# Treatment of IBS Article



## cookies4marilyn (Jun 30, 2000)

Article from Previous post from Eric:Treatment of Irritable Bowel Syndrome.Spiller RC.Department of Gastroenterology, University Hospital, Derby Road, Nottingham NG7 2UH, UK. robin.spiller###nottingham.ac.ukIrritable bowel syndrome IBS is an extremely common cause of consultation, and at present is diagnosed on the basis of symptoms and a few simple exclusion tests. Exclusion diets can be successful, but many patients have already attempted and failed such treatments before consulting. Anxiety and somatization may be an important driver of consultation. Patients' concerns should be understood and addressed. Those with prominent psychiatric disease may benefit from psychotherapy. Hypnotherapy benefits symptoms in those without psychologic disturbance, but its availability is limited. Antidepressants are effective in improving both mood and IBS symptoms globally, and the evidence is particularly good for tricyclic antidepressants. Although antispasmodics are currently the most commonly prescribed drugs, most responses 75% are due to the placebo effect and not specific to the drug. Bulk laxatives such as ispaghula can increase stool frequency and help pain, but bloating may be aggravated. Loperamide is effective treatment for urgency and loose stools, but less effective for bloating and pain. 5-HT 3 antagonists such as alosetron improve urgency, stool consistency, and pain in diarrhea-predominant-IBS. The 5-HT(4) agonist tegaserod shows modest benefit in constipation-predominant IBS, improving stool frequency, consistency, and bloating as well as global improvement. There are many new drugs, such as cholecystokinin, neurokinin, and corticotropin receptor antagonists, in development.PMID: 12846942"Hypnotherapy benefits symptoms in those without psychologic disturbance, but its availability is limited. Aliment Pharmacol Ther. 2003 Mar 1;17 5:635-42. Related Articles, Links Gut-focused hypnotherapy normalizes disordered rectal sensitivity in patients with irritable bowel syndrome.Lea R, Houghton LA, Calvert EL, Larder S, Gonsalkorale WM, Whelan V, Randles J, Cooper P, Cruickshanks P, Miller V, Whorwell PJ.Academic Department of Medicine, University Hospital of South Manchester, UK.BACKGROUND: We have previously shown that hypnotherapy alters rectal sensitivity in some patients with irritable bowel syndrome. However, this previous study used incremental volume distension of a latex balloon, which might be susceptible to subject response bias and might compromise the assessment of compliance. In addition, the study group was symptomatically rather than physiologically defined. AIM: To assess the effect of hypnotherapy on rectal sensitivity in hypersensitive, hyposensitive and normally sensitive irritable bowel syndrome patients using a distension technique barostat that addresses these technical issues. METHODS: Twenty-three irritable bowel syndrome Rome I patients aged 24-72 years were assessed before and after 12 weeks of hypnotherapy in terms of rectal sensitivity, symptomatology, anxiety and depression. Normal values for sensitivity were established in 17 healthy volunteers aged 20-55 years). RESULTS: Compared with controls, 10 patients were hypersensitive, seven hyposensitive and six normally sensitive before treatment. Following hypnotherapy, the mean pain sensory threshold increased in the hypersensitive group P = 0.04 and decreased in the hyposensitive group, although the latter failed to reach statistical significance P = 0.19). Normal sensory perception was unchanged. Sensory improvement in the hypersensitive patients tended to correlate with a reduction in abdominal pain r = 0.714, P = 0.07. CONCLUSION: Hypnotherapy improves abnormal sensory perception in irritable bowel syndrome, leaving normal sensation unchanged.PMID: 1264151Just as a few examples."Gut-focused hypnotherapy normalizes disordered rectal sensitivity in patients with irritable bowel syndrome."--------------------Retired-Moderator of the Cognitive Behavioral Therapy, Anxiety and Hypnotherapy forum.I am not a doctor. All information I present is for educational purposes only and should not be subsituted for the advise of a quilified health care provider.Please make sure you have your symptoms diagnosed by a medical practitioner or a doctor. It is important to remember that you cannot self diagnose IBS and there are many serious conditions that mimic IBS.I am a thirty year + IBS sufferer.My website on IBS is www.ibshealth.com Please visit for accurate information on IBS.--------------------------------------------------------------------------------From: Portland OR USA | Registered: Jul 1999 | IP: Logged |


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