P0319 - Efficacy and Safety of Rifaximin for IBS in Diarrheal and Non-Diarrheal Patients: A Systematic Review and Meta-Analysis

Trisha Chandra Mohan, ¹, Rishikesh R. Magaji, ¹, Ananya Prasad, ², Omar Oudit, DO³, Vinay Chandramouli Bellur, ⁴, Vibhav MS, ⁵, Shradha Chervittara Karaveetil, ², Keerthi Balaji Babu Naidu, ⁴, Aryan Gupta, ⁵, Pavan Kumara Kasam Shiva, ⁵, Druvadeep Srinivas, ⁶, Ashwin Kemtur, ⁷, Sravani Bhavanam, ⁸, Prakriti Ramamurthy, MBBS, MD⁹
1BGS Global Institute of Medical Sciences, Bangalore, Karnataka, India; 2ramaiah medical college, Bangalore, Karnataka, India; 3Brookdale University Hospital Medical Center, Brooklyn, NY; 4Ramaiah medical college, Bangalore, Karnataka, India; 5bangalore medical college and research institute, Bangalore, Karnataka, India; 6rajarajeshwari medical college & hospital, Bangalore, Karnataka, India; 7Kempegowda Institute of Medical Sciences, Bengaluru, Karnataka, India; 8Brookdale University Hospital Medical Center, Bangalore, Karnataka, India; 9University of Massachusetts Chan Medical School - Baystate Health, Springfield, MA

Introduction:

Irritable Bowel Syndrome (IBS) is a chronic functional gastrointestinal disorder marked by abdominal discomfort, bloating, and altered bowel habits, often leading to a significant reduction in quality of life. Rifaximin, a minimally-absorbed, gut-targeted antibiotic has emerged as a promising treatment for symptom relief. Beyond its microbiota-modulating effects, studies have shown consistent improvement in bloating and overall well-being, even in patients with constipation-predominant IBS. This meta-analysis evaluates the efficacy of rifaximin in improving bloating, alleviating constipation, and enhancing quality of life in individuals with IBS.

Methods:

The review conducted follows the PRISMA guidelines. PUBMED, Google Scholar and Science-Direct were searched using a comprehensive search term to identify and retrieve available articles. The articles included Rates of Relief of Symptoms and Difference in constipation severity. 

 

The data was analysed using the Meta, Metadata and the Metafor packages of R Studio. The proportion of the Odds Ratio (OR) of Relief of Global Symptoms between Rifaximin vs Placebo was assessed as our primary outcome. The proportion of the Odds Ratio (OR) of Relief of Bloating Symptoms and difference in constipation severity post treatment with Rifaximin vs Placebo were assessed as secondary outcomes. The Mantel-Haenszel method and the Inverse variance method were utilised to analyse the odds ratio. The I^2 test was used to assess the heterogeneity of the studies.

Results:

The study included a total of 12 studies where 3022 patients with IBS received Rifaximin Therapy and 3115 patients were in the control group. Patients who received Rifaximin showed significantly higher rates of Relief of Global Symptoms (OR=1.51 (1.32;1.72) ,95% CI, p=0.02194 ,I^2=28.7%). Patients receiving Rifaximin also reported increased relief from bloating symptoms (OR=1.47 (1.28;1.68) ,95% CI, p=0.6197 ,I^2=0.0%). There was a notable reduction in the severity of constipation in the Rifaximin group (OR=1.47 (1.28;1.68) ,95% CI, p=0.6197,I^2=0.0%).

Discussion:

Our study indicates that patients on Rifaximin therapy showed higher rates of Relief of Global Symptoms in comparison to Placebo group. Patients receiving Rifaximin also showed increased relief from bloating symptoms and a notable reduction in the severity of constipation. This highlights the potency of Rifaximin in improvement of symptoms of IBS.


Figure: Odds Ratio of Relief of Bloating Symotoms between Rifaximin vs Placebo
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Odds Ratio of Relief of Global Symptoms between Rifaximin Vs Placebo


Figure: Difference in Constipation severity after treatment with Rifaximin Vs Placebo

Disclosures:
Trisha Chandra Mohan indicated no relevant financial relationships.
Rishikesh R. Magaji indicated no relevant financial relationships.
Ananya Prasad indicated no relevant financial relationships.
Omar Oudit indicated no relevant financial relationships.
Vinay Chandramouli Bellur indicated no relevant financial relationships.
Vibhav MS indicated no relevant financial relationships.
Shradha Chervittara Karaveetil indicated no relevant financial relationships.
Keerthi Balaji Babu Naidu indicated no relevant financial relationships.
Aryan Gupta indicated no relevant financial relationships.
Pavan Kumara Kasam Shiva indicated no relevant financial relationships.
Druvadeep Srinivas indicated no relevant financial relationships.
Ashwin Kemtur indicated no relevant financial relationships.
Sravani Bhavanam indicated no relevant financial relationships.
Prakriti Ramamurthy indicated no relevant financial relationships.

Trisha Chandra Mohan, ¹, Rishikesh R. Magaji, ¹, Ananya Prasad, ², Omar Oudit, DO³, Vinay Chandramouli Bellur, ⁴, Vibhav MS, ⁵, Shradha Chervittara Karaveetil, ², Keerthi Balaji Babu Naidu, ⁴, Aryan Gupta, ⁵, Pavan Kumara Kasam Shiva, ⁵, Druvadeep Srinivas, ⁶, Ashwin Kemtur, ⁷, Sravani Bhavanam, ⁸, Prakriti Ramamurthy, MBBS, MD⁹. P0319 - Efficacy and Safety of Rifaximin for IBS in Diarrheal and Non-Diarrheal Patients: A Systematic Review and Meta-Analysis, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.