FRIDAY, Aug. 8, 2014 (HealthDay News) -- Newly released
guidelines for the treatment of irritable bowel syndrome and a type
of constipation known as chronic idiopathic constipation reveal a
number of proven treatments for these two common conditions.
"There's a greater variety of approaches which reflect a greater understanding of the disorders," said guidelines co-author Dr. Eamonn Quigley, chief of the division of gastroenterology and hepatology at Houston Methodist Hospital.
"We now have a better opportunity to improve the lives of our patients," Quigley said.
The guidelines are published in the August issue of the
American Journal of Gastroenterology.
An estimated 5 percent to 15 percent of the world's population
has irritable bowel syndrome, a condition that can cause symptoms
such as abdominal pain, diarrhea or constipation, cramping and
bloating, and gas. It can affect people at any age but is
especially common when people are in their 20s and 30s, Quigley
The condition can be difficult to diagnose because other
conditions share the same symptoms. Unlike other conditions,
however, there's no specific diagnostic test for irritable bowel
syndrome, he noted. Physicians must rely purely on symptoms to make
The new guidelines, released this week by the American College
of Gastroenterology, say there's evidence to support the following
treatments for irritable bowel syndrome:
The irritable bowel syndrome guidelines also say that research
has boosted the case for using antidepressant medications and
Probiotics are a hot topic in medicine. Quigley said research
supports their use, but it's not clear which ones are best. "We
need more studies comparing doses and preparations, and there
hasn't been a lot of that done," he said. Still, probiotics are
safe and patients tolerate them well, he noted.
"In regards to specifics, patients have to talk to their doctor," Quigley said.
Dr. William Chey, a gastroenterologist and professor of medicine
at the University of Michigan, agreed that it's difficult to decide
which probiotic product to recommend. He said one possibility is
the product known as Align, which is widely available.
However, the guidelines indicate that there's not enough
evidence to support the use of prebiotics (components of food that
can't be digested and promote healthy bacteria) and synbiotics
(products that combine probiotics and prebiotics).
As for diet, Quigley said there's some evidence that gluten-free
diets and so-called "FODMAP" diets can help reduce symptoms of
irritable bowel syndrome. FODMAP diets cut out potentially
troublesome foods, such as certain added sugars, and then
reintroduce them to the diets of patients to help figure out which
ones cause symptoms.
Chey said the guidelines slightly understate the value of
treatments that involve changing diet since there's evidence that
"diet plays a role in the development of the condition and has a
role in treatment."
For patients with chronic idiopathic constipation, Quigley said,
"there are a lot of relatively simple and relatively inexpensive
treatments that work for constipation, and most of them are pretty
Chronic idiopathic constipation is long-term constipation that
doesn't have a known cause. Approximately 10 percent to 15 percent
of the general population suffers from this condition.
The guidelines for chronic idiopathic constipation strongly
recommend the use of fiber supplements plus laxatives such as
polyethylene glycol (MiraLax), lactulose (Generlac), sodium
picosulfate and bisacodyl (Dulcolax).
The guidelines also strongly recommend linaclotide (Linzess) and
lubiprostone (Amitiza), which also appear in the recommendations to
treat irritable bowel syndrome, and prucalopride (Resolor).
Some of these drugs are available over the counter, Quigley
said. Prescription drugs are available for people with more severe
cases of constipation, he said.
For more about irritable bowel syndrome, try the
U.S. National Institute of Diabetes and Digestive ...
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