Irritable Bowel Syndrome (IBS) Medication

00:01 Let's move on to irritable bowel syndrome, or irritable bowel disease. I find it sometimes the two diseases to be indistinguishable, so we'll categorize or classify all of the drugs into one slide here. So these IBS type syndromes, can be including the antispasmodics, the serotonin inhibitors, and the chloride channel activators.

00:25 Let's start off with the antispasmodics. So these agents are used to relieve abdominal pain, in patients who we believe are having spasm of the bowel for no apparent reason. I'm not entirely convinced of their efficacy.

00:40 However, remember that this particular disease is very very hard to treat and we often are throwing the kitchen sink at the patients to try and help treat them.

00:51 Another type of treatment are serotonin inhibitors. So, the serotonin 3 antagonists, tend to be used in women, with severe IBS with diarrhoea. Now IBS is divided into IBS diarrhoea and IBS constipation, and we obviously are using different approaches for each of those categories of IBS. The nice thing about these serotonin 3 receptor antagonists, is that they also have some anti-emetic effects. Now unfortunately, the anti-emetic effects may be linked to ischemic colitis. We are not entirely sure, so you have to be careful with these medications.

01:30 These agents are restricted to GI specialists with experience in this area. So, as a person who does not have a lot of experience with these agent, I will not prescribe it. I will refer this on, so that a specialist can use it.

01:46 For this reason, it probably won't show up on your exam, other than to let you know, today that this agent is out there.

01:54 Don't spend too much time memorizing it for your exam.

02:01 Let's move on to the chloride channel activators. Now these activate type 2 chloride channels in the small intestine, and they are approved for women with severe IBS in constipation. Other agents are acting directly the cyclic GMP production, and they also activate the type 2 chloride channel. And for this reason they are placed in the same drug category.