Cargando…

Targeted therapies for diarrhea-predominant irritable bowel syndrome

Irritable bowel syndrome (IBS) causes gastrointestinal symptoms such as abdominal pain, bloating, and bowel pattern abnormalities, which compromise patients’ daily functioning. Common therapies address one or two IBS symptoms, while others offer wider symptom control, presumably by targeting pathoph...

Descripción completa

Detalles Bibliográficos
Autor principal: Olden, Kevin W
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3385976/
https://www.ncbi.nlm.nih.gov/pubmed/22754282
http://dx.doi.org/10.2147/CEG.S29023
_version_ 1782236927460638720
author Olden, Kevin W
author_facet Olden, Kevin W
author_sort Olden, Kevin W
collection PubMed
description Irritable bowel syndrome (IBS) causes gastrointestinal symptoms such as abdominal pain, bloating, and bowel pattern abnormalities, which compromise patients’ daily functioning. Common therapies address one or two IBS symptoms, while others offer wider symptom control, presumably by targeting pathophysiologic mechanisms of IBS. The aim of this targeted literature review was to capture clinical trial reports of agents receiving the highest recommendation (Grade 1) for treatment of IBS from the 2009 American College of Gastroenterology IBS Task Force, with an emphasis on diarrhea-predominant IBS. Literature searches in PubMed captured articles detailing randomized placebo-controlled trials in IBS/diarrhea-predominant IBS for agents receiving Grade I (strong) 2009 American College of Gastroenterology IBS Task Force recommendations: tricyclic antidepressants, nonabsorbable antibiotics, and the 5-HT(3) receptor antagonist alosetron. Studies specific for constipation-predominant IBS were excluded. Tricyclic antidepressants appear to improve global IBS symptoms but have variable effects on abdominal pain and uncertain tolerability; effects on stool consistency, frequency, and urgency were not adequately assessed. Nonabsorbable antibiotics show positive effects on global symptoms, abdominal pain, bloating, and stool consistency but may be most efficacious in patients with altered intestinal microbiota. Alosetron improves global symptoms and abdominal pain and normalizes bowel irregularities, including stool frequency, consistency, and fecal urgency. Both the nonabsorbable antibiotic rifaximin and the 5-HT(3) receptor antagonist alosetron improve quality of life. Targeted therapies provide more complete relief of IBS symptoms than conventional agents. Familiarization with the quantity and quality of evidence of effectiveness can facilitate more individualized treatment plans for patients with this heterogeneous disorder.
format Online
Article
Text
id pubmed-3385976
institution National Center for Biotechnology Information
language English
publishDate 2012
publisher Dove Medical Press
record_format MEDLINE/PubMed
spelling pubmed-33859762012-06-29 Targeted therapies for diarrhea-predominant irritable bowel syndrome Olden, Kevin W Clin Exp Gastroenterol Review Irritable bowel syndrome (IBS) causes gastrointestinal symptoms such as abdominal pain, bloating, and bowel pattern abnormalities, which compromise patients’ daily functioning. Common therapies address one or two IBS symptoms, while others offer wider symptom control, presumably by targeting pathophysiologic mechanisms of IBS. The aim of this targeted literature review was to capture clinical trial reports of agents receiving the highest recommendation (Grade 1) for treatment of IBS from the 2009 American College of Gastroenterology IBS Task Force, with an emphasis on diarrhea-predominant IBS. Literature searches in PubMed captured articles detailing randomized placebo-controlled trials in IBS/diarrhea-predominant IBS for agents receiving Grade I (strong) 2009 American College of Gastroenterology IBS Task Force recommendations: tricyclic antidepressants, nonabsorbable antibiotics, and the 5-HT(3) receptor antagonist alosetron. Studies specific for constipation-predominant IBS were excluded. Tricyclic antidepressants appear to improve global IBS symptoms but have variable effects on abdominal pain and uncertain tolerability; effects on stool consistency, frequency, and urgency were not adequately assessed. Nonabsorbable antibiotics show positive effects on global symptoms, abdominal pain, bloating, and stool consistency but may be most efficacious in patients with altered intestinal microbiota. Alosetron improves global symptoms and abdominal pain and normalizes bowel irregularities, including stool frequency, consistency, and fecal urgency. Both the nonabsorbable antibiotic rifaximin and the 5-HT(3) receptor antagonist alosetron improve quality of life. Targeted therapies provide more complete relief of IBS symptoms than conventional agents. Familiarization with the quantity and quality of evidence of effectiveness can facilitate more individualized treatment plans for patients with this heterogeneous disorder. Dove Medical Press 2012-05-25 /pmc/articles/PMC3385976/ /pubmed/22754282 http://dx.doi.org/10.2147/CEG.S29023 Text en © 2012 Olden, publisher and licensee Dove Medical Press Ltd This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.
spellingShingle Review
Olden, Kevin W
Targeted therapies for diarrhea-predominant irritable bowel syndrome
title Targeted therapies for diarrhea-predominant irritable bowel syndrome
title_full Targeted therapies for diarrhea-predominant irritable bowel syndrome
title_fullStr Targeted therapies for diarrhea-predominant irritable bowel syndrome
title_full_unstemmed Targeted therapies for diarrhea-predominant irritable bowel syndrome
title_short Targeted therapies for diarrhea-predominant irritable bowel syndrome
title_sort targeted therapies for diarrhea-predominant irritable bowel syndrome
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3385976/
https://www.ncbi.nlm.nih.gov/pubmed/22754282
http://dx.doi.org/10.2147/CEG.S29023
work_keys_str_mv AT oldenkevinw targetedtherapiesfordiarrheapredominantirritablebowelsyndrome