Two Strategies Aim to Modify Gut Flora in IBS

“We don't know enough, in my mind, to be saying absolutely everybody with IBS should be on this. … The problem we have currently is what to recommend—what dose, how often, which type,” Dr. Talley added.

Nevertheless, these are promising new approaches worthy of thorough exploration at a time when medical understanding of the true nature of IBS has undergone a complete change. IBS is no longer viewed by experts as a psychogenic disorder with no demonstrable physical pathology. It is a mixed motility disorder involving a hyperacute sensation of pain to the gut.

“Yes, psychologic factors are relevant, but IBS is a real disease of the gut. It involves immunologic changes, inflammatory changes, and—based upon limited data so far—flora changes,” the gastroenterologist observed.

Dr. Quigley is a consultant to and stock shareholder in Alimentary Health, which is developing B. infantis 35624 for commercial applications.

Dr. Pimentel is a consultant to Salix Pharmaceuticals Inc., which markets rifaximin for the indication of traveler's diarrhea.

Of patients in the rifaximin group, 38% were clinical responders, compared with 16% of those on placebo. DR. PIMENTEL