Irritable bowel syndrome: A concise review of current treatment concepts

Table 1 Irritable bowel syndrome subtypes

Subtype	Definition
	(symptoms classified using Bristol stool form scale)
IBS with constipation (IBS-C)	> 25% of stools are hard or lumpy and < 25% of stools are loose/mushy or watery
IBS with diarrhea (IBS-D)	> 25% of stools are loose/mushy or watery stools and < 25% are hard or lumpy
Mixed IBS (IBS-M)	> 25% of stools are loose/mushy or watery stools and > 25% and hard or lumpy
Unsubtyped IBS	insufficient abnormality of stool consistency to meet criteria for IBS-C, D, or M (in the absence of antidiarrheals or laxatives)

IBS: Irritable bowel syndrome.

Table 2 Response rates for lubiprostone 12 wk phase III irritable bowel syndrome with constipation studies

	Lubiprostone	Placebo	P value
Overall responder	17.90%	10.10%	0.001
Month 1	10.80%	7.50%	0.078
Month 2	18.20%	11.40%	0.003
Month 3	22.00%	14.50%	0.003

Table 3 Adverse events for lubiprostone phase III irritable bowel syndrome with constipation studies

	Lubiprostone	Placebo	Lubiprostone
	12 wk	12 wk	36 wk
Serious	1%	1%	1.90%
Treatment related	22%	21%	25.40%
Nausea	8%	4%	11%
Diarrhea	6%	4%	11%
Abdominal distension	2%	2%	3.70%
Discontinuation due to ADR	5%	7%	4%

ADR: Adverse drug reaction.

Table 4 Probiotic strains

Clinical condition	Effectiveness	Specific strain
IBS	B	Bifidobacterium infantis B5624
IBS	B	VSL33 (composite containing multiple strains):
		3 strains of Bifidobacterium:
		Bifidobacterium longum
		Bifidobacterium finfantis
		Bifidobacterium breve
		4 strains of Lactobacillus:
		Lactobacillus acidophilus
		Lactobacillus casei
		Lactobacillus bulgaricus
		Lactobacillus plantarum
		1 strain of Streptococcus salivarius, subspecies
		Thermophilus
IBS	C	Bifidobacterium animalis
IBS	C	Lactobacillus plantarum 299V

IBS: Irritable bowel syndrome.