Can antibiotics treat irritable bowel syndrome (IBS)?
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Irritable bowel syndrome may be linked with bacterial infections in some cases. Studies have demonstrated that people with bacterial gastroenteritis - an infection of the intestines - occasionally develop irritable bowel syndrome. For these people, antibiotics may provide relief from their irritable bowel syndrome symptoms. Research is still under way.
Irritable bowel syndrome may be linked with bacterial infections in some cases. Studies have demonstrated that people with bacterial gastroenteritis - an infection of the intestines - occasionally develop irritable bowel syndrome. For these... More -
Dr. Bill Salt answered:In some cases yes, but it's complicated.
IBS AND BACTERIA
The role that bacteria in the gut play in causing or contributing to the symptoms of IBS is the subject of considerable research interest, since it has been known for at least 10 years that some people with IBS (but not all) have alterations in bacterial content of their small intestine and/or colon. Small intestinal bacterial overgrowth (SIBO) is an established medical condition with increased number and/or type of bacteria in the upper small intestine.IBS AND ANTIBIOTICS
Recent scientific studies of an antibiotic called rifaximin (trade name = Xifaxan) in nonconstipated IBS patients (New England Journal of Medicine 2011;364:22-32) show significant benefits in some for up to 12 weeks after a 10 -14 day course. The advantage of rifaximin over other antibiotics is that very little of it is absorbed into the body, but antibiotics and rifaximin are not FDA - approved for treatment of IBS, so their use in treatment of IBS is what doctors call, "off-label."CAVEATS ABOUT USING ANTIBIOTICS TO TREAT IBS
It is important to emphasize that IBS is a chronic, relapsing condition, which raises many concerns about using antibiotics to treat IBS, including what to do if/when IBS symptoms relapse, and that long-term use of antibiotics can have undesirable effects on the body, increase susceptibility to certain infections, and promote antibiotic-resistant bacteria.DOES INTESTINAL BACTERIAL OVERGROWTH CAUSE IBS?
It remains unclear whether SIBO actually causes IBS or is a bystander of something else. A recent comprehensive review by gastroenterologist, Brennan MR Spiegel, MD in a medical journal, Clinical Gastroenterology and Hepatology (2011;9:461-469) concludes that:"bacteria may contribute to some IBS symptoms, but that bacteria cannot be the only explanation, and a causal link between SIBO and IBS is not secure."
WHAT I RECOMMEND
I agree with this conclusion and also with another statement he makes in the article:"...I use antibiotics in selected patients, such as those with persistent bloating, fullness, or distention despite other failed attempts at management, including assistance from an IBS-trained dietitian."
Helpful? 1 person found this helpfulIn some cases yes, but it's complicated. IBS AND BACTERIAThe role that bacteria in the gut play in causing or contributing to the symptoms of IBS is the subject of considerable research interest, since it has been known for at least 10 years that... More -
Dr. Lawrence Friedman answered:A substantial percentage of irritable bowel syndrome (IBS) patients have an overgrowth of bacteria in their small intestines. Research shows treatment with antibiotics to eliminate this overgrowth may help improve symptoms. One small study compared the gut-specific, broad-spectrum antibiotic rifaximin against placebo. Eighty-seven study participants took either rifaximin or placebo for 10 days. Over the 10 weeks of follow-up, people who had taken the antibiotic enjoyed significant improvement in overall symptoms and in bloating in particular compared with those taking placebo, with no notable side effects.A substantial percentage of irritable bowel syndrome (IBS) patients have an overgrowth of bacteria in their small intestines. Research shows treatment with antibiotics to eliminate this overgrowth may help improve symptoms. One small study compared... More
