Wetenschappelijk onderzoek over het prikkelbare darmsyndroom

Het protocol voor de behandeling het prikkelbare darmsyndroom is op basis van wetenschappelijke publicaties ontwikkeld. Hierbij is gebruik gemaakt van de National Library of Medicine (PubMed). Daar waar mogelijk werden studies die opgezet zijn volgens het “placebo controlled cross-over” principe gebruikt. Andere vormen die vaak werden gebruik zijn reviews en epidemiologisch onderzoek. Publicaties uit bladen als The Lancet, The New England Journal of Medicine hadden de voorkeur

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Oorzaken van het prikkelbare darmsyndroom

    National Library of Medicine (PubMed)

Supplements

Psyllium (Ispaghula) bij de behandeling van het prikkelbare darmsyndroom

  1. Bijkerk CJ, de Wit NJ, Muris JW, Whorwell PJ, Knottnerus JA, Hoes AW. BMJ. 2009 Aug 27;339:b3154. doi: 10.1136/bmj.b3154. Soluble or insoluble fibre in irritable bowel syndrome in primary care? Randomised placebo controlled trial
    Psyllium offers benefits in patients with irritable bowel syndrome in primary care.
[Article]
  • Washington N, Harris M, Mussellwhite A, Spiller RC. Am J Clin Nutr. 1998 Feb;67(2):317-21. Moderation of lactulose-induced diarrhea by psyllium: effects on motility and fermentation
    Psyllium delays gastric emptying, probably by increasing meal viscosity, and reduces the acceleration of colon transit, possibly by delaying the production of gaseous fermentation products.[Article]
  • Chapman ND, Grillage MG, Mazumder R, Atkinson SN. Br J Clin Pract. 1990 Nov;44(11):461-6. A comparison of mebeverine with high-fibre dietary advice and mebeverine plus ispaghula in the treatment of irritable bowel syndrome: an open, prospectively randomised, parallel group study
    Both treatments are effective in the treatment of irritable bowel syndrome in adults. The fixed combination of mebeverine/ispaghula, however, was found to be unpalatable by up to 28% of the patients in that group. There does not, therefore, appear to be any advantage in using fixed combination therapy in this condition.[Abstract]
  • Jalihal A, Kurian G. J Gastroenterol Hepatol. 1990 Sep-Oct;5(5):507-13. Ispaghula therapy in irritable bowel syndrome: improvement in overall well-being is related to reduction in bowel dissatisfaction
    The easing of bowel dissatisfaction appears to be a major reason for the therapeutic success of ispaghula in IBS.[Abstract]
  • Prior A, Whorwell PJ. Gut. 1987 Nov;28(11):1510-3. Double blind study of ispaghula in irritable bowel syndrome
    Ispaghula significantly improves overall well being in patients with irritable bowel syndrome, and in those with constipation favourably affects bowel habit and transit time.[Article]
  • Kumar A, Kumar N, Vij JC, Sarin SK, Anand BS. Gut. 1987 Feb;28(2):150-5. Optimum dosage of ispaghula husk in patients with irritable bowel syndrome: correlation of symptom relief with whole gut transit time and stool weight
    It is concluded that the optimum dose of ispaghula husk in irritable bowel syndrome is 20 g per day. There is some correlation between the increase in stool weight and the improvement in symptom score but the whole gut transit time remains unchanged despite alterations in stool weight and patients’ symptoms.[Article]
  • Hotz J, Plein K. Med Klin (Munich). 1994 Dec 15;89(12):645-51. Effectiveness of plantago seed husks in comparison with wheat brain on stool frequency and manifestations of irritable colon syndrome with constipation
    he results of this study demonstrate the effectiveness of psyllium seeds and wheat bran on stool frequency and consistency of patients with irritable bowel syndrome. Psyllium seeds showed to be superior to wheat brain with respect to stool frequency and abdominal distension so that it should be preferred in treatment of irritable bowel syndrome and constipation.[Abstract]

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  • Pepermuntolie bij de behandeling prikkelbare darmsyndroom

    1. Merat S, Khalili S, Mostajabi P, Ghorbani A, Ansari R, Malekzadeh R. Dig Dis Sci. 2010 May;55(5):1385-90 The effect of enteric-coated, delayed-release peppermint oil on irritable bowel syndrome
      Colpermin is effective and safe as a therapeutic agent in patients with IBS suffering from abdominal pain or discomfort.[Abstract]
    2. Cappello G, Spezzaferro M, Grossi L, Manzoli L, Marzio L. Dig Liver Dis. 2007 Jun;39(6):530-6. Peppermint oil (Mintoil) in the treatment of irritable bowel syndrome: a prospective double blind placebo-controlled randomized trial
      A 4 weeks treatment with peppermint oil improves abdominal symptoms in patients with irritable bowel syndrome.[Abstract]
    3. Liu JH, Chen GH, Yeh HZ, Huang CK, Poon SK. J Gastroenterol. 1997 Dec;32(6):765-8. Enteric-coated peppermint-oil capsules in the treatment of irritable bowel syndrome: a prospective, randomized trial
      Thus, in this trial, Colpermin was effective and well tolerated.[Abstract]
    4. Grigoleit HG, Grigoleit P. Phytomedicine. 2005 Aug;12(8):601-6. Peppermint oil in irritable bowel syndrome
      Taking into account the currently available drug treatments for IBS PO (1-2 capsules t.i.d. over 24 weeks) may be the drug of first choice in IBS patients with non-serious constipation or diarrhea to alleviate general symptoms and to improve quality of life.[Abstract]
    5. Kline RM, Kline JJ, Di Palma J, Barbero GJ. J Pediatr. 2001 Jan;138(1):125-8. Enteric-coated, pH-dependent peppermint oil capsules for the treatment of irritable bowel syndrome in children
      In a randomized, double-blind controlled trial, 42 children with irritable bowel syndrome (IBS) were given pH-dependent, enteric-coated peppermint oil capsules or placebo. After 2 weeks, 75% of those receiving peppermint oil had reduced severity of pain associated with IBS. Peppermint oil may be used as a therapeutic agent during the symptomatic phase of IBS.[Abstract]
    6. Grigoleit HG, Grigoleit P. Phytomedicine. 2005 Aug;12(8):612-6. Pharmacology and preclinical pharmacokinetics of peppermint oil
      The principal pharmacodynamic effect of peppermint oil relevant to the gastrointestinal tract is a dose-related antispasmodic effect on the smooth musculature due to the interference of menthol with the movement of calcium across the cell membrane. The choleretic and antifoaming effects of peppermint oil may play an additional role in medicinal use.[Abstract]

    Artisjok bij de behandeling prikkelbare darmsyndroom

    1. Bundy R, Walker AF, Middleton RW, Marakis G, Booth JC. J Altern Complement Med. 2004 Aug;10(4):667-9. Artichoke leaf extract reduces symptoms of irritable bowel syndrome and improves quality of life in otherwise healthy volunteers suffering from concomitant dyspepsia: a subset analysis
      This report supports previous findings that ALE ameliorates symptoms of IBS, plus improves health-related QOL.[Abstract]
    2. Walker AF, Middleton RW, Petrowicz O. Phytother Res. 2001 Feb;15(1):58-61. Artichoke leaf extract reduces symptoms of irritable bowel syndrome in a post-marketing surveillance study
      There is a growing body of evidence which indicates therapeutic properties for artichoke leaf extract (ALE). Dyspepsia is the condition for which the herb is specifically indicated, but the symptom overlap between dyspeptic syndrome and IBS has given rise to the notion that ALE may have potential for treating IBS as well. Furthermore, 96% of patients rated ALE as better than or at least equal to previous therapies administered for their symptoms, and the tolerability of ALE was very good. These results provide support for the notion that ALE has potential value in relieving IBS symptoms and suggest that a controlled trial is justified.[Abstract]
    3. Holtmann G, Adam B, Haag S, Collet W, Grünewald E, Windeck T. Aliment Pharmacol Ther. 2003 Dec;18(11-12):1099-105. Efficacy of artichoke leaf extract in the treatment of patients with functional dyspepsia: a six-week placebo-controlled, double-blind, multicentre trial
      The ALE preparation tested was significantly better than the placebo in alleviating symptoms and improving the disease-specific quality of life in patients with functional dyspepsia.[Abstract]
    4. Marakis G, Walker AF, Middleton RW, Booth JC, Wright J, Pike DJ. Phytomedicine. 2002 Dec;9(8):694-9. Artichoke leaf extract reduces mild dyspepsia in an open study
      We conclude that ALE shows promise to ameliorate upper gastro-intestinal symptoms and improve quality of life in otherwise healthy subjects suffering from dyspepsia.[Abstract]

    Probiotica bij de behandeling prikkelbare darmsyndroom

    1. Ko SJ, Ryu B, Kim J, Hong BG, Yeo I, Lee BJ, Lee JM, Park JW. Trials. 2011 Oct 6;12:219. Effect of herbal extract granules combined with probiotic mixture on irritable bowel syndrome with diarrhea: study protocol for a randomized controlled trial
      The present study is designed to examine the safety and efficacy of GJS and Duolac7S combination therapy on D-IBS. Our study provides the clinical evidence of a new therapeutic strategy for D-IBS.[Article]
    2. Bixquert Jiménez M. Rev Esp Enferm Dig. 2009 Aug;101(8):553-64. Treatment of irritable bowel syndrome with probiotics. An etiopathogenic approach at last?
      Evidence has now accumulated to suggest the efficacy of certain probiotics like Lp299v, which may be capable of bringing about a significant reduction in pain, abdominal distension and flatulence, while increasing health-related quality of life in IBS..[Article]
    3. Guglielmetti S, Mora D, Gschwender M, Popp K. Aliment Pharmacol Ther. 2011 May;33(10):1123-32. doi: 10.1111/j.1365-2036.2011.04633.x. Randomised clinical trial: Bifidobacterium bifidum MIMBb75 significantly alleviates irritable bowel syndrome and improves quality of life–a double-blind, placebo-controlled study
      Bifidobacterium bifidum MIMBb75 effectively alleviates global IBS and improves IBS symptoms simultaneously with an improvement of quality of life. Considering the high efficacy of MIMBb75 in IBS along with the good side-effect profile, MIMBb75 is a promising candidate for IBS therapy.[Abstract]
    4. Francavilla R, Miniello V, Magistà AM, De Canio A, Bucci N, Gagliardi F, Lionetti E, Castellaneta S, Polimeno L, Peccarisi L, Indrio F, Cavallo L. Pediatrics. 2010 Dec;126(6):e1445-52. A randomized controlled trial of Lactobacillus GG in children with functional abdominal pain
      LGG significantly reduces the frequency and severity of abdominal pain in children with IBS; this effect is sustained and may be secondary to improvement of the gut barrier.[Article]
    5. Kajander K, Krogius-Kurikka L, Rinttilä T, Karjalainen H, Palva A, Korpela R. Aliment Pharmacol Ther. 2007 Aug 1;26(3):463-73. Effects of multispecies probiotic supplementation on intestinal microbiota in irritable bowel syndrome
      A multispecies probiotic has shown beneficial effects in irritable bowel syndrome. In addition, certain other probiotics have demonstrated advantageous effects, but the mechanisms behind this are poorly understood. Each supplemented probiotic strain was detected in faecal samples. Intestinal microbiota remained stable during the trial, except for Bifidobacterium spp., which increased in the placebo group and decreased in the probiotic group (P = 0.028). No changes in short-chain fatty acids occurred. A decrease in ss-glucuronidase activity was detected in 67% of the subjects in the probiotic group vs. 38% in the placebo group (P = 0.06).[Abstract]
    6. Guandalini S, Magazzù G, Chiaro A, La Balestra V, Di Nardo G, Gopalan S, Sibal A, Romano C, Canani RB, Lionetti P, Setty M. J Pediatr Gastroenterol Nutr. 2010 Jul;51(1):24-30. VSL#3 improves symptoms in children with irritable bowel syndrome: a multicenter, randomized, placebo-controlled, double-blind, crossover study
      VSL#3 is safe and more effective than placebo in ameliorating symptoms and improving the quality of life in children affected by IBS.[Abstract]
    7. Dolin BJ. Methods Find Exp Clin Pharmacol. 2009 Dec;31(10):655-9. Effects of a proprietary Bacillus coagulans preparation on symptoms of diarrhea-predominant irritable bowel syndrome
      This small pilot study provides evidence that the proprietary B. coagulans GBI-30, 6086 probiotic is safe and effective for reducing daily bowel movements in patients with IBS-D.[Abstract]
    8. Hun L. Postgrad Med. 2009 Mar;121(2):119-24. Bacillus coagulans significantly improved abdominal pain and bloating in patients with IBS
      Preliminary data suggest that the patented B coagulans GBI-30, 6086 probiotic may be a safe and effective option for the relief of abdominal pain and bloating for patients with IBS. Larger, extended trials are needed to verify these results.[Article]
    9. Enck P, Zimmermann K, Menke G, Klosterhalfen S. Z Gastroenterol. 2009 Feb;47(2):209-14. Randomized controlled treatment trial of irritable bowel syndrome with a probiotic E.-coli preparation (DSM17252) compared to placebo
      Treatment of IBS with the probiotic Symbioflor-2 is effective and superior to placebo in reducing typical symptoms of IBS patients seen by general practitioners and by gastroenterologists.[Abstract]
    10. Williams EA, Stimpson J, Wang D, Plummer S, Garaiova I, Barker ME, Corfe BM. Aliment Pharmacol Ther. 2009 Jan;29(1):97-103. doi: 10.1111/j.1365-2036.2008.03848.x.
      LAB4 multistrain probiotic supplement may benefit subjects with IBS.[Abstract]
    11. Sinn DH, Song JH, Kim HJ, Lee JH, Son HJ, Chang DK, Kim YH, Kim JJ, Rhee JC, Rhee PL. Dig Dis Sci. 2008 Oct;53(10):2714-8. Therapeutic effect of Lactobacillus acidophilus-SDC 2012, 2013 in patients with irritable bowel syndrome
      There was no drop out or adverse events for either group during the study period. Lactobacillus acidophilus-SDC 2012, 2013 appeared to have a beneficial effect in patients with IBS. Further studies are warranted.[Abstract]
    12. Kajander K, Myllyluoma E, Rajili?-Stojanovi? M, Kyrönpalo S, Rasmussen M, Järvenpää S, Zoetendal EG, de Vos WM, Vapaatalo H, Korpela R. Aliment Pharmacol Ther. 2008 Jan 1;27(1):48-57. Clinical trial: multispecies probiotic supplementation alleviates the symptoms of irritable bowel syndrome and stabilizes intestinal microbiota
      This multispecies probiotic seems to be an effective and safe option to alleviate symptoms of irritable bowel syndrome, and to stabilize the intestinal microbiota.[Abstract]
    13. Fanigliulo L, Comparato G, Aragona G, Cavallaro L, Iori V, Maino M, Cavestro GM, Soliani P, Sianesi M, Franzè A, Di Mario F Acta Biomed. 2006 Aug;77(2):85-9. Role of gut microflora and probiotic effects in the irritable bowel syndrome
      The increased colonisation by Bifi-dobacterium longum W11, after the cyclic administration of rifaximin, which eradicates the bacterial overgrowth of the small intestine, may reduce symptoms, especially those related to bowel habit and stool frequency in patients with IBS. The abnormalities observed in the colonic flora of IBS suggest, in fact, that a probiotic approach will ultimately be justified.[Article]

    Prebiotica bij de behandeling van prikkelbare darmsyndroom

    1. Silk DB, Davis A, Vulevic J, Tzortzis G, Gibson GR. Aliment Pharmacol Ther. 2009 Mar 1;29(5):508-18. Clinical trial: the effects of a trans-galactooligosaccharide prebiotic on faecal microbiota and symptoms in irritable bowel syndrome
      The galactooligosaccharide acted as a prebiotic in specifically stimulating gut bifidobacteria in IBS patients and is effective in alleviating symptoms. These findings suggest that the prebiotic has potential as a therapeutic agent in IBS.[Abstract]
    2. Brenner DM, Moeller MJ, Chey WD, Schoenfeld PS. Am J Gastroenterol. 2009 Apr;104(4):1033-49; quiz 1050. The utility of probiotics in the treatment of irritable bowel syndrome: a systematic review
      B. infantis 35624 has shown efficacy for improvement of IBS symptoms..[Abstract]
    3. Spiller R. Aliment Pharmacol Ther. 2008 Aug 15;28(4):385-96. Review article: probiotics and prebiotics in irritable bowel syndrome
      Each probiotic has unique features and IBS patients are heterogeneous. Future efforts should be directed to identifying biomarkers of responsiveness to facilitate better targeting of treatment and hence improved efficacy.[Abstract]
    4. Enck P, Zimmermann K, Menke G, Müller-Lissner S, Martens U, Klosterhalfen S. Neurogastroenterol Motil. 2008 Oct;20(10):1103-9. A mixture of Escherichia coli (DSM 17252) and Enterococcus faecalis (DSM 16440) for treatment of the irritable bowel syndrome–a randomized controlled trial with primary care physicians
      Two hundred ninety-seven patients with lower abdominal symptoms diagnosed as IBS were treated for 8 weeks by the compound ProSymbioflor((R)) (Symbiopharm GmbH, Herborn, Germany), an autolysate of cells and cell fragments of Enterococcus faecalis and Escherichia coli, or placebo in a double-blinded, randomized fashion..[Abstract]
    5. Bittner AC, Croffut RM, Stranahan MC, Yokelson TN. Clin Ther. 2007 Jun;29(6):1153-60. Prescript-assist probiotic-prebiotic treatment for irritable bowel syndrome: an open-label, partially controlled, 1-year extension of a previously published controlled clinical trial
      Based on the results from the present 1-year extension study, treatment with this probiotic-prebiotic complex may be an option for short-term (2-4 weeks) and long-term ( approximately 60-week) reductions in IBS symptoms.[Abstract]
    6. Gawro?ska A, Dziechciarz P, Horvath A, Szajewska H. Aliment Pharmacol Ther. 2007 Jan 15;25(2):177-84. A randomized double-blind placebo-controlled trial of Lactobacillus GG for abdominal pain disorders in children
      The LGG appears to moderately increase treatment success, particularly among children with IBS.[Abstract]

    Rode peper bij de behandeling prikkelbare darmsyndroom

    1. Bortolotti M, Porta S. Dig Dis Sci. 2011 Nov;56(11):3288-95. Effect of red pepper on symptoms of irritable bowel syndrome: preliminary study
      The results of this preliminary study indicate that the chronic administration of red pepper powder in IBS patients with enteric-coated pills was significantly more effective than placebo in decreasing the intensity of abdominal pain and bloating and was considered by the patients more effective than placebo.[Abstract]
    2. Bortolotti M, Coccia G, Grossi G, Miglioli M. Bortolotti M, Coccia G, Grossi G, Miglioli M. Aliment Pharmacol Ther. 2002 Jun;16(6):1075-82. The treatment of functional dyspepsia with red pepper
      Red pepper was more effective than placebo in decreasing the intensity of dyspeptic symptoms, probably through a desensitization of gastric nociceptive C-fibres induced by its content of capsaicin. It could represent a potential therapy for functional dyspepsia.[Article]
    3. Agarwal MK, Bhatia SJ, Desai SA, Bhure U, Melgiri S. Indian J Gastroenterol. 2002 Sep-Oct;21(5):179-82. Effect of red chillies on small bowel and colonic transit and rectal sensitivity in men with irritable bowel syndrome
      Men with IBS do not have SBT or CT abnormalities, but have a lower rectal balloon sensitivity threshold. Chilli powder does not alter either SBT or CT in men with IBS or healthy men; however, it increases the rectal threshold for pain in the latter.[Abstract]

    ander mogelijkheden bij de behandeling prikkelbare darmsyndroom

    1. Zhou Q, Price DD, Callam CS, Woodruff MA, Verne GN. J Pain. 2011 Feb;12(2):297-303. Effects of the N-methyl-D-aspartate receptor on temporal summation of second pain (wind-up) in irritable bowel syndrome
      This study evaluates temporal summation of second pain in a subset of IBS patients that is blocked by Dextromethorphan, an NMDA receptor antagonist. Theses results could lead to the use of an NMDA receptor antagonist in the treatment of pain in a subset of IBS patients.[Article]
    2. Pan F, Zhang T, Zhang YH, Xu JJ, Chen FM. Chin J Integr Med. 2009 Jun;15(3):216-9. Effect of Tongxie Yaofang Granule in treating diarrhea-predominate irritable bowel syndrome
      XYF is an effective preparation for the treatment of D-IBS. It can quickly lessen abdominal pain and distention, improve the property of stool, and improve mental tension and depression in patients. Its mechanism of action might be through the adjustment of MCs activation to decrease visceral hypersensitivity.[Abstract]

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    Leefstijl

    Psyche bij de behandeling prikkelbare darmsyndroom

    1. Gaylord SA, Palsson OS, Garland EL, Faurot KR, Coble RS, Mann JD, Frey W, Leniek K, Whitehead WE. Am J Gastroenterol. 2011 Sep;106(9):1678-88. doi: 10.1038/ajg.2011.184. Mindfulness training reduces the severity of irritable bowel syndrome in women: results of a randomized controlled trial
      This randomized controlled trial demonstrated that mindfulness training has a substantial therapeutic effect on bowel symptom severity, improves health-related quality of life, and reduces distress. The beneficial effects persist for at least 3 months after group training.[Abstract]

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    Voeding bij de behandeling prikkelbare darmsyndroom

    1. Ford AC, Spiegel BM, Talley NJ, Moayyedi P. Clin Gastroenterol Hepatol. 2009 Dec;7(12):1279-86. Small intestinal bacterial overgrowth in irritable bowel syndrome: systematic review and meta-analysis
      Prevalence of SIBO in individuals meeting diagnostic criteria for IBS was highest with breath testing. The prevalence in cases with IBS compared with controls varied according to criteria used to define a positive test. The role of testing for SIBO in individuals with suspected IBS remains unclear.[Abstract]

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    FODMAP bij de behandeling prikkelbare darmsyndroom

      RCT
    1. Halmos EP1, Power VA2, Shepherd SJ2, Gibson PR3, Muir JG3. Gastroenterology. 2014 Jan;146(1):67-75.e5. doi: 10.1053/j.gastro.2013.09.046. A diet low in FODMAPs reduces symptoms of irritable bowel syndrome
      In a controlled, cross-over study of patients with IBS, a diet low in FODMAPs effectively reduced functional gastrointestinal symptoms. This high-quality evidence supports its use as a first-line therapy.[Abstract]
    2. OTHER
    3. de Roest RH1, Dobbs BR, Chapman BA, Batman B, O’Brien LA, Leeper JA, Hebblethwaite CR, Gearry RB. Int J Clin Pract. 2013 Sep;67(9):895-903. doi: 10.1111/ijcp.12128. The low FODMAP diet improves gastrointestinal symptoms in patients with irritable bowel syndrome: a prospective study
      The low FODMAP diet shows efficacy for IBS patients. The current strategy of breath testing and dietary advice provides a good basis to understand and adhere to the diet.[Abstract]
    4. REVIEW
    5. Dtsch Med Wochenschr. 2014 Jun;139(24):1310-4. doi: 10.1055/s-0034-1370108. Malabsorption of fermentable oligo-, di-, or monosaccharides and polyols (FODMAP) as a common cause of unclear abdominal discomfort
      A general restriction of all FODMAP components can be beneficial in relieving symptoms and improving quality of life in patients with functional gastrointestinal complaints.[Abstract]
    6. REVIEW
    7. Gibson PR1, Barrett JS, Muir JG. Intern Med J. 2013 Oct;43(10):1067-74. doi: 10.1111/imj.12266. Functional bowel symptoms and diet
      By determining food content of FODMAP, a diet in which foods low in FODMAP are favoured over those high in FODMAP can be designed. Observational, comparative and randomised controlled treatment and rechallenge studies have shown that such an approach is efficacious in the majority of patients with IBS. The low FODMAP diet is now the primary dietary therapy for such patients.[Abstract]

    8. .[Abstract]