In a recent study, Rebamipide enhanced the integrity of the intestinal barrier in diarrheal variant of irritable bowel syndrome overlapping with functional dyspepsia (D-IBSoFD)-affected people, resulting in reduced enterocyte damage and inflammation, with effects comparable to or surpassing those of Trimebutine. Researchers sought to assess the impact of Rebamipide on the severity of symptoms, the function and composition of the intestinal microbiota, and the status of the intestinal barrier in D-IBSoFD.

In this randomized controlled trial, 60 subjects were randomly assigned to receive Trimebutine, Trimebutine + Rebamipide, or Rebamipide alone over a 2-month period. Assessments of gut barrier status, the function (short-chain fatty acid fecal content) and composition (16S rRNA gene sequencing) of the gut microbiota, overall well-being (36-Item Short Form Survey [SF-36]), and digestive symptom intensity (Gastrointestinal Symptom Rating and 7 × 7 scales) were conducted at the study's onset and conclusion.

Most digestive symptoms severity decreased in both the Rebamipide and Trimebutine + Rebamipide groups, comparable to the Trimebutine group. Reduction in eosinophilic infiltration in the sigmoid, as well as lymphocytic infiltration in the duodenum and sigmoid were noted in the Rebamipide and Trimebutine + Rebamipide groups, but not in the Trimebutine group. Serum zonulin levels were substantially reduced in the Rebamipide group only.

A reduced infiltration in the sigmoid colon was related to enhanced consistency of stool and reduced intensity of the sensation of inadequate bowel evacuation. On the other hand, a drop in intraepithelial lymphocytic infiltration in the duodenum was linked with declined flatulence and rumbling intensity. The findings highlighted Rebamipide's positive impact on both intestinal barrier health and symptomatic relief in D-IBSoFD, showcasing effects non-inferior to Trimebutine.