Consultant, Department of Internal Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
Support: Writing assistance provided by Katrina Mountfort.
Received: 14.11.13 Accepted: 09.12.13
Citation: EMJ Gastroenterol. 2013;1:30-38.
Irritable bowel syndrome (IBS) is a highly prevalent functional disorder characterised by chronic and recurrent abdominal pain and altered bowel habit. Numerous pharmacological and non pharmacological treatment options have proven to have some benefit in the condition, and a multidisciplinary approach should ensure that treatment is tailored to the individual. Recently, an enhanced understanding of the pathophysiological processes underlying the condition has led to the development of new therapies, including prokinetic agents targeting serotonin (5-HT) pathways, and pro-secretory agents. Many are still at an early stage of clinical development, however, some have demonstrated improved outcomes in clinical trials and have gained regulatory approval. Lubiprostone, a calcium channel activator and linaclotide, a novel secretagogue that activates the guanylate cyclase C receptor, have demonstrated improvement of abdominal pain as well as improved bowel function in patients with IBS with constipation (IBS-C) in a series of randomised, placebo-controlled studies.