Traditional pharmacotherapy for irritable bowel syndrome typically starts with traditional pharmacotherapy combined with behavioural therapy. If there is no improvement, treatment recommendations often progress to oral anticholinergic agents such as alosetron or rosiglitazone.
However, there has never been a head-to-head trial comparing conventional pharmacotherapy for irritable bowel syndrome with behavioural therapy alone. The study was performed by two different groups of investigators from the University of Washington and the University of Utah. Both groups found that the results were very similar.
In the conventional pharmacotherapy study, investigators randomly assigned 75 patients with irritable bowel syndrome to receive either an antibiotic regimen or standard pharmacotherapy. Both groups reported improvements in irritable bowel syndrome symptoms. However, the researchers noted that only the antibiotic group showed a significant reduction in abdominal pain, compared to placebo.
In the alternative pharmacotherapy study, investigators assigned 101 patients with irritable bowel syndrome to receive either standard or an antibiotic combination
They found that the patients who received the antibiotic combined treatment experienced a greater reduction in abdominal pain than those who received standard pharmacotherapy. The other study was designed to compare the efficacy of standard and complementary pharmacotherapies for irritable bowel syndrome.
The investigators randomly assigned a subset of patients with irritable bowel syndrome to receive either standard or complementary treatments, then assessed the results by evaluating patient satisfaction. The patients who received these treatments were treated with the same medications that were prescribed in the standard course of treatment.
However, the group included patients receiving no drug was also administered an anti-anxiety medication, an antihistamine, and a mood stabilizer to help patients with depression and anxiety during the course of the trial. After six weeks, all three drugs showed similar effects on the patients’ scores, which were similar to the drug effects of standard medication in terms of improving symptoms.
When the results of both studies were compared, it became clear that there was no significant difference between the two types of treatment This is consistent with the findings from the earlier trial. Although most physicians believe that standard medication is most effective when used in conjunction with behavioural therapy.
They recognize that additional pharmacotherapy is needed in some cases. For example, when medications are not helpful, more severe forms of irritable bowel syndrome can be treated with non-pharmacologic therapy.
For instance, acupuncture, hypnotherapy, exercise, or biofeedback may also help
The question remains as to whether or not the combination of drugs and non-pharmacologic measures is beneficial for irritable bowel syndrome patients. Since most physicians agree that standard drug therapy is usually not enough to relieve symptoms of irritable bowel syndrome, it may be useful to try alternative pharmacotherapies, in addition to standard treatment.
However, many patients find that standard drug therapy does not work for them. and they require more intensive, specialized treatment to relieve their symptoms. If you are experiencing abdominal pain and other symptoms of irritable bowel syndrome, it may be helpful to seek the advice of your doctor about alternative treatment.
Although most physicians do not recommend non-pharmacologic treatment, if your doctor has never tried alternative treatments, you may want to discuss your symptoms with him or her. to determine if there is anything that may be done in an outpatient setting that will help ease your symptoms.
Although the research about alternative pharmacotherapy is inconclusive
it is not impossible to treat irritable bowel syndrome with pharmacotherapy. In the long run, the best treatment is probably to treat the cause of the problem, rather than treat the symptoms. Many patients with irritable bowel syndrome who have tried alternative pharmacotherapy have found that the results were more successful in easing their symptoms than those who have received standard medication.
It may be that the combination of treatment approaches used in a trial may be helpful in relieving symptoms and preventing relapse in a majority of cases. Because of the lack of scientific evidence about the effectiveness of alternative pharmacotherapy.
It is important to talk to your doctor before you begin a treatment program for irritable bowel syndrome. You can also talk to other people who suffer from the condition to determine whether it would be in your best interest to try alternative medications.
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