I read with great interest the article by Scarpignato et al1 evaluating the efficacy of rifaximin in preventing intestinal lesions associated with nonsteroidal anti-inflammatory drugs (NSAIDs). The authors declare that rifaximin is effective in preventing the occurrence of NSAID-induced intestinal lesions and that intestinal bacteria contribute to the development of NSAID-associated enteropathy.1 Intestinal mucosal injury is very common in NSAID users,2 and effective treatment for NSAID-associated enteropathy is lacking to date.