OBJECTIVE. To determine the frequency of the syndrome of excessive bacterial growth in patients with cholecystectomy and PL, justify the need for correction of intestinal microflora and to assess the effectiveness of rifaksimin decontamination.
Material and methods: The study involved 35 patients with gallstone disease (GSD) (3 men, 32 women, average age--59 +/- 9 years) and 50 patients who underwent cholecystectomy at the cholecystolithiasis (4 men, 46 women, average age--60 +/- 9 years). Inclusion criteria were the complaints that are characteristic for the syndrome of excessive bacterial growth in the small intestine (EBG). All the patients underwent clinical, laboratory and instrumental examinations and hydrogen breath test. In identifying the EBG was a rifaksimin treatment at a dose of 800 mg/day for 7 days. Treatment efficacy was determined by the dynamics of clinical symptoms and indicators of the hydrogen breath test at the 8 th and 30th day of observation.
Results and discussion: Patients who was underwent cholecystectomy, EBG was detected in 58%, and among patients with gallstone disease--in 28%. The rifaksimin treatment to 8 th day was declining intensity of clinical symptoms correlated with the dynamics of the hydrogen breath test. On day 30 the majority of patients clinical symptoms of EBD disappeared (from 56 to 75% depending on the symptoms), but in some patients it persisted, despite the reduction in their severity. These data also correlated with the dynamics of the hydrogen breath test.
Conclusion: At cholecystolithiasis and in patients with removal of the gallbladder detected EBG in 28 and 52% respectively, which requires corrective therapy. The rifaksimin therapy have positive dynamics in relieving clinical symptoms and the decline in the hydrogen breath test. However, some patients with therapy at a dose of 800 mg/day uncropped pain and dyspeptic symptoms and hadn't accompanied by normalization of pH test.