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Irritable Bowel Syndrome (IBS)

  1. Irritable bowel syndrome (IBS) is a functional bowel disorder in which abdominal pain is associated with defecation or a change in bowel habit.
  2. There is no structural pathology in the intestine.

Lubiprostone: It activates a specific chloride channel (CIC-2) on cells lining the gut, therapy for chronic constipation.


Diagnostic criteria for IBS (Rome II criteria, 2006)
Recurrent abdominal pain or discomfort at least 3 days per month in the last 3 month associated with two or more of the following
  1. Improvement with defecation
  2. Onset associated with a change in frequency of stool
  3. Onset associated with change in form (appearance) of stool
Extra Edge
  1. Pre requisite for diagnosis of IBS – Abdominal pain
  2. Most consistence feature of IBS – Altered bowel habits
Note: Features are against the diagnosis of IBS.
  1. Presence of fever
  2. GI bleed
  3. Marked weight loss.


  1. Psycho therapy
  2. Amitriptyline
  3. 5-HT4 agonists.
Recent Advances (Ref. Hari. 18th ed., Pg - 2500)
  1. Bifidobacterium infantis showed significant improvement in the composite score for abdominal pain, bloating/distention, and/or bowel movement, especially in bloating symptoms.
  2. Rifaximin: It is an antibiotic used in IBS, especially in bloating symptoms.
  3. Tegaserod: It is used for the short-term treatment of women with (IBS) whose primary bowel symptom is constipation. Tegaserod a selective and partial agonist at the 5-HT4. exhibit prokinetic activity by stimulating peristalsis
  4. Lubiprostone is a bicyclic fatty acid that stimulates chloride channels in the apical membrane of intestinal epithelial cells.
    Tegaserod & Lubiprostone are used mainly in constipation symptoms.
  5. Alosetron and Cilancetron: 5HT3 receptor antagonist. It slows colonic transit, enhances small intestine fluid reabsorption and improves visceral pain.

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