Calming irritable bowel syndrome
Constipation in patients with Irritable Bowel Syndrome(IBS) respond to treatment with fibre or simple laxatives,including osmotic agents: psychotherapy may also be beneficial.
1. The Serotonin (5-HT3) antagonist losartan was found to provide adequate relif of pain,improved stool frequency,decrease urgency,and consistency for many patients whose predominant bowel distrubance was diarrhea.
The medicaltion was withdrawn from the market because of side effects (eg. severe constipation and ischemic colitis) but it was reintroduced;the Food and Drug Administration has approved it for treatment of women with severe diarrhea-predominant Irritable Bowel Syndrome whose condition failed to respond to conventional treatment.Other compounds in the same class(cilansetron) are undergoing trials.
Other serotoninergic agents thet activate the 5-HT4 receptor may be approved for treatment of constipation-predominant IBS.Tegaserod,the first of this class of drugs, appears to be modestly effective in women with contipation-predominant IBS3;it has been approved by the FDA for this use.IBS patients tend to use complementary and alternative medicibe(CAM) more frequently than patients with organic bowel diseases.IBS patients who used CAM were found to have significantly poorer quality of life scores for emotional and social factors than patients who did not use CAM.
Physician need to be aware of this,both with regard to the potential for adverse intraction and as an indication of emmotional unease in patients.
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