Friday, May 28, 2004
Paxil and irritable bowel syndrome
IBS is one of the more frustrating diseases to treat. Increased fiber intake, antispasmodic agents, and Zelnorm (for constipation predominant disease) are among the treament choices. However, in many cases, these treatments aren't enough and many patients unfortunately remain symptommatic. In the GI forum that I moderate, there are many who report refractory IBS symptoms.Today comes a study from the American Journal of Gastroenterology that examines the effect of Paxil on IBS:
OBJECTIVES: The purpose of the trial was to determine whether a high-fiber diet (HFD) alone or in combination with paroxetine or placebo was effective treatment for patients with irritable bowel syndrome (IBS).
METHODS: Design: Trial of HFD alone (Group 1) followed by a randomized, double-blind trial of HFD with paroxetine or placebo (Group 2). Setting: Gastroenterology office in a 524-bed university-affiliated community hospital in Pittsburgh. Patients: Men and women, aged 18–65 yr, previously diagnosed with IBS but otherwise healthy. Intervention: Institution of HFD in 98 participants consuming low- or average-fiber diets. Allocation of paroxetine to 38 and placebo to 43 symptomatic participants consuming HFDs. Measurements: Overall well-being, abdominal pain, and abdominal bloating (Groups 1 and 2); food avoidance, work functioning, and social functioning (Group 2).
RESULTS: In Group 1, overall well-being improved in 26% patients, and abdominal pain and bloating decreased in 22% and 26% patients, respectively, with an HFD. In Group 2, overall well-being improved more with paroxetine than with placebo (63.3%vs 26.3%; p= 0.01), but abdominal pain, bloating, and social functioning did not. With paroxetine, food avoidance decreased (p= 0.03) and work functioning was marginally better (p= 0.08). Before unblinding, more paroxetine recipients than placebo recipients wanted to continue their study medication (84%vs 37%; p < 0.001).
CONCLUSIONS: The difference in overall well-being found in our paroxetine/placebo trial is greater than that found in previously published drug/placebo trials for IBS. Moreover, the difference in well-being applied to nondepressed recipients of paroxetine.
If we can add to our treatment options for IBS, this can only be encouraging. I'll probably try this with some of my more refractory patients.
Posted by Kevin |
link
| Comments (3)
| 
Comments:
I'm not an MD, but from my readings I'd recommend that, in addition to other treatments, your patients try ingesting some serious probiotics with lots of L. casei. Check out http://www.probiohealth.com
And here's a report of new Mayo Clinic research that examined possible link between IBS and celiac disease:
http://tinyurl.com/2jfbs
--Don at Zap*Germs (http://zapgerms.blogspot.com)
And here's a report of new Mayo Clinic research that examined possible link between IBS and celiac disease:
http://tinyurl.com/2jfbs
--Don at Zap*Germs (http://zapgerms.blogspot.com)
Hi, I tried everything for IBS suffered over 10 years. There is a new progra of Diet based on blood test that has a 80 % sucess rate. Its called L.E.A.P to find the program and a local Dr who will test you go to thier web site,
Just type in any serch engine leap for IBS and you will find it.
I was ready to give up till I found my Dr who does L.E.A.P testing
Just type in any serch engine leap for IBS and you will find it.
I was ready to give up till I found my Dr who does L.E.A.P testing
# posted by 
: 9:57 PM
: 9:57 PM
I've been dealing with IBS-D for over 3 years now, I was on Paxil for two of them, unfortunately, nausea was a side-effect for me that didn't ever really go away. It took 6 months for me to come off Paxil, and I've noticed a decrease in my sex-drive.
I'm currently handling my IBS quite well at the moment by using Imodium + SFS (soluble fibre supplements). Unfortunately, without the Imodium, I have almost chronic 'D'.
A good place to send your patients t o for more info (Recipes, Do-Not-Eat lists, coping etc) is HelpForIBS.com. I got a lot of help from them.
Post a Comment
I'm currently handling my IBS quite well at the moment by using Imodium + SFS (soluble fibre supplements). Unfortunately, without the Imodium, I have almost chronic 'D'.
A good place to send your patients t o for more info (Recipes, Do-Not-Eat lists, coping etc) is HelpForIBS.com. I got a lot of help from them.
