Monthira Maneerattanaporn

Emerging pharmacological therapies for the irritable bowel syndrome.

The irritable bowel syndrome (IBS) is a symptom-based disorder defined by the presence of abdominal pain and altered bowel habits. Clinical presentations of IBS are diverse, with some patients reporting diarrhea, some constipation, and others a mixture of both. Like the varied clinical phenotypes, the pathogenesis of IBS is also diverse. IBS is not a single disease entity, but rather likely consists of several different disease states. This fact has important implications for the choices and efficacy of IBS treatment. This article reviews the IBS drugs that have reached phase II or III clinical trials.

Sleep disorders and gastrointestinal symptoms: chicken, egg or vicious cycle?

Sleep disturbance is commonly reported bygastro-oesophageal reflux disease (GORD) sufferers.A telephone survey sponsored by the AmericanGastroenterological Association which queried 1000persons with at least weekly heartburn found that 79%of respondents experienced nighttime heartburn atleast once per week.

Efficacy and safety of nortriptyline in functional dyspepsia in Asians: A randomized double-blind placebo-controlled trial: Nortriptyline in functional dyspepsia

Current treatments of functional dyspepsia (FD) are unsatisfied. Tricyclic antidepressants alter visceral hypersensitivity and brain–gut interaction. We assessed the efficacy and safety of nortriptyline in patients with FD.

S1333 A Comparison of Two Radio-Opaque Marker Methodologies in the Assessment of Colonic Transit of Adults With Constipation

of 4.The IBS-M showed the highest likelihood ratio for changing while the IBS-U showed the lowest ratio. Conclusions:Patients with IBS have less than a 38% probability of having a Bristol between 3 and 5 except for the IBS-U that has a 78% probability. A 4-week treatment with PB+S has a notable impact on the expected frequency of stool patterns, especially in the IBS-M followed by the IBS-C. Figure show the basal and after treatment expected frequencies of stool patterns in IBS-C.

The Number of Retained Rectosigmoid Markers During Colonic Transit Testing Does Not Reliably Predict the Presence of Dyssynergic Defecation

tion). During a 4 week period of temporary stimulation, patients were randomized ONOFF/OFF-ON for two 2-week periods. Prior to insertion (PRE), and during each crossover period, outcome variables (bowel diaries, constipation and GIQoL scores) were assessed, and rectal sensory thresholds determined. Results: All thirteen patients completed the trial without complication. Following stimulation, there was a significant increase in percentage of successful bowel movements (PRE: median 34% [0-100] vs ON: 74% [20-100] vs OFF: 72% [0-100]; P=0.007), and Wexner constipation scores improved in 11/13 patients, (PRE: median 18 [9-26] vs ON: 12 [6-27] vs OFF: 13 [5-29]; P=0.01). Defaecatory desire volume (DDV) to rectal balloon distension were normalized in 11/13 patients (PRE: median 277 ml [120-380] vs ON: 163 ml [90-260] vs OFF: 220 ml [80-340 ml]; P=0.006) and maximum tolerable volume (MTV) in 11/13 (PRE: median 350 ml [270-420] vs ON: 262 ml [100400] vs OFF: 298 ml [120-410 ml]; P=0.01). There were no significant changes in health related quality of life measures (GIQoL, Sf36). Conclusion: Patients with constipation secondary to rectal evacuatory dysfunction with rectal hyposensitivity appear to benefit from SNS, at least in the short-term. The physiological results presented support a mechanistic role for rectal afferent modulation.