Randomised clinical trial: rifaximin versus placebo for the treatment of functional dyspepsia

Aliment Pharmacol Ther. 2017 Mar;45(6):767-776. doi: 10.1111/apt.13945. Epub 2017 Jan 23.


Background: Gut dysbiosis may contribute to pain and bloating in patients with functional gastrointestinal disease.

Aims: To determine if treatment with rifaximin would improve the symptoms of functional dyspepsia in Chinese patients in a double-blinded, randomised, placebo-controlled trial.

Methods: Consecutive subjects with a diagnosis of functional dyspepsia as per the Rome III criteria were randomised to receive rifaximin 400 mg or placebo, all taken three times daily for 2 weeks. The investigators and study subjects were blinded to the treatment allocation. Subjects were followed up for 8 weeks. The primary end point was adequate relief of global dyspeptic symptoms (GDS). Secondary endpoints were relief of individual dyspeptic symptoms.

Results: Eighty-six subjects were recruited. At week 8, there were significantly more subjects in the rifaximin than in the placebo group who experienced adequate relief of GDS (78% vs. 52%, P = 0.02). A trend favouring rifaximin group was also noted in the preceding 4 weeks. Rifaximin was also superior to placebo in providing adequate relief of belching and post-prandial fullness/bloating (PPF) in subjects at week 4. Subgroup analysis revealed that female subjects had more significant response to rifaximin treatment (adequate relief of GDS at week 4: 76% vs. 42%, P = 0.006; week 8: 79% vs. 47%, P = 0.008), as well as improvements in their belching and PPF at week 4. The incidences of adverse effects were similar in both groups.

Conclusions: Treatment with 2 weeks of rifaximin led to adequate relief of global dyspeptic symptoms, belching and post-prandial fullness/bloating in subjects with functional dyspepsia. The difference was more marked in females. (clinicaltrials.org NCT01643083).

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Double-Blind Method
  • Dyspepsia / diagnosis
  • Dyspepsia / drug therapy*
  • Dyspepsia / epidemiology*
  • Eructation / diagnosis
  • Eructation / drug therapy
  • Eructation / epidemiology
  • Female
  • Gastrointestinal Agents / pharmacology
  • Gastrointestinal Agents / therapeutic use*
  • Hong Kong / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Pain / diagnosis
  • Pain / drug therapy
  • Pain / epidemiology
  • Placebo Effect
  • Postprandial Period / drug effects
  • Postprandial Period / physiology
  • Rifamycins / pharmacology
  • Rifamycins / therapeutic use*
  • Rifaximin
  • Treatment Outcome


  • Gastrointestinal Agents
  • Rifamycins
  • Rifaximin

Associated data

  • ClinicalTrials.gov/NCT01643083