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irritable Bowel Syndrome Constipation

Darren M Brenner, Ronald Fogel, Spencer D Dorn, Richard Krause, Paul Eng, Robert Kirshoff, Anhthu Nguyen, Robert A Crozier, Leslie Magnus, Patrick H Griffin
OBJECTIVES: Two identical, phase 3, randomized, double-blind, placebo-controlled trials evaluated the efficacy and safety of plecanatide in patients with irritable bowel syndrome with constipation (IBS-C). METHODS: Adults meeting Rome III criteria for IBS-C were randomized (1:1:1) to placebo or plecanatide (3 or 6 mg) for 12 weeks. The primary efficacy end point was the percentage of overall responders (patients reporting ≥30% reduction from baseline in worst abdominal pain plus an increase of ≥1 complete spontaneous bowel movement (CSBM)/week from baseline in the same week for ≥6 of 12 treatment weeks)...
March 15, 2018: American Journal of Gastroenterology
Michael Malone, Abdul Waheed, Samiullah Samiullah
Functional lower gastrointestinal disorders include irritable bowel syndrome (IBS), functional constipation, functional fecal incontinence, and functional anorectal pain. These disorders are common and have significant medical and social effects. They also can be challenging to manage. Patients with mild symptoms may benefit from lifestyle modification. IBS is classified into two subtypes: diarrhea-predominant and constipation-predominant. Depending on the IBS subtype and its likely etiology, patients may benefit from treatment with antispasmodics, antidepressants, guanylate cyclase-C agonists, chloride channel activators, antidiarrheal agents, probiotics, and/or antibiotics...
March 2018: FP Essentials
Egbert Clevers, William E Whitehead, Olafur S Palsson, Ami D Sperber, Hans Törnblom, Lukas Van Oudenhove, Jan Tack, Magnus Simrén
BACKGROUND AND AIMS: The Rome IV criteria define functional gastrointestinal (GI) disorders by specific combinations of symptoms. It is possible to empirically evaluate these symptom combinations by factor analysis (a statistical procedure that groups variables that correlate). However, this analysis has not been performed for the Rome IV criteria, and factor analyses based on the previous versions of the Rome criteria did not use population-based data. We therefore investigated symptom grouping by the Rome IV questionnaire using factor analysis of a population-based sample...
March 3, 2018: Clinical Gastroenterology and Hepatology
Konstantinos Leventogiannis, Paraskevas Gkolfakis, Georgios Spithakis, Aikaterini Tsatali, Aikaterini Pistiki, Athanasios Sioulas, Evangelos J Giamarellos-Bourboulis, Konstantinos Triantafyllou
The effect of probiotics on small intestinal bacterial overgrowth (SIBO) in irritable bowel syndrome (IBS) has never been studied so far. In this prospective trial, five patients with IBS and SIBO and 21 patients with IBS without SIBO were administered an oral capsule containing Saccharomyces boulardii, Bifidobacterium lactis, Lactobacillus acidophilus, and Lactobacillus plantarum (Lactolevure® ) every 12 h for 30 days. SIBO was defined by quantitative culture of the third part of the duodenum; IBS was defined by the Rome III criteria...
March 5, 2018: Probiotics and Antimicrobial Proteins
Michel Bouchoucha, Ghislain Devroede, Florence Mary, Cyriaque Bon, Bakhtiar Bejou, Robert Benamouzig
PURPOSE: Abdominal pain is not used to characterize constipated patients. This study aimed to compare clinical, psychological, and physiological features in patients with IBS-constipation (IBS-C) with those in patients with functional constipation (FC) according to the intensity of abdominal pain. METHODS: All patients filled a standard Rome III questionnaire. In addition, they indicated the intensity of constipation, diarrhea, bloating, and abdominal pain on a 10-point Likert scale, and their stool form with the Bristol Stool Form Scale...
February 28, 2018: Digestive Diseases and Sciences
S C M Heemskerk, A H Rotteveel, M A Benninga, C I M Baeten, A A M Masclee, J Melenhorst, S M J van Kuijk, C D Dirksen, S O Breukink
PURPOSE: The evidence regarding the (cost-)effectiveness of sacral neuromodulation (SNM) in patients with therapy-resistant idiopathic slow-transit constipation is of suboptimal quality. The Dutch Ministry of Health, Welfare and Sports has granted conditional reimbursement for SNM treatment. The objective is to assess the effectiveness, cost-effectiveness, and budget impact of SNM compared to personalized conservative treatment (PCT) in patients with idiopathic slow-transit constipation refractory to conservative treatment...
February 22, 2018: International Journal of Colorectal Disease
David P Richardson, Juliet Ansell, Lynley N Drummond
PURPOSE: To describe the nutritional and health attributes of kiwifruit and the benefits relating to improved nutritional status, digestive, immune and metabolic health. The review includes a brief history of green and gold varieties of kiwifruit from an ornamental curiosity from China in the 19th century to a crop of international economic importance in the 21st century; comparative data on their nutritional composition, particularly the high and distinctive amount of vitamin C; and an update on the latest available scientific evidence from well-designed and executed human studies on the multiple beneficial physiological effects...
February 22, 2018: European Journal of Nutrition
M Rukunuzzaman, A B Karim, M Nurullah, M W Mazumder, K Sultana, F Hussain, F Sultana
Irritable bowel syndrome (IBS) is one of the most common and best studied disorders among the group of functional gastrointestinal disorders. It is a functional bowel disorder in which abdominal pain or discomfort is associated with defecation or a change in bowel habit. Visceral hypersensitivity and increased GIT motility are the main patho-physiological mechanism for developing IBS. IBS present with diarrhea and constipation or both. Investigation is least needed for diagnosis of IBS rather done to exclude differential diagnosis...
January 2018: Mymensingh Medical Journal: MMJ
Emily K Stern, Darren M Brenner
Irritable bowel syndrome (IBS) is a common, heterogeneous disorder characterized by abdominal pain associated with changes in bowel habits. The pathogenesis of IBS is multifactorial and may relate to alterations in the gut microbiota, changes in visceral sensation and motility, and genetic and environmental factors. Administration of systemic antibiotics may increase the risk of IBS by altering gastrointestinal homeostasis. Therapeutic interventions for IBS with diarrhea that are thought to target alterations in the gut microbiota include the nonsystemic antibiotic rifaximin, the medical food serum-derived bovine immunoglobulin, prebiotics, probiotics, and dietary modification...
February 15, 2018: Clinical and Translational Gastroenterology
Dongbo Jiang, Dong Huang, Weiming Cai, Ting Li, Yan Wang, Huayan Chen, Tangming Guan, Xiaoli Ma
Several studies have reported an association between GNβ3 C825T polymorphism and irritable bowel syndrome (IBS). However, the results remain inconclusive and controversial, particularly for the data derived from different ethnicities and IBS subtypes. Therefore, we performed an updated meta-analysis to evaluate this association. All eligible case-control studies that met the search criteria were retrieved from multiple databases, and eleven case-control studies were included for detailed evaluation. The pooled odds ratios (ORs) with 95% confidence intervals (95% CIs) were calculated to assess the strengths of the association between GNβ3 C825T polymorphism and susceptibility to IBS and its subtypes...
January 5, 2018: Oncotarget
Stacy B Menees, Christopher V Almario, Brennan M R Spiegel, William D Chey
BACKGROUND & AIMS: Fecal incontinence (FI) is characterized by uncontrolled passage of solid or liquid stool. We aimed to determine the prevalence and severity of FI in a large sample of United States residents. METHODS: We recruited a representative sample of patients in October 2015 to complete the National Gastrointestinal (GI) Survey; a mobile app called MyGiHealth was used to systematically collect data on GI symptoms. FI was defined as accidental leakage of solid or liquid stool...
February 3, 2018: Gastroenterology
Kristen R Weaver, Gail D'Eramo Melkus, Jason Fletcher, Wendy A Henderson
Irritable bowel syndrome (IBS) is a chronic, common disorder of the gastrointestinal tract associated with high psychological comorbidity and diminished quality of life. Patients with IBS display a heightened sensitivity to stress, although the literature is inconsistent as to whether they have a dysregulated stress response. The purpose of the present investigation, a substudy of a larger research effort, was to examine physiological correlates of perceived stress in patients with IBS (cortisol and adrenocorticotropic hormone) and to explore associations between perceived stress and quality of life...
January 1, 2018: Biological Research for Nursing
Eric D Shah, Hyungjin Myra Kim, Philip Schoenfeld
OBJECTIVES: Linaclotide and plecanatide are guanylate cyclase-C (GCC) agonists for the treatment of chronic idiopathic constipation (CIC) and irritable bowel syndrome with constipation (IBS-C). Our objective is to evaluate the efficacy and tolerability of GCC agonists based on data from multiple randomized controlled trials (RCTs). METHODS: We searched PubMED, EMBASE, Cochrane databases,, major conference abstracts, Food and Drug Administration (FDA) websites, and United States Securities and Exchange Commission filings of drug sponsors to identify RCTs of CIC or IBS-C patients...
January 30, 2018: American Journal of Gastroenterology
Philip B Miner
Uroguanylin interacting with intestinal Guanylate Cyclase C (GC-C) receptors plays an important role in gastrointestinal fluid and electrolyte homeostasis. Plecanatide is the first uroguanylin analog that stimulates GC-C receptors on gastrointestinal mucosa with pH-sensitive receptor binding. Binding to the GC-C receptor activates intracellular conversion of GTP to cGMP resulting in the stimulation of intestinal fluid secretion. Areas covered: Herein, all published research regarding the development of and clinical experience with plecanatide is reviewed...
January 29, 2018: Expert Opinion on Pharmacotherapy
Mark Pimentel
Irritable bowel syndrome (IBS), a complex disorder of the gastrointestinal tract, is characterized by abdominal pain associated with defecation or changes in stool form or frequency. IBS is associated with substantial burden, including direct medical costs and indirect costs. Direct costs associated with IBS in the United States have been estimated to exceed $1 billion. However, indirect costs, such as negative effect on quality of life (QOL) and work productivity, are difficult to quantify. There are 3 main subtypes: IBS with prominent diarrhea (IBS-D), IBS with constipation, and IBS with mixed symptoms of both constipation and diarrhea...
January 2018: American Journal of Managed Care
Mark Pimentel
Irritable bowel syndrome (IBS), a complex disorder of the gastrointestinal tract, is characterized by abdominal pain associated with defecation or changes in stool form or frequency. IBS is associated with substantial burden, including direct medical costs and indirect costs. Direct costs associated with IBS in the United States have been estimated to exceed $1 billion. However, indirect costs, such as negative effect on quality of life (QOL) and work productivity, are difficult to quantify. There are 3 main subtypes: IBS with prominent diarrhea (IBS-D), IBS with constipation, and IBS with mixed symptoms of both constipation and diarrhea...
January 2018: American Journal of Managed Care
Da Eun Jang, Ji Hyun Bae, Yoo Jin Chang, Yoon Hoo Lee, Ki Taek Nam, Il Yong Kim, Je Kyung Seong, Yong Chan Lee, Su Cheong Yeom
BACKGROUND: Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder involving changes in normal bowel movements. The pathophysiology of IBS is not clearly understood owing to the lack of identifiable pathological abnormalities and reliable biomarkers. AIM: The aim of this study was to discover the novel and reliable biomarker for IBS. METHOD: In this study, neonatal maternal separation (NMS) stress model was used for the IBS mouse model...
January 25, 2018: Digestive Diseases and Sciences
Biljana Radovanovic-Dinic, Snezana Tesic-Rajkovic, Sasa Grgov, Gordana Petrovic, Valentina Zivkovic
Irritable bowel syndrome (IBS) is a chronic and relapsing functional gastrointestinal disorder that affects 9-23% of the population across the world. Patients with IBS are often referred to gastroenterology, undergo various investigations, take various medicines, take time off work and have a poor quality of life. The pathophysiology of IBS is not yet completely understood and seems to be multifactorial. Many pathogenetic factors, in various combinations, and not all necessarily present in each patient, can play an important role...
January 18, 2018: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
Rinaldo Pellicano, Davide G Ribaldone, Marco Astegiano, Luca Dughera, Edda Battaglia, Anna Morgando, Arrigo Arrigoni, Mauro Spandre, Mario Grassini, Giorgio M Saracco, Francis Mégraud
This special article reports on two crucial issues discussed during a meeting. The first was the updated management of Helicobacter pylori infection. This was approached taking into account the recent European Guidelines, with a focus on novelties in treatment. In particular, considering the increasing H. pylori antibiotic resistance to clarithromycin, in countries with a high clarithromycin resistance rate the bismuth-containing quadruple therapies should be preferred. The new formulation, with bismuth, metronidazole, and tetracycline contained in a single capsule (three-in-one), has shown exciting results both in naive and in non-responder patients...
January 10, 2018: Minerva Gastroenterologica e Dietologica
Yunsheng Yang, Jingyuan Fang, Xiaozhong Guo, Ning Dai, Xizhong Shen, Youlin Yang, Jing Sun, Bal Raj Bhandari, David S Reasner, Jacquelyn A Cronin, Mark G Currie, Jeffrey M Johnston, Peter Zeng, Niwat Montreewasuwat, George Zhijian Chen, Sam Lim
BACKGROUND AND AIM: Linaclotide is a guanylate cyclase-C agonist approved in multiple countries to treat irritable bowel syndrome with constipation (IBS-C). China has unmet need for well-tolerated therapy that is effective in treating both bowel and abdominal symptoms of IBS-C. This trial evaluated linaclotide's efficacy and safety in IBS-C patients in China and other regions. METHODS: This Phase 3, double-blind trial randomized IBS-C patients to once-daily oral 290-μg linaclotide or placebo at centers in China, North America, and Oceania...
January 10, 2018: Journal of Gastroenterology and Hepatology
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