Pharmacological Ad-vancements in the Management of Constipation-Predominant Irritable Bowel Syndrome: A Comprehensive Review | Chapter 6 | Medical Science: Trends and Innovations Vol. 4

Irritable bowel syndrome (IBS) is a complex disorder of gut-brain interaction (DGBI). It affects a diverse population across various age groups and ethnicities. IBS is a common medical disorder worldwide, with reported prevalence rates ranging from 5% to 35%. Patients diagnosed with IBS often experience significant disruptions in their daily activities and a diminished quality of life, which can be attributed to the limited effectiveness of conventional treatment options. Additionally, the long-term consequences of the condition may give rise to psychological challenges, potentially resulting in polypharmacy or the concurrent use of multiple medications. This scenario presents inherent risks, including the possibility of drug interactions, a decline in overall health, and increased healthcare costs. The symptoms of IBS may include abdominal pain and bloating, frequently associated with visceral hypersensitivity and psychological factors, along with diarrhea, constipation, or a combination of these bowel patterns. In accordance with the Rome IV criteria, IBS is classified based on different types of bowel patterns. There are four recognized subtypes of IBS: IBS with constipation (IBS-C), IBS with diarrhea (IBS-D), mixed IBS (IBS-M), and unsubtyped IBS (IBS-U). This classification system facilitates the accurate diagnosis and effective management of the condition.

The IBS-C subtype affects a significant number of patients, particularly older adults and those from lower socioeconomic backgrounds. Recent studies indicate that IBS-C is linked to higher levels of functional impairment compared to other subtypes of IBS.

Conventional pharmacological and non-pharmacological treatment options for IBS-C have limited effectiveness and may cause significant adverse effects. This results in higher long-term healthcare costs. Over the past few decades, the ineffectiveness in treating patients with IBS-C has largely stemmed from a poor understanding of the disease's pathophysiology, a failure to consider the patient as a whole, and inappropriate patient selection and treatment endpoints in clinical trials.

Over the past two decades, significant advancements have been made in the development of effective and safer pharmacologic treatments for IBS-C. These advancements are grounded in an enhanced understanding of the pathophysiological mechanisms underlying IBS-C and the introduction of medications that demonstrate increased selectivity within established pharmacologic classes recognized for their efficacy.

This narrative review aims to provide a comprehensive overview of the available treatment options for IBS-C, highlighting their mechanisms of action, as well as their efficacy and safety profiles as determined by pertinent clinical trials. The review commences with a summary of laxative-based therapies and subsequently offers an up-to-date evaluation of four distinct classes of medications: prokinetics, prosecretory agents, bile acid modulators, and tenapanor.

 

Author (s) Details

Khaled Jadallah
Department of Internal Medicine, King Abdullah University Hospital, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.

 

Roberto De Giorgio
Department of Translational Sciences, University of Ferrara, Ferrara, Italy.

 

Rami Jadallah
Department of Internal Medicine, King Abdullah University Hospital, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.

 

Please see the book here:- https://doi.org/10.9734/bpi/msti/v4/4177

Study about Neuroplasticity and Spinal Cord Injury: Pathophysiology and Epidemiology | Chapter 15 | Current Practice in Medical Science Vol. 3

Neuroplasticity is a phenomena that occurs from the time of conception until old age and has distinct properties throughout life. There are three alternative approaches to understand neuroplasticity: morphological neuroplasticity, functional neuroplasticity, and synaptic plasticity. On the other hand, there are several events, such as ontogenetic plasticity, critical period, and impriting, that occur during the development of the nervous system in the embryonic and postnatal periods. Neuroplasticity, whether morphological, functional, or synaptic, is a process that underlies the dysfunctions that occur throughout life. In order to restore the destroyed circuit that will result in a neuroregenerative process, this work investigates the mechanism of neuroplasticity involving spinal cord injuries. a functional recovery, that is. Numerous organic barriers, including gliosis or the release of neurotoxic molecules, as well as other dysfunctions, were discovered both during and after the trauma mechanism, i.e., there is a primary injury brought on by the trauma itself and a secondary injury that is characterised by a chemical injury brought on by trauma, as well as an inflammatory reaction, among other things. On the basis of these earlier discoveries, pharmacological and non-pharmacological therapies have been created to enhance the neuroplasticity process and attempt to stop or slow down the chemical damage process. The work's main goals were to define and illustrate further uses of the term "neuroplasticity," discuss a few pathological and non-pathological circumstances, and, lastly, illustrate how neuroplasticity and some of its therapies relate to the progression of spinal cord injury. To further develop this study, a narrative evaluation of the literature from the PubMed and UpTo Date platforms from 2000 to 2020 was conducted, as well as an examination of three books. Studies on diseases and methods of treating spinal cord injuries in humans and animals were covered. Articles from before 2000 were disqualified. For the 1990s Bracken studies, an exception was made. In order to promote adequate neuroplasticity in the lesion and reduce the chemical lesion as well as other dysfunctions present at the site, pharmacological studies involving parenteral drug administration were discovered. However, many side effects, such as overdose, were reported after administration. As a result, non-pharmacological techniques incorporating, among other things, spinal supports, stem cells, and nanotechnology were created. Although some of the materials employed did not work for the therapy, nanotechnology showed promise in both the treatment and other forms. It can be said that the best way to treat spinal cord injury is to combine pharmacological and non-pharmacological treatments because it encourages neuroplasticity and helps patients with spinal cord injury overcome organic barriers and other dysfunctions. If further research yields reliable and positive results, the treatment should be registered and patented for spinal cord injury patients.

Author(s) Details:

Vinicius Benatti Freire,

Nove de Julho University, Campus Vergueiro, Brazil.

Lucas Cressoni de Souza,

Nove de Julho University, Campus Vergueiro, Brazil.

Mario Henrique de Lima Martinelli,

Nove de Julho University, Campus Vergueiro, Brazil.

Antônio Eduardo Damin,

Department of Neurology of the Nove de Julho UNiversity Medical School, Neurologist and Professor of Neurology at Nove de Julho University Medical School, São Paulo, Brazil .

Please see the link here: https://stm.bookpi.org/CPMS-V3/article/view/7393