Bulking agents, antispasmodic and antidepressant medication for the treatment of irritable bowel syndrome

Quartero, A. Otto; Meiniche‐Schmidt, Villy; Muris, Jean; Rubin, Gregory; Wit, Niek de

doi:10.1002/14651858.cd003460.pub2

Cited by 123 publications

(46 citation statements)

References 55 publications

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“…In view of the normal or elevated expression of p11 in individual IBS patients, this variation may also explain the relative variation in efficacy of antidepressants in the treatment of IBS (29) whose function in other neural tissues is altered by the expression of p11 mRNA. Further studies are needed to explore whether concomitant anxiety or depression influence p11 expression and the response to antidepressants.…”

Section: Discussionmentioning

confidence: 99%

Alterations in Expression of p11 and SERT in Mucosal Biopsy Specimens of Patients With Irritable Bowel Syndrome

et al. 2007

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Background/Aim-The pathophysiology of irritable bowel syndrome (IBS) remains enigmatic; abnormalities in serotonin metabolism have been implicated. Two proteins that influence the function of serotonin and serotonergic receptors are serotonin transporter protein (SERT or soluble carrier protein SLC6A4) and p11 (S-100A10, or calpactin I light chain). Both proteins are reported to be associated with depression-like states, a frequent co-morbid condition in IBS. We explored the hypothesis that expression of these two proteins in colonic and rectal mucosa is abnormal in patients with IBS as compared to healthy controls.

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Section: Discussionmentioning

confidence: 99%

Alterations in Expression of p11 and SERT in Mucosal Biopsy Specimens of Patients With Irritable Bowel Syndrome

et al. 2007

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“…Two of these studies suggested an increase in abdominal bloating, discomfort and flatulence during fibre supplementation. 4,5 It may be worth bearing in mind that patients with a tendency to frequent stool passage may be helped by reducing intake of caffeine and sorbitol (present in chewing gum and sweeteners). True food allergies are much rarer than lay perception would predict; food fads and avoidances should be discouraged.…”

Section: Lifestyle Interventionsmentioning

confidence: 99%

“…True food allergies are much rarer than lay perception would predict; food fads and avoidances should be discouraged. 5 …”

Section: Lifestyle Interventionsmentioning

confidence: 99%

“…Generally they are well tolerated and can be used on an as-required basis (before meals) -hence they are sometimes used when simple reassurance fails to improve symptoms. 5,9 By contrast, several randomised placebo-controlled studies have shown that low-dose tricyclic antidepressants effectively decrease symptoms (NNT 3). 8 They have anticholinergic and non-selective serotonin re-uptake inhibitor (non-SSRI) effects, altering pain perception independent of mood or anxiety effects.…”

Section: Abdominal Painmentioning

confidence: 99%

“…It has been suggested that the SSRIs may have efficacy in treating constipationpredominant IBS, with tricyclics favoured for diarrhoea predominance. 5 Though logical, given their respective side effect profiles, this hypothesis remains unproven.…”

Section: Abdominal Painmentioning

confidence: 99%

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Treating functional lower gastrointestinal symptoms

Thoua

Emmanuel

2006

Clinical Medicine

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Diagnosis and Treatment of Irritable Bowel Syndrome

Camilleri

2021

JAMA

207

135

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ImportanceThe prevalence of irritable bowel syndrome (IBS) in the United States is between 7% and 16%, most common in women and young people, with annual direct costs estimated at more than $1 billion dollars in the United States. Traditionally, the diagnosis of IBS has been based on the positive identification of symptoms that correlate with several different syndromes associated with disorders such as IBS diarrhea, IBS constipation, functional diarrhea, functional constipation, chronic functional abdominal pain, or bloating. Several peripheral and central mechanisms initiate gastrointestinal motor and sensory dysfunctions leading to IBS symptoms. Those dysfunctions may require evaluation in patients whose symptoms do not respond to first-line treatments.ObservationsValidation studies of consensus symptom-based criteria have identified deficiencies that favor a simpler identification of the predominant symptoms of abdominal pain, bowel dysfunction, and bloating and exclusion of alarm symptoms such as unintentional weight loss, rectal bleeding, or recent change in bowel function. Symptom-based diagnosis of IBS is enhanced with additional history for symptoms of somatoform and psychological disorders and alarm symptoms, physical examination including digital rectal examination, and screening tests to exclude organic disease (by measuring hemoglobin and C-reactive protein concentrations). The initial treatment plan should include patient education, reassurance, and first-line treatments such as fiber and osmotic laxatives for constipation, opioids for diarrhea, antispasmodics for pain and for management of associated psychological disorders. For patients who do not respond to those IBS treatments, testing for specific functional disorders may be required in a minority of patients with IBS. These disorders include rectal evacuation disorder, abnormal colonic transit, and bile acid diarrhea. Their identification is followed by individualized treatment, such as pelvic floor retraining for rectal evacuation disorders, sequestrants for bile acid diarrhea, and secretory agents for constipation, although there is only limited evidence that this individualized management approach is effective.Conclusions and RelevanceAdvances in the identification of specific dysfunctions as causes of individual symptoms in the “IBS spectrum” leads to the potential to enhance the diagnosis and management of symptoms for the majority of patients for whom first-line therapies of IBS and management of comorbid psychological disorders are insufficient.

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Bulking agents, antispasmodic and antidepressant medication for the treatment of irritable bowel syndrome

Cited by 123 publications

References 55 publications

Alterations in Expression of p11 and SERT in Mucosal Biopsy Specimens of Patients With Irritable Bowel Syndrome

Alterations in Expression of p11 and SERT in Mucosal Biopsy Specimens of Patients With Irritable Bowel Syndrome

Treating functional lower gastrointestinal symptoms

Diagnosis and Treatment of Irritable Bowel Syndrome

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