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Highlights of ACG's New Recommendations on IBS Therapies
      01/09/09 11:10 AM

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Highlights of ACG's New Recommendations on IBS Therapies

In general, treatments for IBS are directed towards the patient's predominant symptoms. There are a wide variety of available therapies, many of which improve individual IBS symptoms. Only a small number of therapies has been shown to be of benefit for global symptoms of IBS.

- Trials suggest soluble fiber, certain antispasmodics, and peppermint oil are effective in IBS patients although the quality of the evidence is poor.

- Evidence suggests that some probiotics may be effective in reducing overall IBS symptoms but more data are needed.

- Anti-diarrheals reduce the frequency of stools but do not affect the overall symptoms of IBS.

- 5HT 3 antagonists are efficacious in IBS patients with diarrhea and the quality of evidence is good. Patients need to be carefully selected, however, because potentially serious side effects include constipation and colon ischemia. Current use of alosetron is regulated by a prescribing program set forth by the FDA.

- 5HT 4 agonists are modestly effective in IBS patients with constipation and the quality of evidence is good although the possible risk of cardiovascular events associated with these agents may limit their utility. Currently, there are no 5-HT 4 receptor agonists available for use in North

- Tricyclic anti-depressants and selective serotonin reuptake inhibitors have been shown to be effective in IBS patients of all subtypes. The trials generally are of good quality but the limited number of patients included in trials implies that further evidence could change the confidence in the estimate of effect and therefore the quality of evidence was graded as moderate.

- Non-absorbable antibiotics are effective, particularly in
diarrhea-predominant IBS.

- The selective C-2 chloride channel activator, lubiprostone, is efficacious in constipation-predominant IBS with a moderate quality of evidence.

- Psychological therapies also may provide benefit to IBS patients although the quality of evidence is poor.

Heather is the Administrator of the IBS Message Boards. She is the author of Eating for IBS and The First Year: IBS, and the CEO of Heather's Tummy Care. Join her IBS Newsletter. Meet Heather on Facebook!

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