Xifaxin Studies???? (??)

November 28, 2006

Hi everyone! :-)

This is going to be long and so I apologize in advance. But, please

bear with me to the end.

Some weeks ago I posted my thoughts about xifaxin and the fact that I

can now eat foods I hadn't been able to eat in 20-25 years. (See my

message #89271) Well, since then, I've been carefully and slowly trying

more and more foods. For the first time since 1981, I can drink orange

juice!!! I can eat strawberries, and spinach, and pineapple. This has

been such an incredibly exciting time for me.

Anyway, today I saw my gastro dr. and told him about all this. My

theory -- Since xifaxin is an antibiotic which works only in the gut, my

theory is that some of the toxins, naturally produced by bacteria during

digestion, had been causing the irritation which kept my Crohn's in a

constant state of unrest.

He said that YES!!! There are a FEW drs. working on this same theory

and have produced similar results in some patients. He didn't have any

other info to give me other than to confirm that this is not a figment

of my HE imagination.

I don't know if I can begin to communicate what this has meant for me.

To be able to eat a more balanced diet for the first time in 25 years

means that I now have the courage to begin a weight-loss program. For

anyone who is interested in losing weight in a very healthy and

supportive way, go to

http://www.sparkpeople.com/ and tell them Cantata sent you! This

program has been heaven-sent for me and I recommend it with no

hesitation whatsoever. I learned of it a few weeks ago from a very dear

friend.

I've lost 9 lbs already (only 2 tons minus 9 lbs. to go!) and am slowly

increasing my cardio and strength training. I'm already less dependent

on my walker around the house. And the best part --- the ever-present

nausea is GONE!!!! Yes, gone! Not diminished, not lessened, but gone,

completely and wonderfully gone!! Apparently due to the improved diet.

My bloodwork shows that the PSC is slowly continuing its downward

progression, but my daily existence has become so incredibly improved,

that I alternate laughing and crying. After years of nausea, decades of

wishing I could eat this or that. Can you imagine??? HE seemed such a

horrible step down, but it has turned into the richest of blessings!!!

Without HE, I would never have been put on xifaxin. Talk about a silver

lining!!!

-- Do you know of any studies which are showing this research that

is presently being done?

Hugs to everyone!!

Carolyn B in SC

(who is now going to do a Maureen and luxuriate in a long sign-off!

I've not posted much lately because I'm totally swamped with making

costumes for our church's Christmas Pageant. This is a 50-member cast

of adults and children, with all costumes carefully researched for

accuracy in design, fabric, and style. I'm drowning in fabric here!!

I'll return to my usual posting level after Christmas.)

November 29, 2006

Hi Carolyn;

This is such great news. Congratulations!

I think the antibiotic " xifaxin " that you mention is most

likely " xifaxan " , which is the same as " rifaximin " . It's a non-

absorbable antibiotic, meaning that it stays in the gut and is not

absorbed into the blood stream. It has been used extensively for

treatment of hepatic encephalopathy:

Digestion. 2006;73 Suppl 1:94-101.

Management of hepatic encephalopathy: focus on antibiotic therapy.

Festi D, Vestito A, Mazzella G, Roda E, Colecchia A.

Department of Internal Medicine and Gastroenterology, University of

Bologna, Bologna, Italy. festi@...

Hepatic encephalopathy (HE) is a major neuropsychiatric complication

of both acute and chronic liver failure. Symptoms of HE include

attention deficits, alterations of sleep patterns and muscular

incoordination progressing to stupor and coma. The pathogenesis of HE

is still unknown, although ammonia-induced alterations of cerebral

neurotransmitter balance, especially at the astrocyte-neurone

interface, may play a major role. Treatment of HE is therefore

directed at reducing the production and absorption of gut-derived

neurotoxic substances, especially ammonia. The non-absorbable

disaccharides lactulose and lactitol were long considered as a first-

line pharmacological treatment of HE, but a recent systematic review

questioned their efficacy, pointing out that there is insufficient

high-quality evidence to support their use. Oral antibiotics are

regarded as a suitable therapeutic alternative. However, the

prolonged use of antimicrobials is precluded by the possible

occurrence of adverse events. Rifaximin, a synthetic antibiotic

structurally related to rifamycin, displays a wide spectrum of

antibacterial activity against Gram-negative and Gram-positive

bacteria, both aerobic and anaerobic, and a very low rate of systemic

absorption. Available evidence suggests that rifaximin - thanks to

its efficacy and remarkable safety - has the highest benefit-risk

ratio in the overall treatment of HE. PMID: 16498257.

It's also used to treat traveller's diarrhea, irritable bowel

syndrome, and it is being tested as a treatment for Crohn's disease:

Aliment Pharmacol Ther. 2006 Apr 15;23(8):1117-25.

Antibiotic treatment of Crohn's disease: results of a multicentre,

double blind, randomized, placebo-controlled trial with rifaximin.

Prantera C, Lochs H, Campieri M, Scribano ML, Sturniolo GC,

Castiglione F, Cottone M.

Operative Unit of Gastroenterology, St Camillo-Forlanini Hospital,

Rome, Italy. prantera@...

BACKGROUND: Clinicians often employ antibiotics in Crohn's disease.

Rifaximin is active against bacteria frequently found in the

intestinal mucosa of Crohn's disease patients. AIM: To evaluate the

difference in efficacy between once and twice/daily oral

administration of rifaximin and placebo in the treatment of active

Crohn's disease. METHODS: We enrolled 83 patients with mild-to-

moderate Crohn's disease and randomized to three treatments for 12

weeks: Group A (rifaximin 800 mg o.d. + placebo), Group B (rifaximin

800 mg b.d.) and Group C (placebo b.d.). RESULTS: Clinical remission

was achieved by 52% of Group B, 32% (A) and 33% ©. Clinical

response was seen in 67% (, 48% (A) and 41% ©, without reaching a

statistically significant difference. Treatment failures were: 4%

(, 12% (A) and 33% ©, (P = 0.010). Remission and response rates

of rifaximin 800 mg b.d. were significantly higher than those of

placebo and rifaximin 800 mg o.d. in patients with elevated C

reactive protein values (P < 0.05). CONCLUSIONS: Rifaximin 800 mg

b.d. was superior to placebo in inducing clinical remission of active

Crohn's disease. Although this difference was not statistically

significant, the number of the failures in the placebo group was

significantly higher than those who received rifaximin 800 mg b.d.

PMID: 16611272.

Here's a news article on it from May 2005:

______________________

http://www.medicalnewstoday.com/medicalnews.php?newsid=24693

Rifaximin may help Crohn's Disease patients who haven't responded to

medications

18 May 2005

A small, open-label study conducted by physicians at NewYork-

Presbyterian Hospital/Weill Cornell Medical Center suggests that

there may be a new application for the novel antibiotic rifaximin in

treating patients who suffer from severe Crohn's Disease and who have

not responded to all other available medications for the disease.

The study was conducted by Dr. Ellen Scherl--Assistant Professor of

Medicine at Weill Medical College of Cornell University, and Director

of the Center for Inflammatory Bowel Disease in the Division of

Gastroenterology and Hepatology, and at the Iris Cantor Women's

Health Center at NewYork-Presbyterian/Weill Cornell--and Dr.

Bosworth, Fellow in the Division of Gastroenterology and Hepatology

in the Department of Medicine at NewYork-Presbyterian/Weill Cornell.

The physicians are encouraged by the unexpected results of rifaximin,

which was FDA- approved last year for Traveler's diarrhea. But, they

caution, these preliminary findings still require larger, controlled

studies. They note that what makes rifaximin a potentially ideal

antibiotic treatment for Crohn's Disease is that it remains primarily

in the gut, has minimal side effects, and has a lower resistance than

other antibiotics.

The researchers' analysis was performed on 8 patients. Both baseline

and post-treatment disease activity were measured via the Harvey

Bradshaw index, a simple clinical index of Crohn's Disease severity.

Patients varied in age from 17 to 83 and had an initial Harvey

Bradshaw index ranging from 6 to 16 (mean 10.9). Following the

treatment with rifaximin (400 mg twice daily), the Harvey Bradshaw

index of these patients decreased significantly, range 1 to 7 (mean

3.8), with a mean decrease in value of 7.1. There was a significant

improvement in the Harvey Bradshaw index, and the median time to

response was 8.9 days.

The cause of Crohn's Disease is unknown; however, many scientists

suspect that it is an abnormal response to bacteria in the

gastrointestinal tract. It is this supposition that led researchers

to analyze treatment with rifaximin, a nonabsorbed oral antibiotic

that is gut-selective with broad-spectrum in vivo activity against

gram-positive and gram-negative enteric organisms.

Results of the analysis suggest that rifaximin may be a safe and

effective treatment for Crohn's Disease. Researchers say that this

small assessment shows promise for those afflicted with Crohn's

Disease, and that the role of rifaximin in the induction and

maintenance of remission of inflammatory bowel disease, as well as

the optimal dosing schedule, should be explored in well-controlled,

double-blinded clinical studies.

Crohn's Disease is a chronic inflammatory disease of the intestines

and is frequently referred to as inflammatory bowel disease (IBD). It

primarily causes ulcerations (breaks in the lining) of the small and

large intestines. IBD affects approximately 500,000 to 2 million

people in the United States. Men and women are equally affected.

Common symptoms of Crohn's Disease include abdominal pain, diarrhea,

and weight loss. Less common symptoms include poor appetite, fever,

night sweats, rectal pain, and rectal bleeding. The symptoms of

Crohn's Disease are dependent on the location, the extent, and the

severity of the inflammation. There is currently no known cure for

Crohn's Disease.

About Digestive Disease Week

Digestive Disease Week (DDW) is the largest international gathering

of physicians, researchers, and academics in the fields of

gastroenterology, hepatology, endoscopy, and gastrointestinal

surgery. Jointly sponsored by the American Association for the Study

of Liver Diseases (AASLD), the American Gastroenterological

Association (AGA), the American Society for Gastrointestinal

Endoscopy (ASGE), and the Society for Surgery of the Alimentary Tract

(SSAT), DDW takes place May 14-19, 2005, in Chicago. The meeting

showcases approximately 5,000 abstracts and hundreds

Contact: Jan Sileo

MedThink Communications

http://www.medthink.com

____________________

Best regards,

Dave

(father of (21); PSC 07/03; UC 08/03)

November 29, 2006