Recent developments in the therapy of irritable bowel syndrome.
There is tremendous activity and excitement in the arena of drug development for the treatment of the irritable bowel syndrome (IBS). Pharmacologic therapy has been largely limited to gut acting therapeutic agents including antidiarrheals, laxatives and antispasmodics that primarily target individual symptoms. Various antidepressants have gained popularity although their efficacy in clinical trials has been modest and their clinical utility is limited by untoward side effects. Serotonergic agents have demonstrated efficacy on the global symptoms of IBS; however, recent concerns about safety have severely limited their use. Recent discoveries regarding the pathophysiology of IBS have revealed numerous potential therapeutic targets. Agents under development include newer serotonergic agents and antidepressants; chloride channel, guanylate cyclase, opioid and motilin receptor ligands; various central, peripheral and autonomic neural receptor ligands; and gut immune modulators.
Saad
Richard J
RJ
Division of Gastroenterology, Department of Medicine, University of Michigan Medical Center, Ann Arbor, MI, USA.
Chey
William D
WD
D000818:Animals; D000928:Antidepressive Agents / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D003346:Corticotropin-Releasing Hormone / Q000037:antagonists & inhibitors; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D043183:Irritable Bowel Syndrome / Q000188:drug therapy* / Q000503:physiopathology; D054368:Laxatives / Q000627:therapeutic use; D008550:Melatonin / Q000627:therapeutic use; D009292:Narcotic Antagonists; D010276:Parasympatholytics / Q000627:therapeutic use; D000069583:Pregabalin; D011964:Receptors, Gastrointestinal Hormone / Q000819:agonists; D018013:Receptors, Neuropeptide / Q000819:agonists; D011957:Receptors, Opioid / Q000819:agonists; D018039:Receptors, Tachykinin / Q000037:antagonists & inhibitors; D018490:Serotonin Agents / Q000627:therapeutic use; D005680:gamma-Aminobutyric Acid / Q000031:analogs & derivatives / Q000627:therapeutic use
D000928:Antidepressive Agents; D002121:Calcium Channel Blockers; D007155:Immunologic Factors; D054368:Laxatives; D009292:Narcotic Antagonists; D010276:Parasympatholytics; D011964:Receptors, Gastrointestinal Hormone; D018013:Receptors, Neuropeptide; D011957:Receptors, Opioid; D018039:Receptors, Tachykinin; D018490:Serotonin Agents; C050802:motilin receptor; D000069583:Pregabalin; D005680:gamma-Aminobutyric Acid; D003346:Corticotropin-Releasing Hormone; D008550:Melatonin