Joan wrote:The article says that Rifaximin "has high-quality evidence of reducing global IBS symptoms, especially bloating, with short-term dosing although symptom recurrence is common."
Does this imply that IBS is actually a bacterial infection which this drug treats, but it isn't killing all of them so it reccurs?
Not necessarily. Usually, that antibiotic is most effective against bacteria such as E. coli. It's not effective against bacteria such as Campylobacter, Shigella, or the various Salmonella species, for example.
You have to bear in mind that many/most antibiotics are not "bactericidal", (bactericidals work by actually killing bacteria). Many antibiotics are "bacteriostatic", meaning that they work by stopping bacteria from multiplying.
Each different type of antibiotic affects different bacteria in different ways. For example, an antibiotic might inhibit the ability of a species of bacteria to turn glucose into energy, or its ability to construct or repair its cell wall. When this happens, the bacterium dies instead of reproducing. Typically, bacteriostatic antibiotics achieve those effects by altering the DNA of a bacterium, so that some part of the organism cannot function normally. If a vital component cannot function normally, then the cell either cannot survive, or it cannot reproduce.
If you think about that a bit, the ability to alter the DNA structure of a cell, (i.e., a single-celled organism), is a very powerful tool, and most likely to have rather complex implications. Therefore, like most/all meds, there are almost surely some side effects that go along with most/all of these antibiotics. IOW, there is a very good chance that they also have certain effects on human tissue, that change the way that certain cells behave, and this is possibly the mechanism by which certain antibiotics tend to control D. For example, we have long observed that Ciprofloxacin will stop the D caused by an MC reaction in virtually every case. No one knows exactly how this is accomplished, but it is almost certainly related to some sort of antibiotic-modulated effect on the cellular level. Since the changes are not permanent, obviously, then apparently the temporary changes that occur in human cells due to the influence of the antibiotic, are not due to a DNA modification in human cells.
Note that everything in that last paragraph is just my thoughts on the matter. It's possible that it might be documented somewhere, but I didn't research it - those are just my thoughts. Everything else, above that, though, is documented fact, and common knowledge.
Tex