1. Symptoms of IBS
    • abdominal pain or discomfort
    • altered bowel habits (diarrhea, constipation, or alternating both)
    • physical and emotional distress
  2. Therapy for the abdominal pain caused by IBS
    • myorelaxants (hycosamine and dicyclomine - avail in US but not shown effective)
    • opioid receptor agonists (loperamide - inconsistent data)
    • peppermint oil (may help, but study design not awesome)
  3. Treatment of abdominal distention and bloating from gas in IBS
    • Beano (alpha-galactosidase) supposed to decr gas, but doesn't help in IBS
    • simethicone and activated charcoal don't work either
  4. Antibiotics that may be beneficial in IBS related bloating
    • rifaximin
    • metronidazole
    • neomycin
  5. Treatment of C-IBS
    • Soluble fiber - can increase stool consistency and decrease colonic transit time (ispaghula, calcium polycarbophil, psyllium) 20-25 g/d recommended
    • Stool softeners (docusate sodium)
    • Emollients (mineral oil)
    • Bowel stimulants (bisacodyl, cascara, senna, ricineoleic acid)
    • Osmotic laxatives (glycerin, lactulose, Mg salts, sodium, phosphate, sorbitol)
    • PEG (efficacy in one small study)
    • Lubiprostone -for women who have failed tx - MOA is CCl2 channel activator in GIT which increases intestinal secretions to facilitate intestinal motility
  6. Treatment for D-IBS
    • loperamide (decreases bowel freq)
    • alosetron (available with strict limited license)
  7. What is the FDA status and role in IBS therapy of lubiprostone, tegaserod, and alosetron?
    • lubiprostone: recently approved for women > 18 who have failed other tx
    • tegaserod: was for constipation, but no longer on mkt
    • alosetron: use limited to D-IBS women who are refractory to other tx - prescribed only with limited license
  8. Role of non-drug and alternative therapies for IBS
    • peppermint oil may help with abdominal pain
    • probiotics may decr bloating and gas
    • fiber - soluble is good for constipation; insoluble worsens bloating and pain
Card Set
Therapeutics Exam6 IBS Dr. Thill