Pharmacological and Clinical Treatment of Irritable Bowel Syndrome
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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.
KeywordsIrritable bowel syndrome Intestinal transit Visceral pain G protein-coupled receptors Ion channels Hypnosis
List of abbreviations
µ Opioid receptor
δ Opioid receptor
κ Opioid receptor
Central nervous system
Chloride ion channels
Cystic fibrosis transmembrane conductance regulator
Chronic idiopathic constipation
Constipation-predominant irritable bowel syndrome
- DPP IV
Dipeptidyl peptidase IV
Endogenous opioid system
Guanylate cyclase C
- HEK cells
Human embryonic kidney cells
- EC cells
Serotonin-selective reuptake transporter
Spontaneous complete bowel movement
Tryptophan hydroxylase 1/2
Type 2B serotonin receptor
Type 3 serotonin receptor
Type 4 serotonin receptor
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.
The authors have nothing to disclose.
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