ALLERGY, RESPIRATORY
New Spray Could Benefit Cystic Fibrosis Patients
Obesity May Raise Kids' Allergy Risk
Asthmatics Who Quit Smoking May Reverse Lung Damage
ALTERNATIVE MEDICINE
Acupuncture Eases Side Effects of Head, Neck Cancer Treatments
Placebo Acupuncture Tied to Higher IVF Pregnancies
Acupuncture Eases Breast Cancer Treatment Side Effects
ANIMAL CARE
Separation Anxiety, Canine-Style
Animals Respond to Acupuncture's Healing Touch
Safe Toys for Dogs
BONES & JOINTS
Brazilian Mint Tea Naturally Good for Pain Relief
Scientists ID New Genes Tied to Crohn's Disease
Majority of College Students Report Backpack-Related Pain
CANCER
Where You Live May Affect Your Cancer Diagnosis
Vitamin D May Improve Melanoma Survival
Want to Stop Cancer? You Can, Experts Say
CAREGIVING
Study of Everest Climbers Questions Oxygen Use
Omega-3 Fatty Acid May Help 'Preemie' Girls' Brains
Critically Ill Patients Lack Vitamin D
CIRCULATORY SYSTEM
Firefighters Have Narrower-Than-Normal Arteries, Study Finds
Bye, Bye Back Fat?
Potassium-Rich Foods May Cut Stroke, Heart Disease Risk
COSMETIC
Wrinkle Fillers Need Better Label Warnings: FDA Panel
Science May Banish Bad Hair Days
Get Sugared!.... Its a sweet choice for hair removal
DENTAL, ORAL
A Sweet Way to Shield Baby's Teeth
Most Insured Adults Worry About Health Care Costs: Poll
Gum Disease Treatment Doesn't Cut Preterm Birth Risk
DIABETES
Spices, Herbs Boost Health for Diabetics
Exercise Protects Black Women From Type 2 Diabetes
Brown Rice Bests White for Diabetes Prevention
DIET, NUTRITION
Fasting on Alternate Days May Make Dieting Easier
Vitamin B12 Key to Aging Brain
Eat Up, But Eat Healthy This Holiday Season
DISABILITIES
Review Finds Marijuana May Help MS Patients
Could Your Cell Phone Help Shield You From Alzheimer's?
ENVIRONMENTAL HEALTH
Household Insecticides May Be Linked to Autoimmune Diseases
Global Warming May Bring More Respiratory Woes
Household Chemicals May Affect Cholesterol Levels
EYE CARE, VISION
'Blind' Man Navigates Obstacle Course Without Error
When Corks Fly, Watch the Eyes
Drinking Green Tea May Protect Eyes
FITNESS
Tai Chi and Qigong Offer Many Health Benefits: Review
Fall Cleanup Is a Prime Time for Accidents
Keep Safety in Mind While Your Kids Are Cooling Off in the Water
GASTROINTESTINAL PROBLEMS
Japanese Herbals May Ease Gastro Woes
Bowel Prep Harder on Women Than Men
Gum Chewing May Speed Colon Surgery Recovery
GENERAL HEALTH
The Brain Comes Alive With the Sounds of Music
Hidden Salt in Diet Haunts Many With Heart Failure
More Calcium And Dairy Products in Childhood Could Mean Longer Life
HEAD & NECK
Many Children Will Outgrow Headaches
Ski Helmets Encouraged for All
Zen May Thicken Brain, Thwart Pain
HEALTH & TECHNOLOGY
'Comfort Dogs' Come to Emotional Rescue
Using Light Therapy to Silence Harmful Brain Activity
Study Suggests Link Between Cell Phones and Brain Tumors
HEARING
Summer Sounds Can Lead to Hearing Loss
Noise Hurts Men's Hearing More, Study Shows
HEART & CARDIOVASCULAR
Walk Long, Slow and Often to Help the Heart
An Apple a Day May Help Keep Heart Disease Away
Cherry-Enriched Diet Cut Heart Risks in Rats
INFECTIOUS DISEASE
Swine Flu Closes Three Schools in NYC
Viral Infection Might Trigger High Blood Pressure
Older Adults May Have Some Immunity to Swine Flu
INFERTILITY
Obesity May Affect Fertility in Young Womene
KID'S HEALTH
Health Tip: Back Pain in Children
Standard IQ Test May Underestimate People With Autism
Exercise in Adolescence May Cut Risk of Deadly Brain Tumor
MEN'S HEALTH
Sunlight May Help Protect Men From Kidney Cancer
Drinking Green Tea May Slow Prostate Cancer
Whole Grains, Bran May Fight Hypertension in Men
MENTAL HEALTH
Mind Exercise Might Help Stroke Patients
Psychotherapy Can Boost Happiness More Than Money
Living Alone Increases Odds of Developing Dementia
PAIN
Acupuncture, Real or Fake, Eases Back Pain
Are We Exercising Pain Away? Not So Much.
Alleviating Rheumatoid Arthritis
PHYSICAL THERAPY
PREGNANCY
Pregnant Women Exposed To Certain Pollutants Could Lower Childs IQ
Alternative Treatments May Boost IVF Success
Pre-Pregnancy Weight Linked to Babies' Heart Problems
SENIORS
Want Better Health in the New Year, Add Exercise to Your Day
Community Exercise Programs Boost Seniors' Strength
Vitamin D May Help Keep Aging at Bay
SEXUAL HEALTH
SLEEP DISORDERS
Exercising Throat Muscles May Relieve Sleep Apnea
Lose Weight, Sleep Apnea May Improve
Daylight Savings: Not a Bright Time for All
WOMEN'S HEALTH
Steady Weight Gain Boosts Late-Life Breast Cancer Risk
Pre-Pregnancy Weight Linked to Babies' Heart Problems
Simple Carbs Pose Heart Risk for Women
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