Cilansetron in the treatment of diarrhea-predominant irritable bowel syndrome?

Information on the 5-hydroxytryptamine type 3 receptor antagonist cilansetron is scarce and most studies have only been published in abstract form. Results from preclinical and two dose-finding studies have suggested that cilansetron could be effective in the treatment of patients with diarrhea-predominant irritable bowel syndrome. Two large efficacy and safety trials extending over 3 and 6 months revealed a superiority of cilansetron 2 mg orally three-times daily over placebo reflected by numbers needed to treat of 4.

Gastric emptying of glucose solution and associated plasma concentrations of GLP-1, GIP, and PYY before and after fundoplication.

Background: This study was designed to assess the relationship between gastric emptying of glucose solution and the ensuing plasma concentrations of glucagon-like peptide-1 (GLP-1), peptide YY (PYY), and glucose-dependent insulinotropic polypeptide (GIP) in patients having undergone fundoplication for gastroesophageal reflux (GERD).

Subjects And Methods: In 10 male patients the emptying of 50% glucose solution was determined scintigraphically and its relationship with plasma glucose, GLP-1, PYY, and GIP concentrations was studied before and 3 months after fundoplication.

Results: In the first 30 min after glucose ingestion, emptying was significantly (p = 0.

Esophageal acid exposure in upright and recumbent postures: roles of lower esophageal sphincter, esophageal contractile and transport function, hiatal hernia, age, sex, and body mass.

This study aimed to assess, using multiple regression analyses, the roles of lower esophageal sphincter, esophageal contractile and transport function, hiatal hernia, age, sex, and body mass for esophageal acid exposure in upright and recumbent postures and for esophagitis. In 116 patients with reflux symptoms, acid exposure was recorded by 24-hr pH monitoring, motility manometrically, bolus transport scintigraphically, hiatal hernia and esophagitis endoscopically. In upright posture, the percentage time at pH <4 increased significantly with higher body mass index and lower distal esophageal amplitude, the number of episodes >5 min at pH <4 with lower distal amplitude, slower transport, and higher body mass, and the longest episode at pH <4 with lower distal amplitude.

Visceral hypersensitivity in irritable bowel syndrome: a summary review.

We examined published reports from 1970 to the present to evaluate the theory that abnormal visceral sensitivity characterizes the irritable bowel syndrome. Evidence to support claims that abnormal visceral sensitivity defines the irritable bowel syndrome falls short because of cognitive deficits in gastrointestinal neurobiology, limitations in experimental design and execution, and the interpretation of results.