PHARMACOLOGIC TREATMENT OF THE IRRITABLE BOWEL SYNDROME: A COMPREHENSIVE SYSTEMATIC REVIEW

Authors

  • Landong Sijabat Cileungsi Regional General Hospital, Indonesia Author
  • Guinanti Novettiandari Faculty of Medicine, Malahayati University, Indonesia Author

DOI:

https://doi.org/10.61841/ypxr6c52

Keywords:

IBS, treatment, minesapride, geraniol, tenapanor, melatonin, PEA/PD

Abstract

Background: Abdominal pain and changes in stool frequency are two of the symptoms of Irritable Bowel Syndrome (IBS), a chronic gastrointestinal illness. As there is no known cure, treatment focuses on symptom management. Patients struggle with psychological and emotional issues that lower their quality of life. Clinical trials have demonstrated the therapeutic effects of several therapeutic drugs, which may improve GI symptoms and general quality of life. Effective treatment of IBS requires an understanding of the connection between pharmaceutical medicines and the illness.

Methods: Following PRISMA 2020 guidelines, this systematic review concentrated on full-text English literature published between 2014 and 2024. Editorials and review articles that appeared in the same journal as the submission were not accepted without a DOI. The literature was assembled using a variety of online databases, including ScienceDirect, PubMed, and SagePub.

Result: The study screened about 20.000 publications using reputable sources including Science Direct, SagePub, and PubMed. Seven papers were found to be pertinent for systematic investigation, after which the entire material was examined in more detail.

Conclusion: IBS treatment has shown significant improvement in patients with Minesapride, a novel 5-HT4 receptor agonist, and tenapanor. Tenapanor showed significant improvement in symptoms, treatment metrics, and satisfaction, while geraniol improved the inflammatory profile. Melatonin showed improvement in IBS score and GI symptoms, but no significant improvement in frequency of defecations per week. Amitriptyline showed effectiveness over placebo, while comicronized PEA/PD improved IBS symptoms in children.

References

Sperber, A. D., Bangdiwala, S. I., Drossman, D. A., Ghoshal, U. C., Simren, M., Tack, J., Whitehead, W. E., Dumitrascu, D. L., Fang, X., Fukudo, S., Kellow, J., Okeke, E., Quigley, E. M. M., Schmulson, M., Whorwell, P., Archampong, T., Adibi, P., Andresen, V., Benninga, M. A., … Palsson, O. S. (2021). Worldwide Prevalence and Burden of Functional Gastrointestinal Disorders, Results of Rome Foundation Global Study. Gastroenterology, 160(1), 99-114.e3. https://doi.org/10.1053/j.gastro.2020.04.014.

2. Ford, A. C., Sperber, A. D., Corsetti, M., & Camilleri, M. (2020). Irritable bowel syndrome. The Lancet, 396(10263), 1675–1688. https://doi.org/10.1016/S0140-6736(20)31548-8

3. Barberio, B., Houghton, L. A., Yiannakou, Y., Savarino, E. V., Black, C. J., & Ford, A. C. (2021). Symptom Stability in Rome IV vs Rome III Irritable Bowel Syndrome. In The American journal of gastroenterology (Vol. 116, Issue 2). https://doi.org/10.14309/ajg.0000000000000946

4. Oka, P., Parr, H., Barberio, B., Black, C. J., Savarino, E. V., & Ford, A. C. (2020). Global prevalence of irritable bowel syndrome according to Rome III or IV criteria: a systematic review and meta-analysis. The Lancet Gastroenterology and Hepatology, 5(10), 908–917. https://doi.org/10.1016/S2468-1253(20)30217-X

5. Scarpato, E., Kolacek, S., Jojkic-Pavkov, D., Konjik, V., Živković, N., Roman, E., Kostovski, A., Zdraveska, N., Altamimi, E., Papadopoulou, A., Karagiozoglou-Lampoudi, T., Shamir, R., Bar Lev, M. R., Koleilat, A., Mneimneh, S., Bruzzese, D., Leis, R., Staiano, A., Kafritsa, P., … Ivković, L. (2018). Prevalence of Functional Gastrointestinal Disorders in Children and Adolescents in the Mediterranean Region of Europe. Clinical Gastroenterology and Hepatology, 16(6), 870–876. https://doi.org/10.1016/j.cgh.2017.11.005

6. Nardo, G. Di, Bernardo, L., Cremon, C., Barbara, G., Felici, E., Evangelisti, M., Ferretti, A., Furio, S., Piccirillo, M., Coluzzi, F., Parisi, P., Mauro, A., Mari, C. Di, D’Angelo, F., & Mennini, M. (2024). Palmitoylethanolamide and polydatin in pediatric irritable bowel syndrome: A multicentric randomized controlled trial. Nutrition, 122. https://doi.org/10.1016/j.nut.2024.112397

7. Vasant, D. H., Paine, P. A., Black, C. J., Houghton, L. A., Everitt, H. A., Corsetti, M., Agrawal, A., Aziz, I., Farmer, A. D., Eugenicos, M. P., Moss-Morris, R., Yiannakou, Y., & Ford, A. C. (2021). British Society of Gastroenterology guidelines on the management of irritable bowel syndrome. Gut, 70(7), 1214–1240. https://doi.org/10.1136/gutjnl-2021-324598

8. Lacy, B. E., Chang, L., Rao, S. S. C., Heimanson, Z., & Sayuk, G. S. (2023). Rifaximin Treatment for Individual and Multiple Symptoms of Irritable Bowel Syndrome With Diarrhea: An Analysis Using New End Points. Clinical Therapeutics, 45(3), 198–209. https://doi.org/10.1016/j.clinthera.2023.01.010

9. Ford, A. C., Wright-Hughes, A., Alderson, S. L., Ow, P. L., Ridd, M. J., Foy, R., Bianco, G., Bishop, F. L., Chaddock, M., Cook, H., Cooper, D., Fernandez, C., Guthrie, E. A., Hartley, S., Herbert, A., Howdon, D., Muir, D. P., Nath, T., Newman, S., … Everitt, H. A. (2023). Amitriptyline at Low-Dose and Titrated for Irritable Bowel Syndrome as Second-Line Treatment in primary care (ATLANTIS): a randomised, double-blind, placebocontrolled, phase 3 trial. The Lancet, 402(10414), 1773–1785. https://doi.org/10.1016/S0140-6736(23)01523-4

10. Goodoory, V. C., Guthrie, E. A., Ng, C. E., Black, C. J., & Ford, A. C. (2023). Factors associated with lower disease-specific and generic health-related quality of life in Rome IV irritable bowel syndrome. Alimentary

Pharmacology and Therapeutics, 57(3), 323–334. https://doi.org/10.1111/apt.17356

11. Tang, H.-Y., Jiang, A.-J., Wang, X.-Y., Wang, H., Guan, Y.-Y., Li, F., & Shen, G.-M. (2021). Uncovering the pathophysiology of irritable bowel syndrome by exploring the gut-brain axis: a narrative review. Annals of Translational Medicine, 9(14), 1187–1187. https://doi.org/10.21037/atm-21-2779

12. Ballou, S., Mcmahon, C., Lee, H., Katon, J., Shin, A., Singh, P., Nee, J., Camilleri, M., Lembo, A., Israel, B., Medical, D., Enteric, C., Translational, N., & Clinic, M. (2020). HHS Public Access. 17(12), 2471–2478. https://doi.org/10.1016/j.cgh.2019.08.016.Effects

13. Hoekman, D. R., Rutten, J. M. T. M., Vlieger, A. M., Benninga, M. A., & Dijkgraaf, M. G. W. (2015). Annual Costs of Care for Pediatric Irritable Bowel Syndrome, Functional Abdominal Pain, and Functional Abdominal Pain Syndrome. Journal of Pediatrics, 167(5), 1103-1108.e2. https://doi.org/10.1016/j.jpeds.2015.07.058

14. Törnblom, H., Goosey, R., Wiseman, G., Baker, S., & Emmanuel, A. (2018). Understanding symptom burden and attitudes to irritable bowel syndrome with diarrhoea: Results from patient and healthcare professional surveys. United European Gastroenterology Journal, 6(9), 1417–1427. https://doi.org/10.1177/2050640618787648

15. Faghih Dinevari, M., Jafarzadeh, F., Jabbaripour Sarmadian, A., Abbasian, S., Nikniaz, Z., & Riazi, A. (2023). The effect of melatonin on irritable bowel syndrome patients with and without sleep disorders: a randomized double-blinded placebo-controlled trial study. BMC Gastroenterology, 23(1), 1–11. https://doi.org/10.1186/s12876-023-02760-0

16. Ricci, C., Rizzello, F., Valerii, M. C., Spisni, E., Gionchetti, P., Turroni, S., Candela, M., D’Amico, F., Spigarelli, R., Bellocchio, I., Marasco, G., & Barbara, G. (2022). Geraniol Treatment for Irritable Bowel Syndrome: A Double-Blind Randomized Clinical Trial. Nutrients, 14(19). https://doi.org/10.3390/nu14194208

17. Hamatani, T., Fukudo, S., Nakada, Y., Inada, H., Kazumori, K., & Miwa, H. (2020). Randomised clinical trial: minesapride vs placebo for irritable bowel syndrome with predominant constipation. Alimentary Pharmacology and Therapeutics, 52(3), 430–441. https://doi.org/10.1111/apt.15907

18. Chey, W. D., Lembo, A. J., Yang, Y., & Rosenbaum, D. P. (2021). Efficacy of Tenapanor in Treating Patients With Irritable Bowel Syndrome With Constipation: A 26-Week, Placebo-Controlled Phase 3 Trial (T3MPO-2). American Journal of Gastroenterology, 116(6), 1294–1303. https://doi.org/10.14309/ajg.0000000000001056

19. Fukudo, S., Miwa, H., Nakajima, A., Haruma, K., Kosako, M., Nakagawa, A., Akiho, H., Yamaguchi, Y., Johnston, J. M., Currie, M., & Kinoshita, Y. (2018). A randomized controlled and long-term linaclotide study of irritable bowel syndrome with constipation patients in Japan. Neurogastroenterology and Motility, 30(12), 1–12. https://doi.org/10.1111/nmo.13444

20. Rizzello, F., Ricci, C., Scandella, M., Cavazza, E., Giovanardi, E., Valerii, M. C., Campieri, M., Comparone, A., De Fazio, L., Candela, M., Turroni, S., & Spisni, E. (2018). Dietary geraniol ameliorates intestinal dysbiosis and relieves symptoms in irritable bowel syndrome patients: A pilot study. BMC Complementary and Alternative Medicine, 18(1), 1–11. https://doi.org/10.1186/s12906-018-2403-6

21. Brinn, N. R., & Gandhi, M. A. (2014). A review of the role of melatonin in irritable bowel syndrome. American Journal of Pharmacy and Health Research, 2(12), 1.

22. Wang, B., Duan, R., & Duan, L. (2018). Prevalence of sleep disorder in irritable bowel syndrome: A systematic review with meta-analysis. Saudi Journal of Gastroenterology, 24(3), 141–150. https://doi.org/10.4103/sjg.SJG_603_17

23. Hookway, C., Buckner, S., Crosland, P., & Longson, D. (2015). Irritable bowel syndrome in adults in primary care: Summary of updated NICE guidance. BMJ (Online), 350(February), 1–4. https://doi.org/10.1136/bmj.h701

24. Lembo, A., Kelley, J. M., Nee, J., Ballou, S., Iturrino, J., Cheng, V., Rangan, V., Katon, J., Hirsch, W., Kirsch, I., Hall, K., Davis, R. B., & Kaptchuk, T. J. (2021). Open-label placebo vs double-blind placebo for irritable bowel syndrome: A randomized clinical trial. Pain, 162(9), 2428–2435. https://doi.org/10.1097/j.pain.0000000000002234

25. Lembo, A., Pimentel, M., Rao, S. S., Schoenfeld, P., Cash, B., Weinstock, L. B., Paterson, C., Bortey, E., & Forbes, W. P. (2016). Repeat Treatment With Rifaximin Is Safe and Effective in Patients With Diarrhea-Predominant Irritable Bowel Syndrome. Gastroenterology, 151(6), 1113–1121. https://doi.org/10.1053/j.gastro.2016.08.003

26. US Department of Health and Human Services, Food and Drug Administration, Center for Drug Evaluation and Research. Guidance for Industry: Irritable Bowel Syndrome—Clinical Evaluation of Drugs for Treatment. Silver Spring, MD: Center for Drug Evaluation and Research (CDER); 2012.

27. Cremon, C., Stanghellini, V., Barbaro, M. R., Cogliandro, R. F., Bellacosa, L., Santos, J., Vicario, M., Pigrau, M., Alonso Cotoner, C., Lobo, B., Azpiroz, F., Bruley des Varannes, S., Neunlist, M., DeFilippis, D., Iuvone, T., Petrosino, S., Di Marzo, V., & Barbara, G. (2017). Randomised clinical trial: the analgesic properties of dietary supplementation with palmitoylethanolamide and polydatin in irritable bowel syndrome. Alimentary Pharmacology and Therapeutics, 45(7), 909–922. https://doi.org/10.1111/apt.13958

28. Cremon, C., Stanghellini, V., Pallotti, F., Fogacci, E., Bellacosa, L., Morselli-Labate, A. M., Paccapelo, A., Di Nardo, G., Cogliandro, R. F., De Giorgio, R., Corinaldesi, R., & Barbara, G. (2014). Salmonella gastroenteritis during childhood is a risk factor for irritable bowel syndrome in adulthood. Gastroenterology, 147(1), 69–77. https://doi.org/10.1053/j.gastro.2014.03.013

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Published

2024-05-02

How to Cite

Sijabat, L., & Novettiandari, G. (2024). PHARMACOLOGIC TREATMENT OF THE IRRITABLE BOWEL SYNDROME: A COMPREHENSIVE SYSTEMATIC REVIEW . Journal of Advanced Research in Medical and Health Science (ISSN 2208-2425), 10(5), 26-34. https://doi.org/10.61841/ypxr6c52

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