Defining the predictors of the placebo response in irritable bowel syndrome

Pitz, Marshall; Cheang, Mary; Bernstein, Çharles N.

doi:10.1016/s1542-3565(04)00626-3

Cited by 94 publications

(94 citation statements)

References 86 publications

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“…The placebo effect is known to be maximal during the first 4 weeks of treatment and reflects to a large part the spontaneous improvement of symptoms. 11,26 Despite the high placebo response observed in this study, similar to that observed in previous published studies, 27 We have pointed out that the effect of P ⁄ TMP occurs within the first few days of treatment. But, P ⁄ TMP had also an efficacy, which is maintained as the daily improvement was persistent until the 7th day in the P ⁄ TMP vs. placebo group.…”

Section: Discussionsupporting

confidence: 89%

Acute exacerbation of pain in irritable bowel syndrome: efficacy of phloroglucinol/trimethylphloroglucinol – a randomized, double‐blind, placebo‐controlled study

Chassany

Bonaz

Varannes

et al. 2007

Aliment Pharmacol Ther

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Section: Discussionsupporting

confidence: 89%

Acute exacerbation of pain in irritable bowel syndrome: efficacy of phloroglucinol/trimethylphloroglucinol – a randomized, double‐blind, placebo‐controlled study

Chassany

Bonaz

Varannes

et al. 2007

Aliment Pharmacol Ther

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“…The possible mechanism for explaining the difference need to be investigated further. Considering that in other clinical trials, it is not uncommon to have placebo effects as high as 50%, 29 this study has the limitation of no placebo group. Nevertheless, it is noteworthy that dietary fiber such as sea tangle, radish and glasswort had additive effects on the symptoms of constipation, especially in the constipation-predominant IBS.…”

Section: Discussionmentioning

confidence: 99%

Probiotic Fermented Milk Containing Dietary Fiber Has Additive Effects in IBS with Constipation Compared to Plain Probiotic Fer-mented Milk

Choi

Kim²,

Rhee³

et al. 2011

Gut Liver

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Background/Aims: Although controversial, probiotics and dietary fiber are commonly used for patients with irritable bowel syndrome (IBS). We evaluated the effects of multistrain probiotics on the symptoms of IBS to determine whether the addition of dietary fi ber had an additive effect on constipation-predominant IBS. Methods: A total of 142 participants who met the Rome III criteria were recruited and randomized into a control group or a test group. Participants in the control group received multistrain probiotic fermented milk with Streptococcus thermophilus, Lactobacillus acidophilus and Bifi dobacterium infantis; the participants in the test group received the same probiotic fermented milk mixed with dietary fi ber such as sea tangle extracts, radish extracts and glasswort extracts. The patients were treated for four weeks. Results: Most of the symptoms of IBS, with the exception of fl atulence, stool consistency, and frequency of defecation, signifi cantly improved in both groups. In the analysis of IBS subtypes, especially constipation-predominant IBS, the frequency and duration of defecation and straining at stool were improved more in the test group than in the control group. Conclusions: Dietary fiber had additive benefits for the symptoms of constipation, especially in constipationpredominant IBS. (Gut Liver 2011;5:22-28)

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“…The latter rate is particularly high when compared with the response rate of 19-30 % in the placebo control group for IBD. In another meta-analysis of RCTs investigating drug agents and food products, overall improvement and the alleviation of abdominal pain were 52 and 38 %, respectively, in the placebo group [130]. The high overall improvement rate in the placebo group might be attributable to the high number of hospital visits, trial duration and treatment efficacy in the real drug group.…”

Section: Cq Is Placebo Effective In Treating Ibs?mentioning

confidence: 97%

“…For IBS patients with anxiety, antidepressants with anxiolytic action are indicated and antianxiety drugs [124][125][126][127] for a short duration may be helpful for relieving anxiety. In some cases, simple psychotherapy [129][130][131] will be added to manage psychosocial stress and negative emotion. In patients with less influence of psychosocial factors, further examination of the digestive system or other organs [48][49][50][51][52][53] is indicated to rule out organic GI or systemic diseases depending on the clinical demand.…”

Section: Therapeutic Algorithm In Japanese Ibs Guidelinementioning

confidence: 99%

Evidence-based clinical practice guidelines for irritable bowel syndrome

et al. 2014

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New strategies for the care of irritable bowel syndrome (IBS) are developing and several novel treatments have been globally produced. New methods of care should be customized geographically because each country has a specific medical system, life style, eating habit, gut microbiota, genes and so on. Several clinical guidelines for IBS have been proposed and the Japanese Society of Gastroenterology (JSGE) subsequently developed evidence-based clinical practice guidelines for IBS. Sixty-two clinical questions (CQs) comprising 1 definition, 6 epidemiology, 6 pathophysiology, 10 diagnosis, 30 treatment, 4 prognosis, and 5 complications were proposed and statements were made to answer to CQs. A diagnosis algorithm and a three-step treatment was provided for patients with chronic abdominal pain or abdominal discomfort and/or abnormal bowel movement. If more than one alarm symptom/sign, risk factor and/or routine examination is positive, colonoscopy is indicated. If all of them, or the subsequent colonoscopy, are/is negative, Rome III or compatible criteria is applied. After IBS diagnosis, step 1 therapy consisting of diet therapy, behavioral modification and guttargeted pharmacotherapy is indicated for four weeks. Nonresponders to step 1 therapy proceed to the second step that includes psychopharmacological agents and simple psychotherapy for four weeks. In the third step, for patients nonresponsive to step 2 therapy, a combination of gut-targeted pharmacotherapy, psychopharmacological treatments and/or specific psychotherapy is/are indicated. Clinical guidelines and consensus for IBS treatment in Japan are well suited for Japanese IBS patients; as such, they may provide useful insight for IBS treatment in other countries around the world.

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Defining the predictors of the placebo response in irritable bowel syndrome

Cited by 94 publications

References 86 publications

Acute exacerbation of pain in irritable bowel syndrome: efficacy of phloroglucinol/trimethylphloroglucinol – a randomized, double‐blind, placebo‐controlled study

Acute exacerbation of pain in irritable bowel syndrome: efficacy of phloroglucinol/trimethylphloroglucinol – a randomized, double‐blind, placebo‐controlled study

Probiotic Fermented Milk Containing Dietary Fiber Has Additive Effects in IBS with Constipation Compared to Plain Probiotic Fer-mented Milk

Evidence-based clinical practice guidelines for irritable bowel syndrome

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