Double blind trial of ispaghula/poloxamer in the Irritable Bowel Syndrome.
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Biomedical subjects
Publications and source records attributed to J F Fielding.
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Histological gastritis was present in nearly two-thirds of consecutive patients with lower intestinal irritable bowel (irritable colon) syndrome. The presence of gastritis had no relationship to upper intestinal symptoms; we believe that upper intestinal symptoms in these patients are therefore unlikely to be due to coexistent gastritis. Abnormal pyloroduodenal motility with consequent abnormal bile reflux or clearance may account for gastritis in patients with irritable colon. This study, admittedly uncontrolled, provides further indirect evidence to support the concept of a widespread neuromuscular abnormality throughout the gastrointestinal tract in irritable bowel syndrome patients who have predominantly colonic symptoms.
Domperidone treatment did not differ significantly from placebo treatment in irritable bowel syndrome patients concurrently put on high fibre diet. No side effects attributable to the drug were encountered. This study further reinforces the necessity to have patients concurrently on a high fibre diet when testing for drug efficiency in the irritable bowel syndrome. Double-blind drug versus placebo studies should be undertaken in the irritable bowel syndrome patients who fail to respond to a high fibre diet. Dopamine receptor sites are unlikely to be primarily involved in the irritable bowel syndrome.
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