Tratamiento farmacológico del síndrome de intestino irritable: revisión técnica
Pharmacological treatment of the irritable bowel syndrome: a technical review
JM. Remes-Trochea, O. Gómez-Escuderob, JR. Nogueira-de Rojasc, R. Carmona-Sánchezd, J. Pérez-Manautae, A. López-Colombof, JL. Sanjurjo-Garcíae, A. Noble-Lugoe, JA. Chávez-Barrerag, M. González-Martínez Mh
a Laboratorio de Fisiología Digestiva y Motilidad Gastrointestinal, Instituto de Investigaciones Médico-Biológicas, Universidad Veracruzana. Vera-cruz, Ver.
b Coordinador, División de Gastroenterología, Hospital Ángeles. Puebla, Puebla.
c Hospital General de Irapuato. Irapuato, Guanajuato.
d Hospital Ángeles-Centro Médico del Potosí. San Luis Potosí, San Luis Potosí.
e Hospital Español de México. México, D. F.
f Unidad Médica de Alta Especialidad, IMSS. Puebla, Puebla.
g Centro Médico Nacional La Raza, IMSS. México, D. F.
h Centro Médico Nacional Siglo XXI, IMSS. México, D. F.
Introduction: The goal of a comprehensive treatment in irritable bowel syndrome (IBS) patients should be the improvement of symptoms and improve the quality of life. Aim: To review the drugs recommended in IBS, their mechanisms of action, side effects, risks and benefits, contraindications, availability in our country and the evidence supporting their use. Material and methods: A technical and narrative review which evaluated the articles published in national and world literature regarding the pharmacological treatment of IBS was performed. PubMed and IMBIOMED electronic databases were searched (until September 2009) using all descriptors regarding IBS and drug therapy. Results: There is enough clinical evidence to recommend the use of antispasmodics (alone or in combination) and tricyclic antidepressants for pain treatment in IBS. Laxatives are useful in the management of chronic constipation, but there is little evidence in the management of IBS. Although, antiflatulents and antidiarrheals are widely used there is little information supporting its use. The use of a nonabsorbable antibiotic (rifaximin) is effective in a subgroup of IBS patients. Serotoninergics drugs have proven effective in relieving symptoms of IBS; however, these drugs require caution in their use. There are studies have shown that probiotics improve some symptoms of IBS. Conclusions: There are many effective treatment options in the symptomatic management of IBS. The choice of treatment should be based on the predominant symptoms of each patient.
síndrome de intestino irritable, tratamiento, enfermedades funcionales del colon, revisión, México
irritable bowel syndrome, treatment, functional colonic diseases, review, Mexico
Rev Gastroenterol Mex 2010;75:42-66 - Vol. 75 Núm.1