Management Options for Irritable Bowel Syndrome

Camilleri, Michael

doi:10.1016/j.mayocp.2018.04.032

Cited by 94 publications

(80 citation statements)

References 144 publications

(128 reference statements)

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“…It is currently prescribed in the USA. Diarrhea, cramping, and rare cardiovascular (CVS) side effects are seen with this drug [ 26 ].…”

Section: Reviewmentioning

confidence: 99%

“…Both change central nervous system (CNS) response to pain perception and might reduce activation of pain center and reduce pain processing. TCAs increase oro-cecal and intestinal transient time, so are used in IBS-D. SSRIs decrease oro-cecal and intestinal transient time and are used in IBS-C. Amitryptiline improved incomplete defecation and loose stools compared with placebo, but because of ADR such as drowsiness, dry mouth, and greater cost of SSRI, it is not prescribed [ 36 , 26 ]. Camilleri mentioned in his review article on duloxetine RCT that it improves IBS symptoms, abdominal pain, bowel dysfunction, and quality of life [ 36 ].…”

Section: Reviewmentioning

confidence: 99%

See 1 more Smart Citation

How Serotonin Level Fluctuation Affects the Effectiveness of Treatment in Irritable Bowel Syndrome

Vahora¹,

Tsouklidis²,

Kumar³

et al. 2020

Cureus

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Irritable bowel syndrome (IBS) is one of the most commonly diagnosed functional gastrointestinal (GI) disorders. It affects both men and women. Enteric serotonin (5HT) is responsible for gut motility, secretion, visceral hypersensitivity, and inflammation. The serotonin reuptake transporter (SERT) maintains serotonin levels by regulating its reuptake. An increase in SERT expression causes a decrease in serotonin, which leads to IBS-C (irritable bowel syndrome, constipation-predominant), whereas a decrease in SERT transcription causes an increase in serotonin, which leads to IBS-D (irritable bowel syndrome, diarrhea-predominant). Some factors can alter SERT transcription, such as certain bacteria, inflammation, growth factor, and glucagon-like peptide-1. This shows that 5HT and SERT both have an important role in IBS pathophysiology so that it would be a better subject to target for the treatment aspect of IBS. 5HT3 receptor antagonists are advisable for IBS-D to block the excessive activity of serotonin at the 5HT3 receptor and reduce gut motility. For IBS-C, we prescribe 5HT4 receptor agonists, which promote gut motility. Also, the latest treatment approach, antidepressant drugs TCAs (tricyclic antidepressants) and SSRIs (selective serotonin reuptake inhibitors), are helpful by modulating serotonin levels in the gut. In this literature review, we found that serotonin is one of the main pathophysiological factors for IBS, and we can treat IBS by targeting serotonin function on gut motility.

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“…It is currently prescribed in the USA. Diarrhea, cramping, and rare cardiovascular (CVS) side effects are seen with this drug [ 26 ].…”

Section: Reviewmentioning

confidence: 99%

Section: Reviewmentioning

confidence: 99%

How Serotonin Level Fluctuation Affects the Effectiveness of Treatment in Irritable Bowel Syndrome

Vahora¹,

Tsouklidis²,

Kumar³

et al. 2020

Cureus

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“…Though probiotics are considered beneficial in IBS treatment according to several meta-analysis and systematical reviews [24][25][26][27][28] , specific probiotics recommendations for IBS management are still not possible yet for the lack of data from high-quality RCTs [13,[29][30][31] . Most previous studies ignore the heterogeneity of IBS and lack of validated symptoms and QOL assessment, result in obscure outcomes of probiotics effectiveness.…”

Section: Discussionmentioning

confidence: 99%

The efficacy of Bifidobacterium quadruple viable tablet in the treatment of diarrhea predominant irritable bowel syndrome: a randomized, double-blind, placebo-controlled, multicenter trial.

Zeng

Bai

Long

et al. 2019

Preprint

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Background: Irritable bowel syndrome (IBS) is one of the most acommon functional gastrointestinal disorders characterized by recurrent abdominal pain associated with defecation or a change in bowel habits. Leading to significant negative effect on patients’ quality of life and huge financial burden to health system, the management of IBS is a great challenge. Probiotics are considered as an effective therapy, however, in a lack of high-quality evidence of efficacy, no specific strain- and dose-probiotics were recommended in clinical guidelines. This study aims to evaluate the efficacy of the bifidobacterium quadruple viable tablet in the treatment of IBS-D. Methods/design: A multicenter randomized controlled trial will be performed in fourteen hospitals. A total of three hundred patients fulfill the eligible criteria will be stratified divided into an experimental group and a control group randomly in a ratio of 1:1. The experimental group is treated with the bifidobacterium quadruple viable tablet while the control group is treated with placebo. All the patients will receive a 4-week treatment and a 2-week follow-up. The primary outcome is the effectiveness in improving abdominal pain and stool consistency, the secondary outcome include evaluation of overall symptom relief, frequency of defecation, bloating, urgency of defecation, remedial medication, score of IBS-QOL and changes of microbiota and metabonomics. Physical examination, vital signs, laboratory tests, adverse events and concomitant medication will be taken into account for intervention safety assessment during the trial. Discussion: This multicenter randomized controlled trial may provide high-quality evidence on the efficacy of the bifidobacterium quadruple viable tablet for IBS-D on both physical and mental dimensions in China. To fill the gap of previous probiotics intervention studies, in addition, this study will also present safety assessment which will be a significant emphasis.

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“…2,3 Due to different treatment strategies between GI dysmotility and IBS, it is important to diagnose the diseases correctly. Functional bowel diseases are mainly treated with dietary advice in the form of regular meals with carbohydrate restriction and psychological therapy, 4 whereas dysmotility is treated with prokinetic drugs and dietary supplemental therapy. 5…”

Section: Introductionmentioning

confidence: 99%

Autonomic and peripheral neuropathy with reduced intraepidermal nerve fiber density can be observed in patients with gastrointestinal dysmotility

Ohlsson

Dahlin

Englund

et al. 2019

Clinical Case Reports

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Neuropathy should be considered as a possible etiological factor in patients with severe gastrointestinal symptoms, without signs of disease on routine investigations.Examinations of the autonomic and peripheral nervous systems may be helpful to select the patients who should be investigated with full-thickness intestinal biopsy, and to give appropriate care. K E Y W O R D Sautonomic dysfunction, enteric neuropathy, gastrointestinal dysmotility, intraepidermal nerve fiber density, peripheral neuropathy How to cite this article: Ohlsson B, Dahlin LB, Englund E, Veress B. Autonomic and peripheral neuropathy with reduced intraepidermal nerve fiber density can be observed in patients with gastrointestinal dysmotility. Clin Case Rep.

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Management Options for Irritable Bowel Syndrome

Cited by 94 publications

References 144 publications

How Serotonin Level Fluctuation Affects the Effectiveness of Treatment in Irritable Bowel Syndrome

How Serotonin Level Fluctuation Affects the Effectiveness of Treatment in Irritable Bowel Syndrome

The efficacy of Bifidobacterium quadruple viable tablet in the treatment of diarrhea predominant irritable bowel syndrome: a randomized, double-blind, placebo-controlled, multicenter trial.

Autonomic and peripheral neuropathy with reduced intraepidermal nerve fiber density can be observed in patients with gastrointestinal dysmotility

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