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- Colomier, Esther, 1995, et al.
(författare)
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Pharmacological Therapies and Their Clinical Targets in Irritable Bowel Syndrome With Diarrhea
- 2021
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Ingår i: Frontiers in Pharmacology. - : Frontiers Media SA. - 1663-9812. ; 11
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Forskningsöversikt (refereegranskat)abstract
- 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.
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| 2. |
- Melchior, Chloé, 1985, et al.
(författare)
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Perceived Gastrointestinal Symptoms and Association With Meals in a French Cohort of Patients With Irritable Bowel Syndrome
- 2021
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Ingår i: Journal of Neurogastroenterology and Motility. - : The Korean Society of Neurogastroenterology and Motility. - 2093-0879 .- 2093-0887. ; 27:4, s. 574-580
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Tidskriftsartikel (refereegranskat)abstract
- Background/Aims The aim of our study is to evaluate the association between meals and perceived gastrointestinal symptoms in real life in a French cohort of irritable bowel syndrome (IBS) patients. Methods This prospective cross-sectional observational study included patients from the French association (association des patients souffrant du syndrome de l'intestin irritable [APSSII]) of IBS. Data were collected on demographics, IBS subtype, dietary food, and meal-induced gastrointestinal symptoms from patient filled self-questionnaires or questionnaires. Results Eighty-four patients with IBS were included; 82.3% female with a mean age of 46.9 +/- 15.7 years. Each transit pattern subtype represented one-third of the population. Forty-five percent of patients had severe IBS according to IBS-Severity Scoring System; mean IBS Quality of Life score was 53.9 +/- 18.3. Patients believed that food could trigger or exacerbate gastrointestinal symptoms in 73.3% and 93.4%, respectively. Eighty-nine percent had already tried diets, mostly lactose free diet and low fermentable, oligosaccharides, disaccharides, monosaccharides, and polyols diet in 61.3% and 53.6% of cases. Thirty-nine percent of meals induced gastrointestinal symptoms. Meal-induced gastrointestinal symptoms were associated with severity and subtype but not with quality of life. Conclusions This study has confirmed the important link between gastrointestinal symptoms and food. Gastrointestinal symptoms induced by meals are frequent and associated with severity and IBS-diarrhea subtype. Our study also underlines patients' interest in food and diet. More knowledge is needed on food that triggers IBS symptoms but also on diet conditions in order to improve this condition. (J Neurogastroenterol Motil 2021;27:574-580)
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| 3. |
- Richard, N., et al.
(författare)
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The effectiveness of rotating versus single course antibiotics for small intestinal bacterial overgrowth
- 2021
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Ingår i: United European Gastroenterology Journal. - : Wiley. - 2050-6406 .- 2050-6414. ; 9:6, s. 645-654
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Tidskriftsartikel (refereegranskat)abstract
- Background: Small intestinal bacterial overgrowth treatment is usually based on antibiotics with no guidelines available. Objective: This study aimed to investigate the efficacy of different antibiotics to treat small intestinal bacterial overgrowth. Methods: Consecutive patients referred to our tertiary center and diagnosed with intestinal bacterial overgrowth were retrospectively included. Patients were diagnosed using a 75g glucose breath test. Patients were treated either with a single antibiotic (quinolone or azole) or rotating antibiotics (quinolone and azole, one after the other) for 10 consecutive days per month for 3months. A negative glucose breath test after antibiotic treatment was considered as remission. Quality of life (GIQLI) and gastrointestinal severity (IBS-SSS) were assessed before and after antibiotic treatment. Symptomatic evaluation was realized in simple blind of glucose breath test result: patients were unaware of their results. Results: Between August 2005 and February 2020, 223 patients were included in the analysis (female 79.8%, mean age 50.2±15.7years). Remission was observed in 119 patients (53.4%) after one course of antibiotics and was more frequent in patients receiving rotating antibiotics than in patients receiving a single antibiotic (70.0% vs. 50.8%, p=0.050). Remission was associated with a significant improvement in quality of life (p=0.035) and in bloating (p=0.004). Conclusion: In this study, the treatment of small intestinal bacterial overgrowth using rotating antibiotics was more effective than treatment using a single course of antibiotic. Remission was associated with improvement in both quality of life and bloating. © 2021 The Authors. United European Gastroenterology Journal published by Wiley Periodicals LLC. on behalf of United European Gastroenterology.
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