title: IBS and the role of otilonium bromide.
abstract: BACKGROUND
  Awareness of the seriousness of irritable bowel disorder (IBS) remains low among clinicians. In this review, we summarize the current knowledge of IBS and highlight the major personal, economic, and social burden of the disease, and the importance of adequate treatment of what is still often viewed as a trivial disorder. In fact, IBS is a major reason for referral.
  
  
  METHODS
  It is crucial that the varied pathophysiologies of this complex heterogeneous disease are understood in order to be able to treat both the presenting symptoms (pain, bloating, flatulence, abnormal defecation, diarrhea, constipation) and the underlying disorder effectively. Low-grade inflammatory and immune activation has been observed, but the precise triggers and mechanisms, and the relevance to symptom generation, remain to be established.
  
  
  METHODS
  IBS patients require different treatment strategies according to the pattern, severity, frequency, and symptoms. While initial therapy traditionally targets the most bothersome symptom, long-term therapy aims at maintaining symptom control and preventing recurrence. In addition to dietary/lifestyle interventions and psychosocial strategies, a wide range of pharmacologic therapies are approved for use in IBS depending on the symptoms reported. Musculotropic spasmolytics, which act directly on intestinal smooth muscle contractility, such as otilonium bromide, are effective, particularly in the relief of abdominal pain and bloating, and are well tolerated in IBS. THE OBIS TRIAL: The recent large placebo-controlled Otilonium Bromide in Irritable Bowel Syndrome study demonstrated the superiority of otilonium bromide versus placebo not only in the reduction of pain and bloating, but also in protection from relapse due to the long-lasting effect.
authors.affiliation: Department of Gastroenterology, Translational Research Center for Gastrointestinal Disorders, University Hospital Leuven, Catholic University of Leuven, Herestraat 49, 3000 Leuven, Belgium.
authors.forename: Guy
authors.initials: G
authors.lastname: Boeckxstaens
authors.forename: Enrico S
authors.initials: ES
authors.lastname: Corazziari
authors.forename: Fermín
authors.initials: F
authors.lastname: Mearin
authors.forename: Jan
authors.initials: J
authors.lastname: Tack
mesh_terms: D002986:Clinical Trials as Topic; D017281:Cost of Illness; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D010276:Parasympatholytics / Q000627:therapeutic use; D000644:Quaternary Ammonium Compounds / Q000627:therapeutic use*
chemical_list: D005765:Gastrointestinal Agents; D010276:Parasympatholytics; D000644:Quaternary Ammonium Compounds; C013934:octylonium