Restless legs syndrome in patients with irritable bowel syndrome: response to small intestinal bacterial overgrowth therapy

Dig Dis Sci. 2008 May;53(5):1252-6. doi: 10.1007/s10620-007-0021-0. Epub 2007 Oct 13.

Abstract

Background: Small intestinal bacterial overgrowth (SIBO) occurs in irritable bowel syndrome (IBS) and fibromyalgia. Since restless legs syndrome (RLS) occurs with fibromyalgia, a link between IBS, SIBO, and RLS was studied.

Methods: BS patients with abnormal lactulose breath tests received rifaximin 1,200 mg day(-1) for 10 days, followed by tegaserod 3 mg, long-term, and 1 month of zinc 220 mg day(-1) and once-daily probiotic (N = 11) or rifaximin monotherapy (N = 2). IBS symptom improvement was assessed after rifaximin. RLS symptoms, IBS symptoms, and overall IBS global improvement were assessed at last posttreatment visit: 8/10 patients were followed long-term (mean, 139 days; range, 54-450 days).

Results: Ten of 13 patients exhibited > or =80% improvement from baseline in RLS symptoms. Five maintained complete resolution of RLS symptoms. Global gastrointestinal symptom improvement was great (n = 6), moderate (n = 5), or mild (n = 2).

Conclusion: This study suggests that SIBO associated with IBS may be a factor in some RLS patients and SIBO therapy provides long-term RLS improvement.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Breath Tests
  • Drug Therapy, Combination
  • Female
  • Gastrointestinal Agents / therapeutic use
  • Humans
  • Indoles / therapeutic use
  • Intestine, Small / microbiology*
  • Irritable Bowel Syndrome / complications*
  • Irritable Bowel Syndrome / drug therapy
  • Irritable Bowel Syndrome / microbiology*
  • Male
  • Middle Aged
  • Pilot Projects
  • Restless Legs Syndrome / complications*
  • Rifamycins / therapeutic use
  • Rifaximin
  • Serotonin Receptor Agonists
  • Surveys and Questionnaires
  • Treatment Outcome

Substances

  • Gastrointestinal Agents
  • Indoles
  • Rifamycins
  • Serotonin Receptor Agonists
  • tegaserod
  • Rifaximin