Patients suffering from inflammatory diseases are often prescribed NSAIDs. They are also prescribed PPI (Proton pump inhibitor) to protect their stomach. In a joint study, clinical pharmacologist Markus Zeitlinger and gastroenterologist Werner Dolak from MedUni Vienna showed that this combination of medication can result in inflammation in the small intestine. However, if an additional antibiotic (rifaximin) is prescribed, the intestine remains protected. The study has now been published in the leading journal Gastroenterology.
People who suffer from inflammatory joint conditions are often given NSAIDs like Diclofenac. However, such drugs often attack the stomach lining, so these patients are also given PPI to protect their stomach lining. These PPI have a negative impact on the gut flora and could lead to colonization of undesirable bacteria. This can adversely affect the highly individual microbiome of the person concerned.
Live images from the intestines
The study involved 60 healthy volunteers over a period of 14 days, monitoring the drug-related reaction in the intestinal tract by Capsule endoscopy. This procedure involves visualization of the intestine, by swallowing a capsule containing a camera, which automatically takes pictures throughout its way and then transmits to an external portable data recorder. The images can be analysed on the computer and camera is excreted in the normal way.
The volunteers were initially examined and then divided into 2 groups.
1 group: Patients who were given Diclofenac+Omeprazol+rifamixin
2 group: Patients who were given a placebo in the place of rifamixin.
After 2 weeks, another capsule endoscopy was performed, and this showed significant inflammations in the small intestine in approximately 1/3rd of the latter group. The other group of volunteers who had taken rifamixin showed fewer inflammatory changes and wherever they occurred, they were less severe.
The results of the double-blinded study served to confirm the proposition that additional administration of rifamixin protects the intestines. As a next step it is intended to conduct a study to investigate the treatment concept on regular users of NSAIDs.