Menu

A+ A A-

Download article

DOI: https://doi.org/10.22263/2312-4156.2017.6.23

Makarenko E.V.
Irritable bowel syndrome: dietetic recommendations  and principles of treatment
Vitebsk State Order of Peoples’ Friendship Medical University, Vitebsk, Republic of Belarus

Vestnik VGMU. 2017;16(6):23-34.

Abstract.
Irritable bowel syndrome (IBS) is one of the most common gastrointestinal disorders. The disease is characterized by the abdominal pain combined with the changes in the frequency and characteristics of the stool and bloating. The singling out of clinical subtypes of IBS (IBS with constipation, IBS with diarrhea, mixed IBS and unclassified IBS) is based on the variants of bowel function disturbance. The recommendations concerning the diagnosis and treatment of IBS patients are based on the guidelines of the Roman IV Consensus and the British Dietetic Association published in 2016. The treatment of IBS is carried out taking into account the clinical manifestations of the disease and includes such drugs as antispasmodics, laxatives, antidiarrheals, antagonists of 5-hydroxytryptamine-3-receptors, antidepressants, as well as gut microflora manipulation.
Key words: irritable bowel syndrome, recommendations for diagnosis, treatment and nutrition.

References

1. Lovell RM, Ford AC. Global prevalence of and risk factors for irritable bowel syndrome: a metaanalysis. Clin Gastroenterol Hepatol. 2012 Jul;10(7):712-721.e4. doi: http://dx.doi.org/10.1016/j.cgh.2012.02.029
2. Camilleri M. Peripheral mechanisms in irritable bowel syndrome. N Engl J Med. 2012 Oct;367(17):1626-35. doi: http://dx.doi.org/10.1056/NEJMra1207068
3. Sultan S, Malhotra A. Irritable Bowel Syndrome. Ann Intern Med. 2017 Jun;166(11):ITC81-ITC96. doi: http://dx.doi.org/10.7326/AITC201706060
4. Ford AC, Marwaha A, Lim A, Moayyedi P. Systematic review and meta-analysis of the prevalence of irritable bowel syndrome in individuals with dyspepsia. Clin Gastroenterol Hepatol. 2010 May;8(5):401-9. doi: http://dx.doi.org/10.1016/j.cgh.2009.07.020
5. Pimanov SI, Silivonchik NN. Functional gastrointestinal disorders: Rome IV consensus: posobie dlia vrachei. Vitebsk, RB: VGMU; 2016. 189 р. (In Russ.)
6. Pimanov SI, Makarenko EV. Diagnosis and treatment of functional dyspepsia from the standpoint of the Rome consensus. Consilium medicum Gastroenterologiia. 2007;(1):3-7. (In Russ.)
7. Drossman DA. Functional gastrointestinal disorders: history, pathophysiology, clinical features and Rome IV. Gastroenterology. 2016 Feb. pii: S0016-5085(16)00223-7. doi: http://dx.doi.org/10.1053/j.gastro.2016.02.032
8. Menees SB, Powell C, Kurlander J, Goel A, Chey WD. A metaanalysis of the utility of C-reactive protein, erythrocyte sedimentation rate, fecal calprotectin, and fecal lactoferrin to exclude inflammatory bowel disease in adults with IBS. Am J Gastroenterol. 2015 Mar;110(3):444-54. doi: http://dx.doi.org/10.1038/ajg.2015.6  
9. Cash BD, Rubenstein JH, Young PE, Gentry A, Nojkov B, Lee D, et al. The prevalence of celiac disease among patients with nonconstipated irritable bowel syndrome is similar to controls. Gastroenterology. 2011 Oct;141(4):1187-93. doi: http://dx.doi.org/10.1053/j.gastro.2011.06.084
10. Mikhaylova EI, Pimanov SI, Voropaev EV, Timashova VR. Fecal marker of ulcerative colitis. Ros Zhurn Gastroenterologii Gepatologii Koloproktologii. 2007;17(5): 60-4. (In Russ.)
11. Pimanov SI, Vergasova EV, Lemeshko ZA. Diagnostic screening of colon cancer. Ros Zhurn Gastroenterologii Gepatologii Koloproktologii. 2001;11(6):15-23. (In Russ.)
12. Begtrup LM, Engsbro AL, Kjeldsen J, Larsen PV, Schaffalitzky de Muckadell O, Bytzer P, et al. A positive diagnostic strategy is noninferior to a strategy of exclusion for patients with irritable bowel syndrome. Clin Gastroenterol Hepatol. 2013 Aug;11(8):956-62.e1. doi: http://dx.doi.org/10.1016/j.cgh.2012.12.038
13. McKenzie YA, Bowyer RK, Leach H, Gulia P, Horobin J, O'Sullivan NA, et al. British Dietetic Association systematic review of systematic reviews and evidence-based practice guidelines for the use of probiotics in the management of irritable bowel syndrome in adults (2016 update). J Hum Nutr Diet. 2016 Oct;29(5):549-75. doi: http://dx.doi.org/10.1111/jhn.12385
14. Hayes PA, Fraher MH, Quigley EM. Irritable bowel syndrome: the role of food in pathogenesis and management. Gastroenterol Hepatol (N Y). 2014 Mar;10(3):164-74.
15. Monsbakken K, Vandvik P, Farup P. Perceived food intolerance in subjects with irritable bowel syndrome – etiology, prevalence and consequences. Eur J Clin Nutr. 2006 May;60(5):667-72. doi: http://dx.doi.org/10.1038/sj.ejcn.1602367
16. Guo YB, Zhuang KM, Kuang L, Zhan Q, Wang XF, Liu SD. Association between diet and lifestyle habits and irritable bowel syndrome: a case–control study. Gut Liver. 2015 Sep 23;9(5):649-56. doi: http://dx.doi.org/10.5009/gnl13437
17. El-Salhy M, Ostgaard H, Gundersen D, Hatlebakk JG, Hausken T. The role of diet in the pathogenesis and management of irritable bowel syndrome (review). Int J Mol Med. 2012 May;29(5):723-31. doi: http://dx.doi.org/10.3892/ijmm.2012.926
18. Bagyánszki M, Krecsmarik M, De Winter BY, De Man JG, Fekete E, Pelckmans PA, et al. Chronic alcohol consumption affects gastrointestinal motility and reduces the proportion of neuronal NOS-immunoreactive myenteric neurons in the murine jejunum. Anat Rec (Hoboken). 2010 Sep;293(9):1536-42. doi: http://dx.doi.org/10.1002/ar.21192
19. Rao SS, Welcher K, Zimmerman B, Stumbo P. Is coffee a colonic stimulant? Eur J Gastroenterol Hepatol. 1998 Feb;10(2):113-8.
20. Horowitz M, Wishart J, Maddox A, Russo A. The effect of chilli on gastrointestinal transit. J Gastroenterol Hepatol. 1992 Jan-Feb;7(1):52-6.
21. Caldarella MP, Milano A, Laterza F, Sacco F, Balatsinou C, Lapenna D, et al. Visceral sensitivity and symptoms in patients with constipationor diarrhea-predominant irritable bowel syndrome (IBS): effect of a low-fat intraduodenal infusion. Am J Gastroenterol. 2005 Feb;100(2):383-9. doi: http://dx.doi.org/10.1111/j.1572-0241.2005.40100.x
22. Hammer HF, Phillips SF, Camilleri M, Hanson RB. Rectal tone, distensibility, and perception: reproducibility andresponse to different distensions. Am J Physiol. 1998 Mar;274(3 Pt 1):G584-90.
23. Eswaran S, Tack J, Chey WD. Food: the forgotten factor in the irritable bowel syndrome. Gastroenterol Clin North Am. 2011 Mar;40(1):141-62. doi: http://dx.doi.org/10.1016/j.gtc.2010.12.012
24. Moayyedi P, Quigley EM, Lacy BE, Lembo AJ, Saito YA, Schiller LR, et al. The effect of fiber supplementation on irritable bowel syndrome: a systematic review and metaanalysis. Am J Gastroenterol. 2014 Sep;109(9):1367-74. doi: http://dx.doi.org/10.1038/ajg.2014
25. McKenzie YA, Alder A, Anderson W, Wills A, Goddard L, Gulia P, et al. British Dietetic Association evidence-based guidelines for the dietary management of irritable bowel syndrome in adults. J Hum Nutr Diet. 2012 Jun;25(3):260-74. doi: http://dx.doi.org/10.1111/j.1365-277X.2012.01242.x
26. Grundmann O, Yoon SL. Complementary and alternative medicines in irritable bowel syndrome: an integrative view. World J Gastroenterol. 2014 Jan;20(2):346-62. doi: http://dx.doi.org/10.3748/wjg.v20.i2.346
27. Villoria A, Serra J, Azpiroz F, Malagelada JR. Physical activity and intestinal gas clearance in patients with bloating. Am J Gastroenterol. 2006 Nov;101(11):2552-7. doi: http://dx.doi.org/10.1111/j.1572-0241.2006.00873.x
28. Ford AC, Quigley EM, Lacy BE, Lembo AJ, Saito YA, Schiller LR, et al. Effect of antidepressants and psychological therapies, including hypnotherapy, in irritable bowel syndrome: systematic review and meta-analysis. Am J Gastroenterol. 2014 Sep;109(9):1350-65; quiz 1366. doi: http://dx.doi.org/10.1038/ajg.2014.148
29. Khalif IL, Quigley EM, Makarchuk PA, Golovenko OV, Podmarenkova LF, Dzhanayev YA. Interactions between symptom and motor and visceral sensory responses of irritable bowel syndrome patients to spasmolytics (antispasmodics). J Gastrointestin Liver Dis. 2009 Mar;18(1):17-22.
30. Ruepert L, Quartero AO, de Wit NJ, van der Heijden GJ, Rubin G, Muris JW. Bulking agents, antispasmodics and antidepressants for the treatment of irritable bowel syndrome. Cochrane Database Syst Rev. 2011 Aug;(8):CD003460. doi: http://dx.doi.org/10.1002/14651858.CD003460.pub3
31. Gershon MD, Tack J. The serotonin signaling system: from basic understanding to drug development for functional GI disorders. Gastroenterology. 2007 Jan;132(1):397-414.
32. Chang L, Lembo A, Sultan S. American Gastroenterological Association Institute Technical Review on the pharmacological management of irritable bowel syndrome. Gastroenterology. 2014 Nov;147(5):1149-72.e2. doi: http://dx.doi.org/10.1053/j.gastro.2014.09.002
33. Shanahan F, Quigley EM. Manipulation of the microbiota for treatment of IBS and IBDchallenges and controversies. Gastroenterology. 2014 May;146(6):1554-63. doi: http://dx.doi.org/10.1053/j.gastro.2014.01.050
34. Ford AC, Quigley EM, Lacy BE, Lembo AJ, Saito YA, Schiller LR, et al. Efficacy of prebiotics, probiotics, and synbiotics in irritable bowel syndrome and chronic idiopathic constipation: systematic review and meta-analysis. Am J Gastroenterol. 2014 Oct;109(10):1547-61; quiz 1546, 1562. doi: http://dx.doi.org/10.1038/ajg.2014.202
35. Mazurak N, Broelz E, Storr M, Enck P. Probiotic Therapy of the Irritable Bowel Syndrome: Why Is the Evidence Still Poor and What Can Be Done About It? J Neurogastroenterol Motil. 2015 Oct;21(4):471-85. doi: http://dx.doi.org/10.5056/jnm15071
36. McGraw T. Safety of polyethylene glycol 3350 solution in chronic constipation: randomized, placebo-controlled trial. Clin Exp Gastroenterol. 2016 Jul;9:173-80. doi: http://dx.doi.org/10.2147/CEG.S111693
37. Castro J, Harrington AM, Hughes PA, Martin CM, Ge P, Shea CM, et al. Linaclotide inhibits colonic nociceptors and relieves abdominal pain via guanylate cyclase-C and extracellular cyclic guanosine 3’,5’-monophosphate. Gastroenterology. 2013 Dec;145(6):1334-46.e1-11. doi: http://dx.doi.org/10.1053/j.gastro.2013.08.017
38. Efskind PS, Bernklev T, Vatn MH. A double-blind placebo-controlled trial with loperamide in irritable bowel syndrome. Scand J Gastroenterol. 1996 May;31(5):463-8.
39. Lavö B, Stenstam M, Nielsen AL. Loperamide in treatment of irritable bowel syndrome—a double-blind placebo controlled study. Scand J Gastroenterol Suppl. 1987;130:77-80.
40. Dove LS, Lembo A, Randall CW, Fogel R, Andrae D, Davenport JM, et al. Eluxadoline benefits patients with irritable bowel syndrome with diarrhea in a phase 2 study. Gastroenterology. 2013 Aug;145(2):329-38.e1. doi: http://dx.doi.org/10.1053/j.gastro.2013.04.006
41. Lembo AJ, Lacy BE, Zuckerman MJ, Schey R, Dove LS, Andrae DA, et al. Eluxadoline for irritable bowel syndrome with diarrhea. N Engl J Med. 2016 Jan;374(3):242-253. doi: http://dx.doi.org/10.1056/NEJMoa1505180
42. Simmen U, Kelber O, Okpanyi SN, Jaeggi R, Bueter B, Weiser D. Binding of STW 5 (Iberogast) and its components to intestinal 5-HT, muscarinic M3, and opioid receptors. Phytomedicine. 2006;13 Suppl 5:51-5. doi: http://dx.doi.org/10.1016/j.phymed.2006.03.012

Information about authors:
Makarenko E.V. – Doctor of Medical Sciences, professor of the Chair of Internal Medicine No. 2 of the Faculty for Advanced Training & Retraining, Vitebsk State Order of Peoples’ Friendship Medical University.

Correspondence address: Republic of Belarus, 210023, Vitebsk, 27 Frunze ave., Vitebsk State Order of Peoples’ Friendship Medical University, Chair of Internal Medicine No. 2 of the Faculty for Advanced Training & Retraining. E-mail: Этот адрес электронной почты защищён от спам-ботов. У вас должен быть включен JavaScript для просмотра. – Elena V. Makarenko.

 

Поиск по сайту