Adaptation of a multicomponent treatment for irritable bowel syndrome to a small-group format

We evaluated a multicomponent treatment program for IBS that had been adapted to a small-group format. Patient acceptance was satisfactory with 14 of 17 potential patients completing treatment. No reductions of GI symptoms were noted in a 12-week symptom-monitoring baseline phase; diarrhea became significantly worse. Treatment led to significant (p<.05) reductions in abdominal pain and diarrhea. Nine of 14 (64.3%) patients were clinically improved.     

Relaxation training as a treatment for irritable bowel syndrome

Although there have been many successful, controlled demonstrations of the clinical efficacy of multicomponent treatments for irritable bowel syndrome (IBS), in the present study we sought to evaluate a single component of many of these regimens, relaxation training. Eight IBS patients received a 10-session (over 8 weeks) regimen of abbreviated progressive muscle relaxation with regular home practice while 8 comparable patients merely monitored GI symptoms. Based on daily GI symptom diaries collected for 4 weeks before and 4 weeks after treatment (or continued symptom monitoring), the Relaxation condition showed significantly (p=.05) more improvement on a composite measure of primary GI symptom reduction than the Symptom Monitoring condition. Fifty percent of the Relaxation group were clinically improved at the end of treatment.     

Bowel sound biofeedback as a treatment for irritable bowel syndrome

Using an electronic stethoscope placed on subjects' abdomens, bowel sound biofeedback was administered to five subjects suffering from irritable bowel syndrome (functional diarrhea). They were instructed to alternately increase and decrease colonic sounds in an attempt to gain control over bowel activity. Using daily ratings of diarrhea as the primary dependent measure, three of five subjects reduced mean ratings enough at posttreatment to meet our 50% criterion for success (100%, 94%, and 54%). At 1-year follow-up, two of the three short-term successes had maintained their level of improvement — each had ratings 75% below those of pretreatment.     

Behavioral treatment of irritable bowel syndrome: a 1-year follow-up study

Sixteen clients afflicted with irritable bowel syndrome (IBS) were reassessed 1 year following completion of a multicomponent treatment package incorporating progressive muscle relaxation, thermal biofeedback, cognitive therapy, and IBS education. For the 14 patients who kept a 2-week symptom diary, significant reductions in ratings of abdominal pain and tenderness, diarrhea, and flatulence were obtained comparing pretreatment and follow-up symptom-diary ratings. Eleven of 14 clients were improved over pretreatment levels, 57% met the criteria for clinical improvement of at least a 50% reduction in major symptom scores, and all but 1 of 16 rated themselves as subjectively improved.     

The irritable bowel syndrome.

The irritable bowel syndrome (IBS) is an extremely common disorder. It is believed to occur usually after emotional stress and perhaps because of behavioural and dietary factors. There is definite evidence of disturbed gastrointestinal function associated with IBS; however, a diagnostic marker remains elusive. The current trend is to diagnose IBS on the basis of the patient''s history and the findings at physical examination and after minimal investigation. The physician-patient relationship remains the most important factor in the management of IBS. Long-term benefit may be achieved with the use of dietary fibre supplements or stool-bulking agents. The evaluation of currently available drugs is difficult because of the placebo effect. Drug therapy should be aimed at specific symptoms and used mainly during the initial phase of treatment.     

Proteomics and irritable bowel syndrome

Introduction: Irritable bowel syndrome (IBS) is a gastrointestinal disease that according to Rome IV criteria is subdivided into four subtypes. The pathophysiology of this disease is not well understood due to numerous factors playing multiple roles in disease development, such as diet, stress and hormones. IBS has a variety of symptoms and overlaps with many other gastrointestinal and non-gastrointestinal diseases.

Area covered: This review aims to present an overview of implementation of proteomics in experimental studies in the field of IBS.

Expert commentary: Proteomics is commonly used for biomarker discovery in and has also been extensively used in IBS research. The necessity of a sensitive and specific biomarker for IBS is apparent, but despite the intensive research performed in this field, an appropriate biomarker is not yet available.     

A 1- and 2-year follow-up study of bowel sound biofeedback as a treatment for irritable bowel syndrome

Five patients initially treated with bowel sound biofeedback were assessed at 1- and 2-year follow-up. Although variable results were reported, subjects who improved to a clinically significant extent at posttreatment maintained their improvement through 1-year and in some cases 2-year follow-up. In light of these results, this form of treatment may prove effective for some patients in the long term.     

A 1- and 2-year follow-up study of bowel sound biofeedback as a treatment for irritable bowel syndrome

Five patients initially treated with bowel sound biofeedback were assessed at 1- and 2-year follow-up. Although variable results were reported, subjects who improved to a clinically significant extent at posttreatment maintained their improvement through 1-year and in some cases 2-year follow-up. In light of these results, this form of treatment may prove effective for some patients in the long term.     

Comparison of various treatments for irritable bowel syndrome.

A previous therapeutic trial of factorial design showed that a combination of a psychotropic drug, a smooth-muscle relaxant, and a bulk former (lorazepam, hyoscine hydrobromide, and ispaghula husk) relieved symptoms of the irritable bowel syndrome more effectively than the same agents given singly. Another trial of similar design was undertaken to compare each of these three agents with another having the equivalent clinical actions--namely, Motival (fluphenazine/nortriptylene mixture), mebeverine, and bran. Ninety-six patients took part; all received three agents, one from each of the three pairs being compared, and no placebos were used. Fifty-six patients reported a sustained symptomatic improvement, which was a significantly higher incidence than in the previous trial, when placebos were used. Ispaghula was significantly more effective than bran. The combination of ispaghula, Motival, and mebeverine improved 11 out of 12 patients--significantly more than bran, Motival, and hyoscine (five improved), or bran, lorazepam, and mebeverine (four improved). Mebeverine was significantly more effective when combined with Motival (18 out of 24 improved) than with lorazepam (10 improved). These results confirm the value of a combined therapeutic approach to the relief of the irritable bowel syndrome and suggest the possibility of synergism between agents.     

Behavioral treatment of irritable bowel syndrome: A 1-year follow-up study

Sixteen clients afflicted with irritable bowel syndrome (IBS) were reassessed 1 year following completion of a multicomponent treatment package incorporating progressive muscle relaxation, thermal biofeedback, cognitive therapy, and IBS education. For the 14 patients who kept a 2-week symptom diary, significant reductions in ratings of abdominal pain and tenderness, diarrhea, and flatulence were obtained comparing pretreatment and follow-up symptom-diary ratings. Eleven of 14 clients were improved over pretreatment levels, 57% met the criteria for clinical improvement of at least a 50% reduction in major symptom scores, and all but 1 of 16 rated themselves as subjectively improved.     

V. Stress and irritable bowel syndrome

Different types of stress play important roles in the onset and modulation of irritable bowel syndrome (IBS) symptoms. The physiological effects of psychological and physical stressors on gut function and brain-gut interactions are mediated by outputs of the emotional motor system in terms of autonomic, neuroendocrine, attentional, and pain modulatory responses. IBS patients show an enhanced responsiveness of this system manifesting in altered modulation of gastrointestinal motility and secretion and in alterations in the perception of visceral events. Functional brain imaging techniques are beginning to identify brain circuits involved in the perceptual alterations. Animal models have recently been proposed that mimic key features of the human syndrome.     

Novel serotonin type 3 receptor partial agonists for the potential treatment of irritable bowel syndrome

Serotonin type 3 (5-HT₃) receptor partial agonists are being targeted as potential new drugs for the treatment of irritable bowel syndrome (IBS). Two new chemical series bearing indazole and indole cores have exhibited nanomolar binding affinity for the h5-HT₃A receptor. A range of partial agonist activities in HEK cells heterologously expressing the h5-HT₃A receptor were measured for the indazole series. Excellent 5-HT₃ receptor selectivity, favorable in vitro metabolic stability and CYP inhibition properties, and good oral in vivo potency in the murine von Bezold-Jarisch reflex model is exemplified thereby indicating the series to have potential utility as improved IBS agents.