Update in the pharmaceutical therapy of the irritable bowel syndrome

Abstract

The therapeutic management of the irritable bowel syndrome (IBS) is ineffective and not satisfying either patients or practitioners. Research in functions of the enteric nervous system and its interaction with the central nervous system is the basis for the development of emerging pharmaceuticals in therapy of the IBS. These pharmaceuticals include agents such as opioid agonists, psychotropic agents and particularly serotonin receptor modulators. These novel pharmaceuticals aim to provide a more comprehensive approach in the therapy of the IBS and will serve both patients and practitioners. So far, the US Food and Drug Administration has approved two agents specifically for the treatment of the IBS, both belonging to the group of serotonin receptor modulators. However, questions remain whether a single therapy is sufficient in the management of IBS because this disease is influenced by biological and psychological as well as cultural and social factors.

Patients with irritable bowel syndrome in primary care appear not to be heavy healthcare utilizers

“…The most common pharmacological treatment prescribed in this study was fibres, bulking laxatives and acid‐suppressive drugs. This is in contrast to other studies stating that antispasmodic, motility‐regulating, antidiarrhoeic and antiflatulence agents are most frequently prescribed to IBS patients 11, 12 . In our study, a majority of IBS patients who were prescribed laxatives and acid‐suppressive drugs also had a notification of constipation, GERD or heartburn in their medical records.…”

“…The general recommendation for drugs in this respect is directed towards the most troublesome symptoms such as constipation, diarrhoea, pain and spasm 10 . Antispasmodic and motility‐regulating agents used alone or in combinations with laxatives, antidiarrhoeic or antidepressants and fibre therapy are frequently used in treatment of IBS today 11–16 . Less than 30% of IBS patients in primary care are referred to specialist 17, 18 .…”