Med. praxi. 2017;14(3):115-122 [Prakt. lékáren. 2017; 13(2): 52-59]

Pharmacotherapy of irritable bowel syndrome

doc. PharmDr. Jan Juřica, Ph.D.1, 2, MUDr. Radek Kroupa, Ph.D.3
1Farmakologický ústav LF MU, Brno
2Ústavní lékárna, Masarykův onkologický ústav, Brno
3Interní gastroenterologická klinika LF MU a FN Brno

Irritable bowel syndrome is one of the most frequent functional diseases of gastrointestinal tract. Among typical symptoms

there are GIT dyscomfort, abdominal pain, bloating, and change in stool consistency and/or stool frequency. Pharmacotherapy

is supplementary to dietary and regime approaches and is truly symptomatic, but it often brings patients significant relief from

symptoms. This article is pharmacological review of groups of drugs used in the treatment of irritable bowel syndrome. It introduces

mechanisms of action, particularities of pharmacokinetics of spasmolytics, laxatives, antidiarhoics, prokinetics, antibiotics

and psychotropic drugs in the treatment of irritable bowel syndrome and their position in the current range of medicines, based

on EBM and current guidelines.

Keywords: irritable bowel, pharmacotherapy, spasmolytics, laxatives, antidiarhoics, antidepressants

Published: July 1, 2017  Show citation

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Juřica J, Kroupa R. Pharmacotherapy of irritable bowel syndrome. Med. praxi. 2017;14(3):115-122.
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References

  1. Seifert B. Dráždivý tračník. Med pro praxi 2010; 7: 313-317.
  2. Seifert B, Lukáš K, Charvátová E, et al. Dolní dyspeptický syndrom. Doporučený diagnostický a léčebný postup pro všeobecné praktické lékaře. In: Centrum doporučených postupů pro praktické lékaře 2007. p. 1-14.
  3. Quigley EM, Fried M, Gwee KA, et al. World Gastroenterology Organisation Global Guidelines Irritable Bowel Syndrome: A Global Perspective Update September 2015. J Clin Gastroenterol 2016; 50: 704-713. Go to original source... Go to PubMed...
  4. Dynamed American Society of Health System Pharmacists I. Dynamed. Record No. 113627, Irritable bowel syndrome (IBS); [updated 2017 Mar 17, cited 26.4.2017] ed. Ipswich (MA): EBSCO Information Services. 1995-2017; 2017.
  5. Kaplan A, Franzen MD, Nickell PV, et al. An open-label trial of duloxetine in patients with irritable bowel syndrome and comorbid generalized anxiety disorder. Int J Psychiatry Clin Pract 2014; 18: 11-15. Go to original source... Go to PubMed...
  6. Oświęcimska J, Szymlak A, Roczniak W, et al. New insights into the pathogenesis and treatment of irritable bowel syndrome. Adv Med Sci 2017; 62: 17-30. Go to original source... Go to PubMed...
  7. Sunderland R. Irritable bowel syndrome in adults: symptoms, treatment and management. Nurs Stand 2017; 31: 52-63.
  8. Hrubant K. Dráždivý tračník a funkční zácpa. Int Med 2010; 12: 407-410.
  9. Šťovíček J. Funkční dyspeptické poruchy: Syndrom dráždivého tračníku. eEdicína pro praxi 2013; 10: 372-375.
  10. NICE. Irritable bowel syndrome in adults: diagnosis and management. In: NICE; 2017. p. 1-22.
  11. Wittmann T, Paradowski L, Ducrotté P, et al. Clinical trial: the efficacy of alverine citrate/simeticone combination on abdominal pain/discomfort in irritable bowel syndrome-a randomized, double-blind, placebo-controlled study. Aliment Pharmacol Ther 2010; 31: 615-624. Go to original source... Go to PubMed...
  12. Ducrotte P, Grimaud JC, Dapoigny M, et al. On-demand treatment with alverine citrate/simeticone compared with standard treatments for irritable bowel syndrome: results of a randomised pragmatic study. Int J Clin Pract 2014; 68: 245-254. Go to original source... Go to PubMed...
  13. InfoPharm. AISLP. In; 2017.
  14. Rai RR, Dwivedi M, Kumar N. Efficacy and safety of drotaverine hydrochloride in irritable bowel syndrome: a randomized double-blind placebo-controlled study. Saudi J Gastroenterol 2014; 20: 378-382. Go to original source... Go to PubMed...
  15. Mueller-Lissner S, Tytgat GN, Paulo LG, et al. Placebo- and paracetamol-controlled study on the efficacy and tolerability of hyoscine butylbromide in the treatment of patients with recurrent crampy abdominal pain. Aliment Pharmacol Ther 2006; 23: 1741-1748. Go to original source... Go to PubMed...
  16. ČLS JEP. Funkční dyspepsie horní a dolní. Doporučený postup pro praktické lékaře. In; 2002. p. 1-8.
  17. Le Nevé B, Brazeilles R, Derrien M, et al. Lactulose Challenge Determines Visceral Sensitivity and Severity of Symptoms in Patients With Irritable Bowel Syndrome. Clin Gastroenterol Hepatol 2016; 14: 226-233.e1-3. Go to original source... Go to PubMed...
  18. Lubiprostone (amitiza) for chronic constipation. Med Lett Drugs Ther 2006; 48: 47-48. Go to PubMed...
  19. Lacy BE, Levy LC. Lubiprostone: a novel treatment for chronic constipation. Clin Interv Aging 2008; 3: 357-364. Go to original source... Go to PubMed...
  20. Layer P, Stanghellini V. Review article: Linaclotide for the management of irritable bowel syndrome with constipation. Aliment Pharmacol Ther 2014; 39: 371-384. Go to original source... Go to PubMed...
  21. Talley NJ. Serotoninergic neuroenteric modulators. Lancet 2001; 358: 2061-2068. Go to original source... Go to PubMed...
  22. Ford AC, Moayyedi P, Lacy BE, et al. American College of Gastroenterology monograph on the management of irritable bowel syndrome and chronic idiopathic constipation. Am J Gastroenterol 2014; 109(Suppl 1): S2-26; quiz S27. Go to original source... Go to PubMed...
  23. Weinberg DS, Smalley W, Heidelbaugh JJ, et al. American Gastroenterological Association Institute Guideline on the pharmacological management of irritable bowel syndrome. Gastroenterology 2014; 147: 1146-1148. Go to original source... Go to PubMed...
  24. Tack J, Vanuytsel T, Corsetti M. Modern Management of Irritable Bowel Syndrome: More Than Motility. Dig Dis 2016; 34: 566-573. Go to original source... Go to PubMed...
  25. Hiyama T, Yoshihara M, Matsuo K, et al. Meta-analysis of the effects of prokinetic agents in patients with functional dyspepsia. J Gastroenterol Hepatol 2007; 22: 304-310. Go to original source... Go to PubMed...
  26. Paré P, Bridges R, Champion MC, et al. Recommendations on chronic constipation (including constipation associated with irritable bowel syndrome) treatment. Can J Gastroenterol 2007; 21(Suppl B): 3B-22B. Go to original source...
  27. Karabulut GS, Beşer OF, Erginöz E, et al. The Incidence of Irritable Bowel Syndrome in Children Using the Rome III Criteria and the Effect of Trimebutine Treatment. J Neurogastroenterol Motil 2013; 19: 90-93. Go to original source... Go to PubMed...
  28. Thompson AJ, Lummis SC. The 5-HT3 receptor as a therapeutic target. Expert Opin Ther Targets 2007; 11: 527-540. Go to original source... Go to PubMed...
  29. Vanuytsel T, Tack JF, Boeckxstaens GE. Treatment of abdominal pain in irritable bowel syndrome. J Gastroenterol 2014; 49: 1193-205. Go to original source... Go to PubMed...
  30. Schey R, Rao SS. The role of rifaximin therapy in patients with irritable bowel syndrome without constipation. Expert Rev Gastroenterol Hepatol 2011; 5: 461-464. Go to original source... Go to PubMed...
  31. Pimentel M, Lembo A, Chey WD, et al. Rifaximin therapy for patients with irritable bowel syndrome without constipation. N Engl J Med 2011; 364: 22-32. Go to original source... Go to PubMed...
  32. Lembo A, Pimentel M, Rao SS, et al. Repeat Treatment With Rifaximin Is Safe and Effective in Patients With Diarrhea-Predominant Irritable Bowel Syndrome. Gastroenterology 2016; 151: 1113-1121. Go to original source... Go to PubMed...
  33. Iorio N, Malik Z, Schey R. Profile of rifaximin and its potential in the treatment of irritable bowel syndrome. Clin Exp Gastroenterol 2015; 8: 159-167. Go to original source... Go to PubMed...
  34. Pimentel M, Chatterjee S, Chow EJ, et al. Neomycin improves constipation-predominant irritable bowel syndrome in a fashion that is dependent on the presence of methane gas: subanalysis of a double-blind randomized controlled study. Dig Dis Sci 2006; 51: 1297-1301. Go to original source... Go to PubMed...
  35. Low K, Hwang L, Hua J, et al. A combination of rifaximin and neomycin is most effective in treating irritable bowel syndrome patients with methane on lactulose breath test. J Clin Gastroenterol 2010; 44: 547-550. Go to original source...
  36. van den Wijngaard RM, Welting O, Bulmer DC, et al. Possible role for TRPV1 in neomycin-induced inhibition of visceral hypersensitivity in rat. Neurogastroenterol Motil 2009; 21: 863-e60. Go to original source... Go to PubMed...
  37. Rahimi R, Nikfar S, Rezaie A, et al. Efficacy of tricyclic antidepressants in irritable bowel syndrome: a meta-analysis. World J Gastroenterol 2009; 15: 1548-1553. Go to original source... Go to PubMed...
  38. Xie C, Tang Y, Wang Y, et al. Efficacy and Safety of Antidepressants for the Treatment of Irritable Bowel Syndrome: A Meta-Analysis. PLoS One 2015; 10: e0127815. Go to original source... Go to PubMed...
  39. Bundeff A, Woodis C. Selective Serotonin Reuptake Inhibitors for the Treatment of Irritable Bowel Syndrome. Annals of Pharmacotherapy 2014; 48: 777-784. Go to original source... Go to PubMed...
  40. Kaplan A, Franzen M, Nickell P, et al. An open-label trial of duloxetine in patients with irritable bowel syndrome and comorbid generalized anxiety disorder. International Journal of Psychiatry in Clinical Practice 2014; 18: 11-15. Go to original source... Go to PubMed...
  41. Distrutti E, Fiorucci S, Hauer SK, et al. Effect of acute and chronic levosulpiride administration on gastric tone and perception in functional dyspepsia. Aliment Pharmacol Ther 2002; 16: 613-622. Go to original source... Go to PubMed...
  42. Lozano R, Concha MP, Montealegre A, et al. Effectiveness and safety of levosulpiride in the treatment of dysmotility-like functional dyspepsia. Ther Clin Risk Manag 2007; 3: 149-155. Go to original source... Go to PubMed...
  43. Camilleri M. American college of gastroenterology monograph on the management of irritable bowel syndrome. Expert Opin Pharmacother 2015; 16: 629-632. Go to original source... Go to PubMed...
  44. Mearin F, Rodrigo L, Perez-Mota A, et al. Levosulpiride and Cisapride in the Treatment of Dysmotility-Like Functional Dyspepsia: A Randomized, Double-Masked Trial. Clinical Gastroenterology and Hepatology 2004; 2: 301-308. Go to original source... Go to PubMed...
  45. Tillisch K, Labus J, Nam B, et al. Neurokinin-1-receptor antagonism decreases anxiety and emotional arousal circuit response to noxious visceral distension in women with irritable bowel syndrome: a pilot study. Alimentary Pharmacology & Therapeutics 2012; 35: 360-367. Go to original source... Go to PubMed...
  46. Acosta A, Camilleri M. Elobixibat and its potential role in chronic idiopathic constipation. Therapeutic Advances in Gastroenterology 2014; 7: 167-175. Go to original source... Go to PubMed...
  47. Biesiekierski JR, Peters SL, Newnham ED, et al. No effects of gluten in patients with self-reported non-celiac gluten sensitivity after dietary reduction of fermentable, poorly absorbed, short-chain carbohydrates. Gastroenterology 2013; 145: 320-328.e1-3. Go to original source... Go to PubMed...
  48. Mearin F, Ciriza C, Mínguez M, et al. Clinical Practice Guideline: Irritable bowel syndrome with constipation and functional constipation in the adult. Rev Esp Enferm Dig 2016; 108: 332-363. Go to original source... Go to PubMed...




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