An update on efficacy and safety considerations for the latest drugs used to treat irritable bowel syndrome

Mousavi, Taraneh; Nikfar, Shekoufeh; Abdollahi, Mohammad

doi:10.1080/17425255.2020.1767067

Cited by 21 publications

(8 citation statements)

References 125 publications

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“…Dronabinol (a cannabinoid receptor agonist) has been probed in IBS patients, showing a reduction in gastrointestinal motility and gain in colonic compliance in IBS-D and IBS-M subtypes but not in IBS-C [ 158 ]. In addition, some serotonin antagonists also have anticholinergic effects, including alosetron, ramosetron, cilansetron, ondansetron, and granisetron; they can reduce gastrointestinal peristalsis and upgrade abdominal pain [ 159 ].…”

Section: Acetylcholinementioning

confidence: 99%

Neurotransmitter Dysfunction in Irritable Bowel Syndrome: Emerging Approaches for Management

Gros

Mesonero

et al. 2021

JCM

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Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder whose aetiology is still unknown. Most hypotheses point out the gut-brain axis as a key factor for IBS. The axis is composed of different anatomic and functional structures intercommunicated through neurotransmitters. However, the implications of key neurotransmitters such as norepinephrine, serotonin, glutamate, GABA or acetylcholine in IBS are poorly studied. The aim of this review is to evaluate the current evidence about neurotransmitter dysfunction in IBS and explore the potential therapeutic approaches. IBS patients with altered colorectal motility show augmented norepinephrine and acetylcholine levels in plasma and an increased sensitivity of central serotonin receptors. A decrease of colonic mucosal serotonin transporter and a downregulation of α2 adrenoceptors are also correlated with visceral hypersensitivity and an increase of 5-hydroxyindole acetic acid levels, enhanced expression of high affinity choline transporter and lower levels of GABA. Given these neurotransmitter dysfunctions, novel pharmacological approaches such as 5-HT3 receptor antagonists and 5-HT4 receptor agonists are being explored for IBS management, for their antiemetic and prokinetic effects. GABA-analogous medications are being considered to reduce visceral pain. Moreover, agonists and antagonists of muscarinic receptors are under clinical trials. Targeting neurotransmitter dysfunction could provide promising new approaches for IBS management.

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Section: Acetylcholinementioning

confidence: 99%

Neurotransmitter Dysfunction in Irritable Bowel Syndrome: Emerging Approaches for Management

Gros

Mesonero

et al. 2021

JCM

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“…Development of a nonabsorbable PAT1 inhibitor (similar to the NHE3 inhibitor tenapanor; ref. 2 ), may be useful in this regard. A concern with chronic PAT1 inhibition is the hyperoxaluria and calcium oxalate nephrolithiasis seen in PAT1-knockout mice due to impaired intestinal oxalate secretion ( 23 ); however, SLC26A6 variants in humans are not associated with hyperoxaluria or nephrolithiasis ( 24 ).…”

Section: Discussionmentioning

confidence: 99%

“…Electroneutral NaCl absorption in the small intestine, which drives fluid absorption, is mediated by the parallel actions of Na + /H + and Cl – /HCO 3 – exchangers. NHE3 is the dominant Na + /H + exchanger in small intestine ( 1 ), and the NHE3 inhibitor tenapanor was recently approved for treatment of irritable bowel syndrome with constipation ( 2 ). SLC26A3 (also known as downregulated in adenoma [DRA]) and SLC26A6 (also known as putative anion transporter 1 [PAT1]) are the principal anion exchangers at the luminal plasma membrane of intestinal epithelial cells ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

SLC26A6-selective inhibitor identified in a small-molecule screen blocks fluid absorption in small intestine

Çil¹,

Haggie

Tan

et al. 2021

JCI Insight

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“…Researchers have found high levels of reported sexual and emotional abuse among patients with IBS. Somatization disorder (SD), a psychiatric disorder has a prevalence of around 25% in patients with IBS, compared with around 1% among the overall population [31].…”

Section: Ibs and Its Subtypesmentioning

confidence: 99%

“…Post and colleagues assessed the biogenic amine metabolites in cerebrospinal fluid (CSF) of clinically Deficiency of serotonin is common in IBS and as well as in many mental disorders. Many studies were done to study the existence of mental illness in IBS patients, here are enlisted some of the studies with the percentage of IBS patients with psychological illness [31] depressed patients before and after an elevation in their physical activity [33]. Patrick and Ames in 2015, studied the effects of aerobic exercise on brain serotonin levels.…”

Section: Alternative/ Complementary Treatmentmentioning

confidence: 99%

The role of serotonin and diet in the prevalence of irritable bowel syndrome: a systematic review

et al. 2021

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Serotonin or 5-hydroxytryptamine (5-HT)- a neurotransmitter of both the Enteric Nervous System and the Central Nervous System is synthesized by the hydroxylation of L- tryptophan to 5-hydroxytryptophan.Serotonin has been associated with gut functions like assimilation and absorption, alongside the regulation of particle transport and fluid discharge in the gastrointestinal tract and its deficiency is found to be a prominent factor in the prevalence of gut disorders like Irritable Bowel Syndrome.For this review, we assessed the conventional treatment methods of common drugs, with the recently accredited treatment options like dietary regulation, exercise, meditation, and acupuncture. Having found that the most commonly used drugs exhibited various side effects like nausea, fatigue, rash, and dizziness, an in-depth evaluation of different Indian dietary patterns and their respective effects on tryptophan levels has been highlighted to formulate an ideal diet for patients with Irritable Bowel Syndrome (IBS). This review seeks to explore the numerous studies conducted to link IBS with the lack of serotonin production in the body, alongside exploring the evidence associating certain foods with raised tryptophan levels to hypothesize a suitable Indian diet.This review, in its essence, stresses the crucial need for further research on the dietary implications of common Indian foods and their FODMAP (Fermented Oligosaccharides, Disaccharides, Monosaccharides, And Polyols) contents, while underscoring the benefits of using unconventional and natural methods for the treatment of tryptophan-related gut disorders.

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An update on efficacy and safety considerations for the latest drugs used to treat irritable bowel syndrome

Cited by 21 publications

References 125 publications

Neurotransmitter Dysfunction in Irritable Bowel Syndrome: Emerging Approaches for Management

Neurotransmitter Dysfunction in Irritable Bowel Syndrome: Emerging Approaches for Management

SLC26A6-selective inhibitor identified in a small-molecule screen blocks fluid absorption in small intestine

The role of serotonin and diet in the prevalence of irritable bowel syndrome: a systematic review

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