Irritable bowel syndrome: pathogenesis, symptoms, diagnosis and pharmacotherapy
Keywords:
irritable bowel syndrome, IBS, rifaximin, paroxetine, fluoxetine, citalapramAbstract
Nowadays irritable bowel syndrome (IBS) is a big problem for 10-20% of the population, of which two thirds are women. The study does not explicitly define the cause of this condition, but takes into account the impact of diet, stress, previous bacterial gastrointestinal infections, serotonin and immunological factors. Characteristic symptoms of IBS are abdominal pain lasting at least 3 months, and constipation or diarrhea, flatulence. Often, patients with IBS also have depression and anxiety disorders. SSRIs (paroxetine, fluoxetine and citalapram) used in these cases, not only affect the improvement of well-being and quality of life, but as have been observed also as having a positive influence on gastrointestinal motility and reducing abdominal pain. This may prove that in the pathogenesis of IBS serotonin plays an important role and may constitute a starting point for a newly discovered and studied agonists/antagonists of 5HT-3 receptors (tegaserod, lubiprostone, alosetron, renzaprid, cilansetron, ramosetron, ME3412), as potential drugs for irritable bowel syndrome. Study on rifaximin showed that IBS may be a consequence of early bacterial infection, because the antibiotic in therapeutic doses causes a reduction of symptoms associated with IBS, and now is considered one of the best in the treatment of IBS, since even treatment repeated 5 times does not reduce its effectiveness. The theory of immune response is only at the stage of research and, if confirmed, could become an effective alternative in the treatment of irritable bowel syndrome.
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