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10 recent developments in IBS research

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Recently the American College of Gastroenterology published new recommendations for the management of irritable bowel syndrome and chronic idiopathic constipation. Last updated in 2009, these guidelines incorporate data from numerous new studies. Here are 10 highlights of IBS research recently presented on Healio.com/Gastroenterology.

1. IBS aggregated in families, including spouses

A nationwide family study in Sweden found a genetic component for increased risk for IBS among first-, second- and third-degree relatives along with an increased nongenetic risk factor among spouses.

“Assortative mating could also contribute to the association among spouses,” the investigators wrote. “Thus, individuals with IBS may be more likely to marry individuals with similar health problems. Moreover, spouses of individuals with IBS may also be more likely to seek medical attention.” Read more

2. Eluxadoline effectively treated IBS patients with predominant diarrhea

Patients with diarrhea-predominant IBS (IBS-D) and treated with eluxadoline experienced greater rates of relief compared with controls, according to data presented at DDW 2014.

Anthony J. Lembo

“Eluxadoline is a first-in-class, oral, locally acting drug candidate for IBS-D, with a novel mechanism,” Anthony J. Lembo, MD, gastroenterologist at Beth Israel Deaconess Medical Center and Harvard Medical School, said. “Efficacy was demonstrated in two large phase 3 studies for which the FDA and EMA endpoints were assessed. There were significant improvements in primary endpoints, simultaneous improvements in both pain and diarrhea, seen within the first few days of therapy and throughout the 26 weeks of treatment.” Read more

3. Colonic bile acid exposure influenced IBS symptoms, therapy

Swedish researchers observed patients with IBS, primarily those who were nonconstipated, had elevated levels of colonic bile acid that was indicative of abnormal 75Se-labeled homocholic acid-taurine retention and high 7 alpha-hydroxy-4-cholesten-3-one serum levels.

“Our findings … strengthen the involvement of increased bile acid exposure in the colon as a partial mechanism for symptom generation in patients with especially nonconstipated IBS, that is, IBS-D and IBS-A,” the researchers concluded. Read more

4. Ramosetron reduced diarrhea, overall symptoms in IBS patients

In a trial conducted in Japan, ramosetron improved stool consistency, overall IBS symptoms and QOL in men with IBS-D, according to recent study data.

“Its high potential, high selectivity, clear efficacy, and lower incidence of serious adverse events suggest that ramosetron is the most promising therapeutic agent for IBS-D,” the researchers wrote. Read more

5. Linaclotide improved severe abdominal symptoms, QOL in IBS-C patients

In two clinical trials linaclotide improved symptoms, QOL and global measures in constipation-predominant IBS patients with severe abdominal symptoms.

“Linaclotide not only improves severe abdominal and bowel symptoms but also improves patient-perceived global relief of IBS symptoms and QOL in these patients with severe abdominal symptoms,” the researchers concluded. Read more

6. Small intestinal motility in IBS patients unaffected by sacral nerve stimulation

Researchers from Denmark found that sacral nerve stimulation therapy had no detectable effect on gastric emptying or small intestinal motility (SNS) in patients with IBS-D or mixed IBS.

“Even though SNS reduces the frequency of defecation, episodes of urgency, and time spent on toilet, this occurs without major changes in small intestinal transit patterns,” the researchers concluded. “We speculate that the effects of SNS in IBS may be caused by modulation of afferent nerve fibers causing altered colorectal sensory perception.” Read more

7. Antidepressants, psychological therapies effectively treated IBS

Antidepressants and various psychological therapies effectively treated symptoms of IBS in a recent study.

Alexander C. Ford

“IBS affects as many as one in 10 people, and it is difficult to treat,” Alexander C. Ford, MBChB, MD, FRCP, associate professor, Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, told Healio.com/Gastroenterology. “Tricyclic antidepressants probably work in IBS, but more studies that are rigorously designed are required.” Read more

8. Fecal lactoferrin differentiated IBD from IBS

Fecal lactoferrin as a diagnostic biomarker effectively distinguished between inflammatory bowel disease and IBS in a recent study conducted in China.

“To our knowledge, this study is the first … to assess the diagnostic performance of FL in differentiating between IBD and IBS,” the researchers wrote. “This meta-analysis showed that FL appears to have good diagnostic precision in distinguishing IBD from IBS both in adults and children.” Read more

9. Giardia infections related to IBS, fatigue 6 years later

People with Giardia infections appear to have an increased risk for IBS and chronic fatigue lasting as long as 6 years after the infection, according to data published in Clinical Infectious Diseases.

Kurt Hanevik

“Physicians should be aware that Giardia infection may cause long-term abdominal symptoms and fatigue even after the parasite has been eradicated,” Kurt Hanevik, MD, of the University of Bergen in Norway, told Infectious Disease News. “This knowledge can be used to advise patients about these complications and that they may gradually improve.” Read more

10. Symptoms, QOL did not differ between IBS subtypes

The three subtypes of IBS did not significantly differ in terms of symptom severity and QOL, according to recent study data.

Peter J. Whorwell

“Traditionally, it has always been thought that patients with the diarrhea form of IBS tend to be more anxious,” Peter J. Whorwell, MD, PhD, professor of medicine and gastroenterology, Wythenshawe Hospital, United Kingdom, told Healio.com/Gastroenterology. “In addition, it has also been considered that the symptom profiles in the three subtypes are different. However, our study does not support these ideas and, in this large group of patients, there was very little to choose between them.” Read more