scholarly journals Pharmacological Therapies and Their Clinical Targets in Irritable Bowel Syndrome With Diarrhea

2021 ◽  
Vol 11 ◽  
Author(s):  
Esther Colomier ◽  
Joost Algera ◽  
Chloé Melchior
Keyword(s):  
Quality Of Life ◽  
Irritable Bowel Syndrome ◽  
Abdominal Pain ◽  
Pharmacological Treatment ◽  
Treatment Options ◽  
Treatment Algorithm ◽  
Gastrointestinal Symptoms ◽  
Bowel Habits ◽  
Irritable Bowel

Irritable bowel syndrome (IBS) is one of the most common disorders of the gut-brain axis, which affects approximately 4% of the global population. The Rome IV criteria define IBS as chronic or recurrent abdominal pain associated with altered bowel habits. Patients can be categorized in four subtypes: IBS with predominant constipation (IBS-C), predominant diarrhea (IBS-D), mixed bowel habits (IBS-M), and unclassified (IBS-U). IBS is associated with a lower quality of life, reduced work productivity, and high healthcare costs. When comparing subtypes, patients with IBS-D report lower disease related quality of life. Due to the scope of this review, we have solely focused on patients with IBS-D. Choosing the right pharmacological treatment in these patients remains challenging due to the heterogeneous patient population, patients’ expectation of the treatment outcome, unavailability of efficacious drugs, and the multifactorial and incompletely understood underlying pathophysiology. Currently, pharmacological treatment options target individual symptoms, such as abdominal pain, altered bowel habits, and bloating. In this review, we aimed to summarize the current and recent pharmacological treatment options in IBS-D, targeting the predominant gastrointestinal symptoms. Additionally, we proposed a pharmacological treatment algorithm which healthcare professionals could use when treating individual patients with IBS-D.

scholarly journals Intestinal barrier dysfunction in irritable bowel syndrome: a systematic review

2021 ◽  
Vol 14 ◽  
pp. 175628482199358
Author(s):  
Nikita Hanning ◽  
Adam L. Edwinson ◽  
Hannah Ceuleers ◽  
Stephanie A. Peters ◽  
Joris G. De Man ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Irritable Bowel Syndrome ◽  
Abdominal Pain ◽  
Barrier Function ◽  
Significant Proportion ◽  
Healthy Controls ◽  
Barrier Dysfunction ◽  
Irritable Bowel

Background and Aim: Irritable bowel syndrome (IBS) is a complex and heterogeneous disorder. Sensory, motor and barrier dysfunctions are the key physiological endophenotypes of IBS. Our aim is to review studies evaluating barrier dysfunction in adults and children with IBS, as well as to link those changes with IBS symptomatology and quality of life. Methods: A comprehensive and systematic review of multiple databases was performed up to March 2020 to identify studies comparing intestinal permeability in IBS patients with healthy controls. Both in vivo and in vitro studies were considered. Results: We identified 66 studies, of which 27 used intestinal probes to quantify barrier function. The prevalence of barrier dysfunction differed between PI-IBS (17–50%), IBS-D (37–62%) and IBS-C (4–25%). At a group level, permeability was increased compared with healthy controls in IBS-D (9/13 studies) and PI-IBS (4/4 studies), but only a minority of IBS-C (2/7 studies) and not in the only IBS-M study. All four studies in children with IBS demonstrated loss of barrier function. A heterogeneous set of tight junction genes were found to be altered in small and large intestines of adults with IBS, but these have not been evaluated in children. Positive associations were identified between barrier dysfunction and bowel disturbances (6/9 studies), abdominal pain (9/13 studies), overall symptom severity (1/6 studies), depression and anxiety (1/1 study) and quality of life (1/4 studies). Fecal slurry or supernatants of IBS patients were found to induce barrier disruption in animal models (5/6 studies). Conclusions: Barrier dysfunction is present in a significant proportion of adult and all pediatric IBS studies, especially in the IBS-D and PI-IBS subtype. The majority of studies indicated a positive association between loss of barrier function and symptoms such as abdominal pain and changes in the bowel function.

scholarly journals Digestive symptoms in daily life of chronic adrenal insufficiency patients are similar to irritable bowel syndrome symptoms

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
L. Quénéhervé ◽  
D. Drui ◽  
J. Blin ◽  
M. Péré ◽  
E. Coron ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Irritable Bowel Syndrome ◽  
Adrenal Insufficiency ◽  
Gastrointestinal Symptoms ◽  
Control Group ◽  
Non Profit ◽  
Acute Adrenal Insufficiency ◽  
Irritable Bowel ◽  
Rome Iv

AbstractGastrointestinal symptoms are frequent in acute adrenal insufficiency. Although digestive symptoms can significantly reduce quality of life, they are rarely described in patients with treated chronic adrenal insufficiency (CAI). We aimed to characterize digestive symptoms in CAI patients. We used the section pertaining functional bowel disorders of the Rome IV questionnaire. A questionnaire was published on the website of the non-profit patient association “Adrenals” (NPPA of CAI patients) for five months. Information on demographics, characteristics of adrenal insufficiency, digestive symptoms and quality of life was collected. The relatives of CAI patients served as a control group. We analyzed responses of 33 control subjects and 119 patients (68 primary adrenal insufficiency (PAI), 30 secondary adrenal insufficiency (SAI) and 21 congenital adrenal hyperplasia (CAH)). Abdominal pain at least once a week over the past 3 months was reported by 40%, 47% and 33% of patients with PAI, SAI and CAH respectively versus 15% for the controls (p = 0.01). Symptoms were consistent with the Rome IV criteria for irritable bowel syndrome in 27%, 33% and 33% of patients respectively versus 6% for the controls (p < 0.0001). Quality of life was described as poor or very poor in 35%, 57% and 24% of patients respectively versus 5% for the controls (p < 0.0001). In conclusion, digestive symptoms are frequent and incapacitating in CAI patients and similar to symptoms of irritable bowel syndrome in 30% of CAI patients. Assessment and management of digestive symptoms should be considered a priority for physicians treating patients with CAI.

scholarly journals TPH Gene Polymorphisms Are Associated With Disease Perception and Quality of Life in Women With Irritable Bowel Syndrome

2012 ◽  
Vol 16 (1) ◽  
pp. 95-104 ◽  
Author(s):  
Sang-Eun Jun ◽  
Ruth Kohen ◽  
Kevin C. Cain ◽  
Monica E. Jarrett ◽  
Margaret M. Heitkemper
Keyword(s):  
Quality Of Life ◽  
Irritable Bowel Syndrome ◽  
Gene Polymorphisms ◽  
Tryptophan Hydroxylase ◽  
Univariate Analysis ◽  
Gastrointestinal Symptoms ◽  
Tph2 Gene ◽  
Irritable Bowel ◽  
The Impact

The aims of this exploratory study were to examine whether tryptophan hydroxylase ( TPH) gene polymorphisms are associated with psychosocial factors in women with irritable bowel syndrome (IBS). TPH is the rate-limiting enzyme in the biosynthesis of serotonin and has two isoforms, TPH1 and TPH2. Four single nucleotide polymorphisms (SNPs) in the TPH1 gene and one SNP in the TPH2 gene were selected based on previous studies investigating associations between these SNPs and psychiatric or behavioral disorders. One hundred ninety-nine Caucasian women with IBS were included. Results of univariate analysis showed no association between TPH1and TPH2 gene SNPs and current level of psychological distress or psychiatric illness. However, TPH1 gene SNPs were associated with IBS-related cognitions (rs4537731 and rs21105) and quality of life (rs684302 and rs1800532), in particular the mental health and energy subscales. These associations were independent of the subjects’ levels of gastrointestinal symptoms. These results suggest that patients’ perception of their illness, and of the impact it has on their lives, may be subject to genetic influences, in this case sequence variants in TPH1. However, caution should be used in interpreting these results given the large number of hypothesis tests performed in this exploratory hypothesis-generating study, and the results should be considered tentative until confirmed in an independent sample.

scholarly journals Effect of Multispecies Probiotic Supplementation on Irritable Bowel Syndrome

2019 ◽  
pp. 1-9
Author(s):  
Saeed Yazdani Ashtiani ◽  
Mersad Amery
Keyword(s):  
Quality Of Life ◽  
Irritable Bowel Syndrome ◽  
Abdominal Pain ◽  
Therapeutic Option ◽  
Intervention Group ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Probiotic Supplementation ◽  
Irritable Bowel

Background: Irritable bowel syndrome (IBS) is a common, chronic and sometimes disabling functional disorder of the gastrointestinal system and its treatment remains as health problem. Thus the aim of this study was to evaluate the Effect of multispecies probiotic supplementation, as a novel and Controversial therapeutic method on Irritable bowel syndrome. Materials and Methods: In this randomized double blind Placebo-controlled clinical trial, 60 patients with IBS were enrolled. The patients were divided randomly into two groups. Patients in intervention group received two 500 mg probiotic capsules (Familact®) and in control group, received two 500 mg placebo capsules daily for 30 consecutive days. The symptoms and quality of life were measured and compared at the beginning and just after the end of study for each case. Results: Results showed the mean score of Abdominal pain after 1 month of treatment in the probiotic group was significantly lower than the control group (1.76 ± 2.04 vs. 2.88 ± 2.25, P=0.049, respectively). While, other symptoms and quality of life did not change significantly (P>0.05). Furthermore, defecation habit and global symptoms improvement was similar after intervention in both groups and we did not observe significant differences in these items (P>0.05). Conclusion: The results of this study showed the beneficial effects of multispecies probiotic supplementation in controlling IBS patients’ abdominal pain. thus it can be prescribed as a therapeutic option in addition to standard therapy and significantly lead to better control of this symptom in the short term.

scholarly journals Effect of Three Diets (Low-FODMAP, Gluten-free and Balanced) on Irritable Bowel Syndrome Symptoms and Health-Related Quality of Life

Nutrients ◽  
2019 ◽  
Vol 11 (7) ◽  
pp. 1566 ◽  
Author(s):  
Danilo Paduano ◽  
Arianna Cingolani ◽  
Elisabetta Tanda ◽  
Paolo Usai
Keyword(s):  
Quality Of Life ◽  
Irritable Bowel Syndrome ◽  
Abdominal Pain ◽  
Gluten Free ◽  
Health Related Quality ◽  
Balanced Diet ◽  
Related Quality ◽  
Health Related ◽  
Irritable Bowel

Several studies have reported some efficacy of diets low in fermentable carbohydrates (Fermentable Oligo-, Di-, Monosaccharides and Polyols (FODMAPs)) in Irritable Bowel Syndrome (IBS). There is no evidence of its superiority compared to gluten-free and balanced diets in improving IBS patients’ quality of life (QoL). The aim of this study is to assess whether different diets can improve QoL in IBS. Forty-two patients with IBS, according to Rome IV criteria, were enrolled. Low-FODMAP, gluten-free and balanced diets were proposed to each patient in the same succession. Each diet was followed for 4 weeks. The Bristol Stool Scale, the Visual Analogue Scale (VAS) for bloating and abdominal pain, and the SF12 questionnaire for health-related quality of life were applied at the beginning and at the end of each diet. Twenty-eight of the forty-two patients completed all the three diets. All the three diets reduced symptom severity (p < 0.01), bloating (p < 0.01) and abdominal pain (p < 0.01), and improved quality of life (p < 0.05); 3% of patients expressed a preference for the low-FODMAP diet, 11% for the gluten-free and 86% for the balanced diet (p < 0.01). The balanced diet improves QoL and VAS pain, provides an adequate quantity of FODMAPs and is more appreciated by patients. For these reasons, the balanced diet could be recommended to patients with irritable bowel syndrome.

scholarly journals A comparison of drug treatment outcome of irritable bowel syndrome patients with and without education: a randomized controlled study

Mediscope ◽  
2015 ◽  
Vol 2 (2) ◽  
pp. 22-27
Author(s):  
B Paik ◽  
Sk Sarker ◽  
PK Chowdhury ◽  
MS Ahmed
Keyword(s):  
Quality Of Life ◽  
Irritable Bowel Syndrome ◽  
Drug Treatment ◽  
Pharmacological Treatment ◽  
Treatment Protocol ◽  
Controlled Study ◽  
Organic Disease ◽  
Randomized Controlled ◽  
Irritable Bowel

The objective of the prospective randomized controlled comparative study to explore about the role of education in the treatment of irritable bowel syndrome (IBS), a chronic continuous or remittent gastrointestinal illness characterized by frequent unexplained symptoms that include abdominal pain, bloating and bowel disturbance. The patients who fulfilled the set criteria of this study and had normal physical examination were considered to undergo screening investigations (Hb%, TC, DC, ESR, blood glucose, serum TSH, stool for R/M/E and short colonoscopy or double contrast barium enema) to exclude any organic disease. In order to administer the same pharmacological treatment only diarrhea predominant patients without any organic disease were recruited for the present study. The number of recruited patients was 80. Of them, 40 patients were given only pharmacological management with Mebeverine Hydrochloride 135 mg thrice daily half an hour before meal and Amitryptyline 10 mg at night for 6 months, and the other 40 patients were given education by a structured and planned educational class for 1 hr in addition to the same pharmacological treatment. In both groups, changes of symptoms and quality of life of the patients were assessed by using a valid IBS related quality of life (IBS-QOL) instrument. The results showed that significant improvement occurred in both the groups of patients at 1 month and 6 months in respect to their baseline IBS-QOL score. But the improvement was not significantly higher in the group with education in comparison to the group without education. Therefore, it can be concluded that the educational class had no extra impact on drug treatment protocol for IBS used in the present study.Mediscope Vol. 2, No. 2: July 2015, Pages 22-27

scholarly journals Effectiveness of Two Dietary Approaches on the Quality of Life and Gastrointestinal Symptoms of Individuals with Irritable Bowel Syndrome

2020 ◽  
Vol 9 (1) ◽  
pp. 125 ◽  
Author(s):  
Maria Margarida Guerreiro ◽  
Zélia Santos ◽  
Elisabete Carolino ◽  
Julieta Correa ◽  
Marilia Cravo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Clinical Trial ◽  
Irritable Bowel Syndrome ◽  
Gastrointestinal Symptoms ◽  
Standard Diet ◽  
Before And After ◽  
Irritable Bowel ◽  
Fodmap Diet ◽  
Third Moment

To evaluate the effectiveness of a low FODMAP (fermentable oligosaccharides, monosaccharaides, disaccharides and polyols) diet in the relief of symptoms and an improvement of the quality of life in individuals with irritable bowel syndrome in comparison to a standard diet according to the British Dietetic Association’s guidelines. A non-randomized clinical trial of adult patients with IBS was compared two diet interventions. An assessment of symptoms, quality of life, and nutritional status was performed before and after the four-week mark of intervention. Individuals from the Low FODMAP Diet (LFD) group were evaluated on a third moment, after the controlled reintroduction of FODMAPs. A total of 70 individuals were divided in two groups: Low FODMAP Diet (LFD; n = 47) and Standard Diet (SD; n = 23). 57 individuals completed the four-week intervention (LFD; n = 39; SD; n = 18). At the completion of four weeks, the symptoms improved in both groups (LFD: p < 0.01; DC: p < 0.05) but LFD led to a higher relief (p < 0.05), primarily with respect to abdominal pain and diarrhoea. Quality of life improved significantly in both groups, with no significant differences between SD vs LFD (p > 0.05). In the LFD group, the relief of symptoms observed at the four-week mark remained constant after reintroduction of FODMAPs. Both interventions seem to be effective for the relief of symptoms and quality of life, however LFD had higher effectiveness in the former. The results with LFD suggest it can be a preferred approach in individuals with diarrhoeal profile.

Adequate Relief as an Endpoint in Clinical Trials in Irritable Bowel Syndrome

1998 ◽  
Vol 26 (2) ◽  
pp. 76-81 ◽  
Author(s):  
AW Mangel ◽  
BA Hahn ◽  
AT Heath ◽  
AR Northcutt ◽  
S Kong ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Irritable Bowel Syndrome ◽  
Abdominal Pain ◽  
Bowel Function ◽  
Recurrent Abdominal Pain ◽  
Response To Therapy ◽  
Multiple Parameters ◽  
Severity Scores ◽  
Irritable Bowel

Irritable bowel syndrome is characterized by recurrent abdominal pain and altered bowel function. In designing studies to evaluate new treatments for this disease, however, it is difficult to select appropriate endpoints to reflect improvement in the range of symptoms of the syndrome. In the present study we evaluated the parameter of adequate relief of abdominal pain and discomfort, as perceived by the patients, as a key endpoint for efficacy in the treatment of patients with irritable bowel syndrome. Abdominal pain and bowel function data were collected daily from 370 patients with the disease during treatment with placebo or a novel potent 5HT3 receptor antagonist. Once every 7 days adequate relief of pain and discomfort was assessed. Quality-of-life data were collected using self-administered questionnaires. The endpoint of adequate relief was significantly ( P < 0.05) correlated with improvement in pain severity scores, percentage of pain-free days, percentage of days with urgency, improvement in stool frequency and consistency, and quality-of-life parameters. Adequate relief of pain and discomfort is significantly correlated with changes in multiple parameters associated with irritable bowel syndrome and can be used as an endpoint for assessing response to therapy in these patients.

scholarly journals Effects of Propolis Supplementation on The Severity of Disease In Irritable Bowel Syndrome Subjects: A Randomized, Double-Blind Clinical Trial

2021 ◽  
Author(s):  
Mahsa Miryan ◽  
Pejman Alavinejad ◽  
Mohammadreza Abbaspour ◽  
Davood Soleimani ◽  
Alireza Ostadrahimi
Keyword(s):  
Quality Of Life ◽  
Irritable Bowel Syndrome ◽  
Abdominal Pain ◽  
Repeated Measures ◽  
Study Groups ◽  
T Test ◽  
Anxiety State ◽  
Anthropometric Indices ◽  
Irritable Bowel

Abstract The effects of propolis, a well-known functional food, on irritable bowel syndrome (IBS), a chronic gastrointestinal disorder, in humans have yet to be investigated. This study evaluated propolis effects in IBS subjects. In this clinical study, 56 patients with IBS diagnosed by Rome IV criteria were assigned for 6 weeks randomly to the study groups. At the baseline and endpoint phase, patients’ gastrointestinal symptoms, quality of life (QOL), anxiety state, dietary intakes, and anthropometric indices were assessed. Independent t-test, paired t-test, Mann-Whitney U test, Wilcoxon, Fisher's exact test, repeated measures analysis of variance and logistic regression test were used for analyzing the data. To adjust the effect of confounders, covariance analysis was used. The results of this study showed that after modulating the effect of potential confounders, propolis supplementation increased the chance of improving IBS severity by 6.22 (with a confidence interval of: 1.33 - 1.14 and P = 0.035). A significant abdominal pain improvement, anxiety state, and bowel habits dissatisfaction reduction was observed within- and between-group differences in propolis group compared to the placebo group (P = 0.040, P = 0.035, P = 0.029, retrospectively). The overall score of quality of life and its domains in the propolis group was statistically significant, but in comparison between the two groups, this difference was not significant. Also, regards to the food intakes and anthropometric indices, there were no significant differences between and within the two study groups. This study illustrated that propolis supplementation could be used as adjunctive therapy in IBS disease to reduce abdominal pain and anxiety state.

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