Potential future therapies for irritable bowel syndrome: will disease modifying therapy as opposed to symptomatic control become a reality?
Irritable bowel syndrome can remit spontaneously, implying cure is possible. Predictors of good prognosis include a short history, acute onset(possibly postinfective origin), absence of psychological disorders, and resolution of chronic life stressors. Possible-disease modifying treatments with long-lasting effects include diet and anti-inflammatory and psychological treatments. Dietary modifications, which often involve excluding dairy and wheat products, are successful in some patients. Anti-inflammatory treatments have been subjected to one RCT in postinfective IBS without benefit. Probiotics may have benefit in altering bacterial flora and as anti-inflammatory agents, but further trials are needed before they can be recommended. Psychological treatments may produce long-lasting responses. Relaxation therapy appears to have a nonspecific benefit. Psychotherapy has been shown to have long-term benefit and is particularly acceptable to, and effective for, those with overt psychological distress. Hypnotherapy has been shown to be effective in randomized placebo controlled trials and has a sustained effect.
Spiller
Robin C
RC
Wolfson Digestive Diseases Centre, University Hospital, C Floor South Bank, Nottingham NG7 2UH, United Kingdom. emma.bradley@nottingham.ac.uk
D000928:Antidepressive Agents / Q000627:therapeutic use; D004032:Diet; D005512:Food Hypersensitivity / Q000276:immunology; D006801:Humans; D006930:Hyperalgesia / Q000503:physiopathology / Q000628:therapy; D007413:Intestinal Mucosa / Q000276:immunology; D043183:Irritable Bowel Syndrome / Q000276:immunology / Q000503:physiopathology / Q000628:therapy*; D019936:Probiotics / Q000627:therapeutic use; D011613:Psychotherapy
D000928:Antidepressive Agents