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I was just browsing the site and under treatments it said that these might be availble over the next few years. Does anyone have any information on them? Like who is it targeted for? I think we could definetely use more options targeting men although it isnt as common. What are examples of some of these drugs?
 

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A recently published paper also mentioned clonidine,http://www.ncbi.nlm.nih.gov/entrez/query.f...l=pubmed_DocSumCurrent gut-directed therapies for irritable bowel syndrome.Chang HY, Kelly EC, Lembo AJ.Beth Israel Deaconess Medical Center/Harvard University Medical School, 330 Brookline Avenue, Dana 501, Boston, MA 02215, USA. alembo###bidmc.harvard.edu.Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder that can present with a wide array of symptoms that make treatment difficult. Current therapies are directed at relieving symptoms of abdominal pain or discomfort, bloating, constipation, and diarrhea. Pharmacologic agents used to treat IBS-associated pain include myorelaxants, peppermint oil, and peripherally acting opiates. Dicyclomine and hyoscyamine, the two myorelaxants available in the United States, have not been proven effective in reducing abdominal pain in patients with IBS. The efficacy of peppermint oil is debated, but methodological problems with existing studies preclude definitive judgment. Loperamide is ineffective for relief of abdominal pain. For IBS patients with excessive abdominal bloating, a small number of studies suggest that bacterial eradication with gut-directed antibiotics and bacterial reconstitution with nonpathogenic probiotics may reduce flatulence. For constipation-predominant (C-IBS) symptoms, current treatment options include fiber supplementation, polyethylene glycol, and tegaserod. Soluble fibers (ispaghula, calcium polycarbophil, psyllium) are more effective than insoluble fibers (wheat bran, corn fiber) in alleviating global symptoms and relieving constipation, although fiber in general has marginal benefit in treatment of overall IBS symptoms. Polyethylene glycol increases bowel frequency in chronic constipation, but its overall efficacy against IBS is unclear. Tegaserod, a 5-HT(4) agonist, demonstrates superiority over placebo in improving bowel frequency and stool consistency and alleviating abdominal pain and bloating in women with C-IBS. Overall global symptoms are modestly improved with tegaserod when compared with placebo. Additional agents under investigation for C-IBS include the ClC(2) chloride channel opener lubiprostone, mu-opioid receptor antagonist alvimopan, and 5-HT(4) agonist renzapride. For diarrhea-predominant (D-IBS) symptoms, available therapies include loperamide, alosetron, and clonidine. Alosetron, a 5-HT(3) antagonist, is superior to placebo for reducing bowel frequency, improving stool consistency, and relieving abdominal pain in women with D-IBS. However, alosetron is available under a restricted license because of concerns for ischemic colitis and severe constipation necessitating colectomy. Clonidine may be helpful in alleviating global symptoms for D-IBS patients.PMID: 16836950
 

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Jeff,Thanks for posting this. It's interesting to see clonidine put on such a short list of possibly effective treatments in such a recent article.Also, this was Dr. Talley's assessment of the Dr. Camilleri study that Flux posted:"This finding was not significant; 90 patients per treatment arm would have been required to show a 20% benefit over placebo. Unfortunately, side effects were frequent with clonidine. Hence, titrating the dose to ensure efficacy with minimal side effects remains the challenge with all of the alpha-2 adrenergic agonists."http://www.medscape.com/viewarticle/434526I too wonder if there have been any other studies on clonidine or other drugs of the class that might fare better in the tolerability department.
 

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Here's another article I dug up that mentions clonidine, also by Nicholas Talley. He says he uses the drug "very rarely" because of the high risk of hypotension (i.e. fainting), which Flux mentioned.http://mediwire.skyscape.com/main/Default....rticleID=111188I have to say that I find Dr. Talley rather intriguing. He's certainly a leading expert on IBS, but is not squeamish about criticizing other world-renowned colleagues like Camilleri and Drossman (whose study on TCA desipramine Talley dismisses as "meaningless" and antidepressants in general as a "Band-Aid" solution). Needless to say I don't understand these things enough to have an opinion one way or another (and have tremendous respect and gratitude for all these experts,) but I find it interesting, if a bit unsettling, that these top experts have such wildly divergent views on the subject of IBS treatment.
 

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It might be interesting to read the new paper above to see if there is some new clinical evidence for clonidine.There does seem to be some uncertainty these days in treatment options, between experts. Still, clincal research studies seem to be the best way to gauge what's a reasonable treatment option.Jeff
 

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What is really important to remember is that IBS is a complex condition that has a variety of causes. It is unlikely that there will ever be a single drug that cures IBS for everyone. Those whose IBS is caused by psychological problems will most likely respond to psychological (or psycho-pharmaceutical) therapies. Those whose IBS symptoms are caused by parasites will respond to treatment for parasites. Those who have immune system reactions to various antagonizing proteins will be the greatest challenge as shutting down the immune system is very tricky and dangerous.However, right now the percentage of IBS patients who have an identifiable, treatable condition is quite high, if only physicians would routinely test for the known causes: celiac disease, food allergies, gut ecosystem issues (bacteria, yeast, etc.), and parasites.
 

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I have met several of these top docs personally. They suffer from the same maladies.-too many patients to focus-too much ego to discredit their own theories and those of their colleagues-more belief in theoretical science than patients personal experiences that refute the so-called science-belief in pills and distrust in natural treatments or Internet information-repeating other colleagues findings - a pyramid of repeated info - much poorly vetted-doctors have the among the hardest jobs in the world and deserve the utmost repect - and their jobs cause often cause extreme stress, exhaustion, ego, and bad decision making to the detriment of patients-the system itself is hosed-for example mayo is the most impressive organized corporation imaginable and has great science - so they are so busy they cant focus enough on any one patient
 

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quote:I have met several of these top docs personally. They suffer from the same maladies.
What?!
quote:-too many patients to focus
They seem to be doing a pretty job of focusing.
quote:-too much ego to discredit their own theories and those of their colleagues-more belief in theoretical science than patients personal experiences that refute the so-called science-belief in pills and distrust in natural treatments or Internet information-repeating other colleagues findings - a pyramid of repeated info - much poorly vetted
Every point is entirely incorrect.
quote:-the system itself is hosed
?
quote:-for example mayo is the most impressive organized corporation imaginable and has great science - so they are so busy they cant focus enough on any one patient
That's about the only accurate statement in all of the above.
 

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I have met several of these top docs personally. They suffer from the same maladies. What?!--What is it that you dont understand here dude - they all have the same problems.quote:-too many patients to focus They seem to be doing a pretty job of focusing.--presumably you've met them too - Im sorry you got a different impression - if they are so well focused then how come none of us has a cause or cure for their sicknesses - opinions dont count - facts - sciencequote:-too much ego to discredit their own theories and those of their colleagues-more belief in theoretical science than patients personal experiences that refute the so-called science-belief in pills and distrust in natural treatments or Internet information-repeating other colleagues findings - a pyramid of repeated info - much poorly vetted Every point is entirely incorrect. --what a coincidence - just like your life onlinequote:-the system itself is hosed ?---the system - the medical system - does not work - capische?quote:-for example mayo is the most impressive organized corporation imaginable and has great science - so they are so busy they cant focus enough on any one patient That's about the only accurate statement in all of the above.--and the others focus even less than they, yet you disputed others dont focus - you are consistently inconsistent just like the doctor IBS theorists, who Im sure are trying their hardest and are honorable all around - you on the other hand are just an agitator it seems
 
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