Tegaserod 6 mg twice daily is an effective, safe, and well tolerated treatment for patients in the Asia-Pacific region suffering from IBS and whose main bowel symptom is not diarrhoea.

Background & Aims Increases in mucosal immune cells have frequently been observed in irritable bowel syndrome (IBS) patients. However, this finding is not completely consistent between studies, possibly due to a combination of methodological variability, population differences and small sample sizes. We performed a meta‐analysis of case–control studies that compared immune cell counts in colonic biopsies of IBS patients and controls. Methods PubMed and Embase were searched in February 2017. Results were pooled using standardized mean difference (SMD) and were considered significant when zero was not within the 95% confidence interval (CI). Heterogeneity was assessed based on I2 statistics where I2 ≤ 50% and I2 > 50% indicated fixed and random effect models, respectively. Key Results Twenty‐two studies on 706 IBS patients and 401 controls were included. Mast cells were increased in the rectosigmoid (SMD: 0.38 [95% CI: 0.06‐0.71]; P = .02) and descending colon (SMD: 1.69 [95% CI: 0.65‐2.73]; P = .001) of IBS patients. Increased mast cells were observed in both constipation (IBS‐C) and diarrhea predominant IBS (IBS‐D). CD3+ T cells were increased in the rectosigmoid (SMD: 0.53 [95% CI: 0.21‐0.85]; P = .001) and the descending colon of the IBS patients (SMD: 0.79, 95% CI [0.28‐1.30]; P = .002). This was possibly in relation to higher CD4+ T cells in IBS (SMD: 0.33 [95% CI: 0.01‐0.65]; P = .04) as there were no differences in CD8+ T cells. Conclusions & Inferences Mast cells and CD3+ T cells are increased in colonic biopsies of patients with IBS vs non‐inflamed controls. These changes are segmental and sometimes IBS‐subtype dependent. The diagnostic value of the quantification of colonic mucosal cells in IBS requires further investigation.

Background The 5-HT 3 receptor antagonists are known to be effective for the treatment of diarrheapredominant irritable bowel syndrome (IBS), but not widely used yet. The aim of this study was to compare the efficacy and safety of ramosetron, a 5-HT 3 receptor antagonist, and mebeverine in male patients with IBS with diarrhea (IBS-D). Methods This study was performed in a multicenter, randomized, open-label design. Data of 343 male patients with IBS-D who were randomized to either a 4-week treatment of ramosetron 5 lg once daily or a 4-week treatment of mebeverine 135 mg three times daily were analyzed by the intent-to-treat analysis. The primary efficacy parameter was the proportion of patients with adequate relief of IBS symptoms at the last week of treatment. The secondary endpoints were changes in each symptom score and the safety profiles. Key Results The responder rates for global IBS symptoms, abdominal pain/discomfort and abnormal bowel habits in the ramosetron and mebeverine groups significantly increased during the treatment period. The severity scores of abdominal pain/discomfort and urgency, the stool form score, and the stool frequency in both treatment arms were significantly reduced, compared with the baselines. There were no significant differences in the responder rates (37% vs 38% on ITT analysis) and adverse event profiles between the ramosetron and mebeverine groups. Neither severe constipation nor ischemic colitis was reported by ramosetron-treated patients. Conclusions & Inferences Ramosetron 5 lg once daily is as effective as mebeverine three times daily in male patients with IBS-D.

Tianeptine is not inferior to amitriptyline for treating IBS-D in terms of both efficacy and tolerability.

SUMMARY BackgroundRecently, many studies reported that high carbohydrate and simple sugar intake increase a risk of obesity and metabolic syndrome significantly.