A Multi-Substrate Carbohydrate Elimination Diet (MCED) Decreases Gastrointestinal (GI) Symptoms in a Subpopulation of Children With Irritable Bowel Syndrome (IBS)

G A A b st ra ct s and methods. Fifty IBS children (20 males, 40%, 30 females, 60%; mean age 9.9 ± 3.7 years) were consecutively enrolled. All subjects underwent lactulose hydrogen/methane breath test (LBT) to assess SIBO before and one month after the treatment with rifaximin 600 mg daily for one week. All IBS patients filled out a Visual Analogic Scale (VAS) to assess and score gastrointestinal symptoms (abdominal pain, constipation, diarrhoea, bloating, flatulence) at baseline and one month after treatment. Results. The prevalence of abnormal LBT in patients with IBS was 66% (33/50). LBT normalization rate after therapy was 64% (21/33). Compliance was excellent, and no relevant side-effects were observed during treatment. VAS score was significantly higher in IBS children with abnormal LBT than SIBO negatives, and strongly improved after successful treatment. Conclusions. Rifaximin was effective and safe in SIBO treatment and IBS symptoms improvement in childhood. Double blind placebo-controlled interventional studies are warranted to verify the real impact of SIBO on gastrointestinal symptoms in children with IBS.