ALLERGY, RESPIRATORY
Obesity May Raise Kids' Allergy Risk
Molecule in Skin May Link Eczema and Asthma
Combating Myths About Seasonal Allergies
ALTERNATIVE MEDICINE
Eight Spiritual Universal Principles in the Art of Practice
Spot light on Dani Antman New Lionheart teacher
Soybean Chemicals May Reduce Effects of Menopause
ANIMAL CARE
'Comfort Dogs' Come to Emotional Rescue
Safe Toys for Dogs
Rest Easy. When It Comes to Swine Flu, Your Pet Is Safe
BONES & JOINTS
Vitamin K Doesn't Slow Bone Loss
Vitamin D Plus Calcium Guards Against Fractures
Active Young Women Need Calcium, Vitamin D
CANCER
Spice Compounds May Stem Tumor Growth
Omega-3 May Safely Treat Precancerous Bowel Polyps
Well Water Might Raise Bladder Cancer Risk
CAREGIVING
When the Caregiver Becomes the Patient
Baby's Sleep Position May Not Affect Severity of Head Flattening
Health Tip: Benefitting From Adult Day Care
CIRCULATORY SYSTEM
Firefighters Have Narrower-Than-Normal Arteries, Study Finds
Varicose Veins May Mask Larger Problem
Secondhand Smoke Quickly Affects Blood Vessels
COSMETIC
Study Evaluates Laser Therapies for Hair Removal
The Acne Drug Accutane More Than Doubles Depression Risk
What to Do If You Have Unsightly Veins
DENTAL, ORAL
Gum Disease May Reactivate AIDS Virus
Holistic Dentistry-My View
An Oral Approach to Heart Disease
DIABETES
Chamomile Tea May Ward Off Diabetes Damage
Findings Challenge Tight Glucose Control for Critically Ill Patients
Diabetes Linked to Cognitive Problems
DIET, NUTRITION
Coffee or Tea Consumption May Lower Stroke Risk
Eating Free Range
Occaisonal Dieting May Cut Breast Cancer, Study Says
DISABILITIES
Review Finds Marijuana May Help MS Patients
Could Your Cell Phone Help Shield You From Alzheimer's?
ENVIRONMENTAL HEALTH
Accumulated Lead May Affect Older Women's Brains
Arsenic in Drinking Water Raises Diabetes Risk
Chemical in Plastics May Cause Fertility Problems
EYE CARE, VISION
Eye Test Could Spot Diabetes Vision Trouble Early
Diabetic Hispanics Missing Out on Eye Exams
Drinking Green Tea May Protect Eyes
FITNESS
Diet, Exercise May Slow Kidney Disease Progression
Vigorous Exercise Can Cut Breast Cancer Risk
Yoga Can Ease Lower Back Pain
GASTROINTESTINAL PROBLEMS
Intestinal Bacteria Trigger Immune Response
Soothing Imagery May Help Rid Some Kids of Stomach Pain
HRT Use Raises Risk of Stomach Trouble
GENERAL HEALTH
Poor Restroom Cleaning Causes Cruise-Ship Sickness
Spot light on Dani Antman New Lionheart teacher
Research Shows Genetic Activity of Antioxidants
HEAD & NECK
Ski Helmets Encouraged for All
Many Children Will Outgrow Headaches
Zen May Thicken Brain, Thwart Pain
HEALTH & TECHNOLOGY
Study Suggests Link Between Cell Phones and Brain Tumors
'Cell Phone Elbow' -- A New Ill for the Wired Age
Save Your Aging Brain, Try Surfing The Web
HEARING
Summer Sounds Can Lead to Hearing Loss
Noise Hurts Men's Hearing More, Study Shows
HEART & CARDIOVASCULAR
Brown Rice Tied to Better Heart Health in Study
Fructose Boosts Blood Pressure, Studies Find
Fondness for Fish Keeps Japanese Hearts Healthy
INFECTIOUS DISEASE
Hand Washing 10 Times a Day May Help Keep Flu Away
Swine Flu Closes Three Schools in NYC
More Medicinal Uses for Pomegranate
INFERTILITY
Obesity May Affect Fertility in Young Womene
KID'S HEALTH
Wood Fires Can Harm the Youngest Lungs
Quick Orthopedic Repair Can Save Young Shoulders
Daily Exercise at School Yields Rewards
MEN'S HEALTH
Soy Linked to Low Sperm Count
Exercise May Prevent Prostate Cancer: Study Shows
Low Iron Levels Cut Cancer Risk in Men With PAD
MENTAL HEALTH
Bullying Seems to Affect Kids Years Later
Daily dose of beet juice promotes brain health in older adults
Cinnamon Breaks Up Brain Plaques, May Hold Key to Fighting Alzheimer’s
PAIN
Acupuncture, Real or Fake, Eases Back Pain
Alleviating Rheumatoid Arthritis
Are We Exercising Pain Away? Not So Much.
PHYSICAL THERAPY
PREGNANCY
Expectant Mom's Exercise Keeps Newborn's Birth Weight Down
Prenatal Stress May Boost Baby's Asthma Risk
Acupuncture May Relieve Acid Indigestation In Pregnancy
SENIORS
Martial Arts Training May Save Seniors' Hips
Tai Chi May Help Ease Fibromyalgia
15-Point Test Gauges Alzheimer's Risk
SEXUAL HEALTH
SLEEP DISORDERS
6 to 8 Hours of Shut-Eye Is Optimal for Health
Daylight Savings: Not a Bright Time for All
Pay Attention to Signs That Say You're Too Fatigued to Drive
WOMEN'S HEALTH
Soy May Not Lead to Denser Breasts
Bitter Melon Extract May Slow, Stop Breast Cancer
Natural Therapies for Menopause
Add your Article

New Guidelines Issued for Management of IBS

THURSDAY, Dec. 18 (HealthDay News) -- A leading organization of gastroenterologists has released new guidelines on the management of irritable bowel syndrome (IBS).

The guidelines, issued by the American College of Gastroenterology and published in the January issue of The American Journal of Gastroenterology, essentially replace a 2002 document.

"The world of IBS is changing quickly because of more therapies and an increased awareness. It is considered a 'real disease,'" said Dr. Lawrence Brandt, chairman of the group's IBS task force and chief of gastroenterology at Montefiore Medical Center in New York City. "A lot of new drugs are being developed, and a lot of work still needs to be done, but there's enough new information since the last time."

"From the practitioner's standpoint, this doesn't change much about practice and there's not that much information that's new, although it is thorough and helpful," said Dr. Benjamin D. Havemann, an assistant professor of internal medicine at the Texas A&M Health Science Center College of Medicine and director of gastroenterology for the Round Rock University Medical Campus of Scott & White Hospital. "It shows what little has transpired [in terms of new treatments] in the last few years. Some of the breakthroughs we had have been withdrawn or are under strict control."

"One powerful piece of information is that extensive work-ups are unhelpful," Havemann said. "It makes sense to me that in the absence of alarm symptoms, the benefit of even basic blood work and other tests is in doubt."

An estimated 7 percent to 10 percent of people have IBS, which can involve abdominal pain, bloating and other discomfort, including constipation and diarrhea. IBS affects both quality of life and productivity for millions of people.

Most IBS treatments relieve symptoms rather than resolve the condition itself.

The new guidelines encompass existing evidence on conventional treatments for IBS as well as new therapies (probiotics, for example) and alternative therapies (acupuncture and more). In summary, the updated guidelines say:

* Fiber products -- including psyllium, anti-spasmodic medications and peppermint oil -- may be effective, at least in some people. "The evidence is poor, but some patients say they feel better," Brandt said. He cautioned that fiber should be used carefully in people with narrowed colons.
* More data is needed on probiotics, live microorganisms (usually bacteria) similar to the "good" organisms found normally in the gut. "This is a very hot topic but an exceedingly complicated subject," Brandt said. Researchers and practitioners need to consider the species of bacteria used, how many species, and dosages.
* Non-absorbable antibiotics -- those targeted to the gut only, such as rifaximin (Xifaxan) -- also seem to help some people, especially those who have "diarrhea-predominant IBS." Brandt said that "the data is not great, but some patients swear they're helping them dramatically."
* Tricyclic antidepressants as well as the antidepressants known as selective serotonin reuptake inhibitors (SSRIs) benefit a broad range of people with IBS. This is backed up by quality studies, although with small numbers of participants, and could change as research on larger numbers of people is evaluated. Psychological counseling may also provide some relief.
* Selective C-2 chloride channel activators, notably lubiprostone (Amitiza), are effective for "constipation-predominant IBS."
* 5HT 3 antagonists such as alosetron (Lotronex) relieve symptoms of diarrhea but can cause constipation and colon ischemia, a restriction of blood flow.
* 5HT 4 agonists, though effective against constipation, are not available in North America because of a heightened risk of cardiovascular problems.
* There is yet to be conclusive evidence on Chinese herbal mixtures, and the mixtures run the risk of causing liver failure and other problems. Differences in the content of compounds and the purity of ingredients complicate evaluation of benefits.
* Similarly, the evidence on acupuncture remains inconclusive.
* There is no evidence at this point that testing for food allergies or following diets that exclude certain foods alleviates IBS symptoms.
* Routine diagnostic testing for IBS is not recommended, although some testing should be performed in certain subgroups of patients.

Though comprehensive, the guidelines were criticized for not explaining what outside funding was used for in the development process. The document does disclose that support was received from Takeda Pharmaceutical Co. and Salix Pharmaceuticals, which make products targeted to IBS.

Dr. Mark Ebell, deputy editor of American Family Physician, said he would feel more comfortable if the guidelines had been "very clear about what support was provided and what they needed the support for: paying for literature searches, for staff. … It's common to have support for guidelines. … I think it's generally unintentional, but when we have a relationship, it creates the potential for problems."

Ebell said that Brandt had relationships with pharmaceutical companies.

Brandt had a different view. "I don't have any ties to industry that would have any relevance to this publication," he said. "I don't receive money directly from any company. I own no stock and, nor does my family, so this is a totally unbiased thing. I have no conflict of interest whatsoever, and I think that does it."

Anne-Louise B. Oliphant, a spokeswoman for the American College of Gastroenterology, said: "No company was involved in any way in either structuring or completing the meta-analysis that forms the basis for the College's evidence-based recommendations on IBS. Furthermore, no company was in any way involved in deciding who served on the task force or in any of its work."

More information

To learn more about IBS, visit the U.S. National Institute of Diabetes and Digestive and Kidney Diseases online.



SOURCES: Lawrence J. Brandt, M.D., chief, division of gastroenterology, Montefiore Medical Center, and professor of medicine and surgery, Albert Einstein College of Medicine, New York City; Mark H. Ebell, M.D., deputy editor, American Family Physician; Anne-Louise B. Oliphant, spokeswoman, American College of Gastroenterology, Bethesda, Md.; Benjamin D. Havemann, M.D., assistant professor, internal medicine, Texas A&M Health Science Center College of Medicine, and director, gastroenterology, Round Rock University Medical Campus, Scott & White Hospital; January 2009 The American Journal of Gastroenterology

Last Updated: Dec. 18, 2008

Copyright © 2008 ScoutNews, LLC. All rights reserved.

Licensed by www.eholistic.com