Irritable bowel syndrome: different approaches to therapy

Abstract

This article provides present-date knowledge on irritable bowel syndrome (IBS) and different approaches to therapy. The method of presenting the materials is based on a specific clinical case, which includes the diagnostic algorithm, a list of modern medicines, defines pharmacological targets and, based on them, describes an approach to the selection of an adequate pharmaceutical drug. In the presented case, patient S. (37 years old) had a functional bowel disorder (stool disorder) for seven years, and short-term pharmacotherapy courses did not produce a lasting effect. The course of the disease had become more alarming over time. The medical examination confirmed irritable bowel syndrome (IBS) in the patient – a mixed variant with pain syndrome during exacerbations. The drug of choice was otilonium bromide, an intestinal antispasmodic, which differed from other intestinal antispasmodics in its complex mechanism of action and practically zero absorption (3%). It allowed for a long-term therapy reducing a risk of side effects. The duration of treatment was 15 weeks (40 mg 3 times a day), of which the last three weeks were regarded as the maintenance therapy at a dose of 40 mg once a day. Pain and dysbiosis were completely relieved at 4 weeks of treatment. Motility and stool were restored, which resulted in the improvement of the quality of life and the symptoms of anxiety were resolved almost completely after 12 weeks of treatment. Thus, otilonium bromide had an effect on all pharmacological targets that were established before treatment.