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Pharmacological and Clinical Treatment of Irritable Bowel Syndrome

  • Maciej SałagaEmail author
  • Paula Mosińska
Chapter
  • 840 Downloads

Abstract

Irritable bowel syndrome (IBS) is a functional gastrointestinal (GI) disorder with an unknown etiology, which is a growing major concern worldwide. Since the pathophysiology of IBS is barely understood there is no specific treatment for this disorder and numerous treatment options aiming at various pharmacological targets located not only in the GI tract, but also in the central nervous system (CNS) are available. In this chapter we provide an overview on drugs that are currently available for IBS therapy with regard to the type of the disease. We discuss their mechanisms of action, evidences for their effectiveness emerging from clinical trials as well as virtues and drawbacks of the most commonly prescribed medications. Furthermore we highlight the practical aspects of the use of certain drugs, such as possible adverse events and contraindications. Moreover we introduce selected complementary and alternative (CAM) medicine methods that have been proven effective in clinical tests.

Keywords

Irritable bowel syndrome Intestinal transit Visceral pain G protein-coupled receptors Ion channels Hypnosis 

List of abbreviations

MOR

µ Opioid receptor

DOR

δ Opioid receptor

KOR

κ Opioid receptor

APN

Aminopeptidase N

CNS

Central nervous system

ClC

Chloride ion channels

CFTR

Cystic fibrosis transmembrane conductance regulator

CC

Chronic constipation

CIC

Chronic idiopathic constipation

IBS-C

Constipation-predominant irritable bowel syndrome

DPP IV

Dipeptidyl peptidase IV

ECS

Endocannabinoid system

EOS

Endogenous opioid system

GI

Gastrointestinal

GC-C

Guanylate cyclase C

HEK cells

Human embryonic kidney cells

EC cells

Enterochromaffin cells

5-HT

Serotonin

SERT

Serotonin-selective reuptake transporter

SCBM

Spontaneous complete bowel movement

TPH1/2

Tryptophan hydroxylase 1/2

5-HT2B

Type 2B serotonin receptor

5-HT3

Type 3 serotonin receptor

5-HT4

Type 4 serotonin receptor

Notes

Acknowledgments

The author is supported by the Medical University of Lodz [502-03/1-156-04/502-14-140 to M Salaga] and the National Science Centre [#UMO-2015/16/T/NZ7/00031 and #UMO-2013/11/N/NZ7/02354 to M Salaga]. This study is also sponsored by the Polpharma Scientific Foundation. The author have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Disclosures

The authors have nothing to disclose.

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Authors and Affiliations

  1. 1.Faculty of Medicine, Department of BiochemistryMedical University of LodzLodzPoland

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