8 recent updates on treatment, pain management
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Irritable bowel syndrome is one of the most burdensome and chronic ailments with an estimated 45 million people affected in the United States, the International Foundation for Gastrointestinal Disorders reports.
Although it is so common, many people remain undiagnosed and unaware their symptoms indicate a recognized disorder. Further, patients are often stigmatized and misunderstood, creating a significant impact on their quality of life.
Throughout April, IBS awareness month highlights the important health messages regarding diagnosis and treatment. Healio Gastroenterology compiled eight recent reports on treatment updates and pain management.
Low FODMAP diet leads to improvements in IBS-D symptoms
A short-term strict low FODMAP diet and long-term ‘modified’ low FODMAP diet was linked to improvements in symptoms and quality of life in irritable bowel syndrome-diarrhea predominant patients, according to study results.
“Compared to [traditional dietary advice (TDA)], [low FODMAP (LFD)] leads to significantly greater improvement in abdominal pain frequency, abdominal distention, bowel habit satisfaction, quality of life and significant reduction in intake of IBS medications,” Omesh Goyal, MD, associate professor, department of gastroenterology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India, and colleagues wrote. “With adequate guidance and motivation, nutritional adequacy and good compliance can be achieved.” READ MORE.
Delayed-release linaclotide improves abdominal pain in IBS-C
Patients with constipation-predominant irritable bowel syndrome treated with a delayed-release version of linaclotide experienced improvements in abdominal pain, according to study results.
William D. Chey, MD, from the University of Michigan, and colleagues wrote that linaclotide is currently used in an immediate-release formula in IBS-C to improve bowel transit. However, it also could have an application for abdominal pain. READ MORE.
ACG develops guidelines for treatment of IBS
The American College of Gastroenterology developed clinical guidelines for the treatment of irritable bowel syndrome.
“We believe that the information provided in this guideline will help guide both practitioners and researchers for years to come,” Brian E. Lacy, PhD, FACG, from the Mayo Clinic in Jacksonville, Florida, and colleagues said in recommendations published in the American Journal of Gastroenterology. “However, as this extensive project evolved, we recognized that there are still significant gaps in our knowledge. Future research is needed to better understand the role of the gut microbiome in patients with IBS and to understand the genesis of visceral pain.” READ MORE.
Mahana obtains marketing authorization for IBS digital therapeutic
Parallel, a prescription digital therapeutic developed by Mahana Therapeutics for the treatment of irritable bowel syndrome, received marketing authorization from the FDA, according to a company press release.
The 3-month digital program uses cognitive behavioral therapy to help adults change factors that might contribute to IBS. READ MORE.
Kiwi fruit effective, well tolerated in treating chronic constipation
Two peeled kiwi fruit per day improved chronic constipation while being better tolerated than other traditional natural remedies, according to a randomized study presented at ACG 2020 Virtual.
“While there are many therapeutic options available for chronic constipation, they only lead to about half of patients feeling better and only offer therapeutic gain of 10% to 15% over placebo showing the need for additional forms of therapy,” Samuel W. Chey, MPH, of University of Michigan, said during his virtual presentation. “Furthermore, consumer shifts in chronic medication, safety and preferences have drawn the public towards more natural solutions for chronic constipation.” READ MORE.
Rifaximin significantly improves bloating in IBS-D
In a composite of three trials, rifaximin provided a durable and significant improvement in bloating in patients with diarrhea-predominant irritable bowel syndrome compared with placebo, according to results presented at UEG Week.
“A significantly greater percentage of patients receiving rifaximin were durable bloating responders compared to placebo using again the greater than or equal to one-point or the greater than or equal to two-point responder definition,” Brian E. Lacy, MD, PhD, from the Mayo Clinic in Jacksonville, Florida, said during his presentation. READ MORE.
Childhood allergies linked with increased adolescent IBS risk
Allergy-related diseases, including asthma and food hypersensitivity, in childhood were associated with an increased risk for having irritable bowel syndrome at age 16 years, according to research presented at UEG Week Virtual.
In her presentation, Jessica Sjölund, MD, from the Institute of Medicine at the University of Gothenburg in Sweden, said that allergy and immune dysregulation may play a role in the development of IBS, but current research has produced conflicting results. READ MORE.
Some alternative therapies may be beneficial in IBS
Some complimentary alternative therapies, including herbal and dietary supplements, may help ease abdominal pain and benefit overall response in patients with irritable bowel syndrome, according to study results.
Andrea Shin, MD, of the Indiana University School of Medicine, and colleagues wrote that patients with IBS often seek complimentary alternative therapies (CAMs), whether they are satisfied with conventional medication or not, and their physicians should be prepared to advise them. READ MORE.
Follow @HealioGastro on Twitter to stay up to date on all the latest research in the field.
Perspective
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Scott Gabbard, MD
While IBS awareness month is in April, we should be diligent about the diagnosis and management of IBS and other disorders of gut-brain interaction through the entire year. IBS is exceedingly common in our clinical practice. As gastroenterologists, it is imperative that we make a confident diagnosis and tailor management to the individual patient. I strongly recommend that all practicing gastroenterologists keep a copy of the recent American College of Gastroenterology guidelines for management of IBS. This is an invaluable resource both for diagnosis and therapeutic options for IBS. Numerous recent studies have demonstrated that IBS therapies are rapidly evolving — from dietary interventions (such as the effect of eating kiwi fruit), to novel behavioral therapy platforms, to pharmacologic therapies (such as antibiotics and second-generation secretagogues). We should always keep our eyes open to new research and developments in the field of IBS and disorders of gut-brain interaction.
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