Diverticulosis, its associated symptoms and complications are one of the most common
pathologies of the gastrointestinal tract in more economically developed countries.
Presence of diverticuli and their clinical consequences can be divided into four categories:
1) diverticulosis, i.e. an asymptomatic presence of diverticuli that are usually found
by accident 2) symptomatic uncomplicated diverticulosis 3) diverticulitis (acute uncomplicated
diverticulitis) 4) complications of diverticulitis (conditions requiring hospital
stay). The aim of this study was to retrospectively analyze the efficacy of rifaximin
in preventing diverticulitis in patients visiting proctology clinics. The diagnostic
criterium for diverticulosis was confirmation by colonoscopy, barium enema or CT colography
(virtual colonoscopy) as well as history of at least one documented episode of diverticulosis.
History of diverticulosis was evaluated based on medical records, clinical symptoms,
elevated level of CRP (>5.0) and/or diagnostic imaging (ultrasound, CT). After
setting strict exclusion criteria, 248 patients were qualified for the study out of
686, and they were later divided into two groups: control group (group I - 145 patients)
and studied group (group II - 103 patients receiving rifaximin prophylaxis). Diverticulitis
rate was comparable in both groups over a period of 6 months before study (p = 0.1306)
and 6 months of treatment (p=0.3044). Between the 6th and 12th month of treatment,
a significantly lower rate of diverticulitis was noted in the group receiving rifaximin
compared to control group (p<0.0001). Patients receiving rifaximin reported higher
quality of life (which was assessed using the VAS scale) compared to control group
after 12 months. The results confirmed the efficacy of riaximin in prevention of diverticulitis,
even in the scheme of repeated courses every 3 months. Not only did application of
rifaximin lower the rate of diverticulitis and its complications in patients after
an episode of diverticulitis, but also it improved the patients' quality of life.
It seems that diverticulitis prophylaxis based on rifaximin can be economically efficient,
however, it requires further research.