Effect of tegaserod on recto-sigmoid tonic and phasic activity in constipation-predominant irritable bowel syndrome.
OBJECTIVE
In irritable bowel syndrome (IBS), the modulation of neural pathways may be altered and we have recently shown that postprandial recto-sigmoid tone modification is impaired. On pathophysiological grounds, we do not know whether this alteration may have a role in symptom onset and, in particular, whether an effective drug, such as tegaserod, can improve this response together with symptom severity.


METHODS
Twenty-two female patients with constipation-predominant IBS (IBS-C), diagnosed according to Rome II criteria, were studied. All subjects underwent an evaluation of the presence and severity of IBS symptoms and the recto-sigmoid barostat test to measure fasting and postprandial recto-sigmoid tone and phasic contractility. They were then randomly assigned to receive either tegaserod 6 mg b.i.d (12 patients) or placebo tablets (10 patients) for 4 wk, according to a double-blind protocol. Symptom assessment and recto-sigmoid tone and contractility were re-evaluated at the end of the treatment.


RESULTS
Both symptom severity and postprandial modification of recto-sigmoid tone improved only in the tegaserod group and a significant correlation was evident between the improvement of bloating and the improvement of postprandial recto-sigmoid tone modification. No effect of tegaserod on recto-sigmoid motility index or correlation between motility index and symptom improvement was evident.


CONCLUSIONS
In IBS-C female patients, the administration of tegaserod improves symptom severity and is accompanied by an improvement of recto-sigmoid tone response to a meal.
Di Stefano
Michele
M
1st Department of Medicine, IRCCS S. Matteo Hospital, University of Pavia, Pavia, Italy.
Miceli
Emanuela
E
Mazzocchi
Samanta
S
Tana
Paola
P
Missanelli
Antonio
A
Corazza
Gino R
GR
D000328:Adult; D012809:Colon, Sigmoid / Q000187:drug effects / Q000503:physiopathology*; D003248:Constipation / Q000188:drug therapy / Q000503:physiopathology; D005260:Female; D006801:Humans; D007211:Indoles / Q000494:pharmacology* / Q000627:therapeutic use; D043183:Irritable Bowel Syndrome / Q000188:drug therapy / Q000503:physiopathology*; D008875:Middle Aged; D009129:Muscle Tonus / Q000187:drug effects / Q000502:physiology; D012007:Rectum / Q000187:drug effects / Q000503:physiopathology*; D017366:Serotonin Receptor Agonists / Q000494:pharmacology* / Q000627:therapeutic use
D007211:Indoles; D017366:Serotonin Receptor Agonists; C105050:tegaserod