scholarly journals Rational pharmacotherapy in modern gastroenterology

2021 ◽  
pp. 13-18
Author(s):  
O. N. Minushkin
Keyword(s):  
Irritable Bowel Syndrome ◽  
Gallstone Disease ◽  
Second Step ◽  
Allergic Reactions ◽  
Rational Pharmacotherapy ◽  
Regulatory Cascade ◽  
Biliary Sludge ◽  
Symptom Complex ◽  
Irritable Bowel ◽  
The Cost

Abstract Introduction. Modern gastroenterology is characterized by the combined (comorbid) nature of the diseases. In treatment, this promotes polypharmacy and increases complications (drug lesions, allergic reactions, exacerbation of diseases of other organs and systems), and, importantly, increases the cost of pharmacotherapy.Aim. To compare two pharmacotherapy options for patients with gallstone disease at the stage of biliary sludge and patients with biliary sludge combined with irritable bowel syndrome.Materials and methods. In the work, based on the experience of treating 170 patients, two options for pharmacotherapy are considered, which may well turn out to be rational in all respects. Option 1 - monotherapy aimed at one of the components that form a complex pathogenetic symptom complex. The basis for offering this treatment option is the biological concept of the “regulatory cascade”. Option 2  – “stepwise” (stepwise) therapy with the  choice of  the “base” drug for  the  first step. Evaluation of the effectiveness and rational correction for the second step of treatment and subsequent ones – if necessary. Results. The biliary sludge was eliminated or reduced in patients who received the UDCA monotherapy against the background of recovery of gastrointestinal motility. The overall treatment effect (for each nosology) in patients with biliary sludge and irritable bowel syndrome using the complex therapy (UDCA and mebeverin) was 84 and 87.8% respectively.Conclusions. Both options are rational today: 1st requires further study; 2nd – active use. Both options exclude polypharmacy and other adverse effects.

The cost-effectiveness of psychotherapy and SSRI antidepressants for severe irritable bowel syndrome

2001 ◽  
Vol 120 (5) ◽  
pp. A115 ◽  
Author(s):  
Francis H. Creed ◽  
Lakshmi Fernandes ◽  
Elspeth Guthrie ◽  
Stephen Palmer ◽  
Joy Ratcliffe ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Cost Effectiveness ◽  
Irritable Bowel ◽  
The Cost

scholarly journals An Update on Irritable Bowel Syndrome

1970 ◽  
Vol 18 (1) ◽  
pp. 66-71
Author(s):  
Md Abdul Ahad ◽  
Quazi Tarikul Islam
Keyword(s):  
Health Care ◽  
General Practice ◽  
Irritable Bowel Syndrome ◽  
Indirect Costs ◽  
Health Care Use ◽  
Sensory Function ◽  
Therapeutic Trial ◽  
Organic Disease ◽  
Symptom Complex ◽  
Irritable Bowel

Irritable bowel syndrome (IBS) is the most common disorder diagnosed by gastroenterologists and one of the more common ones encountered in general practice. The illness has a large economic impact on health care use and indirect costs, chiefly through absenteeism. IBS is a bio-psychosocial disorder in which three major mechanisms interact: Psychosocial factors, altered motility, and/or heightened sensory function of the intestine. Treatment of patients is based on positive diagnosis of the symptom complex, limited exclusion of underlying organic disease and institution of a therapeutic trial.   doi: 10.3329/taj.v18i1.3310 TAJ 2005; 18(1): 66-71

The cost-effectiveness of psychotherapy and paroxetine for severe irritable bowel syndrome

2003 ◽  
Vol 124 (2) ◽  
pp. 303-317 ◽  
Author(s):  
Francis Creed ◽  
Lakshmi Fernandes ◽  
Elspeth Guthrie ◽  
Stephen Palmer ◽  
Joy Ratcliffe ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Cost Effectiveness ◽  
Irritable Bowel ◽  
The Cost

scholarly journals The Cost Of Irritable Bowel Syndrome (Ibs) In England

2014 ◽  
Vol 17 (7) ◽  
pp. A365
Author(s):  
A Soubieres ◽  
PDP Wilson ◽  
A Poullis ◽  
J Wilkins ◽  
M Rance
Keyword(s):  
Irritable Bowel Syndrome ◽  
Irritable Bowel ◽  
The Cost

Investigation and Surgery in Irritable Bowel Syndrome — A Cautionary Series

1994 ◽  
Vol 39 (3) ◽  
pp. 80-81 ◽  
Author(s):  
J.R. Barton
Keyword(s):  
Irritable Bowel Syndrome ◽  
Delay In Diagnosis ◽  
Chi Squared ◽  
Symptom Complex ◽  
Irritable Bowel

Irritable bowel syndrome is a common problem, and, with a broad symptom complex, likely to present to a wide variety of clinicians. Lack of awareness of these manifestations may lead to inappropriate investigation, and surgery. Six patients with irritable bowel syndrome who had multiple investigations and operations are reported. There was a median of seven years delay in diagnosis, patients seeing a median of six different consultants. Over 13 years of follow-up symptoms were unchanged, but patients had undergone a median of eight (often invasive) investigations, and six operations. Several operations were for complications of, or resulted from, a previous procedure. There were far fewer operations after diagnosis, four over 33 patient-years, than prior to diagnosis, 25 over 43 patient-years (chi-squared = 8.074, 1df p<0.0025). All clinicians should be aware of the diffuse symptomatology of irritable bowel, and its potential to mimic other diseases. Surgery should be avoided.

Minimal-Contact Versus Standard Cognitive Behavioral Therapy for Irritable Bowel Syndrome: Cost-Effectiveness Results of a Multisite Trial

2021 ◽  
Author(s):  
Laura J Dunlap ◽  
James Jaccard ◽  
Jeffrey M Lackner
Keyword(s):  
Irritable Bowel Syndrome ◽  
Cost Effectiveness ◽  
Behavioral Therapy ◽  
Cost Effective ◽  
Symptom Improvement ◽  
Activity Based Costing ◽  
Patient Cost ◽  
Minimal Contact ◽  
Irritable Bowel ◽  
The Cost

Abstract Background Irritable bowel syndrome (IBS) is a common, often disabling gastrointestinal (GI) disorder for which there is no satisfactory medical treatment but is responsive to cognitive behavior therapy (CBT). Purpose To evaluate the costs and cost-effectiveness of a minimal contact version of CBT (MC-CBT) condition for N = 145 for IBS relative to a standard, clinic-based CBT (S-CBT; N = 146) and a nonspecific comparator emphasizing education/support (EDU; N = 145). Method We estimated the per-patient cost of each treatment condition using an activity-based costing approach that allowed us to identify and estimate costs for specific components of each intervention as well as the overall total costs. Using simple means analysis and multiple regression models, we estimated the incremental effectiveness of MC-CBT relative to S-CBT and EDU. We then evaluated the cost-effectiveness of MC-CBT relative to these alternatives for selected outcomes at immediate posttreatment and 6 months posttreatment, using both an intent-to-treatment and per-protocol methodology. Key outcomes included scores on the Clinical Global Impressions-Improvement Scale and the percentage of patients who positively responded to treatment. Results The average per-patient cost of delivering MC-CBT was $348, which was significantly less than the cost of S-CBT ($644) and EDU ($457) (p &lt; .01). Furthermore, MC-CBT produced better average patient outcomes at immediate and 6 months posttreatment relative to S-CBT and EDU (p &lt; .01). The current findings indicated that MC-CBT is a cost-effective option relative to S-CBT and EDU. Conclusion As predicted, MC-CBT was delivered at a lower cost per patient than S-CBT and performed better over time on the primary outcome of global IBS symptom improvement.

Letter To The Editor

PEDIATRICS ◽  
1970 ◽  
Vol 46 (6) ◽  
pp. 971-972
Author(s):  
Joseph D. Bullock ◽  
William C. Deamer ◽  
Oscar L. Frick ◽  
James R. Crisp ◽  
Stanley P. Galant ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Food Allergy ◽  
Abdominal Pain ◽  
Recurrent Abdominal Pain ◽  
Functional Basis ◽  
Fatigue Syndrome ◽  
Associated Symptoms ◽  
Symptom Complex ◽  
Diagnostic Possibility ◽  
Irritable Bowel

This is in regards to "Recurrent Abdominal Pain in Childhood," by R.T. Stone, M.D. and G.J. Barbero, M.D. Recurrent abdominal pain and associated symptoms in 102 children were explained on a functional basis, as "irritable bowel syndrome." We should like to draw attention to another organic diagnostic possibility for at least some of the cases. The tension fatigue syndrome (T.F.S.) is a symptom complex occurring mainly in children but also in adults1-10. The T.F.S. is usually due to food allergy.

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