Current US Food and Drug Administration-Approved Pharmacologic Therapies for the Treatment of Irritable Bowel Syndrome with Diarrhea

AbstractIrritable bowel syndrome (IBS) is a functional bowel disorder characterized by abdominal pain and alterations in stool form and/or frequency, leading to reduced quality of life. Pharmacologic agents currently approved by the US Food and Drug Administration for treatment of IBS with diarrhea (IBS-D) in adults are the nonsystemic antibiotic rifaximin, the mixed µ- and κ-opioid receptor agonist/δ-opioid antagonist eluxadoline, and the selective serotonin 5-HT3 antagonist alosetron (the last of which is indicated only in women with severe IBS-D refractory to conventional therapy). Both eluxadoline and alosetron are administered as chronic daily therapies; rifaximin is given as a 2-week course of treatment with repeat courses administered as needed for symptom recurrence. Presumed mechanisms of action of rifaximin include modulation of the gut microbiota, anti-inflammatory activity, normalization of visceral hypersensitivity, and reduction in intestinal permeability. Eluxadoline targets opioid receptors in the gastrointestinal (GI) tract, resulting in decreased GI motility, fluid secretion, and visceral pain perception. Alosetron antagonizes serotonergic afferent neural signals and also slows GI motility. The efficacy and safety of these agents have been investigated in several rigorous clinical trials, and it has been demonstrated that they improve global and individual IBS symptoms. This review highlights the pivotal efficacy and safety data of the thre...
Source: Advances in Therapy - Category: Drugs & Pharmacology Source Type: research

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By Matthew Warren The placebo effect is a curious phenomenon. A wealth of literature has shown that inert treatments can not only produce medical benefits like pain relief, but also have cognitive effects like boosting creativity and learning. And while many of those studies involve misleading people into thinking that they are receiving an effective intervention, a new study in Scientific Reports shows that this deception is not always necessary. Researchers have found that taking a placebo can reduce people’s anxiety before a test — even when they know they are taking an inactive pill.  A...
Source: BPS RESEARCH DIGEST - Category: Psychiatry & Psychology Authors: Tags: Emotion Mental health The self Source Type: blogs
Pain makes us human. It is a bell, fine-tuned by evolution, that often rings in moments necessary for our survival. Because of pain, we can receive warnings that trigger the reflexes to escape potential danger. But what happens when that bell continues to ring? How do we respond to a signal when it interferes with the other elements that make us human? Pain that lasts longer than six months is considered chronic, and it may not go away. With chronic pain, the bell’s ongoing signal gets your nervous system wound up and increases its reactivity to incoming messages. This can be quite distressing and anxiety-provoking. ...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Back Pain Mind body medicine Pain Management Source Type: blogs
Gluten? Lactose? Stomach pain? Digestive troubles? Way too many people suffer from gastrointestinal issues, and much less are aware of the digital technologies that can come to their aid. Did you know that digestibles could successfully replace the dreaded colonoscopy? Or have you heard about microbiome testing? What about the swarm of health apps supporting dietary restrictions? We took a deep breath and jumped into the universe of digital technologies just to bring you as much information about the future of gastroenterology as possible. Will you jump after us? IBS, colorectal cancer, and other animals Referring to...
Source: The Medical Futurist - Category: Information Technology Authors: Tags: Future of Medicine Genomics Health Sensors & Trackers diet dieting digestibles digestion digital health gastro gastroenterologist gastroenterology gastrointestinal gluten gut Innovation lactose microbiome stomach techno Source Type: blogs
Authors: Vacher P, Charlanes A, Chesnel C, Pagès A, Malot C, Le Breton F, Amarenco G, Manceau P Abstract OBJECTIVE: The aim of this article was to describe the diagnostic and therapeutic value of transcranial stimulation in pelvic and perineal disorders. METHODS: A literature review (Medline database and Google scholar) with no time limit was performed using keywords: "transcranial direct stimulation", "transcranial magnetic stimulation", "neurogenic bladder", "urinary incontinence", "Parkinson disease", "multiple sclerosis", "stroke",...
Source: Progres en Urologie - Category: Urology & Nephrology Tags: Prog Urol Source Type: research
The objective of this presentation is to explore historical, scientific, interventional, and other differences between the two paradigms, so that innovators, researchers, practitioners, policy-makers, patients, end-users, and others can gain clarity with respect to both the explicit and implicit assumptions associated with brain advancement agendas of any kind. Over the course of three decades, a series of brain-centric, evolution-inspired insights have been articulated with increasing refinement, as principles of allostasis (Sterling and Eyer, 1988; Sterling, 2004, 2012, 2014). Allostasis recognizes that the role of the ...
Source: Frontiers in Human Neuroscience - Category: Neuroscience Source Type: research
Ryan R. Kelly1,2†, Lindsay T. McDonald1,2†, Nathaniel R. Jensen1,2, Sara J. Sidles1,2 and Amanda C. LaRue1,2* 1Research Services, Ralph H. Johnson VA Medical Center, Charleston, SC, United States 2Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC, United States The significant biochemical and physiological effects of psychological stress are beginning to be recognized as exacerbating common diseases, including osteoporosis. This review discusses the current evidence for psychological stress-associated mental health disorders as risk factors for os...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
Abstract BACKGROUND: This is the first update of a review published in 2015, Issue 1. Chronic pain is common during childhood and adolescence and is associated with negative outcomes, such as increased severity of pain, reduced function, and low mood. Psychological therapies, traditionally delivered face-to-face with a therapist, are efficacious at reducing pain intensity and disability. To address barriers to treatment access, such as distance and cost of treatment, technology is being used to deliver these psychological therapies remotely. Therapies delivered remotely, such as via the Internet, computer-based pr...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
Conclusions We conclude with new opportunities for research and clinical implementations to consider in the next two decades.
Source: Psychosomatic Medicine - Category: Psychiatry & Psychology Tags: REVIEW Source Type: research
Authors: Dellis AE, Mozaffari S, Nikfar S, Papatsoris AG, Abdollahi M Abstract INTRODUCTION: Two of the most frequent components of chronic pelvic pain syndrome (CPPS) are irritable bowel syndrome (IBS) and bladder pain syndrome (BPS), characterized by considerable overlapping symptoms and pathophysiology. Currently, its management is challenging meaning there is high the demand for novel efficient therapeutics to aid patient care and to tackle the socioeconomic burden of IBS and BPS. As there are presently no sufficient treatment strategies, identifying the mechanisms that result in their main symptoms is the oppo...
Source: Expert Opinion on Pharmacotherapy - Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research
Semin Reprod Med 2018; 36: 116-122 DOI: 10.1055/s-0038-1676088Dysmenorrhea and noncyclic pelvic pain (chronic pelvic pain) are common in adolescents. The evaluation of teens with dysmenorrhea or chronic pelvic pain is aimed to diagnose possible gynecologic conditions (endometriosis, pelvic inflammatory disease, ovarian cysts, and obstruction of the reproductive tract) and nongynecologic conditions (irritable bowel syndrome, interstitial cystitis, and myofascial pain). The management of chronic pelvic pain in adolescents is often more complex than in adult women because both the adolescent and her parents are counseled and ...
Source: Seminars in Reproductive Medicine - Category: Reproduction Medicine Authors: Tags: Review Article Source Type: research
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