New approaches to the medical treatment of irritable bowel syndrome

Abstract

Irritable bowel syndrome (IBS) is a common disorder with a worldwide distribution; it is characterized by abdominal pain and discomfort associated with an alteration of bowel function. The treatment approach for IBS depends on the patient's presenting symptoms at the time of diagnosis, and treatment is usually directed toward the predominant symptom. In this review we discuss the current approach to the treatment of IBS.

Effect of tegaserod on colonic transit time in male patients with constipation‐predominant irritable bowel syndrome

“…Serotonin appears to be the common link in gastrointestinal motility, intestinal secretion and pain perception and thus it is considered to play an important role in the pathophysiological abnormalities observed in IBS 31 . 5‐HT 4 receptors are G‐coupled proteins that mediate the release of neurotransmitters involved in gastrointestinal motility, such as acetylcholine and calcitonin gene‐related peptide 32,33 . 5‐HT 4 receptor agonism is therefore beneficial for patients with C‐IBS because it results in enhanced intestinal motility, increased intestinal secretion and reduced visceral hypersensitivity 34 .…”

Review article: the role of serotonergic agents in the treatment of patients with primary chronic constipation

“…Serotonin release from EC cells appears to stimulate 5‐HT 3 receptors on vagal afferents, potentially resulting in nausea and other non‐painful gut sensations such as bloating and abdominal fullness. Antagonism of 5‐HT 3 receptors may thereby reduce symptoms associated with altered visceral sensation, as can be the case in patients with IBS 27, 32–34 . With this as background, it makes intuitive sense that 5‐HT 3 receptor antagonists are most appropriate for patients with IBS whose primary bowel symptom is diarrhoea.…”

“…Antagonism of 5-HT 3 receptors may thereby reduce symptoms associated with altered visceral sensation, as can be the case in patients with IBS. 27,[32][33][34] With this as background, it makes intuitive sense that 5-HT 3 receptor antagonists are most appropriate for patients with IBS whose primary bowel symptom is diarrhoea. Alternatively, it is conceivable that a 5-HT 3 agonist might be of benefit to patients with IBS whose primary bowel symptom is constipation.…”