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• W2913145087 abstract "Purpose: We have recently demonstrated that antibiotic therapy improves IBS and is related to abnormalities on the lactulose breath test. We have further demonstrated a deficiency of migrating motor complexes (MMC) in IBS patients with an abnormal breath test. Based on a disturbed MMC, we test whether low dose erythromycin or tegaserod can prevent the recurrence of symptoms after successful antibiotic treatment. Methods: In this study, a retrospective chart review was conducted on 203 consecutive patients seen in 2005 in the GI Motility Program. Patients were excluded if they did not have IBS, did not have a positive breath test, had an alternative diagnosis, or never had successful eradication of the abnormal breath test with clinical resolution. Those with clinical and breath test resolution were reviewed to determine the method of preventing symptom recurrence (none, erythromycin or tegaserod) and the time to recurrence with this method of prevention. Data was compared between groups as well as within groups if multiple methods were used on the same patient. Results: Out of 203 patients, 64 patients had IBS, abnormal breath test, at least one successful treatment and follow up using a prevention strategy. Based on only the first successful antibiotic treatment, no preventive strategy (N = 6) meant a recurrence of symptoms in 59.7 ± 47.5 days compared to 138.5 ± 132.2 days for erythromycin (P= 0.16) and 241.6 ± 162.2 (P= 0.01 vs. none and P= 0.02 vs. erythromycin). Any use of prevention was 57.4 ± 44.0 for none, 144.7 ± 130.7 for erythromycin (P= 0.04 vs. erythromycin) and 213.4 ± 152.7 days for tegaserod (P= 0.002 vs. none and P= 0.02 vs. erythromycin). In 18 patients after recurrence with erythromycin, tegaserod was used following antibiotic therapy. The number of days of prevention extended from 102.7 ± 67.8 with erythromycin to 224.3 ± 159.2 for tegaserod (P= 0.002). 4 patients on no therapy were later given erythromycin or tegaserod and extended prevention from 46.0 ± 50.1 to 222.8 ± 162.8 days (P= 0.06). Also, 2 patients stopped taking tegaserod prevention after 209 and 365 days of normal bowel function. After stopping tegaserod, symptoms recurred in 30 and 45 days respectively. 14 C-IBS patients used tegaserod as prevention (189.3 ± 109.9 days) and 16 D-IBS (278.6 ± 197.4 days, P= 0.13). Conclusion: Tegaserod is most effective in preventing relapse of clinical symptoms in IBS patients with positive breath test after antibiotic eradication. This work was supported by Novartis Pharmaceuticals." @default.
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• W2913145087 date "2007-09-01" @default.
• W2913145087 modified "2023-09-23" @default.
• W2913145087 title "Nightly Tegaserod Prevents the Clinical Recurrence of Bacterial Overgrowth Symptoms" @default.
• W2913145087 doi "https://doi.org/10.14309/00000434-200709002-01038" @default.
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