The Comment is authored by Professor Robin Spiller, Wolfson Digestive Diseases Centre, University Hospital Nottingham, UK.
He says: “IBS is one of the commonest reasons for a consultation. However, because the disorder is poorly understood, many doctors find patients with IBS difficult to treat.
“Although extra time and effort may be needed, successful management is rewarding because it can substantially improve quality of life.”
IBS has a similar incidence in Europe and the USA, and is increasingly recognised in developing countries, with between 5-10% of the population estimated to be affected.
Patients who present with IBS are typically female, aged 20-40 years. Most patients have abdominal pain or discomfort intermittently, with flares of pain lasting two to four days. Other symptoms include bloating, abnormal stool frequency and abnormal defecation.
IBS is also associated with psychological distress, with 50% of IBS patients who seek medical care also suffering stress or anxiety. IBS patients also have substantially increased health-care costs, with patients consulting their primary-care physician twice as often as non-IBS patients. A third of IBS patients are referred to secondary care and also onto sometimes unnecessary specialties.
Professor Spiller says: “Most IBS patients require reassurance, explanation and lifestyle advice.”
The effects of modifying the diet of IBS sufferers is uncertain – trials have shown systematic exclusion of certain foods (e.g. wheat, dairy products) helped around half the patients in an uncontrolled trial, but how much of this was placebo response was unclear.
Psychological treatments have helped patients cope with IBS but generally without improving their bowel symptoms. Hypnosis has proven beneficial is randomised trials, including the long term, but limited availability of this treatment is a major drawback.
Most doctors and most (but not all) patients prefer to use drug therapy, ranging from antispasmodics to treat pain to serotonin antagonists to combat urgency and diarrhoea, and soluble fibres to improve pain and bowel habit. Tricyclic antidepressants can also prevent pain especially where diarrhoea is one of the symptoms present. But true drug effects in trials (10-15%) were smaller than the placebo effect (40-50%).
Professor Spiller concludes: “There remains a substantial unmet need for more effective remedies for IBS.”
Tony Kirby | alfa
'Exciting' discovery on path to develop new type of vaccine to treat global viruses
18.09.2017 | University of Southampton
A new approach to high insulin levels
18.09.2017 | Schweizerischer Nationalfonds SNF
Using ultrafast flashes of laser and x-ray radiation, scientists at the Max Planck Institute of Quantum Optics (Garching, Germany) took snapshots of the briefest electron motion inside a solid material to date. The electron motion lasted only 750 billionths of the billionth of a second before it fainted, setting a new record of human capability to capture ultrafast processes inside solids!
When x-rays shine onto solid materials or large molecules, an electron is pushed away from its original place near the nucleus of the atom, leaving a hole...
For the first time, physicists have successfully imaged spiral magnetic ordering in a multiferroic material. These materials are considered highly promising candidates for future data storage media. The researchers were able to prove their findings using unique quantum sensors that were developed at Basel University and that can analyze electromagnetic fields on the nanometer scale. The results – obtained by scientists from the University of Basel’s Department of Physics, the Swiss Nanoscience Institute, the University of Montpellier and several laboratories from University Paris-Saclay – were recently published in the journal Nature.
Multiferroics are materials that simultaneously react to electric and magnetic fields. These two properties are rarely found together, and their combined...
MBM ScienceBridge GmbH successfully negotiated a license agreement between University Medical Center Göttingen (UMG) and the biotech company Tissue Systems Holding GmbH about commercial use of a multi-well tissue plate for automated and reliable tissue engineering & drug testing.
MBM ScienceBridge GmbH successfully negotiated a license agreement between University Medical Center Göttingen (UMG) and the biotech company Tissue Systems...
Pathogenic bacteria are becoming resistant to common antibiotics to an ever increasing degree. One of the most difficult germs is Pseudomonas aeruginosa, a...
Scientists from the MPI for Chemical Energy Conversion report in the first issue of the new journal JOULE.
Cell Press has just released the first issue of Joule, a new journal dedicated to sustainable energy research. In this issue James Birrell, Olaf Rüdiger,...
19.09.2017 | Event News
12.09.2017 | Event News
06.09.2017 | Event News
19.09.2017 | Event News
19.09.2017 | Physics and Astronomy
19.09.2017 | Power and Electrical Engineering