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Restless Legs Syndrome in Patients with Irritable Bowel Syndrome: Response to Small Intestinal Bacterial Overgrowth Therapy – Source: Digestive Diseases and Sciences, Oct 13, 2007

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By LB Weinstock, et al. • • October 18, 2007

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 [for SIBO] received rifaximin [an antibiotic that does not pass through the wall of the GI tract into the circulation] 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 of 10 patients were followed long-term (mean, 139 days; range, 54-450 days).


  • 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.

    Source: Digestive Diseases and Sciences. 2007 Oct 13; [E-publication ahead of print] PMID: 17934858, by Weinstock LB, Fern SE, Duntley SP. Washington University School of Medicine, St. Louis, Missouri, USA. [E-mail: ]

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