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Review
. 2004 Apr;141(8):1237-48.
doi: 10.1038/sj.bjp.0705741. Epub 2004 Mar 22.

Treating irritable bowel syndrome: overview, perspective and future therapies

Michael Camilleri  1
Affiliations
Review

Treating irritable bowel syndrome: overview, perspective and future therapies

Michael Camilleri. Br J Pharmacol. 2004 Apr.

Abstract

This article summarizes the ongoing challenges in irritable bowel syndrome and the exciting opportunities for development of novel therapies for this common, enigmatic condition. The challenges include insufficient understanding of mechanisms, lack of specificity of symptoms, differentiation from other conditions, and lack of availability of noninvasive tests to identify dysfunctions. However, significant opportunities are reflected by the advances in clinical trial design and, particularly, clinically relevant end points for such trials, and the increasing understanding of basic neuroenteric science. The latter has delivered two new medications to the practice (alosetron and tegaserod), and other candidate therapies (other serotonergic, tachykininergic, opioid, cannabinoid modulators) are being carefully appraised as potential drugs for the future.

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Figures

Figure 1
Figure 1
Inflammatory and degenerative neuropathy in ‘severe IBS'. Reproduced from Tornblom et al., 2002.
Figure 2
Figure 2
Placebo response rates in irritable bowel syndrome and relationship with study duration. Reproduced from Spiller, 1999.
Figure 3
Figure 3
Pathophysiology of irritable bowel syndrome.
Figure 4
Figure 4
Neuro-anatomical centers involved sensation of visceral sensation.
Figure 5
Figure 5
The pipeline in IBS. Candidate medications and possible mechanisms of action.
See this image and copyright information in PMC

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