Real Help for Irritable Bowel Syndrome
WebMD News Archive
So far, extensive research has revealed no worrisome side
effects with the drug. The most common problems have been headache and nausea.
"There was a two-fold increase in diarrhea in about 6% of those taking
Zelnorm, but it resolved by itself, did not cause dehydration, and most
patients were able to continue in the study," says Lefkowitz. Even so, he
cautions that anyone whose IBS symptoms include diarrhea should not take the
Zelnorm is currently under FDA review with approval expected by
summer, says Lefkowitz.
Help is also on the way for those suffering mainly with
diarrhea. A new drug, cilansetron, is now in the final stages of clinical
trial, and approval is right around the corner, says IBS researcher Michael
Camilleri, MD, professor of medicine and physiology at the Mayo Clinic in
Rochester, Minn. This drug falls into the same serotonin-inhibiting class as
the now-defunct drug Lotronex, he says.
And in other drug development, researchers are trying to
modulate the pain-messaging pathway, and a compound known only as substance P
in particular. "P stands for pain," says Camilleri, "and the theory
is that in IBS, something has gone wrong with the transmission of pain signals
from the gut to the brain." These new compounds will try to short-circuit
those faulty signals, he explains.
Even with these promising new drugs on the horizon, there will
likely be "some IBS patients who do not respond to any available
treatment," says researcher Francis Creed, MD, of Manchester University in
England. "About 50% of them have depression or anxiety in addition to their
Creed's team looked specifically at this hardest-to-treat
group, randomly assigning them to receive eight weeks of standard medical
treatment from a gastroenterologist, eight weeks of Prozac, or eight weeks of
one-on-one psychotherapy session. They followed the patients for a full year
Overall, psychotherapy was more effective than Prozac, and
Prozac was more effective than standard medical treatment at improving overall
quality of life. Interestingly, although the one-on-one counseling was most
expensive in the short term, it was least expensive in the long term, due to
fewer doctor visits, drug prescriptions, and lost work time, says Creed.