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
The genes are not to blame
20.07.2018 | Technische Universität München
Targeting headaches and tumors with nano-submarines
20.07.2018 | Universitätsmedizin der Johannes Gutenberg-Universität Mainz
A new manufacturing technique uses a process similar to newspaper printing to form smoother and more flexible metals for making ultrafast electronic devices.
The low-cost process, developed by Purdue University researchers, combines tools already used in industry for manufacturing metals on a large scale, but uses...
For the first time ever, scientists have determined the cosmic origin of highest-energy neutrinos. A research group led by IceCube scientist Elisa Resconi, spokesperson of the Collaborative Research Center SFB1258 at the Technical University of Munich (TUM), provides an important piece of evidence that the particles detected by the IceCube neutrino telescope at the South Pole originate from a galaxy four billion light-years away from Earth.
To rule out other origins with certainty, the team led by neutrino physicist Elisa Resconi from the Technical University of Munich and multi-wavelength...
For the first time a team of researchers have discovered two different phases of magnetic skyrmions in a single material. Physicists of the Technical Universities of Munich and Dresden and the University of Cologne can now better study and understand the properties of these magnetic structures, which are important for both basic research and applications.
Whirlpools are an everyday experience in a bath tub: When the water is drained a circular vortex is formed. Typically, such whirls are rather stable. Similar...
Physicists working with Roland Wester at the University of Innsbruck have investigated if and how chemical reactions can be influenced by targeted vibrational excitation of the reactants. They were able to demonstrate that excitation with a laser beam does not affect the efficiency of a chemical exchange reaction and that the excited molecular group acts only as a spectator in the reaction.
A frequently used reaction in organic chemistry is nucleophilic substitution. It plays, for example, an important role in in the synthesis of new chemical...
Optical spectroscopy allows investigating the energy structure and dynamic properties of complex quantum systems. Researchers from the University of Würzburg present two new approaches of coherent two-dimensional spectroscopy.
"Put an excitation into the system and observe how it evolves." According to physicist Professor Tobias Brixner, this is the credo of optical spectroscopy....
13.07.2018 | Event News
12.07.2018 | Event News
03.07.2018 | Event News
20.07.2018 | Power and Electrical Engineering
20.07.2018 | Information Technology
20.07.2018 | Materials Sciences