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Drugs best suited for treating Irritable Bowel Syndrome identified

March 26, 2012 - Washington

Two prevalent drug therapies - rifaximin and lubiprostone - have been identified as having the fewest side effects for treating Irritable Bowel Syndrome, according to a study.

Patients with Irritable Bowel Syndrome often experience abdominal pain or cramps, excess gas or bloating and visible abdominal distension. Many drug therapies cause troubling side effects of their own, including nausea, insomnia, palpitations and decreased appetite.

The findings are based on an analysis of more than two dozen large-scale clinical trials.

"For the millions of patients who suffer from IBS, effective treatment options have been very scarce," said Dr Mark Pimentel, a lead author of the study and director of Cedars-Sinai's Gastrointestinal Motility Program.

Pimentel and the other researchers analysed common treatments for IBS. For diarrhoea forms of the condition, they evaluated tricyclic antidepressants; alosetron, a drug that slows movement of stool in the gut; and rifaximin, an antibiotic that stays in the gut and is used to treat traveller's diarrhoea and hepatic encephalopathy.

For constipation forms of IBS, the researchers examined antidepressants known as serotonin reuptake inhibitors and lubiprostone, a drug that promotes gut secretion.

The study found that for every 2.3 patients who benefited from tricyclic antidepressants, one suffered harmful side effects and had to stop taking the medication and for every 2.6 patients helped by alosetron, one had to halt the drug.

By contrast, for every 846 patients aided by rifaximin, one had to discontinue the medication.

Lubiprostone and serotonin reuptake inhibitors demonstrated a complete lack of "harm" to IBS patients with constipation, as defined by the study.

"We found that rifaximin and lubiprostone have the lowest level of harmful side effects of all the well-studied drug therapies for IBS," Pimentel said.

"This underscores the need for us to continue to monitor new therapies for this disease.

"While it is important to see benefit with drugs, harm is something we do not often assess well," he added.

The study was published online by The American Journal of Medicine and is set to appear in the publication's April print edition.


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