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Restless Legs Syndrome in Patients with Irritable Bowel Syndrome: Response to Small Intestinal Bacterial Overgrowth Therapy

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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 ≥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.

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Acknowledgements

Financial disclosure: Partial funding provided by a grant from Salix Pharmaceuticals, Inc.

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Authors and Affiliations

  1. Washington University School of Medicine, 11525 Olde Cabin Road, St. Louis, MO, 63141, USA

    Leonard B. Weinstock, Steve E. Fern & Stephen P. Duntley

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  1. Leonard B. Weinstock
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  2. Steve E. Fern
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Correspondence to Leonard B. Weinstock.

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Weinstock, L.B., Fern, S.E. & Duntley, S.P. Restless Legs Syndrome in Patients with Irritable Bowel Syndrome: Response to Small Intestinal Bacterial Overgrowth Therapy. Dig Dis Sci 53, 1252–1256 (2008). https://doi.org/10.1007/s10620-007-0021-0

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  • DOI: https://doi.org/10.1007/s10620-007-0021-0

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