Relieving abdominal pain is the principal treatment objective for patients with irritable bowel syndrome. No single drug stands out in the treatment strategy for this illness. Antispasmodics, magnesium aluminum silicates, and alverine citrate drugs all remain initial options for treatment, although their prescription is impeded by the fact that an increasing number are no longer approved for reimbursement. Increased dietary fibers often have a harmful effect on symptoms. Some patients are probably intolerant to some foods but there is no satisfactory proof on which to base a restrictive diet. Improved knowledge of the pathophysiology of irritable bowel syndrome has made it possible to diversify treatments that act first on one of the key pathophysiologic elements, visceral hypersensitivity. Antidepressants (especially tricyclics) can be used at low doses. Among the serotonergic drugs, serotonin 5-HT4 receptors agonists (tegaserod) may be available soon, but the development of 5-HT3 antagonists (alosetron, cilansetron) has been stopped for safety reasons (ischemic colitis and severe constipation). Non-drug options such as hypnosis, psychotherapy, relaxation, or yoga, may also be proposed to some patients. Probiotics are a possible treatment in the future.

Departement d'hepatogastroenterologie et de nutrition, Centre hospitalier, ADEN EA 3234 / IFRMP 23, Rouen (76). Presse Med. 2007 May 7

Comment from Tim Brunson DCH: Although this article does not specifically mention hypnosis or other mind/body modalities, I thought that it was significant since many hypnotherapists provide services with IBS. Note that relaxation and slower breathing helps the brain stem stimulate serotonin. Since activation of the parasympathetic nervous system and serotonin production are significant to GI functioning, hypnosis, guided imagery, and relaxation are significant. The article focuses on pharmacological interventions and unfortunately does not discuss the significant of hypnosis, et. al., as an adjunctive treatment.