Institutional and funding constrains

This study aim to compare the efficacy of nitazoxanide in 2-week course of treatment with rifaximin in treating diarrhea associated with IBS. We also aim to study its effect over 10 weeks after treatment to evaluate its efficacy in eradicating symptoms of IBS in the long run.

Inclusion Criteria:

• Patients 18 years of age or older.
• Patients suffering from diarrhea-predominant IBS according to Rome III criteria.
• Active symptoms for at least 2 weeks
• Abdominal Pain Intensity: weekly average of worst daily (in past 24 hours) abdominal pain score of > 3.0 on a 0-to-10-point scale and Stool Consistency: at least one stool with a consistency of Type 6 or Type 7 Bristol stool score (BSS) on at least 2 days per week
• Report no restriction whatsoever on their diet.

Exclusion Criteria:

• Presence of liver disease, malignancy, severe malabsorption, bedridden, endocrinological disorders, or severe chronic obstructive pulmonary disease.
• Patients who have undergone abdominal surgeries except for appendectomy and/or cholecystectomy and/or hysterectomy.
• Patients who consumed any medications that may affect bowel function within the last 2 weeks such as antibiotics, probiotics, prebiotics, antispasmodics, antidiarrheals, narcotics, or any other medication that may alter bowel function
• Patients on antidepressants or antipsychotics starting within the last six weeks before eligibility check.