IBS Awareness Month: Diagnostic tips, treatment options, multidisciplinary care and more
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April is IBS Awareness Month and highlights the importance of public awareness and health messages about the diagnosis, treatment and quality of life for patients with irritable bowel syndrome.
According to the International Foundation for Gastrointestinal Disorders, IBS affects nearly 45 million people in the U.S. and 10% to 15% of the global population. Although common, many people remain undiagnosed and unaware that their symptoms can be managed. Further, patients are often stigmatized and misunderstood, creating a significant impact on their quality of life.
While the exact pathogenesis of IBS remains largely unknown, scientific evidence points to disturbances in gut, brain and nervous system interaction that can cause changes to normal bowel function and produce symptoms ranging from mild inconvenience to severe debilitation.
In support of IBS Awareness Month, Healio has compiled eight recent reports on diagnostic tips, treatment updates, pain management and long-term care for patients with IBS.
Open-label placebo reduces pain in pediatric, adolescent functional GI disorders
Open-label placebo reduced pain and rescue medication use among pediatric and adolescent patients with functional abdominal pain and IBS, according to research published in JAMA Pediatrics.
“Although placebo responses probably play a role in virtually every clinical intervention, the use of deceptive placebos as stand-alone treatments has largely been discouraged because of ethical concerns about patient deception,” Samuel Nurko, MD, MPH, of the Center for Motility and Functional Gastrointestinal Disorders at Boston’s Children’s Hospital, and colleagues wrote. “Until recently, it has been widely believed that patient blinding (via deception or concealment) is required to elicit placebo effects, but recent studies with adults suggest that the open-label placebo honestly prescribed treatment can yield positive effects.” Read more.
Relistor produces rescue-free laxation in patients with opioid-induced constipation
A single dose of Relistor injection produced rescue-free laxation in severely ill patients with opioid-induced constipation who had an insufficient response to laxative therapy, according to a study published in the Journal of Emergency Medicine.
“Methylnaltrexone (Relistor) works in the majority of opioid-induced constipation patients within four hours, and its use doesn’t change the analgesic effects of the opioid,” W. Frank Peacock, MD, FACEP, FACC, lead author and director of research at Baylor College of Medicine in Houston, told Healio. Read more.
Bile acid diarrhea affects bowel symptoms, quality of life in IBS-D
Bile acid diarrhea had a significant impact on bowel symptoms and quality of life in patients with IBS with diarrhea, according to study results.
“We conclude that patients with [bile acid diarrhea (BAD)] had higher BMI, took more antidiarrheal agents and had more severe and frequent diarrhea, as well as urgency,” Joelle BouSaba, MD, of the department of quantitative health sciences at the Mayo Clinic in Rochester, Minnesota, and colleagues wrote in Clinical Gastroenterology and Hepatology. “These symptoms interfere with daily activities, and the impact is confirmed on a rigorous regression model. The study adds to the body of evidence, including impact on health care utilization, that searching for evidence of BAD is relevant in patients with IBS-D, especially in those with more severe and frequent diarrhea associated with urgency.” Read more.
VIDEO: Trulance significantly improves CIC, IBS-C abdominal symptoms
In this video exclusive, Gregory S. Sayuk, MD, MPH, discusses the impact of Trulance on pain, discomfort and bloating in patients with chronic idiopathic constipation and IBS with constipation.
Sayuk, associate professor of medicine and psychiatry and associate director of the fellowship training program at Washington University School of Medicine and gastroenterologist at the John Cochran Veterans Affairs Medical Center, both in St. Louis, presented the research at the 2021 ACG Annual Scientific Meeting. Read more.
The future of IBS care relies on a multidisciplinary, integrative ‘team sport’ approach
As knowledge of IBS has progressed, the traditional focus on abnormalities in motility and visceral sensation has evolved to include psychosocial distress and food as the most important triggers that worsen symptoms. Although one or more of these factors are demonstrable among most patients with IBS, none can account for symptoms in all.
“The diagnosis of IBS relies on the identification of characteristic symptoms and the exclusion of other organic diseases,” William D. Chey, MD, FACG, of Michigan Medicine, and colleagues wrote in a JAMA IBS clinical review. “Management of patients with IBS is optimized by an individualized, holistic approach that embraces dietary, lifestyle, medical and behavioral interventions.” Read more.
VIDEO: Linaclotide yields early reduction in IBS with constipation symptoms
At the 2021 ACG Annual Scientific Meeting, Darren M. Brenner, MD, reported that linaclotide reduces abdominal pain and other symptoms of IBS with constipation within 4 weeks of treatment.
“Importantly, if you allow the patient to continue to take the medication for more than 4 weeks, you may see improvements in 10% to 15% of individuals after that with respect to their abdominal or bowel symptoms,” Brenner said. Read more.
Low FODMAP powders aid in IBS control, detection of triggers
Utilization of low FODMAP powders aided in control of symptom severity, somatization and depression for patients with IBS in a tertiary care setting, according to findings presented at the UEG Week Virtual 2021.
“Blinded reintroduction using powders allows the most objective identification of individual FODMAP triggers,” Karen Van den Houte, PhD, a researcher at KU Leuven in Belgium, said in her presentation. Read more.
VIDEO: Use ‘positive’ language to diagnose patients with IBS
In this video exclusive from the 2021 ACG Annual Scientific Meeting, Brian E. Lacy, MD, PhD, FACG, of the Mayo Clinic in Jacksonville, Florida, highlighted the importance of positivity and encouragement when diagnosing patients with IBS.
“Be positive with the diagnosis, educate your patient, reassure your patient and don’t forget if you need to do tests, it’s OK to start treatment early on,” Lacy said. “Don’t wait until all tests are done before you initiate treatment. Initiate treatment based on the predominant symptom.” Read more.