Treating functional lower gastrointestinal symptoms

Abstract

Tricyclic antidepressants, hypnotherapy and psychotherapy should be considered for patients with functional pain or who have more severe symptoms Loperamide is optimal initial therapy for patients with diarrhoea-predominant irritable bowel syndrome (IBS) Fibre supplementation and adequate fluid intake are recommended as initial therapy for patients with constipation-predominant IBS Use of newer agents such as alosetron and tegaserod should be limited to selected patients with more severe disease because of adverse effects, high cost and limited efficacy Probiotics offer a novel, low side-effect potential therapy for a variety of functional symptoms.