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Colegio de Medicina Interna de México.

2019, Number 6

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Med Int Mex 2019; 35 (6)

Rifaximin-alpha in the treatment of diverticular disease. Evidence and current concepts

García-Zermeño KR, Valdovinos-Díaz MÁ, Raña-Garibay R, Abreu AAT, Remes-Troche JM

Language: Spanish
References: 60
Page: 912-926
PDF size: 553.27 Kb.


ABSTRACT

Diverticular disease or diverticulosis is one of the most frequent gastrointestinal diseases in Western countries, and has been linked to multiple factors such as the consumption of a low-fiber diet, sedentary lifestyle and aging. The spectrum of diverticular disease is broad and includes from asymptomatic forms (diverticulosis) to complications, such as hemorrhage, inflammation and perforation, passing through intermediate forms, such as segmental colitis. Recently it has been described that dysbiosis can play a fundamental role in the development of complications of diverticulosis and in this respect it has been shown that the administration of eubiotic modulators, specifically rifaximin, can be useful. Rifaximin is a nonabsorbable antibiotic with unique eubiotic and antibiotic effects in the management of patients with diverticular disease. Evidence shows that the use of the alpha polymorph of rifaximin (rifaximin-alpha) in uncomplicated diverticular disease alone or in association with fiber is safe and effective. The data available from multiple studies report significant symptomatic improvement and even prevention of new episodes of acute diverticulitis, which is why it is considered as a fundamental part in the treatment of diverticular disease by different guides and consensus at a global level. Efficacy, safety and tolerance of other polymorphs of rifaximin other than alpha are unknown, so it is not appropriate to assume similarity or equivalence based on the studies where rifaximin-alpha was evaluated.


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