Neomycin improves constipation-predominant irritable bowel syndrome in a fashion that is dependent on the presence of methane gas: Subanalysis of a double-blind randomized controlled study
Neomycin improves constipation-predominant irritable bowel syndrome in a fashion that is dependent on the presence of methane gas: Subanalysis of a double-blind randomized controlled study
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DOI：
10.1007/s10620-006-9104-6
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发表时间：
2006-08-01
影响因子：
3.1
通讯作者：
Kong, Yuthana
中科院分区：
文献类型：
--
作者：
Pimentel, Mark;Chatterjee, Soumya;Kong, Yuthana
最近的研究表明，乳果糖呼气试验（LBT）与新霉素的正常化导致肠易激综合征（IBS）症状显着减少。对便秘型IBS亚组（C-IBS）患者进行了亚组分析，以检测新霉素改善便秘的能力及其与呼吸试验中甲烷消除的相关性。IBS受试者以盲法进行LBT。然后他们被随机分配到新霉素组或安慰剂组。出于本分析的目的，仅确定了C-IBS受试者。然后评价他们的整体改善、腹痛和便秘严重程度。还测定了新霉素消除甲烷的能力及其对便秘的相关改善。本研究纳入了符合IBS罗马I标准的111名受试者。其中39人患有C-IBS。其中，20人接受安慰剂，19人接受新霉素。在意向治疗分析中，新霉素组的总体改善率为36.7 +/- 7.9%，而安慰剂组为5.0 +/- 3.2%（P <0.001）。与安慰剂组的18.7 +/- 7.2%相比，新霉素组的依从性改善了32.6 +/- 9.9%（P= 0.26）。在最初的111名受试者中，12名在呼吸测试中显示甲烷。所有12例患者均以便秘为主。在接受新霉素或安慰剂的甲烷产生者中，接受新霉素的便秘改善率（44.0 +/- 12.3%）显著高于安慰剂（5.0 +/- 5.1%）（P <0.05）。新霉素治疗可改善C-IBS患者的便秘。这种改善取决于呼吸测试中甲烷的存在和消除。
Recent studies have shown that normalization of the lactulose breath test (LBT) with neomycin leads to a significant reduction in irritable bowel syndrome (IBS) symptoms. This subanalysis was done on the constipation-predominant IBS subgroup of patients (C-IBS) to test the ability of neomycin to improve constipation and its correlation with the elimination of methane on breath test. IBS subjects underwent LBT in a blinded fashion. They were then randomly allocated to neomycin or placebo groups. For the purpose of this analysis, only the C-IBS subjects were identified. They were then evaluated for global improvement, abdominal pain, and constipation severity. The ability of neomycin to eliminate methane and its associated improvement in constipation was also determined. One hundred eleven subjects meeting Rome I criteria for IBS were included in the study. Thirty-nine of these had C-IBS. Of these, 20 received placebo and 19 received neomycin. With neomycin, a global improvement of 36.7 +/- 7.9% was seen, compared to 5.0 +/- 3.2% for placebo (P < .001) in the intention-to-treat analysis. Constipation was improved by 32.6 +/- 9.9% with neomycin compared to 18.7 +/- 7.2% for placebo (P=.26). Of the original 111 subjects, 12 demonstrated methane on breath test. All 12 of these patients were constipation predominant. In the methane producers receiving neomycin or placebo, improvement in constipation was significantly greater in those receiving neomycin (44.0 +/- 12.3%) compared to placebo (5.0 +/- 5.1%) (P < .05). Treatment with neomycin improves constipation in C-IBS. This improvement depends on the presence and elimination of methane on breath test.