The Rational Use of CCK Antagonists in Irritable Bowel Syndrome

Abstract

The irritable bowel syndrome (IBS) is the name given to a condition that is characterised by the combination of abdominal pain or discomfort and a disorder of bowel habit, for which no pathological cause can be found. The pain is often manifest in the lower abdomen and may be induced or exacerbated by eating a meal, particularly if that meal has a high content of fat. The disorder in bowel habit may vary from diarrhoea to constipation; many patients actually complain of alternating diarrhoea and constipation. Manning et al. [1] have identified a number of symptoms that are characteristic of the irritable bowel; they include abdominal distension, a feeling of incomplete evacuation, abdominal pain relieved by defaecation, looser and more frequent stools with the onset of pain and rectal mucus. These symptoms are also found in inflammatory conditions of the rectum, such as ulcerative colitis [2] and solitary rectal ulcer syndrome [3], and probably indicate rectal “irritation”. Patients with the IBS also frequently suffer from symptoms such as nausea, bloating and early satiety that are referable to the upper gastrointestinal tract, and even drowsiness, irritability, headaches, wheeziness and frequency of micturition that may indicate functional disturbances in other parts of the body.