Meta-analysis: The treatment of irritable bowel syndrome

Details

Serval ID
serval:BIB_71318DCB3C7C
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Meta-analysis: The treatment of irritable bowel syndrome
Journal
Alimentary Pharmacology and Therapeutics
Author(s)
Lesbros-Pantoflickova  D., Michetti  P., Fried  M., Beglinger  C., Blum  A. L.
ISSN
0269-2813 (Print)
Publication state
Published
Issued date
12/2004
Volume
20
Number
11-12
Pages
1253-69
Notes
Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't --- Old month value: Dec
Abstract
To evaluate therapies available for the treatment of irritable bowel syndrome, and provide consensus recommendations for their use, a total of 51 double-blind clinical trials using bulking agents, prokinetics, antispasmodics, alosetron, tegaserod and antidepressants were selected. The quality of studies was assessed using 5-point scale. Meta-analyses were performed on all studies, and on 'high-quality studies'. The efficacy of fibre in the global irritable bowel syndrome symptoms relief (OR: 1.9; 95% CI:1.5-2.4) was lost after exclusion of low-quality trials (OR: 1.4; 95% CI: 1.0-2.0, P = 0.06). When excluding the low-quality trials, an improvement of global irritable bowel syndrome symptoms with all antispasmodics (OR: 2.1; 95% CI:1.8-2.9) was maintained only for octylonium bromide, but on the basis of only two studies. Antidepressants were effective (OR: 2.6, 95% CI: 1.9-3.5), even after exclusion of low-quality studies (OR: 1.9, 95% CI: 1.3-2.7). Alosetron (OR: 2.2; 95% CI: 1.9-2.6) and tegaserod (OR: 1.4; 95% CI: 1.2-1.5) showed a significant effect in women. We recommend the use of tegaserod for women with irritable bowel syndrome with constipation and alosetron for women with severe irritable bowel syndrome with diarrhoea. Antidepressants can be beneficial for irritable bowel syndrome with diarrhoea patients with severe symptoms. Loperamide can be recommended in painless diarrhoea. Evidence is weak to recommend the use of bulking agents in the treatment of irritable bowel syndrome with constipation.
Keywords
Antidiarrheals/therapeutic use Drug Design Gastrointestinal Agents/*therapeutic use Humans Irritable Bowel Syndrome/diet therapy/drug therapy/*therapy Parasympatholytics/therapeutic use Psychotherapy/methods Serotonin Agents/therapeutic use
Pubmed
Web of science
Open Access
Yes
Create date
25/01/2008 16:01
Last modification date
20/08/2019 14:29
Usage data