{"id":2857,"date":"2023-10-21T01:49:51","date_gmt":"2023-10-21T01:49:51","guid":{"rendered":"http:\/\/drhimanshuyadav.com\/eubiotic-effects-of-rifaximin-are-associated-with-reduced-abdominal-pain-in-symptomatic-uncomplicated-diverticular-disease-results-of-an-observational-cohort-study-bmc-gastroenterology\/"},"modified":"2023-10-21T01:49:51","modified_gmt":"2023-10-21T01:49:51","slug":"eubiotic-effects-of-rifaximin-are-associated-with-reduced-abdominal-pain-in-symptomatic-uncomplicated-diverticular-disease-results-of-an-observational-cohort-study-bmc-gastroenterology","status":"publish","type":"post","link":"https:\/\/drhimanshuyadav.com\/blog\/eubiotic-effects-of-rifaximin-are-associated-with-reduced-abdominal-pain-in-symptomatic-uncomplicated-diverticular-disease-results-of-an-observational-cohort-study-bmc-gastroenterology\/","title":{"rendered":"Eubiotic effects of rifaximin are associated with reduced abdominal pain in symptomatic uncomplicated diverticular disease: results of an observational cohort study | BMC Gastroenterology"},"content":{"rendered":"<div id=\"Sec9-content\">\n<p>To our knowledge, this study is the first to evaluate the long-term (i.e., 6 months) effects of rifaximin on the gut microbiota of SUDD patients. Here we show that rifaximin significantly reduced the severity of abdominal pain, which is consistent with previous studies. [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Brandimarte G, Bafutto M, Kruis W, Scarpignato C, Mearin F, Barbara G, et al. Hot topics in Medical Treatment of Diverticular Disease: evidence pro and cons. J Gastrointestin Liver Dis. 2019;28(suppl 4):23\u20139.\" href=\"\/blog\/#ref-CR9\" id=\"ref-link-section-d64294364e2116\">9<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"De Bastiani R, Sanna G, Bertolusso L, Casella G, De Polo M, Zamparella M, et al. General practitioners\u2019 management of symptomatic uncomplicated diverticular disease of the colon by using rifaximin, a non-adsorbable antibiotic. Eur Rev Med Pharmacol Sci. 2021;25(1):423\u201330.\" href=\"\/blog\/#ref-CR10\" id=\"ref-link-section-d64294364e2116_1\">10<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Di Mario F, Miraglia C, Cambie G, Violi A, Nouvenne A, Franceschi M, et al. Long-term efficacy of rifaximin to manage the symptomatic uncomplicated diverticular disease of the colon. J Investig Med. 2019;67(4):767\u201370.\" href=\"\/blog\/#ref-CR11\" id=\"ref-link-section-d64294364e2116_2\">11<\/a>,12].  Treatment with rifaximin over 6 months was not associated with significant changes in the abundance of most major taxa in the fecal microbiome, but the abundance of the fecal microbiome increased. <i>Akkermansia<\/i>Verco Colombia, <i>Ruminococcaceae<\/i> was observed and was inversely associated with abdominal pain severity.<\/p>\n<p>Change in abundance <i>Veillonellaceae<\/i>, <i>diary star<\/i>and <i>Anerostipes<\/i> It was also observed after 6 months of rifaximin administration, but it did not correlate with abdominal pain severity. Therefore, these bacteria may not be involved in the development of abdominal pain in her SUDD.<\/p>\n<p>In our research, <i>Akkermansia<\/i> These bacteria were identified in the fecal microbiome of 2 patients (16.7%) at the time of treatment and in 9 patients (75.0%) after 6 months of rifaximin treatment, but these bacteria were not identified in another study. was detected in 90.5% of healthy individuals (p < 0.001) (unpublished data from [23]).However, a significantly higher amount of <i>A. muciniphila<\/i> reported in fecal samples of SUDD patients compared with healthy controls. [7]. However, both our study and the study by Tursi et al. [7] Patients with a recent history of acute diverticulitis were excluded. In patients with diverticulosis, <i>Akkermansia<\/i> It may increase as a compensatory response. Therefore, patients with a wealth of symptoms may <i>Akkermansia<\/i> Patients who develop asymptomatic diverticulosis or SUDD but do not have enough diverticulosis <i>Akkermansia<\/i> This compensatory response leads to the development of acute diverticulitis. Also, in the study of Tursi et al. [7]in SUDD patients; <i>A. muciniphila<\/i> However, this difference did not reach a significant limit in gut microbiota compared with asymptomatic diverticulosis patients, which may be due to the smaller patient population (15 and 13 patients, respectively). To resolve this issue, new large-scale studies will need to be conducted.<\/p>\n<p><i>Akkermansia<\/i> It is the main representative of the phylum Verrucomicrobia in the intestinal microbiota. This bacterium has several beneficial properties, including anti-inflammatory properties. [<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"de Vos WM. Microbe Profile: Akkermansia muciniphila: a conserved intestinal symbiont that acts as the gatekeeper of our mucosa. Microbiol (Reading). 2017;163(5):646\u20138.\" href=\"\/blog\/#ref-CR28\" id=\"ref-link-section-d64294364e2179\">28<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Derrien M, Belzer C, de Vos WM. Akkermansia muciniphila and its role in regulating host functions. Microb Pathog. 2017;106:171\u201381.\" href=\"\/blog\/#ref-CR29\" id=\"ref-link-section-d64294364e2179_1\">29<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Jayachandran M, Chung SSM, Xu B. A critical review of the relationship between dietary components, the gut microbe Akkermansia muciniphila, and human health. Crit Rev Food Sci Nutr. 2020;60(13):2265\u201376.\" href=\"\/blog\/#ref-CR30\" id=\"ref-link-section-d64294364e2179_2\">30<\/a>,<a data-track=\"click\" data-track-action=\"reference anchor\" data-track-label=\"link\" data-test=\"citation-ref\" title=\"Macchione IG, Lopetuso LR, Ianiro G, Napoli M, Gibiino G, Rizzatti G, et al. Akkermansia muciniphila: key player in metabolic and gastrointestinal disorders. Eur Rev Med Pharmacol Sci. 2019;23(18):8075\u201383.\" href=\"\/blog\/#ref-CR31\" id=\"ref-link-section-d64294364e2179_3\">31<\/a>,32]. in particular, <i>Akkermansia<\/i> Increases the thickness of the mucin layer, improves the intestinal epithelial barrier and prevents the transfer of harmful bacteria and their components to the intestinal wall. [31]. This bacterial translocation causes low-level inflammation, which is thought to play an important role in the development of abdominal pain in SUDD. [1]. Furthermore, the intensity of infiltration of the diverticulum mucosa by inflammatory cells is inversely correlated with the abundance of inflammatory cells. <i>Akkermansia<\/i> Within the mucosal microbiome [5].<\/p>\n<p>positive effect <i>Akkermansia<\/i> This is thought to be because these bacteria break down mucins into molecules that stimulate their formation by feedback, which are then used by family members of the bacteria. <i>Ruminococcaceae<\/i> form butyrate [29, 31]known to strengthen the intestinal barrier [33, 34]. In our research, <i>Akkermansia<\/i> and <i>Ruminococcaceae<\/i> significantly increased after treatment with rifaximin. However, while the amount increases, <i>Akkermansia<\/i> significant at both 3rd and 6th month; <i>Ruminococcaceae<\/i> It was only significant after 6 months of treatment with rifaximin. This result supports the hypothesis of a synergistic effect of these two groups of bacteria on reduced intestinal permeability, bacterial translocation, low-level inflammation, and abdominal pain associated with SUDD patients.<\/p>\n<p>Rifaximin has been reported to increase bacterial abundance in the environment; <i>Ruminococcaceae<\/i> In the case of a family, its use <i>Akkermansia<\/i> [13].In previous research [22]rifaximin significantly altered the relative abundance of specific bacteria in SUDD patients, with a significant increase in the abundance of Bacteroidae. <i>Citrobacter<\/i>and <i>Coprococcus<\/i>and Mogibacteriaceae, Christensenellaceae, Dehalobacteriaceae, Pasteurellaceae, <i>anaero trunks<\/i>, <i>Blautia<\/i>, <i>Egger Terra Renta<\/i>, <i>Dehalobacterium<\/i>, <i>SMB53<\/i>and <i>Haemophilus parainfluenza<\/i> (p-adj < 0.05) was reported. However, these results may not be representative of the long-term effects of rifaximin on the gut microbiota in patients with SUDD, so they should be taken with caution as patients have only been treated with rifaximin for 7 days. Must see.<\/p>\n<p>Two small studies investigated differences in the gut microbiota between patients with asymptomatic diverticulosis and SUDD [5, 7]. In both studies, <i>Akkermansia<\/i> In the intestinal microbiota, <i>A. muciniphila<\/i> The number of species was numerically lower in SUDD patients than in asymptomatic diverticulosis patients (\u22123.56 \u00b1 1.27 vs \u2212 3.41 \u00b1 1.13, respectively). [7]. However, larger studies are needed to confirm the hypothesis of decreased abundance. <i>Akkermansia<\/i> In patients with diverticulosis, it is associated with the transition from asymptomatic to symptomatic status. Additionally, cohort studies of asymptomatic diverticulosis patients and regular analysis of gut microbiota may identify predictive factors for SUDD.<\/p>\n<p>All patients in our study received dietary fiber to prevent constipation, a risk factor for complications of diverticular disease. However, this is unlikely to have influenced the results as we selected patients who had consumed dietary fiber for at least 6 months before enrollment. Furthermore, we did not assess the severity of patients&#8217; stool disturbances or bloating, as this may depend on dietary fiber intake.<\/p>\n<p>It must be recognized that this study has several limitations. First, the number of participants was small and a significant proportion of patients were lost to follow-up. Nevertheless, our preliminary results are promising and may support the design of larger controlled studies. The small number of participants could also be explained by the discontinuation of self-administration of rifaximin, as sustained improvement or other differences led to the exclusion of these patients from the study analysis. Another important limitation of our study is the lack of a placebo control group, which is essential to demonstrate a clear symptomatic benefit of rifaximin. Therefore, large-scale randomized controlled trials are needed to confirm our findings.<\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>To our knowledge, this study is the first to evaluate the long-term (i.e., 6 months) effects of rifaximin on the gut microbiota of SUDD patients. Here we show that rifaximin significantly reduced the severity of abdominal pain, which is consistent with previous studies. [9,10,11,12]. Treatment with rifaximin over 6 months was not associated with significant &#8230; <a title=\"Eubiotic effects of rifaximin are associated with reduced abdominal pain in symptomatic uncomplicated diverticular disease: results of an observational cohort study | BMC Gastroenterology\" class=\"read-more\" href=\"https:\/\/drhimanshuyadav.com\/blog\/eubiotic-effects-of-rifaximin-are-associated-with-reduced-abdominal-pain-in-symptomatic-uncomplicated-diverticular-disease-results-of-an-observational-cohort-study-bmc-gastroenterology\/\" aria-label=\"Read more about Eubiotic effects of rifaximin are associated with reduced abdominal pain in symptomatic uncomplicated diverticular disease: results of an observational cohort study | BMC Gastroenterology\">Read more<\/a><\/p>\n","protected":false},"author":2,"featured_media":2605,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[83],"tags":[897,469,567,17,549,1119,1863,53,1864,598,629,440,1865,342,1484,1866],"class_list":["post-2857","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-diverticular-disease","tag-abdominal","tag-bmc","tag-cohort","tag-disease","tag-diverticular","tag-effects","tag-eubiotic","tag-gastroenterology","tag-observational","tag-pain","tag-reduced","tag-results","tag-rifaximin","tag-study","tag-symptomatic","tag-uncomplicated"],"_links":{"self":[{"href":"https:\/\/drhimanshuyadav.com\/blog\/wp-json\/wp\/v2\/posts\/2857","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/drhimanshuyadav.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/drhimanshuyadav.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/drhimanshuyadav.com\/blog\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/drhimanshuyadav.com\/blog\/wp-json\/wp\/v2\/comments?post=2857"}],"version-history":[{"count":0,"href":"https:\/\/drhimanshuyadav.com\/blog\/wp-json\/wp\/v2\/posts\/2857\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/drhimanshuyadav.com\/blog\/wp-json\/wp\/v2\/media\/2605"}],"wp:attachment":[{"href":"https:\/\/drhimanshuyadav.com\/blog\/wp-json\/wp\/v2\/media?parent=2857"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/drhimanshuyadav.com\/blog\/wp-json\/wp\/v2\/categories?post=2857"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/drhimanshuyadav.com\/blog\/wp-json\/wp\/v2\/tags?post=2857"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}