15 Best Ways to Control Your Irritable Bowel Syndrome (IBS) - Borrow Time Books

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Pathophysiology of Irritable Bowel Syndrome

Sleep disturbances in clinic patients with functional bowel disorders. Non-colonic features of irritable bowel syndrome.


  1. Probiotic Therapy for Irritable Bowel Syndrome.
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  5. Melatonin: a novel treatment for IBS?!
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Self-report and polysomnographic measures of sleep in women with irritable bowel syndrome. Nurs Res ; Extraintestinal symptoms in irritable bowel syndrome and inflammatory bowel diseases: Modulation of sleep quality and autonomic functioning by symptoms of depression in women with irritable bowel syndrome. Sleep and gastric function in irritable bowel syndrome: Migrating motor complex and sleep in health and irritable bowel syndrome.

Abnormal REM sleep in the irritable bowel syndrome. Symptom differences in moderate to severe IBS patients based on predominant bowel habit. Sleep and functional bowel disorders: Goldsmith G, Levin JS. Effect of sleep quality on symptoms of irritable bowel syndrome.

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Probiotic Therapy for Irritable Bowel Syndrome

Melatonin improves abdominal pain in irritable bowel syndrome patients who have sleep disturbances: The first night effect: Mendels J, Hawkins DR. Electroencephalogr Clin Neurophysiol ; Effects of exogenous melatonin on sleep: Sleep Med Rev ; 9: Sleep and mood disorders. Sleep Med Rev ; 1: Autonomic regulation of cardiac function during sleep in patients with irritable bowel syndrome.

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How to Treat IBS Naturally

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Melatonin: a novel treatment for IBS?

These patients were randomized to neomycin or placebo for a total of 7 days. These results were similar to those found in a recent study by Majewski and associates, in which a 4-week course of rifaximin led to improvement in IBS-related symptoms and a negative breath test in patients who previously had positive tests. Interest has recently emerged regarding the possibility of microscopic inflammation as a cause of IBS.

Visceral hypersensitivity has been recognized as one of the potential contributing etiologies of pain associated with IBS. It has long been known that patients with IBS have poor tolerance to rectal distention. Psychological factors have long been known to exacerbate symptoms of patients with known IBS. Although the exact effects of stress, depression, and anxiety on the gut remain unclear, serotonin appears to play a role. Serotonin is known to regulate secretory, motility, and sensory events in the gut; thus, changes in its concentration may contribute to the sensorimotor function in IBS.

Probiotics are live microorganisms with a vast array of therapeutic potential for gastrointestinal disease. They have been studied and used in many gastrointestinal disorders, with growing evidence for use in pouchitis, Clostridium difficile colitis, antibiotic-associated diarrhea, inflammatory bowel disease, and IBS.

The emerging multifactorial pathophysiologic paradigm of IBS may create adjunctive probiotic therapeutic opportunities. Probiotics have a beneficial effect on intestinal mucosa via several proposed mechanisms that include suppression of the growth and binding of pathogenic bacteria, improvement of the barrier function of the epithelium, and alteration of the immune activity of the host. A study by Desbonnet and coworkers investigated the probiotic Bifidobacterium infantis on rats that were chronically subjected to a stressor a forced swim test for 14 days.

Plasma levels of tryptophan and kynurenic acid were also significantly increased in the rats treated with B. There was no improvement in performance during the stressor, though B. These raised levels of tryptophan can potentially reduce depressive overlay and aberrant enteric nervous system effects in IBS. There is a limited amount of quality evidence for the empiric use of probiotics in IBS. The randomized controlled trials that have been performed are typically small and are limited by publication bias. Kim and colleagues performed two double-blind, pla-cebo-controlled trials examining VSL 3 for the treatment of IBS symptoms.

With VSL 3, the decrease in bloating was borderline significant, but there was no effect on gastrointestinal transit or other individual symptoms of IBS. Kim and associates performed a second placebo-controlled trial studying VSL 3 and its effects on IBS symptoms and colonic transit in 48 IBS patients, with abdominal bloating as the primary endpoint.

However, the limitations of this study included its single-blinded design, small study population, and use of pseudo-randomization. Saggioro performed a study with 70 IBS patients, randomizing them to 3 different treatment groups for assessing improvements in abdominal pain and severity scores of 7 IBS symptoms. Both treatment cohorts showed significant decreases in abdominal pain and severity scores at 2 and 4 weeks; however, the major limitation of this study was the inability to perform statistical evaluation due to its small number of patients and its short duration of follow-up.

Those patients randomized to the B. The limitations of this trial, as with other trials involving probiotics, include its small size and lack of power calculation; otherwise, it was a well-designed trial. The authors concluded that additional larger, randomized, controlled trials studying B.

A larger study by Whorwell and coworkers evaluating different doses of B. The authors concluded that the discrepancy in the efficacy of the higher and lower concentrations may have been secondary to the methods that the different formulations use to release the active agent within the intestine.

A study by Guyonnet and colleagues assessed constipation-predominant IBS patients and randomized them to placebo or fermented milk yogurt Activia, Dan-non , which contains Bifidobacterium animalis regularis DN for 6 weeks. This yogurt ie, B. Past studies involving the Lactobacillus species as either a single probiotic agent or in combination with other probiotics have been less impressive. A 6-month double-blind, placebo-controlled study by Kajander and associates evaluated patients with IBS and randomized them to a probiotic mixture containing Lactobacillus rhamnosus GG, L.

A recent meta-analysis by Moayyedi and coworkers reviewed 4 trials evaluating single strains of Lactobacillus and found no significant benefit in alleviating IBS symptoms in patients. Nine trials evaluated different probiotic combinations most often including Bifidobacterium, Lactobacillus, and Streptococcus in patients and showed a significant effect in improving IBS symptoms.

Brenner and coworkers conducted a meta-analysis in that included 16 randomized controlled trials evaluating the efficacy, safety, and tolerability of probiotics in IBS patients. Bifidobacterium likely has a beneficial effect in the symptom relief of IBS either as a single agent or in combination with other probiotics, though the available data are inadequate and further well-designed trials are still needed.

Probiotics will likely have an emerging adjunctive therapeutic role in treating IBS. The studies to date simultaneously provide interesting observations and raise fundamental questions. Overall, many of the studies involved were small in size, of short duration, and had significant design flaws, but there is growing evidence that B. If larger, well-controlled studies involving other strains of probiotics are performed, we may begin to have other options regarding different probiotic species and for the treatment of more specific subsets of IBS symptoms. Additional issues that still need to be determined include the most effective probiotic strain, dose, and duration of therapy; whether patients should be treated for specific IBS symptoms only; and whether there is a role for maintenance IBS therapy or only IBS therapy on an as-needed basis.

In addition, cost-effectiveness analysis and safety profiles still need to be addressed in large, well-designed trials.