to have predictive value. These tests are currently available but in many cases require private pay because Medicare and private insurers do not yet cover them all.