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« on: July 27, 2006, 02:06:55 pm »

About Irritable Bowel Syndrome~(IBS)


Most individuals are surprised to learn they are not alone with symptoms of IBS. In fact, irritable bowel syndrome (IBS) affects approximately 10-15% or more of the general population. It is the most common disease diagnosed by gastroenterologists (doctors who specialize in medical treatment of disorders of the stomach and intestines) and one of the most common disorders seen by primary care physicians.

Sometimes irritable bowel syndrome is referred to as spastic colon, mucous colitis, spastic colitis, nervous stomach, or irritable colon.

Irritable bowel syndrome, or IBS, is generally classified as a "functional" disorder. A functional disorder refers to a disorder or disease where the primary abnormality is an altered physiological function (the way the body works), rather than an identifiable structural or biochemical cause. It characterizes a disorder that generally can not be diagnosed in a traditional way; that is, as an inflammatory, infectious, or structural abnormality that can be seen by commonly used examination, x-ray, or blood test.


Irritable bowel syndrome is understood as a multi-faceted disorder. In people with IBS, symptoms result from what appears to be a disturbance in the interaction between the gut or intestines, the brain, and the autonomic nervous system that alters regulation of bowel motility (motor function) or sensory function.

Irritable bowel syndrome is characterized by a group of symptoms in which abdominal pain or discomfort is associated with a change in bowel pattern, such as loose or more frequent bowel movements, diarrhea, and/or constipation.

Treatment options are available to manage IBS—whether symptoms are mild, moderate, or severe.

 

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« Reply #1 on: July 27, 2006, 02:44:04 pm »

Travel Tips Help IBS Sufferers Enjoy Their Summer Vacations

 Travel can be very difficult for Irritable Bowel Syndrome (IBS) sufferers, who fear they may not be able to control their symptoms when away from home. In fact, a recent survey of 1,000 Americans conducted by the International Foundation for Functional Gastrointestinal Disorders (IFFGD) revealed that 23 percent of respondents suffering from symptoms suggesting IBS cancelled a vacation and 58 percent avoided travel at least once during the previous year.

Travel tips include:


  • Allow enough time in the morning to get to the airport on time without worry. When traveling to and from your destination, bring an extra bag with a change of clothes in the event that your luggage is lost. Throughout your trip, always have a change of clothes with you, and bring a supply of tissue in case there's none available where you are going.


  • Traveling by plane can be difficult for those who suffer from IBS. Always ask to sit as close to the restroom as possible. Also, sit on an aisle for easy and fast access so you will not have to ask others to move. If you are traveling to Washington, D.C., for security reasons, know that you cannot get out of your seat for the last 30 minutes of the flight.


  • When planning your trip, consider driving if possible. Some people may feel more comfortable traveling by car, because they can stop when necessary to use a restroom or take a break. There is a greater sense of control when traveling by car, as you don't have to be on someone else's schedule or timetable.


  • If you are making a long drive to get to and from your destination, know how much distance there is between rest areas or highway exits with available restrooms. Map your walking and driving routes ahead of time and determine how to get from point A to point B as quickly and directly as possible. Some people may avoid buses, boats and other transportation that do not have accessible restrooms.


  • Avoid lodging where multiple rooms share a single restroom. If you know you will be arriving before check-in time, ask for early check in. If you need to check out later, don't hesitate to ask-most hotels will accommodate your needs.


  • Avoid foods and beverages that you know can aggravate your IBS symptoms, and avoid excessive caffeine and liquor, which can exacerbate symptoms. This is not the time to experiment. Eating in restaurants may be challenging-stick with foods with which you are comfortable.


  • Know how to ask where the restroom is in the local language, and always have change for pay toilets. Public restrooms are usually available and accessible in the United States, but may not be in other countries.


  • Know what documentation may be necessary to refill prescriptions at your destination.

  • Divide your medication(s) into two containers; keep one in your hotel room and one with you at all times.


  • Bring your physician's contact information with you. If you are traveling internationally, consider bringing an international cell phone or purchasing an international calling card so that you can reach your physician if necessary.


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« Reply #2 on: August 11, 2006, 10:37:27 am »

Tegaserod First Drug Effective for Women With Irritable Bowel Syndrome and "Mixed" Symptoms

LOS ANGELES, C.A. -- May 23, 2006 -- Tegaserod (Zelnorm) is effective and safe for the treatment of irritable bowel syndrome (IBS) in women with a mixed/alternating (constipation/diarrhea) bowel habit.

This study is the first to indicate a potentially effective treatment for patients with IBS and a mixed bowel pattern, noted the presenter and lead investigator William Chey, MD, associate professor of medicine, University of Michigan Medical Center, Ann Arbor, Michigan.

"When people seek treatment for IBS, they are classified as having either IBS with constipation or IBS with diarrhea," explained Dr. Chey. "But then there is this other group that doesn't fit into either one of those categories. They either have a combination of diarrhea or constipation during the week or they alternate between longer periods of the 2 conditions. This is a substantial group -- 30% to 40% of IBS patients."

Dr. Chey noted that no current therapies have been rigorously tested for these mixed-symptom patients. "There are data showing significant movement between the IBS-with-constipation (IBS-C) group and the IBS-with-mixed-symptoms (IBS-M) group. So it made sense to study tegaserod, which works for IBS-C patients."

Dr. Chey and his team of researchers randomized 661 women (IBS-C, 337 and IBS-M, 324) to 4 weeks of treatment with tegaserod 6 mg twice daily or placebo.

The team reported that tegaserod provided statistically significant improvement in satisfactory relief of IBS symptoms over the 4-week treatment period for both the IBS-C and IBS-M groups.

For both groups, the percentage of patients experiencing satisfactory relief of IBS symptoms (considered 3 out of 4 weeks of treatment) was significantly higher for tegaserod compared with placebo.

Tegaserod was also significantly better than placebo at improving weekly bowel-movement frequency, stool consistency, and days per week with straining.

"The main finding was that tegaserod at 6 mg taken twice daily was effective both in women with IBS-C and in women with IBS-M," said Dr. Chey. "This is the first well-designed, large study that has shown these beneficial results for the mixed-symptom group."

Tegaserod is indicated for the short-term treatment of women with IBS whose primary bowel symptom is constipation. Tegaserod is also indicated for the treatment of male and female patients less than 65 years of age with chronic idiopathic constipation.

This study was supported by Novartis Pharmaceuticals, East Hanover, New Jersey.


                                   


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« Reply #3 on: September 23, 2006, 08:23:36 am »

New Study Demonstrates that Amitizia (Lubiprostone) May Help Improve Symptoms of Irritable Bowel Syndrome with Constipation
LOS ANGELES, C.A.


 A new study found that Amitizia(TM) (lubiprostone) may help relieve the symptoms associated with constipation-predominant irritable bowel syndrome (IBS-C). IBS is a condition that affects nearly 30 million people in North America and accounts for 25-50 percent of referrals to gastroenterologists. The study was presented today at Digestive Disease Week, the largest annual meeting of digestive disease specialists.

"The results of this study suggest that Amitizia may help improve several of the most frequently reported symptoms of IBS-C, including abdominal pain, bloating and discomfort," said John Johanson, MD, primary investigator and clinical associate professor, University of Illinois College of Medicine. "There are several additional studies underway that further explore the uses of Amitizia in this patient population and we look forward to learning the findings."

Amitizia is a novel selective chloride channel activator that has been shown to be effective and well-tolerated in a number of well-controlled clinical trials in patients with chronic idiopathic constipation. Amitizia was approved for use for chronic idiopathic constipation in adults on January 31, 2006. This is the first time Amitizia has been tested exclusively in the IBS-C population.

About the Study
In a double-blind, placebo-controlled, dose-ranging study, approximately 200 patients with diagnosed IBS-C (per the Rome II criteria) were randomized to receive placebo or Amitizia (8, 16 or 24 mcg) twice-daily for 12 weeks. In an electronic diary, patients recorded data related to dosing, side effects and IBS-C symptoms including bloating, abdominal pain/discomfort, frequency of and straining during bowel movements, stool consistency and rescue medication use.

Significant improvements versus placebo were observed for at least two of the three months for abdominal pain/discomfort, abdominal bloating, frequency of spontaneous bowel movements (SBM), stool consistency, bowel straining and assessments of constipation severity. Comparisons between the groups revealed that during the first and second months, the improvements in abdominal discomfort/pain and SBM frequency rates were more than doubled in all Amitizia groups.

Overall, the improvements were typically highest in the highest Amitizia dose group (48 mcg/day). Dose-dependent trends were also seen for adverse events, with incidence and drop-out rates rising with the dose of Amitizia.

About Irritable Bowel Syndrome (IBS)
Irritable bowel syndrome (IBS) is a chronic disorder characterized by multiple symptoms of abdominal pain and discomfort, bloating, and changes of bowel habits such as constipation and/or diarrhea. The condition can significantly interfere with daily activities and reduce patients' quality of life, resulting in absences from school, missed work and reduced productivity.

Three main types of IBS exist: constipation-predominant (IBS-C), diarrhea- predominant (IBS-D) and alternating constipation and diarrhea (IBS-A). In IBS-C, symptoms are present for at least 12 weeks (these do not need to be consecutive) over a 12-month period.

Although people with IBS-C report suffering from many of the same symptoms associated with constipation, the presence of pain and discomfort is what differentiates IBS-C from chronic constipation. The condition is approximately 2 to 2.5 times more prevalent in women than men, and women are more likely to report a history of constipation, whereas men are more likely to report diarrhea.

About Amitizia
Amitizia, approved by the U.S. Food and Drug Administration (FDA) in January 2006 for the treatment of chronic idiopathic constipation in adults, is an oral treatment that works by increasing fluid secretion in the small intestine by activating ClC-2 chloride channels, and thereby increasing the passage of the stool and improving symptoms associated with chronic idiopathic constipation.

Amitizia is indicated for the treatment of chronic idiopathic constipation in the adult population. Amitizia should not be used in patients with a known hypersensitivity to any components of the formulation and in patients with a history of mechanical gastrointestinal obstruction. Patients with symptoms suggestive of mechanical gastrointestinal obstruction should be evaluated prior to initiating Amitizia treatment.

The safety of Amitizia in pregnancy has not been evaluated in humans. In guinea pigs, lubiprostone has been shown to have the potential to cause fetal loss. Amitizia should be used during pregnancy only if the benefit justifies the potential risk to the fetus. Women who could become pregnant should have a negative pregnancy test prior to beginning therapy with Amitizia and should be capable of complying with effective contraceptive measures.

Amitizia should not be administered to patients that have severe diarrhea. Patients should be aware of the possible occurrence of diarrhea during treatment. If the diarrhea becomes severe, patients should consult their health professional.

In clinical trials, the most common adverse event was nausea (31%). Other adverse events (greater than or equal to 5% of patients) included diarrhea (13%), headache (13%), abdominal distention (7%), abdominal pain (7%), flatulence (6%), sinusitis (5%) and vomiting (5%).


Amitizia is a trademark of Sucampo Pharmaceuticals, Inc.

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« Reply #4 on: October 03, 2006, 04:06:49 pm »

Irritable Bowel, Pain Syndromes Linked


Sept. 28, 2006 -- Doctors have long suspected a link between irritable bowel syndrome, pain syndromes, and depression. New data now strongly support this theory.

The findings come from data on 97,593 people with irritable bowel syndrome enrolled in a large U.S. health plan from 1996 to 2002. J. Alexander Cole, DSc, MPH, and colleagues at Boston University compared these patients with 27,402 people seeking routine health care.

Their results show that people with irritable bowel syndrome are:

80% more likely to suffer fibromyalgia
60% more likely to suffer migraine
40% more likely to suffer depression
Overall, 60% more likely to suffer fibromyalgia, migraine, or depression
"Perhaps what is driving the relation between irritable bowel syndrome and these other conditions is some underlying biological disorder," Cole tells WebMD. "Nobody is sure what this could be. But people suggest that there is this constellation of symptoms among people with irritable bowel syndrome, fibromyalgia, migraine, and depression that might present in different ways."

Cole and colleagues report their findings in the Sept. 28 issue of the online journal BMC Gastroenterology.

Common Cause of Pain Syndromes?

Cole, now an epidemiologist with i3 Drug Safety, is not an expert on irritable bowel syndrome. Reza Shaker, MD, is. Shaker, chief of gastroenterology and hepatology at the Medical College of Wisconsin, was not involved in the Cole study.

"Clinical observations of patients with pain syndromes indicate that we are dealing with a syndrome bigger than a single organ," Shaker tells WebMD. "These findings confirm these previous observations."

Shaker says people with irritable bowel syndrome and people with pain syndromes such as fibromyalgia and migraine have something in common. They all have nerve pathways which somehow have become vastly oversensitive to pain signals -- a process doctors call sensitization.

Perhaps, Shaker suggests, there's a common problem at the crossroads where these nerve pathways intersect.

"Is it possible that there is an event -- possibly an early life event -- that affects the crossroads of all these nerve pathways?" he asks. "In areas where these nerves cross, it could be that there is sensitization occurring, affecting different neural circuits."

Cole suggests that different doctors looking at the same underlying illness might make different diagnoses. A gastroenterologist, for example, might diagnose irritable bowel syndrome, while a rheumatologist might diagnose fibromyalgia.

This sounds a lot like the blind men who, on first encountering an elephant, declare it to be like a snake or a tree depending on whether they are touching the elephant's trunk or its leg. Shaker says this analogy is apt. But most doctors, he says, will examine the whole elephant, not just its parts.

"A professional doesn't just focus on one symptom. If we see irritable bowel syndrome along with noncardiac chest pain or fibromyalgia, then we tackle this," he says. "But we doctors need to have a more global picture of this, instead of pigeonholing our diagnosis according to our own specialty or subspecialty."

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« Reply #5 on: October 09, 2006, 10:38:07 am »

When a diagnosis of irritable bowel syndrome (IBS) comes to mind, consider migraine, fibromyalgia, and depression as well.


Explain to interested patients that the associations reported here are based on cohort study that relied on medical and pharmacy records. They have not been confirmed by patient examination or interview.
Patients with IBS were 60% more likely to have one of those conditions than were those who didn't have IBS, according to J. Alexander Cole, D.Sc., M.P.H., of Boston University, and colleagues, who studied nearly 100,000 IBS patients enrolled in a national health insurance plan.


Patients who were treated for IBS were 40% more likely to have depression, 60% more likely to suffer migraine, and 80% more likely to seek treatment for fibromyalgia, they reported in the current issue of BMC Gastroenterology.


Dr. Cole and colleagues used a database of medical and pharmacy claims filed from January 1, 1996, through June 30, 2002, to identify 97,593 people who were treated for IBS.


They compared the IBS cohort with a random sample of 27,402 who were enrolled in the same health insurance plan.


Women comprised about 75% of the IBS cohort and roughly half of the controls. Age ranged from 18 to more than 65 and distribution was similar in both groups.


In the IBS cohort the prevalence of having at least one of the three disorders (migraine, depression, or fibromyalgia) was 264 per 1,000, they wrote. By contrast, the prevalence in the control group was 46 per 1,000.


In both control and IBS cohorts depression was the most prevalent condition, with a prevalence of 128 per 1,000 among IBS patients and 60 per 1,000 in the controls.


Those in the IBS cohort had a pooled prevalence odds ratio of 1.6 for having one of the three conditions (95% confidence interval 1.5-1.7), while the pooled odds ratio for fibromyalgia in the IBS was 1.8 (95% CI, 1.7-1.9). For migraine the IBS patients had a pooled odds ratio of 1.6 (95% CI, 1.4-1.7) and for depression it was 1.4 (95% CI 1.3-1.4).


The authors cautioned that relying on medical and pharmacy claims data limited the ability to ascertain clinical characteristics, such as the predominant symptom of IBS -- constipation or diarrhea -- that might confound the relationship they reported. The lack of that information also prevented them from determining whether there was heterogeneity in the prevalence of depression, fibromyalgia, and migraine in the IBS cohort.

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« Reply #6 on: October 16, 2006, 07:42:04 pm »

Findings Confirm Close Link between Brain and the Miseries of IBS

As many as one out of five adult Americans experience Irritable Bowel Syndrome (IBS), but the disorder - and its causes - are often misunderstood.

The syndrome can include abdominal cramps, diarrhea at some times and constipation at others, and a frequent sensation that a bowel movement has not produced a complete evacuation.

The discomfort, urgency, and uncertainty of IBS (also referred to as spastic colon) can create a restricted lifestyle in which patients feel the need to be always aware of the location of the nearest toilet. For some people, IBS can be disabling. They may be unable to work, attend social events, or even travel short distances.

"Panic and anxiety are present among some patients," says Reza Shaker, MD, Medical College of Wisconsin Professor of Medicine and Chief of the Division of Gastroenterology and Hepatology. "Social and family life can become disturbed and disrupted." Depression is also frequently associated with IBS.

It is theorized that sex hormones could play a role in IBS, since the disorder tends to be more prevalent among women, especially those of child-bearing age. At the same time, the incidence of IBS is increasing among men, most likely brought about by the stresses of daily life.

There is some good news: "IBS might make life quite uncomfortable, but fortunately its symptoms do not cause permanent damage to the body," says Dr. Shaker. "Quality of life can be diminished significantly, but the disorder does not affect the patient's lifespan."

Colon, Brain Closely Connected
Recent research in which Dr. Shaker has been involved documents the close connection between psychological state and IBS. "We have for the first time, using fMRI (Functional Magnetic Resonance Imaging), shown that the neural circuits and brain cells of IBS sufferers are overly sensitive to some stimuli," he says.

"Just as the psychological state of a patient affects breathing and the beating of the heart, it also affects the gut," Dr. Shaker explains. For example, stress makes the brain more responsive to impulses from the colon.

The major function of the colon is to absorb water, nutrients, and salts from the partially digested food that enters from the small intestine. When the gastrointestinal system is working optimally, an appropriate amount of fluid is absorbed, while enough is left in the colon to ensure an easy elimination.

But in people with IBS, certain stressors or foods can cause the food residue to move too rapidly through the colon. As a result, less fluid is absorbed and more is left to mix with the colon contents, resulting in cramping and diarrhea.

In other cases, stress or food can slow down colon function so too much fluid is absorbed. In this situation there is less fluid available to mix with colon matter and stools become dry, hard, and difficult to eliminate. In other words, the patient is constipated.

Diagnosis is Based on Expertise
The working definition of IBS includes changes in bowel habits, along with pain and discomfort that affects the patient for at least three months. These problems might occur continuously or only at intervals and they are relieved by a bowel movement. "This definition is based on the consensus of specialists who have seen numerous IBS patients and have carefully studied the illness," says Dr. Shaker.

"There are currently no standard clinical tests with which we are able to diagnose IBS," he continues. "Therefore doctors must rely on clinical presentation of symptoms. IBS is a diagnosis of exclusion, that is, we first rule out other problems - such as an obstruction or an overgrowth of bacteria in the gut - before we make a diagnosis of IBS. We base the diagnosis not only on symptoms but on factors such as the patient's age, history, and the duration of the illness."

Self-Diagnosis Is Risky
While the typical symptoms of IBS might be familiar to many people, Dr. Shaker cautions strongly against self-diagnosis. "With the flood of information available today, especially on the Internet, it is tempting for people to start self-diagnosing and self-managing their problems," he notes. "But it's always important to have IBS diagnosed by a doctor to avoid missing treatable or malignant diseases."

Celiac disease, for example, produces IBS-type symptoms but requires a different course of treatment. Celiac disease involves sensitivity to common gluten-containing foods such as bread and other wheat- or barley-based products. A specialist will be able to diagnose this problem and provide the appropriate treatment.

Rarely, IBS-like symptoms might mask more serious conditions such as intestinal lymphoma or Inflammatory Bowel Disease (IBD), a serious disease causing long-term damage to the body.

With a professional diagnosis and medical consultation, patients are encouraged to take responsibility for managing their illness, using reputable websites and other professional materials. (See bottom of page for additional resources.)

Dietary Changes Can Be Helpful
For some IBS patients, a crucial element of treatment is diet modification. Depending on their history and self-reported symptoms after eating particular foods or drinking certain beverages, some fairly simple steps can help alleviate their symptoms. For instance, Dr. Shaker explains, "some patients have lactose intolerance. Others have trouble with gas-forming foods like beans or broccoli, and the gut over-reacts."

Some patients might need to minimize or eliminate their intake of carbonated beverages, chocolate, wheat, rye, barley, alcohol, milk products, or caffeine. Some might also respond favorably to the addition of fiber-rich foods or bulk-forming materials such as psyllium (found in certain foods and also in over-the-counter products such as Metamucil).

Role of Serotonin
Along with changing the diet, "We may add medications that reduce the hyper-responsiveness of the brain-gut connection," says Dr. Shaker. One class of medication that has shown great promise is the neurotransmitter group called SSRIs, or Selective Serotonin Reuptake Inhibitors. Although these medications are known primarily for their use in depression, they also have an effect on intestinal function.

The gastrointestinal tract secretes about 95% of the body's serotonin, while the brain contains the remaining 5%. Recent findings have shown that serotonin and the nerves responsive to it might influence the development of IBS in some people, especially those in whom constipation is dominant. In addition, serotonin plays a significant role in processing symptoms arising from the intestine or colon.

Recent findings have revealed that IBS patients show a lower-than-normal level of serotonin receptor activity, raising the level of serotonin remaining in the GI tract. The significance of serotonin levels in IBS patients is an important focus of current research.

IBS Studies Yield Hope for the Future
"The causes and treatments of Irritable Bowel Syndrome are areas of intense interest among gastroenterologists," Dr. Shaker says. "Recent research has already helped us to understand this disorder and to improve its treatment. We look forward to even greater improvements in the future."

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« Reply #7 on: October 19, 2006, 10:25:48 am »

Antibiotic May Aid Irritable Bowel


Oct. 16, 2006 -- Ten days' treatment with the antibiotic Xifaxan reduces symptoms of irritable bowel syndrome (IBS), a small clinical trial suggests.

IBS is a condition of the intestinal tract that causes symptoms of bloating, gas, abdominal cramping, diarrhea, and constipation.

Xifaxan, now approved for the treatment of travelers' diarrhea, kills bacteria living in the gut. Experts disagree over the cause of IBS. Some suspect the root cause to be overgrowth of gut bacteria.

One of these experts is Mark Pimentel, MD, director of the gastrointestinal motility program at Cedars-Sinai Medical Center in Los Angeles. In prior studies, Pimentel used breath tests to show that about 80% of IBS patients may have serious bacterial fermentation going on in their gut.

This led him to wonder what would happen if he used a powerful antibiotic to shift the balance between overgrowth of these theoretically harmful bacteria and normal bacteria living in the gut.

So Pimentel and colleagues gave a 10-day course of Xifaxan or inactive placebo to 87 IBS patients. Seventy-two patients finished the study. As is common in IBS studies, those who got placebo felt a bit better. Those who got Xifaxan reported even more improvement -- especially less bloating.

"Xifaxan was superior to placebo for control of IBS," Pimentel tells WebMD. "It suggests we are finally tackling a sustainable cause of IBS. If it is bacteria, we have changed the environment so that IBS is better on a semipermanent basis."

The study, funded by Xifaxan maker Salix Pharmaceuticals, appears in the Oct. 17 issue of Annals of Internal Medicine. Pimentel is a consultant to Salix and has received speaking fees from the company. Cedars-Sinai Medical Center has a licensing agreement with Salix.

Change of IBS Treatment?

Is Xifaxan a new treatment for IBS? Not yet. A larger study, looking at IBS patients treated by their own doctors with Xifaxan, is already underway. Until those results are known, Xifaxan is not an officially approved treatment for IBS.

But Pimentel says he's treated "thousands" of IBS patients with Xifaxan -- and he says now the word is getting out.

"The gem here is you have a sustained effect in IBS. The larger, longer studies will show how well this works," he says. "We've reported these results at professional meetings, and it has changed the way IBS is treated. Sixty percent of gastroenterologists in the country are starting to do it this way."

Pimentel says the average patient needs re-treatment every two or three months, but that response varies greatly from patient to patient.

Controversy Over IBS Treatment

Not all experts are convinced that bacterial overgrowth is a root cause of IBS, or that antibiotics are the best treatment. One of these experts is Douglas A. Drossman, MD, co-director of the University of North Carolina Center for Functional GI and Motility Disorders, Chapel Hill.

In an editorial accompanying the Pimentel study, Drossman notes that IBS is a complex disorder that springs from the complex interplay of an oversensitive gut and the brain.

Breath tests, he says, aren't reliable for diagnosing bacterial overgrowth. And Pimentel's study, he says, does not prove that treating bacterial overgrowth helps.

Drossman is not impressed by Pimentel's finding that IBS patients reported an average 36.4% improvement in the 10 weeks after treatment with Xifaxan, while those given placebo treatment reported an average 21% improvement.

"Only bloating improved, and abdominal pain, diarrhea, and constipation did not improve," Drossman notes. "The benefit of using antibiotics is not fully proven and must be balanced with potential risks in terms of side effects, high costs -- a 10-day course of Xifaxan is $250 -- and a breath test, if ordered, costs an additional $304, and the need for recurrent treatment."

Pimentel says new studies now coming out will support the bacterial-overgrowth theory of IBS. He does, however, say people with IBS have "movement disorders of the small bowel." He is hoping that a drug to promote movement in the small bowel will improve outcomes for IBS patients treated with antibiotics.
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« Reply #8 on: November 06, 2006, 08:43:10 am »

Treatment Options and Strategies for Chronic Constipation
     

 
 LAS VEGAS, Oct. 31 -- For treating patients with chronic constipation, a recently approved chloride channel activator compares well with other medications in efficacy and tolerability, according to a review of published data presented here. Action Points




Amitiza selectively activates CLC-2 chloride channels, enhancing intestinal fluid secretion, Dr. Chang said.


This method of action differs from that of other drugs for treating constipation. Lactulose and PEG 3350, both approved for short-term constipation treatment and sold under a variety of brand names, are osmotic laxatives. Zelnorm (tegaserod), is a 5-HT4 agonist, Dr. Chang said.


Both Zelnorm and Amitiza are FDA-approved for long-term treatment of constipation, Dr. Chang noted.


When doctors prescribe a drug for constipation, patients are usually anxious to know is how soon they will have a bowel movement, Dr. Chang said. Clinicians should be prepared for the question.


In a study of 237 patients published in the American Journal of Gastroenterology last year, 61.3% of patients who received Amitiza had a spontaneous bowel movement within 24 hours, compared with 31.4% of patients in the placebo group, Dr. Chang said.


In a study published in the same journal this year, 73.2% of patients who received Zelnorm had a spontaneous bowel movement within 24 hours, compared with 52% of the placebo group, Dr. Chang noted.


In terms of adverse event profiles, the most common adverse events associated with lactulose and PEG 3350 are flatulence, intestinal cramps, diarrhea, nausea, and vomiting, Dr. Chang said.


For Zelnorm, the most common adverse events are headache, diarrhea, and abdominal pain, Dr. Chang said. For Amitiza, adverse effects were nearly identical: nausea, diarrhea, and headache, she said.


Both Amitiza and Zelnorm have proven well tolerated in short-term use (four to 12 weeks) and long-term use (six to 16 months), Dr. Chang said. Amitiza is classed as pregnancy category C, while Zelnorm is classed as pregnancy category B.


After Dr. Chang's presentation, a panel discussion ensued on whether laxatives approved for short-term use might also be useful for long-term treatment of constipation. The panelists also discussed whether combining laxative treatments might be beneficial.


Panelists were Dr. Satish S.C. Rao, M.D., Ph.D, of the University of Iowa in Iowa City, and David A. Peura, M.D., of the University of Virginia in Charlottesville.


Dr. Peura said that, according to his clinical experience, lactulose is not well tolerated for long periods of time because of the side effects of bloating and gas. It is difficult to get patients to comply with taking this drug for extended periods, he said.


Dr. Rao agreed. For managing long-term constipation, lactulose "has a very limited role to play in today's management," he said.


PEG 3350, on the other hand, is often well-tolerated in adults for up to three months, and there is data to suggest the drug is well-tolerated for up to a year in pediatric populations, Dr. Rao added.


As far as combining constipation treatments, there is a theoretical benefit to combining two mechanisms of action, but clinical experience has not borne that out, both Drs. Roa and Peura said.


In addition, there have been no studies examining combined constipation treatments, they said. "We have no clinical data on that," Dr. Peura said.


Finally, combination treatment for constipation would likely be prohibitively expensive, both doctors agreed. "It is going to break the bank," Dr. Peura said. "When you start adding up a lot of different medications it gets really expensive."


The symposium was sponsored by Sucampo Pharmaceuticals Inc., of Bethesda, Md., and Takeda Pharmaceuticals of North America, l in Deerfield, Ill.. They co-market Amitiza.
 
 

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« Reply #9 on: November 10, 2006, 10:56:56 am »

November 7, 2006
Crohn’s Disease and Colitis Are Linked to Mutant Gene

A team of American and Canadian researchers have identified a major gene associated with Crohn’s disease and ulcerative colitis, two closely related diseases collectively known as inflammatory bowel disease, or I.B.D. The discovery may help in finding more effective treatments.

The Centers for Disease Control and Prevention estimates that I.B.D., which is more common among Ashkenazi Jews than other groups, affects more than a million Americans.

Crohn’s disease causes breaks in the lining of the small and large intestines and can affect the entire digestive system. Ulcerative colitis is usually restricted to the large intestine and involves inflammation of more superficial layers of the bowel lining, while Crohn’s also affects deeper layers. In some cases, the intestinal wall can be punctured, causing abscesses, infection and fever.

In addition to intestinal problems — cramps, diarrhea and rectal bleeding — Crohn’s can also cause painful skin ulcers, eye conditions that can interfere with vision, inflammation of the liver and arthritis, among other complications. Symptoms usually begin in adolescence or young adulthood and then intermittently flare up.

There are treatments for Crohn’s, but no cure. Anti-inflammatory drugs, immune system suppressants, antibiotics and surgery are all used, with varying degrees of success. Most treatments have side effects that can range from trivial to debilitating.

Various causes for Crohn’s have been proposed, including diet, infections with specific bacteria, possible environmental factors and immune system disorders. But most scientists believe that an immune response to normally beneficial intestinal bacteria in genetically susceptible people is the cause. Understanding this susceptibility may allow the development of treatments that will specifically target the key immune response pathways.

In this study, researchers compared the genomes of Crohn’s patients of European descent, both Jewish and non-Jewish, to those of healthy controls of the same ancestries. More than 1,900 subjects were involved in the analysis. The report appears online in the Oct. 26 issue of Science Express.

The researchers examined more than 300,000 single nucleotide polymorphisms, or SNPs (pronounced “snips”), the variations that occur when a nucleotide, a molecular subunit of DNA, is altered. They found that the frequency of variations in the gene for a receptor of a protein called interleukin-23, or IL-23, was significantly different in people with Crohn’s disease compared with healthy people. After finding the difference in Crohn’s patients, they found it in ulcerative colitis sufferers as well. This genetic variation leads to a susceptibility to the inflammation that characterizes I.B.D.

The IL-23 receptor gene is not the only one thought to be associated with I.B.D., but it seems an especially good candidate. “The IL-23 immune pathway was already implicated in I.B.D., psoriasis, rheumatoid arthritis and multiple sclerosis,” said Dr. Richard H. Duerr, the study’s lead author and an associate professor of medicine at the University of Pittsburgh.

Animal models offer further evidence. Mice genetically engineered to express a subunit of IL-23 suffer severe systemic inflammation, including in the small and large intestines.

“This immune pathway has been very intensively studied over the past year or so, and is probably involved in multiple organ inflammations,” said Dr. Judy H. Cho, the senior author of the paper and an associate professor of medicine at Yale. “So the genetic findings in the IL-23 receptor made sense in the context of what was already known about the importance of the IL-23 pathway.”

She added, “It’s a nice confluence of animal studies and human genetics, with potential therapeutic implications.”

The researchers discovered a coding variant that apparently protects against I.B.D., because it is found less frequently in patients than in healthy controls. This “is one of the most exciting aspects of the work,” Dr. Duerr said, adding, “If we can mimic the effects of this protective variant, we may be able to more effectively manage patients with I.B.D.”

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« Reply #10 on: November 16, 2006, 08:25:48 am »

Irritable Bowel, Pain Syndromes Linked

 Doctors have long suspected a link between irritable bowel syndrome, pain syndromes, and depression. New data now strongly support this theory.

The findings come from data on 97,593 people with irritable bowel syndrome enrolled in a large U.S. health plan from 1996 to 2002. J. Alexander Cole, DSc, MPH, and colleagues at Boston University compared these patients with 27,402 people seeking routine health care.

Their results show that people with irritable bowel syndrome are:

80% more likely to suffer fibromyalgia
60% more likely to suffer migraine
40% more likely to suffer depression
Overall, 60% more likely to suffer fibromyalgia, migraine, or depression
"Perhaps what is driving the relation between irritable bowel syndrome and these other conditions is some underlying biological disorder," Cole tells WebMD. "Nobody is sure what this could be. But people suggest that there is this constellation of symptoms among people with irritable bowel syndrome, fibromyalgia, migraine, and depression that might present in different ways."

Cole and colleagues report their findings in the Sept. 28 issue of the online journal BMC Gastroenterology.

Common Cause of Pain Syndromes?

Cole, now an epidemiologist with i3 Drug Safety, is not an expert on irritable bowel syndrome. Reza Shaker, MD, is. Shaker, chief of gastroenterology and hepatology at the Medical College of Wisconsin, was not involved in the Cole study.

"Clinical observations of patients with pain syndromes indicate that we are dealing with a syndrome bigger than a single organ," Shaker tells WebMD. "These findings confirm these previous observations."

Shaker says people with irritable bowel syndrome and people with pain syndromes such as fibromyalgia and migraine have something in common. They all have nerve pathways which somehow have become vastly oversensitive to pain signals -- a process doctors call sensitization.

Perhaps, Shaker suggests, there's a common problem at the crossroads where these nerve pathways intersect.

"Is it possible that there is an event -- possibly an early life event -- that affects the crossroads of all these nerve pathways?" he asks. "In areas where these nerves cross, it could be that there is sensitization occurring, affecting different neural circuits."

Cole suggests that different doctors looking at the same underlying illness might make different diagnoses. A gastroenterologist, for example, might diagnose irritable bowel syndrome, while a rheumatologist might diagnose fibromyalgia.

This sounds a lot like the blind men who, on first encountering an elephant, declare it to be like a snake or a tree depending on whether they are touching the elephant's trunk or its leg. Shaker says this analogy is apt. But most doctors, he says, will examine the whole elephant, not just its parts.

"A professional doesn't just focus on one symptom. If we see irritable bowel syndrome along with noncardiac chest pain or fibromyalgia, then we tackle this," he says. "But we doctors need to have a more global picture of this, instead of pigeonholing our diagnosis according to our own specialty or subspecialty."

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« Reply #11 on: November 30, 2006, 08:27:23 am »

Vitamin D deficiency common in children with IBS

Children with inflammatory bowel disease have a high prevalence of vitamin D deficiency, according to a new study published in the journal Pediatrics.
Inflammatory bowel disease refers to the inflammation of the large or small colon and is characterized by diarrhea, abdominal pain and cramping, bloody stool, weight and appetite loss, and ulceration of the bowel lining. Crohn's disease and ulcerative colitis are two common types of inflammatory bowel disease.

Other studies of vitamin D in children with inflammatory bowel disease have produced mixed results, Dr. Helen M. Pappa and colleagues from Children's Hospital, Boston, note. To further investigate, they evaluated 130 subjects with inflammatory bowel disease who were between the ages of 8 and 22 years old. Of these, 94 had Crohn's disease and 36 had ulcerative colitis.
The team measured the patients' blood levels of 25-hydroxy-vitamin D, a frequently used and accurate means of estimating vitamin D levels in the body. They measured levels of intact parathyroid hormone, which is secreted by the parathyroid gland and works with vitamin D to form new bone tissue. The bone mineral density of the lower spine was also measured.

Thirty-five percent of the children had vitamin D deficiency and 11 percent had severe deficiency. The rates of vitamin D deficiency were similar in patients with Crohn's disease and ulcerative colitis.

Blood levels of 25-hydroxy-vitamin D were 53-percent lower among children with darker skin complexions, 33-percent lower during the winter months and 32-percent higher among children who were receiving vitamin D supplements compared with those who were not, Pappa's team reports.
The researchers also observed a positive correlation between 25-hydroxy-vitamin D and weight, bone mineral density, disease duration and blood levels of albumin.

Patients with Crohn's disease that affected the upper gastrointestinal tract were more likely to be vitamin D deficient than those without it, according to the authors. No association was found between 25-hydroxy-vitamin D levels and bone mineral density of the lower spine or blood levels of parathyroid hormone.
The mechanism involved in vitamin D deficiency in patients with inflammatory bowel disease is not completely clear, and additional studies are needed to better understand this process and to develop successful treatment, the investigators conclude.

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« Reply #12 on: February 15, 2007, 04:13:43 pm »

Dynogen Reports Positive Results in Phase 2 IBS-c Study
 
- DDP733 to enter Phase 2b in the Fourth Quarter -


Dynogen Pharmaceuticals, Inc. today reported positive results of its randomized, double-blind, placebo-controlled, parallel group Phase 2 trial of DDP733 in patients with irritable bowel syndrome with constipation (IBS-c). DDP733 achieved an overall clinical response rate of 54% in patients receiving a dose of 1.4 mg t.i.d. compared to a 15% clinical response rate for patients receiving placebo. This was a statistically significant difference in a clinical endpoint which has been accepted by the FDA as a registration endpoint for this indication. The drug was well tolerated in this study. Detailed results will be submitted for disclosure in a peer-reviewed journal or at a future medical conference.

DDP733 is an oral, partial agonist of the serotonin type 3 receptor (5-HT(3)). This DDP733 Phase 2 trial enrolled 91 men and women with IBS-c as determined by the Rome II criteria at multiple centers in Canada. The clinical response rate was assessed using the Overall Subject Global Assessment (OSGA) of relief of IBS, an accepted measure for efficacy in IBS clinical trials. Additionally, a pharmacodynamic assessment of gastrointestinal transit time was included in the study, but the assay did not perform reliably and no conclusions could be drawn.

"We are extremely pleased to see such positive clinical results in this Phase 2 study," said Lee R. Brettman, M.D., Chief Executive Officer at Dynogen. "There is currently only one approved treatment for IBS-c, a chronic disease that afflicts approximately 9 million adults in the U.S., and is the second most common cause for sick leave behind the common cold. The strong clinical activity and good safety profile clearly differentiate this product candidate from the only marketed drug and other late-stage products in development for IBS-c."

"We demonstrated statistical significance, a robust response rate and clear separation from placebo on an endpoint that has been used as the basis for regulatory approval," commented Dr. Suhail Nurbhai, MRCP, Vice President of Clinical Development at Dynogen. "We plan to initiate a Phase 2b study this year to build on these impressive results."

DDP733 was well tolerated with no unexpected drug-related adverse events. Drug-related adverse events were mainly mild to moderate and transient, and required no intervention. DDP733 has been evaluated in more than 350 subjects to date.

~About DDP733

DDP733 is an oral, partial agonist of the serotonin type 3 receptor (5-HT(3)). Serotonin is a neurotransmitter that is known to be involved in the control of the gastrointestinal (GI) system. Preclinical studies of DDP733 established the compound's prokinetic properties (the ability to promote the motility of the GI tract). Dynogen's preclinical studies have also shown that DDP733 is minimally absorbed by the cells lining the gastrointestinal tract and, as a result, more of the product candidate remains available at the desired local site of action. Previous clinical studies of the compound have demonstrated favorable safety and pharmacokinetic profiles. Dynogen is also studying DDP733 in a Phase 1b clinical trial as a treatment for nocturnal gastroesophageal reflux disease, and expects to complete enrollment of that trial in the first half of 2007.

~About Irritable Bowel Syndrome (IBS)

Irritable bowel syndrome is a chronic condition that is believed to be caused by the dysfunction of the muscles and/or nerves of the organs of the GI tract. Patients with IBS experience abdominal pain, discomfort and bloating accompanied by altered bowel habit that can include either diarrhea, constipation or both.
IBS has prevalence of up to 12% of the general population, and females account for 80% of the patient population with severe cases. It is the most common disease diagnosed by gastroenterologists and one of the most common disorders seen by primary care physicians.

~About Dynogen Pharmaceuticals, Inc.

Dynogen is a clinical-stage company developing a portfolio of treatments for gastrointestinal and genitourinary disorders. The Company is focused on large and untapped markets in disease areas that severely impair a patient's quality of life, such as irritable bowel syndrome, gastroesophageal reflux disease and overactive bladder. The Company leverages its development expertise to identify promising clinical compounds and rapidly advance them towards registration. Dynogen currently has multiple double-blind, placebo-controlled Phase 2 studies underway. www.dynogen.com



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« Reply #13 on: February 18, 2007, 02:01:31 pm »

Proteases Cause Pain In Irritable Bowel Syndrome
Sunday Feb. 18, 2007- Irritable bowel syndrome (IBS) is a common gastrointestinal disorder in the developed world. It is characterized by altered bowel function, abdominal discomfort, and pain. However, there are few effective treatments for IBS, in part because the molecular mechanisms underlying the disease symptoms have not been well defined.


But now, researchers from the University of Calgary have provided evidence that serine proteases and PAR2 might provide new therapeutic targets for the treatment of IBS.

In the study, which appears online on February 15 in advance of publication in the March print issue of the Journal of Clinical Investigation, Nathalie Vergnolle and colleagues show that colonic biopsies from individuals with IBS release increased amounts of serine proteases when cultured in vitro, compared with colonic biopsies from healthy individuals.

Likewise, colonic washes from individuals with IBS contained higher levels of serine proteases than did colonic washes from healthy individuals. The supernatant from cultured colonic biopsies from individuals with IBS activated mouse sensory neurons in vitro and caused mice to exhibit increased responsiveness to pain when it was administered into the colon.

Both these effects were dependent on serine proteases in the supernatant and were mediated by activation of a protein known as PAR2, leading the authors to suggest that targeting serine proteases and/or PAR2 might provide sufferers of IBS with relief from their intense abdominal pain.


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« Reply #14 on: March 03, 2007, 09:46:25 am »


March 2, 2007 – Susan Reynolds announced today that she will be releasing a weekly Irritable Bowel Syndrome Newsletter – absolutely free – to subscribers seeking to further their understanding of the condition and who are seeking additional and alternative treatments for their symptoms.

This announcement follows the success that Susan Reynolds has been enjoying from the publication of her e-book “Irritable Bowel Syndrome Secrets”, which reflects her extensive research into the condition after having suffered with it herself. It was her own experience with IBS which motivated her to look into the disease more fully. Once she began to discover new levels of understanding and treatment that weren’t as readily available to her as they should have been, she decided that it was time to share this information with IBS suffers everywhere to help them to deal with their condition in a healthy and realistic way.

As the e-book grew in popularity, Reynolds began a weekly blog which covered topics of real interest to IBS sufferers, such as alternative and natural treatments, holistic interpretations of the disease, and the most recent studies that have been made to help battle its symptoms.

Now, Reynolds has taken this information sharing one step further with the introduction of her free weekly IBS newsletter. Subscribers can use this newsletter along with the “Irritable Bowel Syndrome Secrets” book and blog, or they can enjoy its information on its own. Either way, readers will learn about:

? Foods that are tasty to eat, simple to digest, and that provide rapid relief to IBS symptoms.
? The solid list of the symptoms of IBS to facilitate early diagnosis.
? Complications that frequently occur with IBS, and how these may be avoided.
? Immune system boosters
? How to manage stress in order to stop it from worsening IBS symptoms.
? Plus, a great deal more

To sign up for Susan Reynolds’ free IBS newsletter, visit http://www.natural-irritable-bowel-syndrome-relief.com?source=pr
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« Reply #15 on: April 17, 2007, 09:50:59 pm »

IBS Symptoms Are Hard for Americans to Stomach

Condition affects 30 million Americans and costs $30 billion a year

 
April is irritable bowel syndrome

(IBS) awareness month, a condition that causes Americans substantial pain,
both physically and financially. The estimated 30 million Americans who
suffer from IBS - a disorder characterized by a range of symptoms,
including abdominal pain and discomfort, bloating, constipation and
diarrhea - spend approximately $30 billion annually, excluding prescription
and over the counter drug costs. It is the most common functional bowel
disorder and is the second leading cause of work absenteeism in the United
States.
   

    To combat this disease, consumers are increasingly shopping for natural
solutions in the form of probiotics, as a safe and cost-effective way of
taking control of their digestive problems. Probiotics are beneficial
bacteria that aid digestion, help strengthen the body's natural defenses
and support a more appropriate balance of healthy bacteria in the
gastrointestinal tract. However, probiotics are not all the same.

    "Consumers need to know that not all probiotics are created equal,"
said Dr. Eamonn Quigley, Professor of Medicine and Human Physiology at the
Cork University Hospital. "There are many probiotic strains on the market
that are not clinically proven to have any benefits. The most important
things to remember when shopping for a probiotic are to know what research
lies behind the bacterial strain in the product and to be able identify the
necessary information from the probiotic label."

    Clinical data to support the benefits of a probiotic strain is
essential when choosing a probiotic. Bifantis(R) (Bifidobacterium infantis
35624) is the first and only probiotic that has been clinically proven to
help manage the full range of symptoms of IBS in a large scale,
placebo-controlled clinical trial. No other probiotic is backed by the
clinical data supporting Bifantis. The clinical study was sponsored by P&G
Health Sciences Institute.

    "It can be hard for consumers to navigate through all of the probiotic
products currently available on the market and to find strains that are
proven effective, like Bifantis," says Dr. Quigley. When shopping for a
probiotic product, consumers should ensure the label includes all of the
following information:
     -- Actual strain(s) name and the quantity of probiotic bacteria for each
        strain listed. The number of probiotic bacteria needed to be effective
        is strain- and product-form specific; more is not necessarily better.
     -- "Best used by" date and a batch or lot code. The code printed on an
        individual container that serves as a reference number for the plant
        to track production information.
     -- Company information. Look for products manufactured by well-trusted
        companies who have a history of good clinical evidence and support for
        their product. Also look for corporate contact details like a Web site
        or a toll-free number.
     -- Dosing information, directions for use and storage. Many products have
        complicated dosing regimens or directions, and the suggested storage
        conditions vary based on probiotic form and stability.
     -- Expectations - does the label tell you what to expect from product
        use?
     -- Facts - the Supplement Facts that includes the nutritional and
        supplement information.
    More information on probiotics, IBS and Bifantis is available at
http://www.Bifantis.com.

    About Irritable Bowel Syndrome (IBS)

    Irritable bowel syndrome is the most common functional bowel disorder,
characterized by a range of symptoms, including abdominal pain and
discomfort, bloating and altered bowel function (constipation and/or
diarrhea).

    Significant morbidity is associated with IBS, as patients suffering
from IBS related symptoms endure a decreased quality of life as they are
prevented from participating in activities they would normally enjoy. The
impact on quality of life has been estimated to be greater than that of
diabetes and similar to that of clinical depression.

    The current goal of therapy is management and reduction in the
frequency and severity of episodes or symptoms. The management of IBS
currently ranges from dietary (increasing fiber and reducing dairy
products) and behavioral changes (restricting diet and slowly adding in new
foods) to medications (over-the-counter and prescription).

    About Bifidobacterium infantis 35624 (Bifantis(R))
    Bifantis is the trademarked name for the probiotic strain
Bifidobacterium infantis 35624. These normal, friendly bacteria play an
important role in basic digestion, proper metabolism and overall
well-being. Bifantis works within the digestive system to restore
intestinal balance and maintain normal digestive health. Bifantis is a
calorie- and lactose-free natural dietary ingredient that is similar to the
active cultures found in some yogurts and fermented milks.

    Bifantis may be especially helpful for people who experience one or
more of the symptoms commonly associated with IBS, including diarrhea,
constipation, bloating, gas, urgency and abdominal discomfort.

    About P&G Health Sciences Institute
    The P&G Health Sciences Institute is a conglomerate of P&G research
expertise and capabilities including state of the art research facilities
dedicated to identifying, developing, and using leading health care
technologies in the development of effective products for both the
developing and developed world. Procter & Gamble has a long history of
scientific research both internally and through collaboration with external
partners in the areas of health, hygiene, and nutrition, dating back more
than 50 years. Please visit pghsi.com for more information on the P&G
Health Sciences Institute as well as pg.com for the latest news and
in-depth information about P&G and its brands.[/size]
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« Reply #16 on: April 23, 2007, 06:03:33 am »

Misconceptions Linger Around Irritable Bowel Syndrome

New York - Irritable bowel syndrome (IBS) is a common disorder that affects 10 percent to 15 percent of people in the United States but is misunderstood by many patients and doctors, says Dr. William D. Chey, a gastroenterologist at the University of Michigan Health System.

"There are a wide spectrum of symptoms that IBS patients can experience, which can make it challenging to diagnose. While we know diet does play a role in symptoms for many patients with IBS, those 'trigger foods' often vary from person to person," Chey, director of U-M's Gastrointestinal Physiology Laboratory, said in a prepared statement.

Symptoms of IBS include cramping, abdominal pain, bloating, constipation and diarrhea. To help people with IBS gain a better understanding of the condition, Chey offered the following information about the condition:

IBS does not exist in the patient's head. While psychological distress or stress can make IBS worse, they're not the primary cause of the condition in most cases.
IBS occurs more frequently in women but "it's important that people know that there are many men diagnosed with IBS, and it also affects the elderly. In fact there's some early evidence to suggest that IBS affects 8 to 10 percent of older individuals," Chey said.

Many doctors believe IBS is not an important condition because it doesn't affect a person's lifespan. But Chey said IBS can have a significant negative effect on quality of life and the ability to function on a day-to-day basis, and should be taken seriously by both doctors and patients.

Lactose intolerance may play a role in some cases of IBS, but it's not the cause of symptoms in the vast majority of people.
Most people with IBS don't need to limit themselves to bland diets. Chey recommended that patients keep a diary of the food they eat and IBS symptoms. "At the end of a two-week period, it's possible to get a fairly good idea about whether there are specific trigger foods associated with the onset of symptoms. Those foods then can be easily eliminated from a patient's diet," he said. Chey noted that fatty foods, milk products, chocolate, alcohol, caffeine and carbonated drinks are more likely to aggravate IBS symptoms.

It doesn't require a lot of medical testing to diagnose IBS. "Identifying the presence of persistent recurrent abdominal pain in association with altered bowel habits, and excluding warning signs (e.g. new symptoms occurring after age 50, GI bleeding, unexplained weight loss, nocturnal diarrhea, severe or progressively worse symptoms or a family history of colon cancer, inflammatory bowel disease, colon cancer or celiac disease), is enough to accurately diagnose IBS in most patients," Chey said.

Effective counseling, dietary and lifestyle changes, and medication can help patients effectively manage IBS.
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« Reply #17 on: September 02, 2007, 11:01:52 am »

IBS Syndrome Explained     


Irritable Bowel Syndrome or IBS is a disorder of the gastrointestinal tract that results to recurrent upper and lower gastrointestinal symptoms. The most common symptoms of IBS include abdominal pain and altered bowel movement such as constipation, diarrhea or both.

There is still no clear cause of IBS that is why it is termed as a functional disorder since there are no signs in the bowel and yet changes are observed from its previous functional quality. Irritable Bowel Disorder may cause a great deal of discomfort and distress but will not result in permanent harm to the bowel and does not increase chances of cancer.

The good news with IBS is the fact that it can be cured by means of diet and medication. Irritable Bowel Syndrome can happen during any period of one’s life. The exact cause of IBS is not yet fully known however similar conditions in children have been observed and are believed to be the portent of adult IBS.

Some factors like emotional conflict or stress tend to aggravate IBS symptoms but research findings have shown contrasting results. Emotional conflicts are no longer accepted as factors that cause IBS.

In addition, studies also show that patients with IBS tend to develop overly sensitive bowels compared to those without IBS. It has been observed that patients with IBS even with minimal stimulation may easily distress their intestinal muscles. Accordingly, patients with IBS may strongly react to a stimulus that does not normally aggravate the bowels of a normal healthy individual.

Ordinary occurrence in the large intestines such as eating or gas production may have adverse effect on the colon of an IBS patient. Certain medications as well as food may trigger IBS symptoms. Most of the foods that trigger IBS symptoms are chocolates, fatty foods, dairy products as well as grain containing products and even alcohol may aggravate and then trigger IBS symptoms.

Caffeine may have laxative effects to some, but for IBS patients it is just one of those products that offend their digestive tract. Likewise, IBS is predominant to women with menstrual periods since reproductive hormones are believed to influence the course of IBS.

There are two types of IBS and these are diarrhea-predominant IBS and constipation-predominant IBS. These two types of IBS suggest that chronic diarrhea and chronic constipation may be examined through the bacteria derived from bowel samples. And since metronidazole and vancomycin (both antibiotics) are effective in reducing diarrhea and constipation IBS, it is a clear indication that an overgrowth of bacteria in the bowel flora may actually cause IBS. Likewise, progressive nerve damage can develop and is exhibited by some patients with chronic constipation.

It is really hard to pinpoint normal a bowel movement since various people have their own normal frequency. There may be some people whose normal bowel movement involves three stools a day while others may move their bowels everyday upon waking up. A healthy bowel movement is one that is formed but not hard, contains no blood and flushes out of the colon without unnecessary cramps or pain.

If you suspect you are suffering with IBS, you should first consult your primary care physician.

 
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« Reply #18 on: December 31, 2007, 11:20:52 pm »



12/31/2007
 Drug maker Mylan Inc. (MYL) said on Monday that the U.S. Food and Drug Administration has approved Mylan Pharmaceuticals Inc.'s Abbreviated New Drug Application for Balsalazide Disodium Capsules, 750 mg.

Balsalazide Disodium capsules are the generic version of Salix Pharmaceuticals' (SLXP) Colazal Capsules, indicated for the treatment of mildly to moderately active Ulcerative Colitis. Balsalazide is a prodrug that is enzymatically cleaved in the colon to produce mesalamine, or 5-aminosalicylic acid, an anti inflammatory drug indicated for the treatment of mildly to moderately active ulcerative colitis.

Colazal Capsules had sales of approximately $130.9 million in U.S. for the 12 months ended September30, 2007.

Mylan said it will start selling 750 mg Balsalazide Disodium Capsules immediately.

MYL closed Friday's regular trading session at $14.05.
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« Reply #19 on: February 20, 2008, 12:45:53 pm »

Oxygen Relieves IBS and Constipation Symptoms in New Clinical Studies


 A natural health company located in Houston, Global Healing Center, Inc., announces the startling results of recent clinical studies indicating their oxygen colon cleanser is extremely successful at relieving symptoms of constipation and Irritable Bowel Syndrome. In fact, the scientific data suggests this powerful colon cleansing supplement is up to 85% MORE EFFECTIVE AT ELIMINATING SYMPTOMS THAN TRADITIONAL LAXATIVES ... with a zero-percent failure rate.

Colon cleansing with an oxygen colon cleanser is likely to become the new standard for patients seeking relief for their constipation and IBS symptoms.

Dr. Edward Group III, the company CEO and head of product development, says using oxygen to colon cleanse is the best thing a person can do to improve their health. Excited about the product's potential to help millions of people suffering from constipation and IBS symptoms, he added, "The results were even better than we'd hoped for -- Oxy-Powder beat the pants off the competition in every category!"

        Results of Oxy-Powder's Effectiveness As Reported By Patients

    Category                           Constipation   Irritable Bowel Syndrome

    Relief for Feelings of Blockage  99% Improvement      100% Improvement
    Improvement in Stool Quality     89% Improvement      100% Improvement
    Relief for Abdominal Pain
     (assoc. with change in
     frequency of stools)                   n/a           100% Improvement
    Relief for Passage of Mucous            n/a           100% Improvement
    Reduction of Straining During
     Bowel Movements                 85% Improvement       96% Improvement
    Success Rate (compared
     to Dulcolax)                    85% More Effective    69% More Effective



No patient who completed the study suffered any ADR (adverse drug reaction) even after 6 weeks of use. 96% OF BOTH THE INVESTIGATORS AND PATIENTS RATED THE PRODUCT AS EITHER "EXCELLENT" OR "GOOD" indicating this colon cleanse supplement is extremely safe and effective in reducing symptoms of constipation and IBS ... and without the harmful side effects of laxatives!

The trials lasted 6 weeks and involved 40 patients suffering from constipation, IBS, or both. The study (properly termed Clinical Trials Phase I - III for Oxy-Powder for Treating Constipation and IBS) was performed according to GCP guidelines for safety, efficacy, and tolerability in human test subjects.

According to a Global Healing Center spokesperson, oxygen colon cleansing is extremely popular and is likely to be the focus of "... the next revolution in organic drug-and-surgery-free healthcare."

The full study data and results can be viewed at:
http://www.oxpowder.com/research
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« Reply #20 on: January 10, 2011, 10:19:44 am »

Salix Drug Helps Irritable Bowel Syndrome

January 6, 2011


Jan. 06--A 14-day round of antibiotic made by a Triangle drug company appears to provide months of relief from some of the worst symptoms of irritable bowel syndrome, researchers announced today.

The antibiotic, which goes by the brand name Xifaxan and is manufactured by Salix Pharmaceuticals of Morrisville, is the first therapy for IBS that offers prolonged benefit -- a feature sufferers hailed as a breakthrough.

Salix is seeking U.S. Food and Drug Administration approval to market the antibiotic for IBS, and a hearing is slated for March. The antibiotic is already approved for traveler’s diarrhea and a rare liver condition.

If approved for IBS, Xifaxan would likely be Salix’s top seller and one of the biggest products among any of the Triangle’s drug-development companies.

Irritable bowel syndrome is one of the most commonly diagnosed problems in the United States, and Salix estimates it could reap $2.5 billion a year in sales if the FDA allows it to market Xifaxan to treat IBS.

The syndrome, afflicting up to 35 million adults in the United States, is marked by varying levels of pain, bloating and either diarrhea or constipation. For those with severe symptoms, the disorder can be debilitating.

Despite the study showing Xifaxan’s success -- results were published today in the New England Journal of Medicine -- the antibiotic doesn’t work for everyone with IBS. It was tested on patients with diarrhea, not constipation, and even then, only 41 percent reported relief. By comparison, 32 percent of study participants taking a dummy pill also reported improved symptoms.

In addition, the drug is pricey, costing up to $500 for the two-week regimen.

Still, patients welcomed a potential new treatment for a disorder that has few effective remedies.

"It was a godsend to me, even though it was expensive," said David Brown, a former Danville, Va., fireman who retired on disability almost five years ago when his irritable bowel condition grew so severe he was in constant distress. Brown participated in the clinical trial testing Xifaxan at UNC-Chapel Hill.

Doctors don’t know what causes IBS, but the success of the antibiotic strongly suggests a bacterial trigger in some cases, said Dr. Yehuda Ringel, an associate professor of medicine at UNC-CH and co-author of the Xifaxan report in today’s journal.

"How does it work? We have no idea. We can speculate," Ringel said of the drug’s effect. " ...When [intestinal bacteria are] targeted, we get beneficial effect. And the effect lasts for 10 weeks, maybe more. That means we are not targeting only symptoms, but maybe the underlying cause."

More research needed

Ringel said more work is needed to figure out what species of bacteria may be the culprits and why they suddenly incite intestinal mayhem.

In addition, he said, more studies are needed to see whether Xifaxan can be used repeatedly when symptoms return, and whether it works among the other half of IBS patients who suffer constipation.

Bill Forbes, executive vice president and chief development officer of Salix, said the company may conduct further tests to explore how long it takes for patients’ symptoms to return and how well patients respond to repeat treatments.

One of the benefits of the therapy, Ringel said, is its targeted approach. The molecule is too large to be absorbed and circulated throughout the body, so it can concentrate its firepower on the bacteria in the intestines. Whatever’s not used in the gut is excreted, leaving most patients with few side effects.

New therapy welcome

Brown, the Virginia patient, said the only effect he had from taking the pill was an improvement in his symptoms -- a major plus over other treatments he has tried. He said another antibiotic caused him terrible pain.

Other IBS treatments have had safety concerns. A drug called Lotronex, manufactured by GlaxoSmithKline, was temporarily pulled from the market over reports it was linked to colitis and even death. It is now available only to women who have chronic IBS with severe diarrhea.

Forbes, the Salix executive, said a new therapy for IBS has been sorely needed.

"With IBS, ... no one really understands why patients have symptoms," Forbes said. "It becomes a condition that is diagnosed by exclusion. But the economic costs rank right up there with the worst medical conditions there are."

Staff writer David Bracken contributed to this report.
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