Irritable bowel syndrome medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

Medical Therapy

Medical therapy of IBS

  • The multimodal treatment regimen is preferred for Irritable Bowel Syndrome (IBS).[1][2][3][4][5]
  • IBS is heterogeneous in its presentation, which makes it difficult to treat.[6]
  • It is necessary to build a good physician patient rapport due to the following reasons:[2][7][8][9][10][11][12][13][14][15][16][17]
    • IBS has a remarkably high placebo response rate
    • Patient regimens need to be individualized in IBS patients
    • Appropriate goals need to be set with emphasis on the chronic nature of the syndrome
    • Patient counseling plays an important role

Dietary Measures

  • General instructions:[18][19][20][21][22][23][24]
    • Careful dietary history must be taken
    • Caffeine and alcohol avoidance decreases anxiety in patients
    • Legume avoidance decreases symptoms of flatulence
    • Skipping entire meals may worsen IBS symptoms
    • Avoidance of large meals
    • Reduced fat intake
    • Elimination diets help remove the most common dietary allergens[25][26][27]
    • Judicious water intake for the constipation-predominant IBS patients
    • Fiber supplementation
    • Individualized dietary recommendations are preferable
    • Avoidance of gluten as gluten sensitivity may manifest in a subset of IBS patients [28][29][30][31]

Exclusion of gas-producing foods:

  • Beans, onions, celery, carrots, raisins, bananas, apricots, prunes, cabbage, onions, brussels sprouts, wheat germ, pretzels, and bagels

Low FODMAP diet:

  • A diet low in fermentable oligo-, di-, and monosaccharides and polyols (FODMAPs) is preferred in IBS patients.[23]
  • Education consists of: [21][25]
    • Elimination of dietary FODMAPs for 6-8 weeks
    • Reintroduction of foods high in FODMAPs to determine individual tolerance to specific foods
  • High FODMAP foods include: [9][32]
    • honey, mangoes cherries, high-fructose corn syrup, apples, pears, or oligosaccharides such as wheat
    • mannitol, sorbitol, fructose, lactose, fructans, xylitol, and galactans
    • sugar-alcohols such as isomalt, maltitol, erythritol, lactitol, mannitol and xylitol
  • High FODMAP foods are poorly absorbed by the gut and are osmotically active short chain carbohydrates.
  • Rapid fermentation of high FODMAP foods results in symptoms of abdominal discomfort and flatulence.[21][32][33][34]

Lactose avoidance:

IBS patients have more subjective lactose intolerance complaints (flatulence and diarrhea) as compared to other individuals.[35][36]

  • Lactose ingestion leads to production of hydrogen gas.
  • Bacterial fermentation of the unabsorbed lactose causes symptoms of bloating and distension.
  • Lactose intolerance can be diagnosed using breath testing.[37]
  • IBS patients with lactose intolerance should be given a lactose-restricted diet.[27][38][39][40]

Fiber in the diet:

  • Dietary fiber decreases symptoms of bloating in IBS patients. [27][41][42][43][44][45]
  • Soluble fibers are preferred as compared to insoluble fibers for treating symptoms of constipation.[46]

PSYCHOLOGICAL THERAPY

  • The 2009 American College of Gastroenterologists (ACG) state that:
  • In all IBS patients, a psychiatric referral must be considered.
  • Cognitive-behavioral therapy and interpersonal psychotherapy
  • Dynamic psychotherapy, and hypnotherapy
  • Antidepressants: Selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants are effective in the treatment of irritable bowel syndrome

ADJUNCTIVE PHARMACOLOGIC THERAPY

  • Agents used for the management of IBS symptoms include:
    • Anticholinergics
    • Antidiarrheals
    • Tricyclic antidepressants
    • Prokinetics
    • Bulk-forming laxatives [6][45][10]
    • Serotonin receptor antagonists
    • Chloride channel activators
    • Guanylate cyclase C (GC-C) agonists: Linaclotide for the management of the constipation-predominant disease (IBS-C) subtype [47]
    • Antispasmodics such as peppermint oil, pinaverium, trimebutine, and cimetropium/dicyclomine [48][49][50][51]
    • Peppermint oil, which has antispasmodic properties by relaxing smooth muscle, Use: abdominal discomfort pain and abdominal distention
    • Loperamide effectively reduced stool frequency and improved stool consistency [44][10][1][52][53][54] [1]
    • Polyethylene glycol [55]: polyethylene glycol can be considered for refractory cases as it was shown to improve stool frequency [44]
    • Rifaximin (550 mg PO q8h for 14 d) for bloating, abdominal pain, diarrhea [56][57][58]

Constipation-predominant symptoms

Linaclotide and lubiprostone enhance chloride-rich intestinal fluid secretions without altering sodium and potassium concentrations in the serum.

  • Lubiprostone (Amitiza) [59][16]
    • MOA: activates chloride channels in the apical part of the small bowel epithelium. As a result, chloride ions are secreted and sodium and water passively diffuse into the lumen to maintain isotonicity.[59]
  • Linaclotide (Linzess) [60][61][60][61]
    • Guanylate cyclase agonist; activates chloride channels in intestinal epithelial cells to increase intestinal fluid secretion

Diarrhea-predominant IBS

  • Alosetron (Lotronex): Alosetron is a 5-HT3 receptor antagonist.
    • 5-HT3 receptors are located on the enteric neurons of the GI tract, and stimulation causes hypersensitivity and hyperactivity of the intestine.
  • Eluxadoline (Viberzi): Eluxadoline is a mu opioid receptor agonist, delta opioid receptor antagonist, and a kappa opioid receptor agonist.

Anticholinergics

  • MOA: inhibit intestinal smooth-muscle depolarization at the muscarinic receptor, relieving symptoms of intestinal spasms in irritable bowel syndrome
    • Dicyclomine hydrochloride (Bentyl)
    • MOA: blocks the action of acetylcholine at parasympathetic sites in secretory glands, smooth muscle, and CNS, decreasing fecal urgency and pain.
    • Hyoscyamine sulfate (Levsin)
    • MOA: blocks the action of acetylcholine at parasympathetic sites in smooth muscle, secretory glands, and the CNS, which, in turn, has antispasmodic effects, decreases fecal urgency and pain.

Antidiarrheals

  • MOA: nonabsorbable synthetic opioids.
    • They prolong the GI transit time
    • decrease secretion via peripheral µ-opioid receptors
    • reduce visceral nociception via afferent pathway inhibition
  • Diphenoxylate hydrochloride 2.5 mg with atropine sulfate 0.025 mg (Lomotil)
  • Diphenoxylate is a constipating meperidine congener and 0.025 mg of atropine discourages abuse.
  • MOA: inhibits excessive GI propulsion and motility, but it may exacerbate constipation.
  • Loperamide (Imodium)
    • MOA: acts on intestinal muscles to inhibit peristalsis and to slow intestinal motility
    • prolongs the movement of electrolytes and fluid through bowel
    • increases the viscosity and loss of fluids and electrolytes
    • Loperamide improves stool frequency and consistency, reduces abdominal pain and fecal urgency, and may exacerbate constipation
    • MOA:  increase gastrointestinal transit time by interacting with the GI musculature, thus allowing for more water absorption Side effects: used with extreme caution because severe constipation

addiction potential.

imipramine and amitriptyline have both antidepressive and analgesic properties.

MOA:

facilitate endogenous endorphin release

blockade of norepinephrine leading to enhancement of descending inhibitory pain pathways

blockade of the pain neuromodulator, serotonin

TCAs, via their anticholinergic properties, also slow intestinal transit time, which may provide benefit in diarrhea-predominant IBS

reduce the visceral hypersensitivity

side effects of constipation and sedation is essential.

    • Imipramine (Tofranil)
    • increases pain threshold in the gut, thereby providing a visceral analgesic effect. [73]
    • prolongs oral-cecal transit time; reduces abdominal pain, mucorrhea, and stool frequency
  • Amitriptyline (Elavil) [74][75]
    • MOA: provides a visceral analgesic effect at doses subtherapeutic for antidepressive actions
    • prolongs oral-cecal transit time, reduces abdominal pain, mucorrhea, and stool frequency

Antibiotics

  • benefit from treatment appears to be transient.
  • routine use of antibiotics in all IBS patients is not recommended.
  • try a 2-wk trial of rifaximin in those patients with IBS without constipation and with moderate to severe symptoms, especially bloating, who have failed other therapies. 
  • MOA: prevent the overgrowth of intestinal bacteria

Rifaximin (Xifaxan) [56][76]

  • Rifaximin is a semisynthetic derivative of rifampin
  • MOA: binding to the beta-subunit of bacterial DNA-dependent RNA polymerase, blocking one of the steps in transcription.
  • inhibition of bacterial protein synthesis thereby inhibiting bacterial growth

Bulk-Forming Laxatives [48]

  • Composition: natural and semi-synthetic hydrophilic polysaccharides and cellulose derivatives that form emollient gels in water and facilitate intestinal passage and stimulate peristalsis.
  • As fiber supplements, these products improve symptoms of constipation and diarrhea
  • Methylcellulose (Citrucel)
    • MOA: promotes bowel evacuation by forming a viscous liquid and promoting peristalsis.
  • Psyllium (Metamucil, Fiberall, Reguloid, Konsyl)
    • Psyllium promotes bowel evacuation by forming a viscous liquid and promoting peristalsis.

INITIAL THERAPY [1]

Education and reassurance — Patient must be involved in treatment decisions.

Physical activity — potential benefit with regard to IBS symptoms and the general health benefits of exercise [77]

  • Exercise relieves symptoms by : [18][78][79][43][80]
    • maintain GI function
    • reduce stress
    • protects against GI symptom aggravation
    • alleviates gas  
    • Pranayama yoga increases sympathetic tone, which is decreased in IBS-D [81][82]

ADJUNCTIVE PHARMACOLOGIC THERAPY 

Constipation —  

IBS with constipation (IBS-C) who have failed a trial of soluble fiber (eg, psyllium/ispaghula), we suggest polyethylene glycol (PEG).
treat patients with persistent constipation despite treatment with PEG with lubiprostone or linaclotide.
  • increase  consumption of fiber-enriched foods
  • fluid intake to prevent stool dehydration
  • schedule times for bowel evacuations with the aid of stimulating substances such as coffee or prunes allows for a regimental routine
  •  Bulking agents (corn fiber, bran, psyllium, polycarbophil, ispaghula husk, and methylcellulose)
  • MOA: increases luminal water, which adds bulk to the stool and allows easier stool passage.

Osmotic laxatives[83] — PEG is inexpensive, widely available, and has fewer side effects as compared with other osmotic laxatives (eg, lactulose, milk of magnesia).[84][85][86][87][88][89][90][91][92][93]

Lubiprostone — Lubiprostone is a locally acting chloride channel activator that enhances chloride-rich intestinal fluid secretion. [16]

Guanylate cyclase agonists — Linaclotide is a guanylate cyclase agonist that stimulates intestinal fluid secretion and transit. Diarrhea was the most common side effect.[16] 

5-hydroxytryptamine (serotonin) 4 receptor agonists  prokinetics or secretagogues for patients with constipation predominant

[94][95] Agonists of the 5-hydroxytryptamine-4 (5-HT4) receptor stimulate the release of neurotransmitters and increase colonic motility.

However, the first partial 5-HT4 receptor agonist, tegaserod has cardiovascular side effects. 

Diarrhea —

Use antidiarrheals (eg, loperamide) as initial treatment Use bile acid sequestrants as second-line therapy

Antidiarrheal agents — loperamide 2 mg 45 minutes before a meal on regularly scheduled doses. Antidiarrheal agents inhibit peristalsis, prolong transit time, and reduce fecal volume.

  • Eluxadoline is an agent that combines a mu-opioid receptor agonist and a delta-opioid receptor antagonist.[96][97][98]

Adverse events associated with eluxadoline were nausea, constipation, and abdominal pain.

Pancreatitis developed in a small fraction of patients treated with eluxadoline. 

Bile acid sequestrants — 

side effects including bloating, flatulence, abdominal discomfort, and constipation. 50 percent of patients with functional diarrhea and IBS-D have bile acid malabsorption [99][100][101][101]

Cholestyramine [44]

Bile acids cause diarrhea by stimulating colonic secretion and motility.

5-hydroxytryptamine (serotonin) 3 receptor antagonists[102][103][104][105][106]  Alosetron, a 5-hydroxytryptamine-3 receptor (5HT-3) antagonist, for the treatment of severe diarrhea-predominant IBS who have failed to respond to all other conventional treatment. Alosetron modulates visceral afferent activity from the gastrointestinal tract, thereby decreasing colonic motility and secretion, and may improve abdominal pain Side effects of ischemic colitis and complications of severe constipation [102][44][107][108]

Abdominal pain and bloating — In patients with abdominal pain due to IBS, we use antispasmodics. In patients with persistent abdominal pain despite antispasmodics, we recommend a trial of antidepressants.

Antispasmodic agents [48][48][109][1][6] — Antispasmodic include those that directly affect intestinal smooth muscle relaxation (eg, mebeverine and pinaverine), and those that act via their anticholinergic properties (eg, dicyclomine and hyoscyamine). [110][111][108]

  • S/E constipation [1]

MOA: The selective inhibition of gastrointestinal smooth muscle by antispasmodics and peppermint oil reduce stimulated colonic motor activity and may be beneficial in patients with postprandial abdominal pain, gas, bloating, and fecal urgency. [42]

Typical doses include:

●Dicyclomine 20 mg orally four times daily

●Hyoscyamine 0.125 to 0.25 mg orally or sublingually three to four times daily as needed

●Sustained release hyoscyamine 0.375 to 0.75 mg orally every 12 hours

Side effects:

constipation

dry mouth

visual disturbances

urinary retention

Antidepressants — [1][48][1][9] Antidepressants have analgesic properties independent of their mood improving effects.

Tricyclic antidepressants (TCAs), via their anticholinergic properties, also slow intestinal transit time, which may provide benefit in diarrhea-predominant IBS. [63][62][73][64]

Due to the delayed onset of action of antidepressants, three to four weeks of therapy should be attempted before increasing the dose. 

Amitriptyline, nortriptyline, and imipramine can be started at a dose of 10 to 25 mg at bedtime.

Desipramine should be started at a dose of 12.5 to 25 mg at bedtime. If the patient is intolerant of one TCA, another may be tried.

Antibiotics — In patients with moderate to severe IBS without constipation, particularly those with bloating, who have failed to respond to other therapies (eg, a diet low in fermentable oligo-, di-, and monosaccharides and polyols [FODMAPs], antispasmodics, and TCAs), we suggest a two-week trial of rifaximin. [112][57][57][113][57]

Probiotics — Probiotics are not routinely recommended in patients with IBS. [114][115][44][6][116][50][117]

 Use: reduce pain, bloating, and defecatory difficulty and to normalize stool habit in IBS patients, regardless of predominant bowel habit.

Probiotics relieve pain, bloating, and flatulence

REFRACTORY SYMPTOMS —presence of alarm features that should prompt further evaluation.

Behavior modification — Patients with unrelenting symptoms that are associated with psychiatric impairment may benefit from behavioral modification in conjunction with antidepressants. [118]

Anxiolytics —  limited to short-term (less than two weeks) reduction of acute situational anxiety that may be contributing to symptoms. Side effects of anxiolytics include the risk of habituation, rebound withdrawal, and drug interactions. Furthermore, benzodiazepines may lower pain thresholds by stimulating gamma aminobutyric acid (GABA) receptors, thereby decreasing brain serotonin.

Other therapies — [116][119][120][117][116] Other therapies have been evaluated in patients with IBS (eg, herbs, acupuncture, enzyme supplementation, and mast cell stabilizers) but their role in the treatment of IBS remains uncertain.

  • herbal medicines
  • Apuncture[121][122]: specific targets for acupuncture on serotonergic, cholinergic, and glutamatergic pathways as well as reductions in blood cortisol level [123][124]
  • mind-body therapies: [1]
    • hypnotherapy
    • cognitive-behavioral therapy
Ketotifen, a mast cell stabilizer, has been studied for the treatment of IBS based upon the theory that mast cell activation contributes to visceral hypersensitivity.[127][128]

Tight-junction modulators (e.g., larazotide) for patients with evidence of immune activation or increased mucosal permeability.

Disease Name

  • 1 Stage 1 - Name of stage
    • 1.1 Specific Organ system involved 1
      • 1.1.1 Adult
        • Preferred regimen (1): drug name 100 mg PO q12h for 10-21 days (Contraindications/specific instructions)
        • Preferred regimen (2): drug name 500 mg PO q8h for 14-21 days
        • Preferred regimen (3): drug name 500 mg q12h for 14-21 days
        • Alternative regimen (1): drug name 500 mg PO q6h for 7–10 days
        • Alternative regimen (2): drug name 500 mg PO q12h for 14–21 days
        • Alternative regimen (3): drug name 500 mg PO q6h for 14–21 days
      • 1.1.2 Pediatric
        • 1.1.2.1 (Specific population e.g. children < 8 years of age)
          • Preferred regimen (1): drug name 50 mg/kg PO per day q8h (maximum, 500 mg per dose)
          • Preferred regimen (2): drug name 30 mg/kg PO per day in 2 divided doses (maximum, 500 mg per dose)
          • Alternative regimen (1): drug name10 mg/kg PO q6h (maximum, 500 mg per day)
          • Alternative regimen (2): drug name 7.5 mg/kg PO q12h (maximum, 500 mg per dose)
          • Alternative regimen (3): drug name 12.5 mg/kg PO q6h (maximum, 500 mg per dose)
        • 1.1.2.2 (Specific population e.g. 'children < 8 years of age')
          • Preferred regimen (1): drug name 4 mg/kg/day PO q12h（maximum, 100 mg per dose）
          • Alternative regimen (1): drug name 10 mg/kg PO q6h (maximum, 500 mg per day)
          • Alternative regimen (2): drug name 7.5 mg/kg PO q12h (maximum, 500 mg per dose)
          • Alternative regimen (3): drug name 12.5 mg/kg PO q6h (maximum, 500 mg per dose)
    • 1.2 Specific Organ system involved 2
      • 1.2.1 Adult
        • Preferred regimen (1): drug name 500 mg PO q8h
      • 1.2.2 Pediatric
        • Preferred regimen (1): drug name 50 mg/kg/day PO q8h (maximum, 500 mg per dose)
  • 2 Stage 2 - Name of stage
    • 2.1 Specific Organ system involved 1
      Note (1):
      Note (2):
      Note (3):
      • 2.1.1 Adult
        • Parenteral regimen
          • Preferred regimen (1): drug name 2 g IV q24h for 14 (14–21) days
          • Alternative regimen (1): drug name 2 g IV q8h for 14 (14–21) days
          • Alternative regimen (2): drug name 18–24 MU/day IV q4h for 14 (14–21) days
        • Oral regimen
          • Preferred regimen (1): drug name 500 mg PO q8h for 14 (14–21) days
          • Preferred regimen (2): drug name 100 mg PO q12h for 14 (14–21) days
          • Preferred regimen (3): drug name 500 mg PO q12h for 14 (14–21) days
          • Alternative regimen (1): drug name 500 mg PO q6h for 7–10 days
          • Alternative regimen (2): drug name 500 mg PO q12h for 14–21 days
          • Alternative regimen (3):drug name 500 mg PO q6h for 14–21 days
      • 2.1.2 Pediatric
        • Parenteral regimen
          • Preferred regimen (1): drug name 50–75 mg/kg IV q24h for 14 (14–21) days (maximum, 2 g)
          • Alternative regimen (1): drug name 150–200 mg/kg/day IV q6–8h for 14 (14–21) days (maximum, 6 g per day)
          • Alternative regimen (2):  drug name 200,000–400,000 U/kg/day IV q4h for 14 (14–21) days (maximum, 18–24 million U per day) '(Contraindications/specific instructions)'
        • Oral regimen
          • Preferred regimen (1): drug name 50 mg/kg/day PO q8h for 14 (14–21) days (maximum, 500 mg per dose)
          • Preferred regimen (2): drug name (for children aged ≥ 8 years) 4 mg/kg/day PO q12h for 14 (14–21) days (maximum, 100 mg per dose)
          • Preferred regimen (3): drug name 30 mg/kg/day PO q12h for 14 (14–21) days (maximum, 500 mg per dose)
          • Alternative regimen (1): drug name 10 mg/kg PO q6h 7–10 days (maximum, 500 mg per day)
          • Alternative regimen (2): drug name 7.5 mg/kg PO q12h for 14–21 days (maximum, 500 mg per dose)
          • Alternative regimen (3): drug name 12.5 mg/kg PO q6h for 14–21 days (maximum,500 mg per dose)
    • 2.2 Other Organ system involved 2
      Note (1):
      Note (2):
      Note (3):
      • 2.2.1 Adult
        • Parenteral regimen
          • Preferred regimen (1): drug name 2 g IV q24h for 14 (14–21) days
          • Alternative regimen (1): drug name 2 g IV q8h for 14 (14–21) days
          • Alternative regimen (2): drug name 18–24 MU/day IV q4h for 14 (14–21) days
        • Oral regimen
          • Preferred regimen (1): drug name 500 mg PO q8h for 14 (14–21) days
          • Preferred regimen (2): drug name 100 mg PO q12h for 14 (14–21) days
          • Preferred regimen (3): drug name 500 mg PO q12h for 14 (14–21) days
          • Alternative regimen (1): drug name 500 mg PO q6h for 7–10 days
          • Alternative regimen (2): drug name 500 mg PO q12h for 14–21 days
          • Alternative regimen (3):drug name 500 mg PO q6h for 14–21 days
      • 2.2.2 Pediatric
        • Parenteral regimen
          • Preferred regimen (1): drug name 50–75 mg/kg IV q24h for 14 (14–21) days (maximum, 2 g)
          • Alternative regimen (1): drug name 150–200 mg/kg/day IV q6–8h for 14 (14–21) days (maximum, 6 g per day)
          • Alternative regimen (2):  drug name 200,000–400,000 U/kg/day IV q4h for 14 (14–21) days (maximum, 18–24 million U per day)
        • Oral regimen
          • Preferred regimen (1): drug name 50 mg/kg/day PO q8h for 14 (14–21) days (maximum, 500 mg per dose)
          • Preferred regimen (2): drug name 4 mg/kg/day PO q12h for 14 (14–21) days (maximum, 100 mg per dose)
          • Preferred regimen (3): drug name 30 mg/kg/day PO q12h for 14 (14–21) days (maximum, 500 mg per dose)
          • Alternative regimen (1): drug name 10 mg/kg PO q6h 7–10 days (maximum, 500 mg per day)
          • Alternative regimen (2): drug name 7.5 mg/kg PO q12h for 14–21 days (maximum, 500 mg per dose)
          • Alternative regimen (3): drug name 12.5 mg/kg PO q6h for 14–21 days (maximum,500 mg per dose)

References

  1. ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 Brandt LJ, Chey WD, Foxx-Orenstein AE, Schiller LR, Schoenfeld PS, Spiegel BM, Talley NJ, Quigley EM (2009). "An evidence-based position statement on the management of irritable bowel syndrome". Am. J. Gastroenterol. 104 Suppl 1: S1–35. doi:10.1038/ajg.2008.122. PMID 19521341.
  2. ↑ 2.0 2.1 Drossman DA, Thompson WG (1992). "The irritable bowel syndrome: review and a graduated multicomponent treatment approach". Ann. Intern. Med. 116 (12 Pt 1): 1009–16. PMID 1586090.
  3. ↑ Weinberg DS, Smalley W, Heidelbaugh JJ, Sultan S (2014). "American Gastroenterological Association Institute Guideline on the pharmacological management of irritable bowel syndrome". Gastroenterology. 147 (5): 1146–8. doi:10.1053/j.gastro.2014.09.001. PMID 25224526.
  4. ↑ Camilleri M (2012). "Pharmacology of the new treatments for lower gastrointestinal motility disorders and irritable bowel syndrome". Clin. Pharmacol. Ther. 91 (1): 44–59. doi:10.1038/clpt.2011.261. PMID 22071696.
  5. ↑ Akehurst R, Kaltenthaler E (2001). "Treatment of irritable bowel syndrome: a review of randomised controlled trials". Gut. 48 (2): 272–82. PMC 1728206. PMID 11156653.
  6. ↑ 6.0 6.1 6.2 6.3 Jailwala J, Imperiale TF, Kroenke K (2000). "Pharmacologic treatment of the irritable bowel syndrome: a systematic review of randomized, controlled trials". Ann. Intern. Med. 133 (2): 136–47. PMID 10896640.
  7. ↑ Owens DM, Nelson DK, Talley NJ (1995). "The irritable bowel syndrome: long-term prognosis and the physician-patient interaction". Ann. Intern. Med. 122 (2): 107–12. PMID 7992984.
  8. ↑ Drossman DA (1995). "Diagnosing and treating patients with refractory functional gastrointestinal disorders". Ann. Intern. Med. 123 (9): 688–97. PMID 7574225.
  9. ↑ 9.0 9.1 9.2 Occhipinti K, Smith JW (2012). "Irritable bowel syndrome: a review and update". Clin Colon Rectal Surg. 25 (1): 46–52. doi:10.1055/s-0032-1301759. PMC 3348735. PMID 23449495.
  10. ↑ 10.0 10.1 10.2 Brandt LJ, Bjorkman D, Fennerty MB, Locke GR, Olden K, Peterson W, Quigley E, Schoenfeld P, Schuster M, Talley N (2002). "Systematic review on the management of irritable bowel syndrome in North America". Am. J. Gastroenterol. 97 (11 Suppl): S7–26. PMID 12425586.
  11. ↑ Stewart AL, Hays RD, Ware JE (1988). "The MOS short-form general health survey. Reliability and validity in a patient population". Med Care. 26 (7): 724–35. PMID 3393032.
  12. ↑ Gralnek IM, Hays RD, Kilbourne A, Naliboff B, Mayer EA (2000). "The impact of irritable bowel syndrome on health-related quality of life". Gastroenterology. 119 (3): 654–60. PMID 10982758.
  13. ↑ Harvey RF, Mauad EC, Brown AM (1987). "Prognosis in the irritable bowel syndrome: a 5-year prospective study". Lancet. 1 (8539): 963–5. PMID 2882351.
  14. ↑ Kaptchuk TJ, Kelley JM, Conboy LA, Davis RB, Kerr CE, Jacobson EE, Kirsch I, Schyner RN, Nam BH, Nguyen LT, Park M, Rivers AL, McManus C, Kokkotou E, Drossman DA, Goldman P, Lembo AJ (2008). "Components of placebo effect: randomised controlled trial in patients with irritable bowel syndrome". BMJ. 336 (7651): 999–1003. doi:10.1136/bmj.39524.439618.25. PMC 2364862. PMID 18390493.
  15. ↑ Drossman DA, Whitehead WE, Camilleri M (1997). "Irritable bowel syndrome: a technical review for practice guideline development". Gastroenterology. 112 (6): 2120–37. PMID 9178709.
  16. ↑ 16.0 16.1 16.2 16.3 Ford AC, Talley NJ (2012). "Irritable bowel syndrome". BMJ. 345: e5836. PMID 22951548.
  17. ↑ Kaminski A, Kamper A, Thaler K, Chapman A, Gartlehner G (2011). "Antidepressants for the treatment of abdominal pain-related functional gastrointestinal disorders in children and adolescents". Cochrane Database Syst Rev (7): CD008013. doi:10.1002/14651858.CD008013.pub2. PMID 21735420.
  18. ↑ 18.0 18.1 Kim YJ, Ban DJ (2005). "Prevalence of irritable bowel syndrome, influence of lifestyle factors and bowel habits in Korean college students". Int J Nurs Stud. 42 (3): 247–54. doi:10.1016/j.ijnurstu.2004.06.015. PMID 15708012.
  19. ↑ McKenzie YA, Alder A, Anderson W, Wills A, Goddard L, Gulia P, Jankovich E, Mutch P, Reeves LB, Singer A, Lomer MC (2012). "British Dietetic Association evidence-based guidelines for the dietary management of irritable bowel syndrome in adults". J Hum Nutr Diet. 25 (3): 260–74. doi:10.1111/j.1365-277X.2012.01242.x. PMID 22489905.
  20. ↑ Shepherd SJ, Parker FC, Muir JG, Gibson PR (2008). "Dietary triggers of abdominal symptoms in patients with irritable bowel syndrome: randomized placebo-controlled evidence". Clin. Gastroenterol. Hepatol. 6 (7): 765–71. doi:10.1016/j.cgh.2008.02.058. PMID 18456565.
  21. ↑ 21.0 21.1 21.2 Ong DK, Mitchell SB, Barrett JS, Shepherd SJ, Irving PM, Biesiekierski JR, Smith S, Gibson PR, Muir JG (2010). "Manipulation of dietary short chain carbohydrates alters the pattern of gas production and genesis of symptoms in irritable bowel syndrome". J. Gastroenterol. Hepatol. 25 (8): 1366–73. doi:10.1111/j.1440-1746.2010.06370.x. PMID 20659225.
  22. ↑ Austin GL, Dalton CB, Hu Y, Morris CB, Hankins J, Weinland SR, Westman EC, Yancy WS, Drossman DA (2009). "A very low-carbohydrate diet improves symptoms and quality of life in diarrhea-predominant irritable bowel syndrome". Clin. Gastroenterol. Hepatol. 7 (6): 706–708.e1. doi:10.1016/j.cgh.2009.02.023. PMC 2693479. PMID 19281859.
  23. ↑ 23.0 23.1 Rao SS, Yu S, Fedewa A (2015). "Systematic review: dietary fibre and FODMAP-restricted diet in the management of constipation and irritable bowel syndrome". Aliment. Pharmacol. Ther. 41 (12): 1256–70. doi:10.1111/apt.13167. PMID 25903636.
  24. ↑ Atkinson W, Sheldon TA, Shaath N, Whorwell PJ (2004). "Food elimination based on IgG antibodies in irritable bowel syndrome: a randomised controlled trial". Gut. 53 (10): 1459–64. doi:10.1136/gut.2003.037697. PMC 1774223. PMID 15361495.
  25. ↑ 25.0 25.1 Lea R, Whorwell PJ (2005). "The role of food intolerance in irritable bowel syndrome". Gastroenterol. Clin. North Am. 34 (2): 247–55. doi:10.1016/j.gtc.2005.02.005. PMID 15862933.
  26. ↑ Harris LR, Roberts L (2008). "Treatments for irritable bowel syndrome: patients' attitudes and acceptability". BMC Complement Altern Med. 8: 65. doi:10.1186/1472-6882-8-65. PMC 2633319. PMID 19099570.
  27. ↑ 27.0 27.1 27.2 Heizer WD, Southern S, McGovern S (2009). "The role of diet in symptoms of irritable bowel syndrome in adults: a narrative review". J Am Diet Assoc. 109 (7): 1204–14. doi:10.1016/j.jada.2009.04.012. PMID 19559137.
  28. ↑ Biesiekierski JR, Newnham ED, Irving PM, Barrett JS, Haines M, Doecke JD, Shepherd SJ, Muir JG, Gibson PR (2011). "Gluten causes gastrointestinal symptoms in subjects without celiac disease: a double-blind randomized placebo-controlled trial". Am. J. Gastroenterol. 106 (3): 508–14, quiz 515. doi:10.1038/ajg.2010.487. PMID 21224837.
  29. ↑ Biesiekierski JR, Peters SL, Newnham ED, Rosella O, Muir JG, Gibson PR (2013). "No effects of gluten in patients with self-reported non-celiac gluten sensitivity after dietary reduction of fermentable, poorly absorbed, short-chain carbohydrates". Gastroenterology. 145 (2): 320–8.e1–3. doi:10.1053/j.gastro.2013.04.051. PMID 23648697.
  30. ↑ Vazquez-Roque MI, Camilleri M, Smyrk T, Murray JA, Marietta E, O'Neill J, Carlson P, Lamsam J, Janzow D, Eckert D, Burton D, Zinsmeister AR (2013). "A controlled trial of gluten-free diet in patients with irritable bowel syndrome-diarrhea: effects on bowel frequency and intestinal function". Gastroenterology. 144 (5): 903–911.e3. doi:10.1053/j.gastro.2013.01.049. PMC 3633663. PMID 23357715.
  31. ↑ Verdu EF, Huang X, Natividad J, Lu J, Blennerhassett PA, David CS, McKay DM, Murray JA (2008). "Gliadin-dependent neuromuscular and epithelial secretory responses in gluten-sensitive HLA-DQ8 transgenic mice". Am. J. Physiol. Gastrointest. Liver Physiol. 294 (1): G217–25. doi:10.1152/ajpgi.00225.2007. PMID 18006603.
  32. ↑ 32.0 32.1 Shepherd SJ, Lomer MC, Gibson PR (2013). "Short-chain carbohydrates and functional gastrointestinal disorders". Am. J. Gastroenterol. 108 (5): 707–17. doi:10.1038/ajg.2013.96. PMID 23588241.
  33. ↑ Halmos EP, Power VA, Shepherd SJ, Gibson PR, Muir JG (2014). "A diet low in FODMAPs reduces symptoms of irritable bowel syndrome". Gastroenterology. 146 (1): 67–75.e5. doi:10.1053/j.gastro.2013.09.046. PMID 24076059.
  34. ↑ Drisko J, Bischoff B, Hall M, McCallum R (2006). "Treating irritable bowel syndrome with a food elimination diet followed by food challenge and probiotics". J Am Coll Nutr. 25 (6): 514–22. PMID 17229899.
  35. ↑ Saberi-Firoozi M, Khademolhosseini F, Mehrabani D, Yousefi M, Salehi M, Heidary ST (2007). "Subjective lactose intolerance in apparently healthy adults in southern Iran: Is it related to irritable bowel syndrome?". Indian J Med Sci. 61 (11): 591–7. PMID 18025745.
  36. ↑ Gupta D, Ghoshal UC, Misra A, Misra A, Choudhuri G, Singh K (2007). "Lactose intolerance in patients with irritable bowel syndrome from northern India: a case-control study". J. Gastroenterol. Hepatol. 22 (12): 2261–5. doi:10.1111/j.1440-1746.2007.04986.x. PMID 17559357.
  37. ↑ Pimentel M, Chow EJ, Lin HC (2003). "Normalization of lactulose breath testing correlates with symptom improvement in irritable bowel syndrome. a double-blind, randomized, placebo-controlled study". Am. J. Gastroenterol. 98 (2): 412–9. doi:10.1111/j.1572-0241.2003.07234.x. PMID 12591062.
  38. ↑ Yang J, Deng Y, Chu H, Cong Y, Zhao J, Pohl D, Misselwitz B, Fried M, Dai N, Fox M (2013). "Prevalence and presentation of lactose intolerance and effects on dairy product intake in healthy subjects and patients with irritable bowel syndrome". Clin. Gastroenterol. Hepatol. 11 (3): 262–268.e1. doi:10.1016/j.cgh.2012.11.034. PMID 23246646.
  39. ↑ Zhu Y, Zheng X, Cong Y, Chu H, Fried M, Dai N, Fox M (2013). "Bloating and distention in irritable bowel syndrome: the role of gas production and visceral sensation after lactose ingestion in a population with lactase deficiency". Am. J. Gastroenterol. 108 (9): 1516–25. doi:10.1038/ajg.2013.198. PMID 23917444.
  40. ↑ Böhmer CJ, Tuynman HA (2001). "The effect of a lactose-restricted diet in patients with a positive lactose tolerance test, earlier diagnosed as irritable bowel syndrome: a 5-year follow-up study". Eur J Gastroenterol Hepatol. 13 (8): 941–4. PMID 11507359.
  41. ↑ Bijkerk CJ, Muris JW, Knottnerus JA, Hoes AW, de Wit NJ (2004). "Systematic review: the role of different types of fibre in the treatment of irritable bowel syndrome". Aliment. Pharmacol. Ther. 19 (3): 245–51. PMID 14984370.
  42. ↑ 42.0 42.1 Ford AC, Talley NJ, Spiegel BM, Foxx-Orenstein AE, Schiller L, Quigley EM, Moayyedi P (2008). "Effect of fibre, antispasmodics, and peppermint oil in the treatment of irritable bowel syndrome: systematic review and meta-analysis". BMJ. 337: a2313. PMC 2583392. PMID 19008265.
  43. ↑ 43.0 43.1 Levy RL, Linde JA, Feld KA, Crowell MD, Jeffery RW (2005). "The association of gastrointestinal symptoms with weight, diet, and exercise in weight-loss program participants". Clin. Gastroenterol. Hepatol. 3 (10): 992–6. PMID 16234045.
  44. ↑ 44.0 44.1 44.2 44.3 44.4 44.5 Talley NJ (2003). "Pharmacologic therapy for the irritable bowel syndrome". Am. J. Gastroenterol. 98 (4): 750–8. doi:10.1111/j.1572-0241.2003.07306.x. PMID 12738451.
  45. ↑ 45.0 45.1 Francis CY, Whorwell PJ (1994). "Bran and irritable bowel syndrome: time for reappraisal". Lancet. 344 (8914): 39–40. PMID 7912305.
  46. ↑ Bijkerk CJ, de Wit NJ, Muris JW, Whorwell PJ, Knottnerus JA, Hoes AW (2009). "Soluble or insoluble fibre in irritable bowel syndrome in primary care? Randomised placebo controlled trial". BMJ. 339: b3154. PMC 3272664. PMID 19713235.
  47. ↑ Rey E, Mearin F, Alcedo J, Ciriza C, Delgado-Aros S, Freitas T, Mascarenhas M, Mínguez M, Santos J, Serra J (2017). "Optimizing the Use of Linaclotide in Patients with Constipation-Predominant Irritable Bowel Syndrome: An Expert Consensus Report". Adv Ther. 34 (3): 587–598. doi:10.1007/s12325-016-0473-8. PMC 5350198. PMID 28083815.
  48. ↑ 48.0 48.1 48.2 48.3 48.4 48.5 Ruepert L, Quartero AO, de Wit NJ, van der Heijden GJ, Rubin G, Muris JW (2011). "Bulking agents, antispasmodics and antidepressants for the treatment of irritable bowel syndrome". Cochrane Database Syst Rev (8): CD003460. doi:10.1002/14651858.CD003460.pub3. PMID 21833945.
  49. ↑ Cappello G, Spezzaferro M, Grossi L, Manzoli L, Marzio L (2007). "Peppermint oil (Mintoil) in the treatment of irritable bowel syndrome: a prospective double blind placebo-controlled randomized trial". Dig Liver Dis. 39 (6): 530–6. doi:10.1016/j.dld.2007.02.006. PMID 17420159.
  50. ↑ 50.0 50.1 Brenner DM, Moeller MJ, Chey WD, Schoenfeld PS (2009). "The utility of probiotics in the treatment of irritable bowel syndrome: a systematic review". Am. J. Gastroenterol. 104 (4): 1033–49, quiz 1050. doi:10.1038/ajg.2009.25. PMID 19277023.
  51. ↑ Merat S, Khalili S, Mostajabi P, Ghorbani A, Ansari R, Malekzadeh R (2010). "The effect of enteric-coated, delayed-release peppermint oil on irritable bowel syndrome". Dig. Dis. Sci. 55 (5): 1385–90. doi:10.1007/s10620-009-0854-9. PMID 19507027.
  52. ↑ Hovdenak N (1987). "Loperamide treatment of the irritable bowel syndrome". Scand. J. Gastroenterol. Suppl. 130: 81–4. PMID 3306904.
  53. ↑ Efskind PS, Bernklev T, Vatn MH (1996). "A double-blind placebo-controlled trial with loperamide in irritable bowel syndrome". Scand. J. Gastroenterol. 31 (5): 463–8. doi:10.3109/00365529609006766. PMID 8734343.
  54. ↑ Cann PA, Read NW, Holdsworth CD, Barends D (1984). "Role of loperamide and placebo in management of irritable bowel syndrome (IBS)". Dig. Dis. Sci. 29 (3): 239–47. PMID 6365490.
  55. ↑ Ford AC, Moayyedi P, Lacy BE, Lembo AJ, Saito YA, Schiller LR, Soffer EE, Spiegel BM, Quigley EM (2014). "American College of Gastroenterology monograph on the management of irritable bowel syndrome and chronic idiopathic constipation". Am. J. Gastroenterol. 109 Suppl 1: S2–26, quiz S27. doi:10.1038/ajg.2014.187. PMID 25091148.
  56. ↑ 56.0 56.1 Menees SB, Maneerattannaporn M, Kim HM, Chey WD (2012). "The efficacy and safety of rifaximin for the irritable bowel syndrome: a systematic review and meta-analysis". Am. J. Gastroenterol. 107 (1): 28–35, quiz 36. doi:10.1038/ajg.2011.355. PMID 22045120.
  57. ↑ 57.0 57.1 57.2 57.3 Pimentel M, Lembo A, Chey WD, Zakko S, Ringel Y, Yu J, Mareya SM, Shaw AL, Bortey E, Forbes WP (2011). "Rifaximin therapy for patients with irritable bowel syndrome without constipation". N. Engl. J. Med. 364 (1): 22–32. doi:10.1056/NEJMoa1004409. PMID 21208106.
  58. ↑ Shanahan F, Quigley EM (2014). "Manipulation of the microbiota for treatment of IBS and IBD-challenges and controversies". Gastroenterology. 146 (6): 1554–63. doi:10.1053/j.gastro.2014.01.050. PMID 24486051.
  59. ↑ 59.0 59.1 Drossman DA, Chey WD, Johanson JF, Fass R, Scott C, Panas R, Ueno R (2009). "Clinical trial: lubiprostone in patients with constipation-associated irritable bowel syndrome--results of two randomized, placebo-controlled studies". Aliment. Pharmacol. Ther. 29 (3): 329–41. doi:10.1111/j.1365-2036.2008.03881.x. PMID 19006537.
  60. ↑ 60.0 60.1 Rao S, Lembo AJ, Shiff SJ, Lavins BJ, Currie MG, Jia XD, Shi K, MacDougall JE, Shao JZ, Eng P, Fox SM, Schneier HA, Kurtz CB, Johnston JM (2012). "A 12-week, randomized, controlled trial with a 4-week randomized withdrawal period to evaluate the efficacy and safety of linaclotide in irritable bowel syndrome with constipation". Am. J. Gastroenterol. 107 (11): 1714–24, quiz p.1725. doi:10.1038/ajg.2012.255. PMC 3504311. PMID 22986440.
  61. ↑ 61.0 61.1 Chey WD, Lembo AJ, Lavins BJ, Shiff SJ, Kurtz CB, Currie MG, MacDougall JE, Jia XD, Shao JZ, Fitch DA, Baird MJ, Schneier HA, Johnston JM (2012). "Linaclotide for irritable bowel syndrome with constipation: a 26-week, randomized, double-blind, placebo-controlled trial to evaluate efficacy and safety". Am. J. Gastroenterol. 107 (11): 1702–12. doi:10.1038/ajg.2012.254. PMID 22986437.
  62. ↑ 62.0 62.1 62.2 Gorard DA, Libby GW, Farthing MJ (1995). "Effect of a tricyclic antidepressant on small intestinal motility in health and diarrhea-predominant irritable bowel syndrome". Dig. Dis. Sci. 40 (1): 86–95. PMID 7821126.
  63. ↑ 63.0 63.1 63.2 Ford AC, Talley NJ, Schoenfeld PS, Quigley EM, Moayyedi P (2009). "Efficacy of antidepressants and psychological therapies in irritable bowel syndrome: systematic review and meta-analysis". Gut. 58 (3): 367–78. doi:10.1136/gut.2008.163162. PMID 19001059.
  64. ↑ 64.0 64.1 Clouse RE, Lustman PJ, Geisman RA, Alpers DH (1994). "Antidepressant therapy in 138 patients with irritable bowel syndrome: a five-year clinical experience". Aliment. Pharmacol. Ther. 8 (4): 409–16. PMID 7986966.
  65. ↑ Tabas G, Beaves M, Wang J, Friday P, Mardini H, Arnold G (2004). "Paroxetine to treat irritable bowel syndrome not responding to high-fiber diet: a double-blind, placebo-controlled trial". Am. J. Gastroenterol. 99 (5): 914–20. doi:10.1111/j.1572-0241.2004.04127.x. PMID 15128360.
  66. ↑ Tack J, Broekaert D, Fischler B, Van Oudenhove L, Gevers AM, Janssens J (2006). "A controlled crossover study of the selective serotonin reuptake inhibitor citalopram in irritable bowel syndrome". Gut. 55 (8): 1095–103. doi:10.1136/gut.2005.077503. PMC 1856276. PMID 16401691.
  67. ↑ Kuiken SD, Tytgat GN, Boeckxstaens GE (2003). "The selective serotonin reuptake inhibitor fluoxetine does not change rectal sensitivity and symptoms in patients with irritable bowel syndrome: a double blind, randomized, placebo-controlled study". Clin. Gastroenterol. Hepatol. 1 (3): 219–28. doi:10.1053/cgh.2003.50032. PMID 15017494.
  68. ↑ Vahedi H, Merat S, Rashidioon A, Ghoddoosi A, Malekzadeh R (2005). "The effect of fluoxetine in patients with pain and constipation-predominant irritable bowel syndrome: a double-blind randomized-controlled study". Aliment. Pharmacol. Ther. 22 (5): 381–5. doi:10.1111/j.1365-2036.2005.02566.x. PMID 16128675.
  69. ↑ Creed F, Fernandes L, Guthrie E, Palmer S, Ratcliffe J, Read N, Rigby C, Thompson D, Tomenson B (2003). "The cost-effectiveness of psychotherapy and paroxetine for severe irritable bowel syndrome". Gastroenterology. 124 (2): 303–17. doi:10.1053/gast.2003.50055. PMID 12557136.
  70. ↑ Ladabaum U, Sharabidze A, Levin TR, Zhao WK, Chung E, Bacchetti P, Jin C, Grimes B, Pepin CJ (2010). "Citalopram provides little or no benefit in nondepressed patients with irritable bowel syndrome". Clin. Gastroenterol. Hepatol. 8 (1): 42–48.e1. doi:10.1016/j.cgh.2009.09.008. PMC 2818161. PMID 19765674.
  71. ↑ Bundeff AW, Woodis CB (2014). "Selective serotonin reuptake inhibitors for the treatment of irritable bowel syndrome". Ann Pharmacother. 48 (6): 777–84. doi:10.1177/1060028014528151. PMID 24651166.
  72. ↑ Xie C, Tang Y, Wang Y, Yu T, Wang Y, Jiang L, Lin L (2015). "Efficacy and Safety of Antidepressants for the Treatment of Irritable Bowel Syndrome: A Meta-Analysis". PLoS ONE. 10 (8): e0127815. doi:10.1371/journal.pone.0127815. PMC 4529302. PMID 26252008.
  73. ↑ 73.0 73.1 Bueno L, Fioramonti J, Delvaux M, Frexinos J (1997). "Mediators and pharmacology of visceral sensitivity: from basic to clinical investigations". Gastroenterology. 112 (5): 1714–43. PMID 9136853.
  74. ↑ Saps M, Youssef N, Miranda A, Nurko S, Hyman P, Cocjin J, Di Lorenzo C (2009). "Multicenter, randomized, placebo-controlled trial of amitriptyline in children with functional gastrointestinal disorders". Gastroenterology. 137 (4): 1261–9. doi:10.1053/j.gastro.2009.06.060. PMC 2827243. PMID 19596010.
  75. ↑ Bahar RJ, Collins BS, Steinmetz B, Ament ME (2008). "Double-blind placebo-controlled trial of amitriptyline for the treatment of irritable bowel syndrome in adolescents". J. Pediatr. 152 (5): 685–9. doi:10.1016/j.jpeds.2007.10.012. PMID 18410774.
  76. ↑ Sharara AI, Aoun E, Abdul-Baki H, Mounzer R, Sidani S, Elhajj I (2006). "A randomized double-blind placebo-controlled trial of rifaximin in patients with abdominal bloating and flatulence". Am. J. Gastroenterol. 101 (2): 326–33. doi:10.1111/j.1572-0241.2006.00458.x. PMID 16454838.
  77. ↑ Johannesson E, Simrén M, Strid H, Bajor A, Sadik R (2011). "Physical activity improves symptoms in irritable bowel syndrome: a randomized controlled trial". Am. J. Gastroenterol. 106 (5): 915–22. doi:10.1038/ajg.2010.480. PMID 21206488.
  78. ↑ Lustyk MK, Jarrett ME, Bennett JC, Heitkemper MM (2001). "Does a physically active lifestyle improve symptoms in women with irritable bowel syndrome?". Gastroenterol Nurs. 24 (3): 129–37. PMID 11847862.
  79. ↑ Daley AJ, Grimmett C, Roberts L, Wilson S, Fatek M, Roalfe A, Singh S (2008). "The effects of exercise upon symptoms and quality of life in patients diagnosed with irritable bowel syndrome: a randomised controlled trial". Int J Sports Med. 29 (9): 778–82. doi:10.1055/s-2008-1038600. PMID 18461499.
  80. ↑ Villoria A, Serra J, Azpiroz F, Malagelada JR (2006). "Physical activity and intestinal gas clearance in patients with bloating". Am. J. Gastroenterol. 101 (11): 2552–7. doi:10.1111/j.1572-0241.2006.00873.x. PMID 17029608.
  81. ↑ Kuttner L, Chambers CT, Hardial J, Israel DM, Jacobson K, Evans K (2006). "A randomized trial of yoga for adolescents with irritable bowel syndrome". Pain Res Manag. 11 (4): 217–23. PMC 2673138. PMID 17149454.
  82. ↑ Taneja I, Deepak KK, Poojary G, Acharya IN, Pandey RM, Sharma MP (2004). "Yogic versus conventional treatment in diarrhea-predominant irritable bowel syndrome: a randomized control study". Appl Psychophysiol Biofeedback. 29 (1): 19–33. PMID 15077462.
  83. ↑ Gordon M, MacDonald JK, Parker CE, Akobeng AK, Thomas AG (2016). "Osmotic and stimulant laxatives for the management of childhood constipation". Cochrane Database Syst Rev (8): CD009118. doi:10.1002/14651858.CD009118.pub3. PMID 27531591.
  84. ↑ Chapman RW, Stanghellini V, Geraint M, Halphen M (2013). "Randomized clinical trial: macrogol/PEG 3350 plus electrolytes for treatment of patients with constipation associated with irritable bowel syndrome". Am. J. Gastroenterol. 108 (9): 1508–15. doi:10.1038/ajg.2013.197. PMID 23835436.
  85. ↑ Michail S, Gendy E, Preud'Homme D, Mezoff A (2004). "Polyethylene glycol for constipation in children younger than eighteen months old". J. Pediatr. Gastroenterol. Nutr. 39 (2): 197–9. PMID 15269628.
  86. ↑ Loening-Baucke V, Krishna R, Pashankar DS (2004). "Polyethylene glycol 3350 without electrolytes for the treatment of functional constipation in infants and toddlers". J. Pediatr. Gastroenterol. Nutr. 39 (5): 536–9. PMID 15572895.
  87. ↑ Loening-Baucke V (2002). "Polyethylene glycol without electrolytes for children with constipation and encopresis". J. Pediatr. Gastroenterol. Nutr. 34 (4): 372–7. PMID 11930092.
  88. ↑ Gremse DA, Hixon J, Crutchfield A (2002). "Comparison of polyethylene glycol 3350 and lactulose for treatment of chronic constipation in children". Clin Pediatr (Phila). 41 (4): 225–9. doi:10.1177/000992280204100405. PMID 12041718.
  89. ↑ Dupont C, Leluyer B, Maamri N, Morali A, Joye JP, Fiorini JM, Abdelatif A, Baranes C, Benoît S, Benssoussan A, Boussioux JL, Boyer P, Brunet E, Delorme J, François-Cecchin S, Gottrand F, Grassart M, Hadji S, Kalidjian A, Languepin J, Leissler C, Lejay D, Livon D, Lopez JP, Mougenot JF, Risse JC, Rizk C, Roumaneix D, Schirrer J, Thoron B, Kalach N (2005). "Double-blind randomized evaluation of clinical and biological tolerance of polyethylene glycol 4000 versus lactulose in constipated children". J. Pediatr. Gastroenterol. Nutr. 41 (5): 625–33. PMID 16254521.
  90. ↑ Thomson MA, Jenkins HR, Bisset WM, Heuschkel R, Kalra DS, Green MR, Wilson DC, Geraint M (2007). "Polyethylene glycol 3350 plus electrolytes for chronic constipation in children: a double blind, placebo controlled, crossover study". Arch. Dis. Child. 92 (11): 996–1000. doi:10.1136/adc.2006.115493. PMC 2083581. PMID 17626140.
  91. ↑ Loening-Baucke V, Pashankar DS (2006). "A randomized, prospective, comparison study of polyethylene glycol 3350 without electrolytes and milk of magnesia for children with constipation and fecal incontinence". Pediatrics. 118 (2): 528–35. doi:10.1542/peds.2006-0220. PMID 16882804.
  92. ↑ Wang Y, Wang B, Jiang X, Jiang M, Xu C, Shao C, Jia L, Huang Z, Xu X, Liu H, Shang L (2012). "Polyethylene glycol 4000 treatment for children with constipation: A randomized comparative multicenter study". Exp Ther Med. 3 (5): 853–856. doi:10.3892/etm.2012.491. PMC 3438798. PMID 22969980.
  93. ↑ Alper A, Pashankar DS (2013). "Polyethylene glycol: a game-changer laxative for children". J. Pediatr. Gastroenterol. Nutr. 57 (2): 134–40. doi:10.1097/MPG.0b013e318296404a. PMID 23591910.
  94. ↑ Khoshoo V, Armstead C, Landry L (2006). "Effect of a laxative with and without tegaserod in adolescents with constipation predominant irritable bowel syndrome". Aliment. Pharmacol. Ther. 23 (1): 191–6. doi:10.1111/j.1365-2036.2006.02705.x. PMID 16393297.
  95. ↑ Scott LJ, Perry CM (1999). "Tegaserod". Drugs. 58 (3): 491–6, discussion 497–8. PMID 10493276.
  96. ↑ Traynor K (2015). "Eluxadoline approved for irritable bowel syndrome with diarrhea". Am J Health Syst Pharm. 72 (13): 1078. doi:10.2146/news150043. PMID 26092951.
  97. ↑ Dove LS, Lembo A, Randall CW, Fogel R, Andrae D, Davenport JM, McIntyre G, Almenoff JS, Covington PS (2013). "Eluxadoline benefits patients with irritable bowel syndrome with diarrhea in a phase 2 study". Gastroenterology. 145 (2): 329–38.e1. doi:10.1053/j.gastro.2013.04.006. PMID 23583433.
  98. ↑ Lembo AJ, Lacy BE, Zuckerman MJ, Schey R, Dove LS, Andrae DA, Davenport JM, McIntyre G, Lopez R, Turner L, Covington PS (2016). "Eluxadoline for Irritable Bowel Syndrome with Diarrhea". N. Engl. J. Med. 374 (3): 242–53. doi:10.1056/NEJMoa1505180. PMID 26789872.
  99. ↑ Wedlake L, A'Hern R, Russell D, Thomas K, Walters JR, Andreyev HJ (2009). "Systematic review: the prevalence of idiopathic bile acid malabsorption as diagnosed by SeHCAT scanning in patients with diarrhoea-predominant irritable bowel syndrome". Aliment. Pharmacol. Ther. 30 (7): 707–17. doi:10.1111/j.1365-2036.2009.04081.x. PMID 19570102.
  100. ↑ Fernández-Bañares F, Esteve M, Salas A, Alsina M, Farré C, González C, Buxeda M, Forné M, Rosinach M, Espinós JC, Maria Viver J (2007). "Systematic evaluation of the causes of chronic watery diarrhea with functional characteristics". Am. J. Gastroenterol. 102 (11): 2520–8. doi:10.1111/j.1572-0241.2007.01438.x. PMID 17680846.
  101. ↑ 101.0 101.1 Odunsi-Shiyanbade ST, Camilleri M, McKinzie S, Burton D, Carlson P, Busciglio IA, Lamsam J, Singh R, Zinsmeister AR (2010). "Effects of chenodeoxycholate and a bile acid sequestrant, colesevelam, on intestinal transit and bowel function". Clin. Gastroenterol. Hepatol. 8 (2): 159–65. doi:10.1016/j.cgh.2009.10.020. PMC 2822105. PMID 19879973.
  102. ↑ 102.0 102.1 Zighelboim J, Talley NJ, Phillips SF, Harmsen WS, Zinsmeister AR (1995). "Visceral perception in irritable bowel syndrome. Rectal and gastric responses to distension and serotonin type 3 antagonism". Dig. Dis. Sci. 40 (4): 819–27. PMID 7720476.
  103. ↑ Prior A, Read NW (1993). "Reduction of rectal sensitivity and post-prandial motility by granisetron, a 5 HT3-receptor antagonist, in patients with irritable bowel syndrome". Aliment. Pharmacol. Ther. 7 (2): 175–80. PMID 8387353.
  104. ↑ Gershon MD (2003). "Serotonin and its implication for the management of irritable bowel syndrome". Rev Gastroenterol Disord. 3 Suppl 2: S25–34. PMID 12776000.
  105. ↑ Garsed K, Chernova J, Hastings M, Lam C, Marciani L, Singh G, Henry A, Hall I, Whorwell P, Spiller R (2014). "A randomised trial of ondansetron for the treatment of irritable bowel syndrome with diarrhoea". Gut. 63 (10): 1617–25. doi:10.1136/gutjnl-2013-305989. PMC 4173656. PMID 24334242.
  106. ↑ Gershon MD, Tack J (2007). "The serotonin signaling system: from basic understanding to drug development for functional GI disorders". Gastroenterology. 132 (1): 397–414. doi:10.1053/j.gastro.2006.11.002. PMID 17241888.
  107. ↑ Drossman DA, Li Z, Andruzzi E, Temple RD, Talley NJ, Thompson WG, Whitehead WE, Janssens J, Funch-Jensen P, Corazziari E (1993). "U.S. householder survey of functional gastrointestinal disorders. Prevalence, sociodemography, and health impact". Dig. Dis. Sci. 38 (9): 1569–80. PMID 8359066.
  108. ↑ 108.0 108.1 Drossman DA, Camilleri M, Mayer EA, Whitehead WE (2002). "AGA technical review on irritable bowel syndrome". Gastroenterology. 123 (6): 2108–31. doi:10.1053/gast.2002.37095. PMID 12454866.
  109. ↑ Poynard T, Regimbeau C, Benhamou Y (2001). "Meta-analysis of smooth muscle relaxants in the treatment of irritable bowel syndrome". Aliment. Pharmacol. Ther. 15 (3): 355–61. PMID 11207510.
  110. ↑ Zheng L, Lai Y, Lu W, Li B, Fan H, Yan Z, Gong C, Wan X, Wu J, Huang D, Wang Y, Mei Y, Li Z, Jiang Z, Liu X, Ye J, Yang Y, Huang H, Xiao J (2015). "Pinaverium Reduces Symptoms of Irritable Bowel Syndrome in a Multicenter, Randomized, Controlled Trial". Clin. Gastroenterol. Hepatol. 13 (7): 1285–1292.e1. doi:10.1016/j.cgh.2015.01.015. PMID 25632806.
  111. ↑ Page JG, Dirnberger GM (1981). "Treatment of the irritable bowel syndrome with Bentyl (dicyclomine hydrochloride)". J. Clin. Gastroenterol. 3 (2): 153–6. PMID 7016973.
  112. ↑ Pimentel M, Park S, Mirocha J, Kane SV, Kong Y (2006). "The effect of a nonabsorbed oral antibiotic (rifaximin) on the symptoms of the irritable bowel syndrome: a randomized trial". Ann. Intern. Med. 145 (8): 557–63. PMID 17043337.
  113. ↑ Pimentel M, Chow EJ, Lin HC (2000). "Eradication of small intestinal bacterial overgrowth reduces symptoms of irritable bowel syndrome". Am. J. Gastroenterol. 95 (12): 3503–6. doi:10.1111/j.1572-0241.2000.03368.x. PMID 11151884.
  114. ↑ Moayyedi P, Ford AC, Talley NJ, Cremonini F, Foxx-Orenstein AE, Brandt LJ, Quigley EM (2010). "The efficacy of probiotics in the treatment of irritable bowel syndrome: a systematic review". Gut. 59 (3): 325–32. doi:10.1136/gut.2008.167270. PMID 19091823.
  115. ↑ Kim HJ, Camilleri M, McKinzie S, Lempke MB, Burton DD, Thomforde GM, Zinsmeister AR (2003). "A randomized controlled trial of a probiotic, VSL#3, on gut transit and symptoms in diarrhoea-predominant irritable bowel syndrome". Aliment. Pharmacol. Ther. 17 (7): 895–904. PMID 12656692.
  116. ↑ 116.0 116.1 116.2 Spanier JA, Howden CW, Jones MP (2003). "A systematic review of alternative therapies in the irritable bowel syndrome". Arch. Intern. Med. 163 (3): 265–74. PMID 12578506.
  117. ↑ 117.0 117.1 Hussain Z, Quigley EM (2006). "Systematic review: Complementary and alternative medicine in the irritable bowel syndrome". Aliment. Pharmacol. Ther. 23 (4): 465–71. doi:10.1111/j.1365-2036.2006.02776.x. PMID 16441466.
  118. ↑ Labus J, Gupta A, Gill HK, Posserud I, Mayer M, Raeen H, Bolus R, Simren M, Naliboff BD, Mayer EA (2013). "Randomised clinical trial: symptoms of the irritable bowel syndrome are improved by a psycho-education group intervention". Aliment. Pharmacol. Ther. 37 (3): 304–15. doi:10.1111/apt.12171. PMC 3829380. PMID 23205588.
  119. ↑ Liu JP, Yang M, Liu YX, Wei M, Grimsgaard S (2006). "Herbal medicines for treatment of irritable bowel syndrome". Cochrane Database Syst Rev (1): CD004116. doi:10.1002/14651858.CD004116.pub2. PMID 16437473.
  120. ↑ Yoon SL, Grundmann O, Koepp L, Farrell L (2011). "Management of irritable bowel syndrome (IBS) in adults: conventional and complementary/alternative approaches". Altern Med Rev. 16 (2): 134–51. PMID 21649455.
  121. ↑ Lembo AJ, Conboy L, Kelley JM, Schnyer RS, McManus CA, Quilty MT, Kerr CE, Drossman D, Jacobson EE, Davis RB (2009). "A treatment trial of acupuncture in IBS patients". Am. J. Gastroenterol. 104 (6): 1489–97. doi:10.1038/ajg.2009.156. PMC 2694961. PMID 19455132.
  122. ↑ Tian SL, Wang XY, Ding GH (2008). "Repeated electro-acupuncture attenuates chronic visceral hypersensitivity and spinal cord NMDA receptor phosphorylation in a rat irritable bowel syndrome model". Life Sci. 83 (9–10): 356–63. doi:10.1016/j.lfs.2008.06.027. PMID 18694764.
  123. ↑ Schneider A, Weiland C, Enck P, Joos S, Streitberger K, Maser-Gluth C, Zipfel S, Bagheri S, Herzog W, Friederich HC (2007). "Neuroendocrinological effects of acupuncture treatment in patients with irritable bowel syndrome". Complement Ther Med. 15 (4): 255–63. doi:10.1016/j.ctim.2006.12.002. PMID 18054727.
  124. ↑ Ma XP, Tan LY, Yang Y, Wu HG, Jiang B, Liu HR, Yang L (2009). "Effect of electro-acupuncture on substance P, its receptor and corticotropin-releasing hormone in rats with irritable bowel syndrome". World J. Gastroenterol. 15 (41): 5211–7. PMC 2773902. PMID 19891022.
  125. ↑ van der Veek PP, van Rood YR, Masclee AA (2007). "Clinical trial: short- and long-term benefit of relaxation training for irritable bowel syndrome". Aliment. Pharmacol. Ther. 26 (6): 943–52. doi:10.1111/j.1365-2036.2007.03437.x. PMID 17767479.
  126. ↑ Gaylord SA, Palsson OS, Garland EL, Faurot KR, Coble RS, Mann JD, Frey W, Leniek K, Whitehead WE (2011). "Mindfulness training reduces the severity of irritable bowel syndrome in women: results of a randomized controlled trial". Am. J. Gastroenterol. 106 (9): 1678–88. doi:10.1038/ajg.2011.184. PMID 21691341.
  127. ↑ Klooker TK, Braak B, Koopman KE, Welting O, Wouters MM, van der Heide S, Schemann M, Bischoff SC, van den Wijngaard RM, Boeckxstaens GE (2010). "The mast cell stabiliser ketotifen decreases visceral hypersensitivity and improves intestinal symptoms in patients with irritable bowel syndrome". Gut. 59 (9): 1213–21. doi:10.1136/gut.2010.213108. PMID 20650926.
  128. ↑ Zhou EH, Liu HR, Wu HG, Shi Y, Wang XM, Tan LY, Yao LQ, Zhong YS, Jiang Y, Zhang LL (2009). "Suspended moxibustion relieves chronic visceral hyperalgesia via serotonin pathway in the colon". Neurosci. Lett. 451 (2): 144–7. doi:10.1016/j.neulet.2008.12.026. PMID 19114087.

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