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Long-term efficacy of rifaximin to manage the symptomatic uncomplicated diverticular disease of the colon
  1. Francesco Di Mario1,
  2. Chiara Miraglia1,
  3. Ginevra Cambiè1,
  4. Alessandra Violi1,
  5. Antonio Nouvenne1,
  6. Marilisa Franceschi2,
  7. Giovanni Brandimarte3,
  8. Walter Elisei4,
  9. Marcello Picchio5,
  10. Antonio Tursi6
  1. 1 Gastroenterology Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
  2. 2 Digestive Endoscopy Unit, ULSS7 Alto Vicentino, Santorso, Italy
  3. 3 Division of Internal Medicine and Gastroenterology, ’Cristo Re' Hospital, Rome, Italy
  4. 4 Division of Gastroenterology, ASL RM6, Albano Laziale, Italy
  5. 5 Division of Surgery, ’P Colombo' Hospital, ASL RM6, Velletri, Italy
  6. 6 Gastroenterology Service, ASL BAT, Andria, Italy
  1. Correspondence to Professor Antonio Tursi, Gastroenterology Service ASL BAT Andria Italy; antotursi{at}tiscali.it

Abstract

Although rifaximin is currently advised in managing symptomatic uncomplicated diverticular disease (SUDD) of the colon, no long-term data are available. This retrospective study assessed the outcome of a large cohort of patients with SUDD, treated with rifaximin, during an 8-year follow-up. The study group (group A) included 346 patients with SUDD (median age 64 years, IQR 58–69, 62.4% females), treated with rifaximin 800 mg/d for 7 days every month. The control group (group B) included 470 patients with SUDD (median age 65 years, IQR 59–74 years, 60.8% females), taking any other treatment on demand. Two symptoms (left lower abdominal pain and bloating) were assessed by a visual analog scale (VAS), graded from 0=no symptom to 10=the most severe symptom. Daily bowel movements were also reported. Median (IQR) VAS score for pain was 6 (5–7) in group A and 6 (6–7) in group B at baseline (p=0.109); at 8-year follow-up it was 3 (3–4) and 6 (5–7), respectively (p<0.000). Both bloating and daily bowel movements were significantly reduced in group A. Acute diverticulitis occurred in 9 (2.6%) patients in group A and in 21 (4.5%) patients in group B (p=0.155). Surgery occurred in 4 (1.2%) patients in group A and 9 (1.9%) in group B (p=0.432). Disease-related mortality occurred in no patient in group A and 2 (0.4%) patients in group B (p=0.239). No side effects were recorded during the entire study period. Rifaximin is effective to relieve symptoms and reduce the risk of disease-related complications in patients with SUDD.

  • abdominal pain
  • colon
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http://dx.doi.org/10.1136/jim-2018-000901

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    Footnotes

    • Contributors Conception and design of the study: FDM, AT. Acquisition of data, or analysis and interpretation of data: FDM, CM, GC, AV, AN, MF, GB, WE, MP, AT. Drafting the article or revising it critically for important intellectual content: FDM, WE, MP, AT. Final approval of the version to be submitted: FDM, CM, GC, AV, AN, MF, GB, WE, MP, AT.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Patient consent for publication Not required.

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    © American Federation for Medical Research 2019. No commercial re-use. See rights and permissions. Published by BMJ.