Dietary and pharmacological treatment of abdominal pain in IBS

Michael Camilleri, Guy Boeckxstaens

Research output: Contribution to journalReview article

36 Citations (Scopus)

Abstract

This review introduces the principles of visceral sensation and appraises the current approaches to management of visceral pain in functional GI diseases, principally IBS. These approaches include dietary measures including fibre supplementation, low fermentable oligosaccharides, disaccharides, monosaccharides and polyols diet, and pharmacological approaches such as antispasmodics, peppermint oil, antidepressants (tricyclic agents, selective serotonin reuptake inhibitors), 5-HT3 receptor antagonists (alosetron, ondansetron, ramosetron), non-absorbed antibiotic (rifaximin), secretagogues (lubiprostone, linaclotide), μ-opioid receptor (OR) and κ-OR agonist, δ-OR antagonist (eluxadoline), histamine H1 receptor antagonist (ebastine), neurokinin-2 receptor antagonist (ibodutant) and GABAergic agents (gabapentin and pregabalin). Efficacy and safety are discussed based on pivotal trials or published systematic reviews and metaanalysis, expressing ORs or relative risks and their 95% CIs. Potential new approaches may be based on recent insights on mucosal expression of genes, and microRNA and epigenetic markers in human biopsies and in animal models of visceral hypersensitivity. The objectives of this review are to appraise the physiology and anatomy of gut sensation and the efficacy in the relief of visceral pain (typically in IBS) of several classes of therapies. These include fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) and different classes of medications.

Original languageEnglish (US)
Pages (from-to)966-974
Number of pages9
JournalGut
Volume66
Issue number5
DOIs
StatePublished - 2017

Fingerprint

Visceral Pain
Monosaccharides
Disaccharides
Opioid Receptors
Oligosaccharides
Abdominal Pain
rifaximin
Neurokinin-2 Receptors
GABA Agents
Pharmacology
Histamine H1 Antagonists
Serotonin 5-HT3 Receptor Antagonists
Receptors, Serotonin, 5-HT3
Ondansetron
Parasympatholytics
Narcotic Antagonists
Tricyclic Antidepressive Agents
Serotonin Uptake Inhibitors
MicroRNAs
Epigenomics

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Dietary and pharmacological treatment of abdominal pain in IBS. / Camilleri, Michael; Boeckxstaens, Guy.

In: Gut, Vol. 66, No. 5, 2017, p. 966-974.

Research output: Contribution to journalReview article

Camilleri, Michael ; Boeckxstaens, Guy. / Dietary and pharmacological treatment of abdominal pain in IBS. In: Gut. 2017 ; Vol. 66, No. 5. pp. 966-974.
@article{ea2bbd7ff1b44ce4aa999647524ac787,
title = "Dietary and pharmacological treatment of abdominal pain in IBS",
abstract = "This review introduces the principles of visceral sensation and appraises the current approaches to management of visceral pain in functional GI diseases, principally IBS. These approaches include dietary measures including fibre supplementation, low fermentable oligosaccharides, disaccharides, monosaccharides and polyols diet, and pharmacological approaches such as antispasmodics, peppermint oil, antidepressants (tricyclic agents, selective serotonin reuptake inhibitors), 5-HT3 receptor antagonists (alosetron, ondansetron, ramosetron), non-absorbed antibiotic (rifaximin), secretagogues (lubiprostone, linaclotide), μ-opioid receptor (OR) and κ-OR agonist, δ-OR antagonist (eluxadoline), histamine H1 receptor antagonist (ebastine), neurokinin-2 receptor antagonist (ibodutant) and GABAergic agents (gabapentin and pregabalin). Efficacy and safety are discussed based on pivotal trials or published systematic reviews and metaanalysis, expressing ORs or relative risks and their 95{\%} CIs. Potential new approaches may be based on recent insights on mucosal expression of genes, and microRNA and epigenetic markers in human biopsies and in animal models of visceral hypersensitivity. The objectives of this review are to appraise the physiology and anatomy of gut sensation and the efficacy in the relief of visceral pain (typically in IBS) of several classes of therapies. These include fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) and different classes of medications.",
author = "Michael Camilleri and Guy Boeckxstaens",
year = "2017",
doi = "10.1136/gutjnl-2016-313425",
language = "English (US)",
volume = "66",
pages = "966--974",
journal = "Gut",
issn = "0017-5749",
publisher = "BMJ Publishing Group",
number = "5",

}

TY - JOUR

T1 - Dietary and pharmacological treatment of abdominal pain in IBS

AU - Camilleri, Michael

AU - Boeckxstaens, Guy

PY - 2017

Y1 - 2017

N2 - This review introduces the principles of visceral sensation and appraises the current approaches to management of visceral pain in functional GI diseases, principally IBS. These approaches include dietary measures including fibre supplementation, low fermentable oligosaccharides, disaccharides, monosaccharides and polyols diet, and pharmacological approaches such as antispasmodics, peppermint oil, antidepressants (tricyclic agents, selective serotonin reuptake inhibitors), 5-HT3 receptor antagonists (alosetron, ondansetron, ramosetron), non-absorbed antibiotic (rifaximin), secretagogues (lubiprostone, linaclotide), μ-opioid receptor (OR) and κ-OR agonist, δ-OR antagonist (eluxadoline), histamine H1 receptor antagonist (ebastine), neurokinin-2 receptor antagonist (ibodutant) and GABAergic agents (gabapentin and pregabalin). Efficacy and safety are discussed based on pivotal trials or published systematic reviews and metaanalysis, expressing ORs or relative risks and their 95% CIs. Potential new approaches may be based on recent insights on mucosal expression of genes, and microRNA and epigenetic markers in human biopsies and in animal models of visceral hypersensitivity. The objectives of this review are to appraise the physiology and anatomy of gut sensation and the efficacy in the relief of visceral pain (typically in IBS) of several classes of therapies. These include fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) and different classes of medications.

AB - This review introduces the principles of visceral sensation and appraises the current approaches to management of visceral pain in functional GI diseases, principally IBS. These approaches include dietary measures including fibre supplementation, low fermentable oligosaccharides, disaccharides, monosaccharides and polyols diet, and pharmacological approaches such as antispasmodics, peppermint oil, antidepressants (tricyclic agents, selective serotonin reuptake inhibitors), 5-HT3 receptor antagonists (alosetron, ondansetron, ramosetron), non-absorbed antibiotic (rifaximin), secretagogues (lubiprostone, linaclotide), μ-opioid receptor (OR) and κ-OR agonist, δ-OR antagonist (eluxadoline), histamine H1 receptor antagonist (ebastine), neurokinin-2 receptor antagonist (ibodutant) and GABAergic agents (gabapentin and pregabalin). Efficacy and safety are discussed based on pivotal trials or published systematic reviews and metaanalysis, expressing ORs or relative risks and their 95% CIs. Potential new approaches may be based on recent insights on mucosal expression of genes, and microRNA and epigenetic markers in human biopsies and in animal models of visceral hypersensitivity. The objectives of this review are to appraise the physiology and anatomy of gut sensation and the efficacy in the relief of visceral pain (typically in IBS) of several classes of therapies. These include fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs) and different classes of medications.

UR - http://www.scopus.com/inward/record.url?scp=85019143579&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85019143579&partnerID=8YFLogxK

U2 - 10.1136/gutjnl-2016-313425

DO - 10.1136/gutjnl-2016-313425

M3 - Review article

C2 - 28232472

AN - SCOPUS:85019143579

VL - 66

SP - 966

EP - 974

JO - Gut

JF - Gut

SN - 0017-5749

IS - 5

ER -