Division of Gastroenterology and Hepatology, Clinical Enteric Neuroscience Translational and Epidemiological Research (CENTER), Mayo Clinic, Rochester, Minnesota, USA.
Neurogastroenterol Motil. 2022 Jan;34(1):e14305. doi: 10.1111/nmo.14305. Epub 2021 Dec 3.
Pain relief remains a significant challenge in the management of irritable bowel syndrome (IBS): "Does anything really help relieve the pain in patients with IBS?". Interventions aimed at pain relief in patients with IBS include diet, probiotics or antibiotics, antidepressants, antispasmodics, and drugs targeting specific gastrointestinal receptors such as opioid or histamine receptors. In the systematic review and meta-analysis published in this journal, Lambarth et al. examined the literature on the role of oral and parenteral anti-neuropathic agents in the management of pain in patients with IBS. This review article appraises their assessment of the efficacy of the anti-neuropathic agents amitriptyline, pregabalin, gabapentin, and duloxetine in the relief of abdominal pain or discomfort, and impact on overall IBS severity and quality of life. This commentary provides an update of current evidence on the efficacy of the dietary and pharmacological treatments that are available or in development, as well psychological and cognitive behavioral therapy for pain in IBS. Advances in recent years augur well for efficacious treatments that may expand the therapeutic arsenal for pain in IBS.
缓解疼痛仍然是肠易激综合征（IBS）管理中的一个重大挑战：“有什么真的可以帮助缓解 IBS 患者的疼痛吗？”。针对 IBS 患者的疼痛缓解干预措施包括饮食、益生菌或抗生素、抗抑郁药、抗痉挛药以及针对特定胃肠道受体的药物，如阿片类或组胺受体。在本期杂志上发表的系统评价和荟萃分析中，Lambarth 等人研究了口服和肠外抗神经病理性药物在 IBS 患者疼痛管理中的作用的文献。这篇综述文章评估了抗神经病理性药物阿米替林、普瑞巴林、加巴喷丁和度洛西汀缓解腹痛或不适的疗效，以及对 IBS 总体严重程度和生活质量的影响。本文对目前可获得或正在开发的饮食和药物治疗以及针对 IBS 疼痛的心理和认知行为疗法的疗效提供了最新信息。近年来的进展预示着有效的治疗方法可能会扩大 IBS 疼痛的治疗武器库。
