Quality of life and psychometric evaluation of patients diagnosed with irritable bowel syndrome: an observational cohort study

ABSTRACT BACKGROUND: Very few data are available for evaluating health-related quality of life among people with irritable bowel syndrome (IBS) and even fewer data are available in relation to anxiety and depression status among these patients. OBJECTIVES: To evaluate the quality of life, anxiety and depression status of patients with IBS. DESIGN AND SETTING: Observational cohort study conducted in a tertiary-care university hospital. METHODS: Patients who had recently been diagnosed with IBS and who had been followed up for IBS-specific treatment for at least three months were included. A quality of life (QoL) survey, the Beck Anxiety Index (BAI) and the Hamilton Depression Index (HAM-D) were applied to the patients. RESULTS: In total, 274 patients with IBS were included in the study cohort. These patients presented very high baseline scores for anxiety and depression, and very poor QoL results. CONCLUSION: Our study showed that IBS had a very high impact on these patients, regarding their anxiety and depression levels, alongside very poor results relating to quality of life.

Rol de los antiespasmódicos en el manejo del síndrome de intestino irritable (SII) / The role of antispasmodics in managing irritable bowel syndrome

Resumen El uso de los antiespasmódicos forma parte de la piedra angular del tratamiento en el síndrome de intestino irritable (SII), independientemente del subtipo. Consideramos relevante hacer una revisión de los medicamentos antiespasmódicos disponibles actualmente en Colombia, los cuales son usados crónicamente, de manera frecuente, en esta enfermedad.

Abstract Although antispasmodics are the cornerstone of treating irritable bowel syndrome, there are a number of antispasmodic medications currently available in Colombia. Since they are frequently used to treat this disease, we consider an evaluation of them to be important.

Meta-analysis of Therapeutic Efficacy and Safety of Mirtazapine Combined with Selective Calcium Ch annel Blocker in the Treatment of Irritable Bowel Syndrome / 中国药房

OBJECTIVE： To systematically review therapeutic efficacy and safety of mirtazapine combined with selective calcium channel blocker （SCCB） in the treatment of irritable bowel syndrome （IBS）， and provide evidence-based reference for clinical medication. METHODS： Retrieved from the Cochrane Library， PubMed， Embase， Medline， CNKI， VIP and Wanfang database， randomized controlled trials （RCTs） about mirtazapine combined with SCCB （trial group） versus SCCB （control group） for IBS were collected. After literature screening and data extraction， quality evaluation was performed by using Cochrane system evaluator manual 5.1.0 recommend bias risk evaluation tool. Meta-analysis was performed by using Stata 14.0 software. RESULTS： A total of 14 RCTs involving 1 005 patients were included. The results of Meta-analysis showed that the total response rate [RR＝1.34，95％CI（1.25，1.44），P＜0.001]，neuropeptide-Y level after treatment [SMD＝0.77，95％CI（0.49，1.05），P＜0.001]， response rate of abdominal pain therapy [RR＝1.32，95％CI（1.06，1.66），P＝0.014] and response rate of treatment for abnormal stool characteristics [RR＝1.75，95％CI（1.36，2.27）， P＜0.001] were significantly higher than control group； the scores of depression scale after treatment [SMD＝－1.87， 95％CI （－2.35， －1.39）， P＜0.001]， anxiety scale after treatment [SMD＝－2.25， 95％CI （－3.35， －1.15）， P＜0.001]， abdominal pain symptom score after treatment [SMD＝－7.41， 95％CI  （－8.30，－6.51）， P＜0.001]， diarrhea symptom score after treatment [SMD＝－6.39， 95％CI （－7.96，－4.81）， P＜0.001] were significantly lower than those of the control group. There were no statistical significance in response rate of abdominal distension therapy [RR＝1.07，95％CI（0.90，1.28），P＝0.421] and response rate of abnormal defecation therapy [RR＝1.05，95％CI（0.88，1.26），P＝0.588]， the incidence of abdominal pain [RR＝0.45，95％CI（0.11，1.97）， P＝0.291] and exhaustion [RR＝5.00，95％CI（0.60，41.79），P＝0.137] between 2 groups. CONCLUSIONS： Mirtazapine combined with SCCB can significantly improve therapeutic efficacy of IBS patients， promote clinical symptoms， but do not increase the occurrence of ADR as abdominal pain and exhaustion.

The Evaluation of Otilonium Bromide Treatment in Asian Patients With Irritable Bowel Syndrome

BACKGROUND/AIMS: Antispasmodics including otilonium bromide (OB) are recommended to treat irritable bowel syndrome (IBS). However, reports about OB experience in Asia is sparse. The purpose of present study was to provide the efficacy of OB in treating Asian IBS patients. METHODS: Overall, 117 IBS patients meeting Rome II criteria were enrolled in an 8-week, double-blind, active-controlled and single center trial. Randomized participants received either OB 40 mg or mebeverine 100 mg 3 doses daily. The primary endpoints were to evaluate the net changes of abdominal pain/discomfort frequency score (APDFS) and safety profile, while the secondary endpoints were to assess the changes in abdominal pain/discomfort intensity, flatulence, abdominal bloating, satisfied stool frequency etc. RESULTS: Finally, 49 OB and 52 mebeverine subjects were eligible for efficacy analysis. Compared to baselines in per protocol populations, the reduced APDFSs in OB and mebeverine were 0.55 +/- 1.20 (P = 0.011) and 0.37 +/- 1.11 (P = 0.042), respectively, to show similarly reduced scores. The most reported side effects included dry mouth, nausea and dizziness. Besides, the improved APDFSs at 4th week visit, final alleviations in abdominal pain intensity, flatulence, abdominal bloating and satisfied stool frequency with global assessments filled by both patients and investigators were significantly achieved by both treatments, and OB was not inferior to mebeverine in treating these parameters. CONCLUSIONS: In Orientals, OB is as effective as mebeverine for alleviating IBS symptoms in terms of abdominal pain, flatulence, abdominal bloating etc. However, obvious side effects are also observed. A large-scaled trial and post-marketing surveillance are recommended to confirm its efficacy and safety.