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Treatment of irritable bowel syndrome.
Am Fam Physician. 2005 Dec 15; 72(12):2501-6.AF

Abstract

Irritable bowel syndrome affects 10 to 15 percent of the U.S. population to some degree. This condition is defined as abdominal pain and discomfort with altered bowel habits in the absence of any other mechanical, inflammatory, or biochemical explanation for these symptoms. Irritable bowel syndrome is more likely to affect women than men and is most common in patients 30 to 50 years of age. Symptoms are improved equally by diets supplemented with fiber or hydrolyzed guar gum, but more patients prefer hydrolyzed guar gum. Antispasmodic agents may be used as needed, but anticholinergic and other side effects limit their use in some patients. Loperamide is an option for treatment of moderately severe diarrhea. Antidepressants have been shown to relieve pain and may be effective in low doses. Trials using alosetron showed a clinically significant, although modest, gain over placebo, but it is indicated only for women with severe diarrhea-predominant symptoms or for those in whom conventional treatment has failed. Tegaserod has an advantage over placebo in constipation-predominant irritable bowel syndrome; it is indicated for up to 12 weeks of treatment in women. However, postmarketing reports of severe diarrhea and ischemic colitis further limit its use. Herbal therapies such as peppermint oil also may be effective in the treatment of irritable bowel syndrome. Therapies should focus on specific gastrointestinal dysfunctions (e.g., constipation, diarrhea, pain), and medications only should be used when nonprescription remedies do not work or when symptoms are severe.

Authors+Show Affiliations

Middlesex Hospital, Family Practice Residency Program, Middletown, CT 06457, USA. Susan_Hadley@midhosp.orgNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

16370407

Citation

Hadley, Susan K., and Stephen M. Gaarder. "Treatment of Irritable Bowel Syndrome." American Family Physician, vol. 72, no. 12, 2005, pp. 2501-6.
Hadley SK, Gaarder SM. Treatment of irritable bowel syndrome. Am Fam Physician. 2005;72(12):2501-6.
Hadley, S. K., & Gaarder, S. M. (2005). Treatment of irritable bowel syndrome. American Family Physician, 72(12), 2501-6.
Hadley SK, Gaarder SM. Treatment of Irritable Bowel Syndrome. Am Fam Physician. 2005 Dec 15;72(12):2501-6. PubMed PMID: 16370407.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment of irritable bowel syndrome. AU - Hadley,Susan K, AU - Gaarder,Stephen M, PY - 2005/12/24/pubmed PY - 2006/1/6/medline PY - 2005/12/24/entrez SP - 2501 EP - 6 JF - American family physician JO - Am Fam Physician VL - 72 IS - 12 N2 - Irritable bowel syndrome affects 10 to 15 percent of the U.S. population to some degree. This condition is defined as abdominal pain and discomfort with altered bowel habits in the absence of any other mechanical, inflammatory, or biochemical explanation for these symptoms. Irritable bowel syndrome is more likely to affect women than men and is most common in patients 30 to 50 years of age. Symptoms are improved equally by diets supplemented with fiber or hydrolyzed guar gum, but more patients prefer hydrolyzed guar gum. Antispasmodic agents may be used as needed, but anticholinergic and other side effects limit their use in some patients. Loperamide is an option for treatment of moderately severe diarrhea. Antidepressants have been shown to relieve pain and may be effective in low doses. Trials using alosetron showed a clinically significant, although modest, gain over placebo, but it is indicated only for women with severe diarrhea-predominant symptoms or for those in whom conventional treatment has failed. Tegaserod has an advantage over placebo in constipation-predominant irritable bowel syndrome; it is indicated for up to 12 weeks of treatment in women. However, postmarketing reports of severe diarrhea and ischemic colitis further limit its use. Herbal therapies such as peppermint oil also may be effective in the treatment of irritable bowel syndrome. Therapies should focus on specific gastrointestinal dysfunctions (e.g., constipation, diarrhea, pain), and medications only should be used when nonprescription remedies do not work or when symptoms are severe. SN - 0002-838X UR - https://www.unboundmedicine.com/medline/citation/16370407/Treatment_of_irritable_bowel_syndrome_ L2 - https://www.aafp.org/link_out?pmid=16370407 DB - PRIME DP - Unbound Medicine ER -