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Background : No currently available treatment provides consistent relief of irritable bowel syndrome. Colonic sensory and motor function are modulated partly through 5HT3‐receptors. Aim : To evaluate effects of the 5HT3‐receptor antagonist, alosetron, in irritable bowel syndrome. Methods : Randomized, double‐blind, placebo‐controlled, dose‐ranging (1, 2, 4, 8 mg b.d. alosetron), 12‐week trial in 370 patients with diarrhoea‐predominant or alternating constipation and diarrhoea irritable bowel syndrome. Weekly measurement of adequate relief was the key end‐point; other irritable bowel syndrome symptoms were collected daily using an electronic phone system. Results : Alosetron (1 mg or 2 mg b.d.) significantly (P < 0.05 vs. placebo) increased the proportion of females, but not males, reporting adequate relief. Stool consistency, frequency and percentage days with urgency improved over placebo (P < 0.05) within the first month with all doses of alosetron, and persisted throughout the trial with all doses in female patients. With 1 mg b.d. alosetron, females had improved stool consistency and urgency within the first week, and adequate relief and improved stool frequency within the first 2 weeks. There was no consistent improvement in bowel function among male patients. Conclusion : In female irritable bowel syndrome patients with predominant diarrhoea or alternating constipation and diarrhoea, alosetron is effective in treatment of abdominal pain and discomfort and bowel‐related symptoms.

SUMMARYBackground: Irritable bowel syndrome is a common gastrointestinal disorder, and its prevalence and demographics have been evaluated by different methodologies with varying results. Aim: To evaluate irritable bowel syndrome demographic and prevalence characteristics utilizing a web-enabled panel.Methods: From an existing 150 000-member panel, 31 829 individuals were randomly selected and sent screening questionnaires to evaluate irritable bowel syndrome symptoms. Individuals who agreed to participate and completed the screening questionnaire received a second questionnaire related to a diagnosis of irritable bowel syndrome, a more detailed symptom description, and additional burden of illness data.

SUMMARY BackgroundGastrointestinal side effects are commonly associated with opioid treatment for pain.

SUMMARY BackgroundIn models of irritable bowel syndrome (IBS), asimadoline, a kappa-opioid agonist, improves pain and abnormal bowel function.