Medical and Research News
An article published in August by several leading European gastroenterologists in the journal Alimentary Pharmacology and Therapeutics has produced a consensus report which may be helpful to doctors and their patients in deciding whether to try specific probiotics for specific lower GI symptoms.
The authors performed a systematic review of randomized, placebo-controlled clinical trials on probiotics in adults. They sought to determine the level of available evidence to support the use of specific probiotics, as a reference to physicians who could then make evidence-based recommendations to their adult patients.
They found high levels of support for a role for specific probiotics in the management of overall symptoms and abdominal pain in patients with irritable bowel syndrome (IBS), and for preventing or reducing antibiotic associated diarrhea. They found moderate evidence to support a role for specific probiotics in managing overall symptoms in patients with diarrhea prominent IBS (IBS-D); improving bowel movements and bloating/distension in patients with IBS; and improving some aspects of health-related quality of life. The authors note that these findings are specific to individual strains or formulations of probiotics and cannot be extrapolated to other products. Further studies are needed to establish similarly high levels of evidence for the role of probiotics in treating other symptoms or other functional GI disorders.
FDA Advisory Committee Will Consider Extended Use of Relistor, a Drug for Opioid-Induced Constipation
The U.S. Food and Drug Administration (FDA) will be holding an advisory committee meeting in March 2014 to review Salix’s supplemental New Drug Application, which seeks to extend the use of Relistor to include patients who are taking opioids to treat chronic pain.
Relistor was approved in the U.S. in 2008 for short-term treatment of opioid-induced constipation in patients with advanced illness who are receiving palliative care when response to laxative therapy has not been sufficient. It has also received approval for this indication in other countries.
A large scale retrospective study has shown that children with attentiondeficit/ hyperactivity disorder (ADHD) are significantly more likely to suffer from chronic constipation and bowel incontinence than kids without ADHD.
The study, published in the journal Pediatrics, looked at the medical records of more than 700,000 children. Researchers found that constipation nearly tripled and fecal incontinence increased six-fold among kids with ADHD. Children with ADHD also tended to see their doctor for their bowel problems more often, possibly suggesting that their constipation and bowel incontinence was more severe.
The study was limited to the children of active-duty military personnel. Further prospective research in the general population is needed, but parents of children with ADHD may wish to discuss these findings with their child’s doctor if they have concerns about their child’s digestive health.