Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 27 September 2016

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Treatment of abdominal pain in irritable bowel syndrome

This month's Journal of Gastroenterology investigates treatment of abdominal pain in irritable bowel syndrome.

News image

Functional abdominal pain in the context of irritable bowel syndrome (IBS) is a challenging problem for primary care physicians, gastroenterologists and pain specialists.

Dr Tim Vanuytsel and colleagues reviewed the evidence for the current and future non-pharmacological and pharmacological treatment options targeting the central nervous system and the gastrointestinal tract.

Cognitive interventions such as cognitive behavioral therapy and hypnotherapy have demonstrated excellent results in IBS patients, but the limited availability and labor-intensive nature limit their routine use in daily practice.

Antispasmodics, including peppermint oil, are the first-line treatment for abdominal pain in IBS
Journal of Gastroenterology

In patients who are refractory to first-line therapy, tricyclic antidepressants and selective serotonin reuptake inhibitors are both effective to obtain symptomatic relief, but only tricyclic antidepressants have been shown to improve abdominal pain in meta-analyses.

The researchers found that a diet low in fermentable carbohydrates and polyols (FODMAP) seems effective in subgroups of patients to reduce abdominal pain, bloating, and to improve the stool pattern.

The team noted that evidence for fiber is limited and only isphagula may be somewhat beneficial.

The efficacy of probiotics is difficult to interpret since several strains in different quantities have been used across studies.

The team observed that antispasmodics, including peppermint oil, are still considered the first-line treatment for abdominal pain in IBS.

Second-line therapies for diarrhea-predominant IBS include the non-absorbable antibiotic rifaximin, and the 5HT3 antagonists alosetron and ramosetron, although the use of the former is restricted because of the rare risk of ischemic colitis.

Dr Vanuytsel's team concludes, "In laxative-resistant, constipation-predominant IBS, the chloride-secretion stimulating drugs lubiprostone and linaclotide, a guanylate cyclase C agonist that also has direct analgesic effects, reduce abdominal pain and improve the stool pattern."

J Gastroenterol 2014: 49(8): 1193-1205
15 August 2014

Go to top of page Email this page Email this page to a colleague

 27 September 2016 
Non-invasive tests of NAFLD
 27 September 2016 
Fecal microbiota transplantation for C.diff in IBD
 27 September 2016 
Fast-track colorectal surgery influences outcomes
 26 September 2016 
Preventing cirrhosis in Hep C with fibrosis
 26 September 2016 
Body image after abdominoperineal excision for rectal cancer
 26 September 2016 
Gastric cancer risk in intestinal metaplasia of the stomach
 23 September 2016 
Sleep quality in nonalcoholic cirrhotic patients
 23 September 2016 
Exercise for NAFLD
 23 September 2016 
BMI history and fatty liver
 22 September 2016 
Predicting small-bowel Crohn’s disease
 22 September 2016 
Colectomy outcomes for ulcerative colitis
 22 September 2016 
Technology vs intervention for weight loss
 21 September 2016 
Cardiopulmonary exercise testing in liver transplant candidates
 21 September 2016 
Employment status and IBD
 21 September 2016 
Patients vs providers on nutrition in IBD
 20 September 2016 
Improving healthcare systems for viral Hepatitis
 20 September 2016 
GI benefits of COX-2 selective inhibitors
 20 September 2016 
Predicting relapse in Crohn's
 19 September 2016 
Prevalence of esophageal cancer in Barrett's
 19 September 2016 
Fecal microbiota transplantation and CDI in IBD
 19 September 2016 
Antibiotic resistance in Helicobacter pylori
 16 September 2016 
Low-residue diet before colonoscopy and bowel cleansing
 16 September 2016 
Genome-wide association in gastric cancer
 16 September 2016 
H. pylori in children with asthma
 15 September 2016 
Improving survival in cholangitis-associated septic shock
 15 September 2016 
Colorectal cancer survival and hospital volumes
 15 September 2016 
Primary sclerosing cholangitis and IBD
 14 September 2016 
Intestinal malabsorption and olmesartan
 14 September 2016 
Infection reduction strategy after colorectal resection
 14 September 2016 
Predicting long-term infliximab use in Crohn's
 13 September 2016 
Predicting survival in refractory celiac disease
 13 September 2016 
Cancer risk stratification in Barrett’s
 13 September 2016 
Screening vs non-screening colonoscopy
 12 September 2016 
Screening in familial colorectal cancer
 12 September 2016 
Metformin improves survival in pancreatic ductal cancer
 12 September 2016 
Consent guidelines for GI endoscopy procedures
 09 September 2016 
Development of IBS
 09 September 2016 
Safe and effective treatment for NASH
 09 September 2016 
Scale for stool measurement in diarrhea-IBS
 08 September 2016 
Prognostic factors for infliximab in Crohn's
 08 September 2016 
Chronic Hep B vs chronic Hep C and mortality
 08 September 2016 
Hematological malignancies in IBD
 07 September 2016 
IBD relapse during pregnancy
 07 September 2016 
New treatments for ulcerative colitis
 07 September 2016 
Alternative to nucleic acid testing in HCV
 06 September 2016 
Endoscopy clinic no-shows
 06 September 2016 
Risk of infection after elective colorectal surgery
 06 September 2016 
EHealth technologies in IBD
 05 September 2016 
Esophageal impedance monitoring
 05 September 2016 
Family history and IBD clinical course
 05 September 2016 
Biomarker for IBD and GI cancer
 02 September 2016 
Dietary carbohydrate intake, insulin resistance and GERD 
 02 September 2016 
Postpolypectomy bleeding in the colorectum
 02 September 2016 
Postop recurrence of Crohn's
 01 September 2016 
Prognostic test for liver transplants
 01 September 2016 
Recovery after colorectal surgery in elderly patients
 01 September 2016 
Obesity and post-ERCP pancreatitis
 30 August 2016 
NAFLD and carotid atherosclerosis
 30 August 2016 
Quality improvement program after colorectal surgery
 30 August 2016 
Gut microbial diversity in smokers with Crohn's

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2016 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us