ClinicalTrials.gg
RecruitingNCT06312683Updated Oct 23, 2026

Rifaximin for the Secondary Prevention of Recurrent Pouchitis

A Phase 4 interventional study of Rifaximin 550 MG Oral Tablet [XIFAXAN] in Pouchitis, sponsored by University of North Carolina, Chapel Hill. Recruiting at 2 sites in United States. Open to participants aged 18 Years to 74 Years. Per ClinicalTrials.gov, last updated 2026-10-23.

Sponsored by University of North Carolina, Chapel Hill · Phase 4, Interventional, and Prevention

From the registry’s dates

  • Started Jul 2024; still recruiting 2 years 4 months later.
Updated Oct 23, 2026Eligibility revisedGo to Updates ↓
Phase
Phase 4
Study type
Interventional
Enrollment
16
Allocation
Not applicable
Ages
18 Years to 74 Years
Sex
All
01

Study summary

Although many people will develop recurrent pouchitis (inflammation of the ileal pouch-anal anastomosis or J-pouch after colectomy for ulcerative colitis) after an initial episode of pouchitis, there are currently no effective treatments to prevent recurrent pouchitis. The goal of this study is to evaluate the potential for rifaximin, an antibiotic, to prevent recurrent pouchitis after treatment for an initial episode of pouchitis. In this study, all patients will be given daily rifaximin for one year after being treated for an initial episode of pouchitis. This study will examine whether people are willing to take rifaximin for one year with the goal of preventing recurrent pouchitis. Additionally, this study will examine whether patients experience any unexpected side effects of rifaximin therapy. The information gained through this study will potentially be helpful in improving the ability to prevent recurrent pouchitis in patients who have a colectomy for ulcerative colitis.

02

Conditions studied

  • Pouchitis

Browse trials for

Keywords

  • Recurrent pouchitis
03

In context

Pouchitis

50 studies on the registry are indexed under Pouchitis; 12 are open to participants now.

This study's planned enrollment of 16 is below the median of 20 across 42 interventional studies indexed under Pouchitis.

Browse Pouchitis studies →

Lead sponsor

University of North Carolina, Chapel Hill is the lead sponsor of 1,372 studies on the registry; 133 are open to participants now.

Of its 161 completed or terminated interventional studies of FDA-regulated products, 139 (86%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

The criteria were revised on the registry on Oct 23, 2026. See what changed

Ages eligible
18 Years to 74 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • will be obtained before any study-related procedures
  • Age > 18 and \<75 years
  • Participants with a proven history of ulcerative colitis and history of 1,2, modified -2 or 3 stage Ileal pouch anal anastomosis (IPAA) and ileostomy takedown
  • Diagnosis of initial episode of pouchitis within the first 12 months after ileostomy takedown/final stage of IPAA surgery OR Current episode of pouchitis, but having not experienced more than 2 episodes of pouchitis in the last 12 months prior to enrollment

Exclusion criteria

Exclusion Criteria:

  • Known to rifaximin or its metabolites
  • Known Crohn's disease
  • History of perianal fistula
  • Known incontinence due to anal sphincter dysfunction
  • Known irritable pouch syndrome
  • Active ongoing pelvic infection/sepsis at baseline visit
  • New onset of high bowel frequency in the setting of acute pouchitis in the first 4 weeks after IPAA
  • Known Clostridoides difficile infection
  • Need for antibiotic long-term therapy (e.g. doxycycline for acne)
  • Known active , C,
  • liver disease (Primary Sclerosing Cholangitis with LFT's \<1.5 can be included)
  • Severe hepatic impairment, defined as Class C
  • Concomitant use of p-glycoprotein (P-gp) inhibitors (e.g. cyclosporine)
  • Known decreased kidney function with a \<60 ml/min/1.732
  • Fecal microbiota transplantation within 16 weeks before ileostomy takedown
  • History of , except for basal cell carcinoma, non- squamous cell carcinoma of the skin, or prior malignancy with curative therapy completed at least 5 years prior to Screening and no recurrence.
  • Clinically significant laboratory results at screening or baseline, as judged by the Investigator from local testing.
  • Female who is pregnant, breast-feeding or intends to become pregnant or is of and not using a highly effective method. Women of child-bearing potential must have a negative urine pregnancy test prior to drug being dispensed.
  • Participation in any clinical trial of an approved or non-approved medicinal product within 30 days before screening.
  • Any disorder, which in the investigator's opinion might jeopardize participant's safety or compliance with the protocol.
Terms in these criteria, in plain language(13)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

Child-Pugh class

A score of how well the liver works in people with liver disease such as cirrhosis: class A is mild, B moderate and C severe.

GFR and eGFR (kidney filtering)

GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².

Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

05

Study design

Phase
Phase 4
Primary purpose
Prevention
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
16 participants (estimated)

Study arms

  • Experimental
    All Participants

    550 mg Rifaximin (Xifaxan) twice a day x 365 days

    Drug: Rifaximin 550 MG Oral Tablet [XIFAXAN]

Interventions

06

What researchers measure

Primary outcomes

  1. Percentage of Participants Who Develop Recurrent Pouchitis

    Recurrent pouchitis, defined as a second episode of pouchitis within a 12 month period after the initial episode of pouchitis or the need for prolonged/recurrent antibiotics after the initial 14 day period (and initiation of rifaximin).

    Time frame: 12 months

07

Study locations

2 of 2 sites recruiting
  • NYU IBD Center
    New York, New York 10016, United States
    Recruiting
  • University of North Carolina
    Chapel Hill, North Carolina 27599, United States
    Recruiting
08

References and documents

Publications

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  • Barnes EL, Herfarth HH, Sandler RS, Chen W, Jaeger E, Nguyen VM, Robb AR, Kappelman MD, Martin CF, Long MD. Pouch-Related Symptoms and Quality of Life in Patients with Ileal Pouch-Anal Anastomosis. Inflamm Bowel Dis. 2017 Jul;23(7):1218-1224. doi: 10.1097/MIB.0000000000001119. PubMed 28426474 ↗
  • Barnes EL, Jiang Y, Kappelman MD, Long MD, Sandler RS, Kinlaw AC, Herfarth HH. Decreasing Colectomy Rate for Ulcerative Colitis in the United States Between 2007 and 2016: A Time Trend Analysis. Inflamm Bowel Dis. 2020 Jul 17;26(8):1225-1231. doi: 10.1093/ibd/izz247. PubMed 31634390 ↗
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  • Barnes EL, Allin KH, Iversen AT, Herfarth HH, Jess T. Increasing Incidence of Pouchitis Between 1996 and 2018: A Population-Based Danish Cohort Study. Clin Gastroenterol Hepatol. 2023 Jan;21(1):192-199.e7. doi: 10.1016/j.cgh.2022.04.015. Epub 2022 May 5. PubMed 35525393 ↗
  • Barnes EL, Kappelman MD, Zhang X, Long MD, Sandler RS, Herfarth HH. Patients With Pouchitis Demonstrate a Significant Cost Burden in the First Two Years After Ileal Pouch-Anal Anastomosis. Clin Gastroenterol Hepatol. 2022 Dec;20(12):2908-2910.e2. doi: 10.1016/j.cgh.2021.09.037. Epub 2021 Oct 2. PubMed 34610443 ↗
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  • Barnes EL, Kochar B, Jessup HR, Herfarth HH. The Incidence and Definition of Crohn's Disease of the Pouch: A Systematic Review and Meta-analysis. Inflamm Bowel Dis. 2019 Aug 20;25(9):1474-1480. doi: 10.1093/ibd/izz005. PubMed 30698715 ↗
  • Kappelman MD, Rifas-Shiman SL, Kleinman K, Ollendorf D, Bousvaros A, Grand RJ, Finkelstein JA. The prevalence and geographic distribution of Crohn's disease and ulcerative colitis in the United States. Clin Gastroenterol Hepatol. 2007 Dec;5(12):1424-9. doi: 10.1016/j.cgh.2007.07.012. Epub 2007 Sep 29. PubMed 17904915 ↗
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  • Gower-Rousseau C, Dauchet L, Vernier-Massouille G, Tilloy E, Brazier F, Merle V, Dupas JL, Savoye G, Balde M, Marti R, Lerebours E, Cortot A, Salomez JL, Turck D, Colombel JF. The natural history of pediatric ulcerative colitis: a population-based cohort study. Am J Gastroenterol. 2009 Aug;104(8):2080-8. doi: 10.1038/ajg.2009.177. Epub 2009 May 12. PubMed 19436273 ↗
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  • Frolkis AD, Dykeman J, Negron ME, Debruyn J, Jette N, Fiest KM, Frolkis T, Barkema HW, Rioux KP, Panaccione R, Ghosh S, Wiebe S, Kaplan GG. Risk of surgery for inflammatory bowel diseases has decreased over time: a systematic review and meta-analysis of population-based studies. Gastroenterology. 2013 Nov;145(5):996-1006. doi: 10.1053/j.gastro.2013.07.041. Epub 2013 Jul 27. PubMed 23896172 ↗
  • Tsai L, Ma C, Dulai PS, Prokop LJ, Eisenstein S, Ramamoorthy SL, Feagan BG, Jairath V, Sandborn WJ, Singh S. Contemporary Risk of Surgery in Patients With Ulcerative Colitis and Crohn's Disease: A Meta-Analysis of Population-Based Cohorts. Clin Gastroenterol Hepatol. 2021 Oct;19(10):2031-2045.e11. doi: 10.1016/j.cgh.2020.10.039. Epub 2020 Oct 27. PubMed 33127595 ↗
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  • Quinn KP, Lightner AL, Faubion WA, Raffals LE. A Comprehensive Approach to Pouch Disorders. Inflamm Bowel Dis. 2019 Feb 21;25(3):460-471. doi: 10.1093/ibd/izy267. PubMed 30124882 ↗
  • Herfarth HH, Long MD, Isaacs KL. Use of Biologics in Pouchitis: A Systematic Review. J Clin Gastroenterol. 2015 Sep;49(8):647-54. doi: 10.1097/MCG.0000000000000367. PubMed 26084005 ↗
  • Dalal RL, Shen B, Schwartz DA. Management of Pouchitis and Other Common Complications of the Pouch. Inflamm Bowel Dis. 2018 Apr 23;24(5):989-996. doi: 10.1093/ibd/izy020. PubMed 29688472 ↗
  • Batista D, Raffals L. Role of intestinal bacteria in the pathogenesis of pouchitis. Inflamm Bowel Dis. 2014 Aug;20(8):1481-6. doi: 10.1097/MIB.0000000000000055. PubMed 25046009 ↗
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  • Administration FaD. Rifaximin
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Individual participant data

Plan to share: Yes — Deidentified individual data that supports the results will be shared beginning 9 to 12 months following publication provided the investigator who proposes to use the data has approval from an Institutional Review Board (IRB), Independent Ethics Committee (IEC), or Research Ethics Board (REB), as applicable, and executes a data use/sharing agreement with UNC.

Supporting information: Study protocol, Statistical analysis plan, Informed consent form

Time frame: beginning 9 and continuing for 12 months following publication

Access criteria: Investigator has approved IRB, IEC, or REB and an executed data use/sharing agreement with UNC.

09

Updates

1 registry update since Sep 25, 2026
Eligibility
1 inclusion criterion edited
What changed in the criteria
Inclusion criteria
  • EditedDiagnosis of initial episode of pouchitis within the first 12 months after ileostomy takedown/final stage of IPAA surgery OR Current episode of pouchitis, but having not experienced more than 2 episodes of pouchitis in the last 12 months prior to enrollment
Oct 23, 2026
Show all 1 update
  1. Oct 23, 2026
    Eligibility 1 inclusion criterion edited
    What changed in the criteria
    Inclusion criteria
    • EditedDiagnosis of initial episode of pouchitis within the first 12 months after ileostomy takedown/final stage of IPAA surgery OR Current episode of pouchitis, but having not experienced more than 2 episodes of pouchitis in the last 12 months prior to enrollment
    + 1 other change: contact details

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT06312683
Responsible party
Sponsor
First posted
Mar 15, 2024
Start date
Jul 1, 2024
Primary completion
Jul 2027 (estimated)
Completion
Jul 2027 (estimated)
Last update
Oct 23, 2026

Study contacts

Mikki Sandridge
Contact
mikki_sandridge@med.unc.edu
(919) 843-3873
Edward Barnes, MD, MPH
principal investigator · University of North Carolina

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drug tested here: Rifaximin

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