scholarly journals Diarrhea-Predominant Irritable Bowel Syndrome: Medical Management Update

2019 ◽  
Author(s):  
Christopher N Andrews ◽  
Marc Bradette
Keyword(s):  
Irritable Bowel Syndrome ◽  
Treatment Options ◽  
Unmet Need ◽  
Work Productivity ◽  
Clinical Trial Data ◽  
Gastrointestinal Disorder ◽  
Lifestyle Modifications ◽  
Individualized Approach ◽  
Irritable Bowel ◽  
Dietary Modifications

Abstract Irritable bowel syndrome (IBS) is a prevalent gastrointestinal disorder, which impacts the quality of life, work productivity and social activities of patients. Diarrhea-predominant IBS (IBS-D) is one of several subtypes, and accounts for approximately one third of all cases. Currently available treatments are typically unable to alleviate the cardinal symptoms of IBS-D, including abdominal pain and diarrhea, and a clinical unmet need remains for an effective treatment which simultaneously relieves multiple symptoms. Patients may benefit from a multipronged, individualized approach, including dietary modifications, and psychological and pharmacological therapies. The aim of this review is to provide an update on the available and upcoming treatment options for IBS-D in Canada, with reference to the recently updated Canadian IBS consensus guidelines. Initial treatment approaches include lifestyle modifications, dietary modifications, and non-prescription therapies such as peppermint oil. While some medications such as tricyclic antidepressants are also used to treat IBS-D symptoms, eluxadoline and rifaximin are the only two pharmacological therapies approved for the treatment of IBS-D in Canada. Key clinical trial data for the currently available pharmacological options are presented to provide an overview of the efficacy and safety of these agents

scholarly journals British Society of Gastroenterology guidelines on the management of irritable bowel syndrome

Gut ◽  
2021 ◽  
pp. gutjnl-2021-324598
Author(s):  
Dipesh H Vasant ◽  
Peter A Paine ◽  
Christopher J Black ◽  
Lesley A Houghton ◽  
Hazel A Everitt ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Evaluation System ◽  
Unmet Need ◽  
Gastrointestinal Disorder ◽  
British Society ◽  
Current Evidence ◽  
Future Research ◽  
Novel Treatments ◽  
Psychological Therapies ◽  
Irritable Bowel

Irritable bowel syndrome (IBS) remains one of the most common gastrointestinal disorders seen by clinicians in both primary and secondary care. Since publication of the last British Society of Gastroenterology (BSG) guideline in 2007, substantial advances have been made in understanding its complex pathophysiology, resulting in its re-classification as a disorder of gut-brain interaction, rather than a functional gastrointestinal disorder. Moreover, there has been a considerable amount of new evidence published concerning the diagnosis, investigation and management of IBS. The primary aim of this guideline, commissioned by the BSG, is to review and summarise the current evidence to inform and guide clinical practice, by providing a practical framework for evidence-based management of patients. One of the strengths of this guideline is that the recommendations for treatment are based on evidence derived from a comprehensive search of the medical literature, which was used to inform an update of a series of trial-based and network meta-analyses assessing the efficacy of dietary, pharmacological and psychological therapies in treating IBS. Specific recommendations have been made according to the Grading of Recommendations Assessment, Development and Evaluation system, summarising both the strength of the recommendations and the overall quality of evidence. Finally, this guideline identifies novel treatments that are in development, as well as highlighting areas of unmet need for future research.

scholarly journals A REVIEW ON THE AYURVEDIC APPROACH OF IRRITABLE BOWEL SYN-DROME WSR TO GRAHANI

2020 ◽  
Vol 08 (11) ◽  
pp. 5100-5104
Author(s):  
Laveena T P
Keyword(s):  
Irritable Bowel Syndrome ◽  
Psychological Factors ◽  
Gastrointestinal Disorder ◽  
Outpatient Clinics ◽  
Structural Abnormality ◽  
Lifestyle Modifications ◽  
Added Benefit ◽  
Irritable Bowel ◽  
Diet And Lifestyle ◽  
Rome Iv

Irritable bowel syndrome is a common functional gastrointestinal disorder with no identifiable structural abnormality. It is characterized by abdominal pain or discomfort and altered bowel habits as major symp-toms. IBS accounts for more than 40% of new referrals to gastroenterology outpatient clinics. Diagnosis is done by Rome IV criteria. Etiology and pathogenesis is not clearly understood. In Ayurveda it can be man-aged with the concept of Grahani. The basic Samprapthi is at the level of Grahani and Pakwasaya which is as a result of Agnidushti. The symptoms of IBS are Tridoshaja with a Vatha predominance. Vatha has Sthanika importance also as Pakwasaya is the seat of Vatha. So, medicines with Deepana, Pachana, Anu-lomana and Grahi properties are ideal. Satwavajaya Chikitsa (psychotherapy) is helpful because of the involvement of psychological factors. Diet and lifestyle modifications with exercises and relaxation tech-niques have added benefit in the management since it has a chronic and relapsing nature.

scholarly journals Changes in serum and urinary metabolomic profile after a dietary intervention in patients with irritable bowel syndrome

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0257331
Author(s):  
Sanna Nybacka ◽  
Magnus Simrén ◽  
Stine Störsrud ◽  
Hans Törnblom ◽  
Anna Winkvist ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Dietary Intervention ◽  
Pantothenic Acid ◽  
Gastrointestinal Disorder ◽  
Response To Treatment ◽  
Post Intervention ◽  
Clinical Trial Registration ◽  
Link Type ◽  
Irritable Bowel ◽  
Dietary Modifications

Background Irritable bowel syndrome (IBS) is a multi-faceted gastrointestinal disorder where food intake often triggers symptoms. Metabolomics may provide mechanistical insights to why responses to dietary modifications are diverse. Objective This study aimed to identify metabolite patterns related to dietary intake in patients with IBS, and to identify metabolites driving the separation between responders and non-responders to treatment. Methods Participants were randomized to a low fermentable oligo-, di-, monosaccharide and polyol (FODMAP) diet (LFD) or traditional IBS diet (TID) for four weeks. Fasting serum and urine samples pre- and post-intervention were analyzed using 1H nuclear magnetic resonance (NMR) metabolomics. Response to treatment was defined as a reduction in IBS severity scoring system (IBS-SSS) ≥50. Results Twenty-five individuals in the LFD (13 responders) and 28 in the TID (14 responders) were included in these post hoc analyses. In endpoint samples, significant decreases in polyols and glucose were seen in the LFD. Post-intervention samples revealed that LFD responders had significantly increased levels of 2-hydroxybuturate and decreased levels of glucose and pantothenic acid compared to non-responders. For the TID, only weak multivariate models were identified and a larger diversity in metabolite response compared to the LFD were noted. Conclusions In this study, metabolite patterns between individuals who responded well to an LFD compared to non-responders could be distinguished. This provides new hypotheses for mechanistic actions related to response to dietary modifications, but the results need to be validated in larger cohorts. Clinical trial registration This trial was registered at www.clinicaltrials.gov, registry number NCT02107625.

scholarly journals Review of Rifaximin: Latest Treatment Frontier for Irritable Bowel Syndrome Mechanism of Action and Clinical Profile

2017 ◽  
Vol 10 ◽  
pp. 117955221772890 ◽  
Author(s):  
Kamesh Gupta ◽  
Harparam Singh Ghuman ◽  
Shivani Vijay Handa
Keyword(s):  
Irritable Bowel Syndrome ◽  
Mechanism Of Action ◽  
Symptomatic Relief ◽  
Treatment Options ◽  
Bacterial Overgrowth ◽  
Gastrointestinal Disorder ◽  
Small Intestinal Bacterial Overgrowth ◽  
Current Treatment ◽  
Predominant Type ◽  
Irritable Bowel

Background: Irritable bowel syndrome is classified as a functional gastrointestinal disorder with the primary symptom of abdominal pain in conjunction with bloating and bowel movement disorder. It affects up to 15% of the world’s population. Among its subtypes, the most common is diarrhoea predominant. However, the current treatment options for diarrhoea-predominant irritable bowel syndrome have had not very promising results; most, such as antispasmodics, only provide partial symptomatic relief. Treatment with antidepressants and alosetron (a 5HT3 antagonist) has shown the most promise to date. The latest drug to be approved for the treatment of irritable bowel syndrome-diarrhoea is rifaximin, which was approved in May 2015. It is a minimally absorbed antibiotic that is used to change the gut microbiota. Small intestinal bacterial overgrowth is one of the causes suggested for irritable bowel syndrome, particularly for the diarrhoea-predominant type. There are various methods for detecting bacterial overgrowth, the simplest of which is breath tests. Rifaximin has been shown to be of benefit to these patients. Purpose: The purpose of the study is to discuss the potential mechanism of action of rifaximin, a minimally absorbed antibiotic. In addition, we evaluate the various clinical trials undertaken to study the efficacy and safety profile of rifaximin.

scholarly journals Multi-target Treatment for Irritable Bowel Syndrome with STW 5: Pharmacological Modes of Action

2020 ◽  
Vol 29 (2) ◽  
pp. 227-233
Author(s):  
Hans-Dieter Allescher ◽  
Rebecca Burgell ◽  
Peter Malfertheiner ◽  
Fermin Mearin
Keyword(s):  
Irritable Bowel Syndrome ◽  
Treatment Options ◽  
Smooth Muscles ◽  
Gastrointestinal Disorder ◽  
In Vivo Studies ◽  
Afferent Nerves ◽  
Target Treatment ◽  
Irritable Bowel

Irritable bowel syndrome (IBS) is a heterogeneous and complex functional gastrointestinal disorder with aglobal prevalence of approximately 11% and high geographic variation. IBS encompasses various symptomclusters considered to reflect complex patho-etiological mechanisms, and effective treatment options arelimited, with most medications targeting individual mechanisms and symptoms. Therefore, multi-targetedtreatment is required. IBS is currently viewed as a disorder of disturbed gut–brain interactions withabnormalities at different sites along the gut–brain axis, including altered gastrointestinal motility, visceralhypersensitivity, increased intestinal permeability, and altered gut microbiota. All of these abnormalitiesrepresent individual targets for STW 5, a herbal preparation with nine different extracts indicated for thetreatment of functional dyspepsia and IBS. As a multi-targeted medicinal drug, STW 5 possesses multiplepharmacodynamic effects. Several in vitro and in vivo studies have demonstrated STW 5 efficacy on numerousIBS patho-mechanisms targeting gastrointestinal smooth muscles, visceral afferent nerves, inflammation, gutpermeability, and the gut microbiome.

scholarly journals The Prevalence of Anti-Zein Antibodies: A Comparative Study between Celiac Disease and Irritable Bowel Syndrome

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 649
Author(s):  
Luis Alberto Sánchez-Vargas ◽  
Karina Guadalupe Hernández-Flores ◽  
Francisco Javier Cabrera-Jorge ◽  
José María Remes-Troche ◽  
Job Reyes-Huerta ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Celiac Disease ◽  
Gastrointestinal Disorder ◽  
Newly Diagnosed ◽  
Disease Group ◽  
Immune Mediated ◽  
Healthy Control ◽  
Gliadin Peptides ◽  
Irritable Bowel ◽  
First Time

Celiac disease (CD) is a chronic immune-mediated enteropathy triggered by exposure to dietary gluten in genetically predisposed individuals. In contrast, irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder affecting the large intestine, without an autoimmune component. Here, we evaluated the prevalence of IgA and IgG antibodies to maize zeins (AZA) in patients with CD and IBS. Using an in-house ELISA assay, the IgA and IgG anti-zein antibodies in the serum of 37 newly diagnosed CD (16 biopsy proved and 21 serological diagnosis) and 375 IBS patients or 302 healthy control (HC) subjects were measured. Elevated levels of IgA AZA were found in CD patients compared with IBS patients (p < 0.01) and HC (p < 0.05). CD patients had the highest prevalence (35.1%), followed by IBS (4.3%) and HCs (2.3%) (p < 0.0001). IgG AZA antibodies were not found in any CD patients, IBS patients, or HC subjects. A significant positive correlation was found between IgA AZA with IgA anti-gliadin (AGA, r = 0.34, p < 0.01) and IgA anti-deaminated gliadin peptides (DGP, r = 0.42, p < 0.001) in the celiac disease group. Taken together, our results show for the first time a higher prevalence of AZA IgA antibodies in newly diagnosed CD patients than in IBS patients, confirming a biased immune response to other gliadin-related prolamins such as maize zeins in genetically susceptible individuals.

scholarly journals Diarrhea Predominant-Irritable Bowel Syndrome (IBS-D): Effects of Different Nutritional Patterns on Intestinal Dysbiosis and Symptoms

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1506
Author(s):  
Annamaria Altomare ◽  
Claudia Di Rosa ◽  
Elena Imperia ◽  
Sara Emerenziani ◽  
Michele Cicala ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Intestinal Microbiota ◽  
Gastrointestinal Disorder ◽  
Additional Energy ◽  
Nutritional Advice ◽  
Intestinal Dysbiosis ◽  
Gi Symptoms ◽  
Mutualistic Relationship ◽  
Irritable Bowel ◽  
Fodmap Diet

Irritable Bowel Syndrome (IBS) is a chronic functional gastrointestinal disorder characterized by abdominal pain associated with defecation or a change in bowel habits. Gut microbiota, which acts as a real organ with well-defined functions, is in a mutualistic relationship with the host, harvesting additional energy and nutrients from the diet and protecting the host from pathogens; specific alterations in its composition seem to play a crucial role in IBS pathophysiology. It is well known that diet can significantly modulate the intestinal microbiota profile but it is less known how different nutritional approach effective in IBS patients, such as the low-FODMAP diet, could be responsible of intestinal microbiota changes, thus influencing the presence of gastrointestinal (GI) symptoms. The aim of this review was to explore the effects of different nutritional protocols (e.g., traditional nutritional advice, low-FODMAP diet, gluten-free diet, etc.) on IBS-D symptoms and on intestinal microbiota variations in both IBS-D patients and healthy subjects. To date, an ideal nutritional protocol does not exist for IBS-D patients but it seems crucial to consider the effect of the different nutritional approaches on the intestinal microbiota composition to better define an efficient strategy to manage this functional disorder.

M1342 Pain Associated With Irritable Bowel Syndrome is a Major Unmet Need Among IBS Sufferers

2010 ◽  
Vol 138 (5) ◽  
pp. S-384
Author(s):  
Daniel W. Gil ◽  
Rozalina Dimitrova ◽  
Simon Daggett ◽  
Peter Sissins ◽  
Wayne Lam ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Unmet Need ◽  
Irritable Bowel

scholarly journals Sex-Bias in Irritable Bowel Syndrome: Linking Steroids to the Gut-Brain Axis

2021 ◽  
Vol 12 ◽  
Author(s):  
Sik Yu So ◽  
Tor C. Savidge
Keyword(s):  
Irritable Bowel Syndrome ◽  
Sex Steroids ◽  
Disease Onset ◽  
Gastrointestinal Disorder ◽  
Underlying Disease ◽  
Disease Mechanism ◽  
Psychological Conditions ◽  
Nervous System Function ◽  
Irritable Bowel ◽  
Insight Into

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder that is more common in females. Despite its high global incidence, the disease mechanism is still unclear and therapeutic options remain limited. The sexual dimorphism in IBS incidence suggests that sex steroids play a role in disease onset and symptoms severity. This review considers sex steroids and their involvement in IBS symptoms and the underlying disease mechanisms. Estrogens and androgens play important regulatory roles in IBS symptomology, including visceral sensitivity, gut motility and psychological conditions, possibly through modulating the gut-brain axis. Steroids are regulators of hypothalamic-pituitary-adrenal activity and autonomic nervous system function. They also modulate gut microbiota and enteric nervous systems, impacting serotonin and mast cell signaling. Sex steroids also facilitate bidirectional cross-talk between the microbiota and host following bacterial transformation and recycling of steroids by the intestine. The sex-specific interplay between sex steroids and the host provides neuroendocrinology insight into the pathophysiology, epigenetics and treatment of IBS patients.

scholarly journals Irritable bowel syndrome dietary modifications - what to forbid and what to recommend?

2020 ◽  
Vol 10 (8) ◽  
pp. 72
Author(s):  
Agnieszka Kaczyńska ◽  
Małgorzata Wieteska ◽  
Paweł Stanicki ◽  
Julita Szarpak
Keyword(s):  
Irritable Bowel Syndrome ◽  
Irritable Bowel ◽  
Dietary Modifications
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