In functional dyspepsia patients diagnosed with small intestinal bacterial overgrowth, Rifaximin is beneficial in decreasing gas while Mosapride can aid in lowering the concentration of hydrogen in the breath.

A randomized trial was conducted to assess the effectiveness of Rifaximin, Mosapride, and combination of Rifaximin and Mosapride to treat small intestine bacterial overgrowth.

For 2 weeks at random distribution in 1:1:1 ratio, the subjects suffering from small intestine bacterial overgrowth and dyspepsia received Rifaximin, Mosapride, or a combination of the two. Prior to and post-therapy, symptom questionnaire and hydrogen-methane glucose breath test were also surveyed. The major endpoint was the percentage of small intestine bacterial overgrowth that was eliminated. Alteration in the gas concentration, safety, and symptoms were the secondary outcomes ascertained.

There were no appreciable differences between the three groups in terms of eradication rates, as depicted in Table 1:

In Rifaximin group, the total hydrogen concentration during glucose breath test was dramatically reduced. Significantly reduced total methane concentration was seen in the Rifaximin and combination groups. Remarkable symptomatic improvements in flatulence with Rifaximin, chest discomfort with the combined groups, and stomach and chest discomfort with Mosapride were also noted. Comparable side effects were witnessed in the study groups.

When used alone or in conjunction with Rifaximin, Mosapride alleviated certain intestinal symptoms in dyspepsia patients.