Emerging strategies for managing IBS: What does the future hold?
A review of any list of currently available therapies for irritable bowel syndrome (IBS) would remind gastroenterologists that the old "standard" agents are neither highly efficacious nor well studied. For example, a number of these therapies are not supported by evidence from robust clinical trials. The American College of Gastroenterology guideline recommends that IBS therapies should not be given a grade A recommendation if they have not been evaluated in randomized, placebo-controlled, clinical trials of adequate duration with well-defined end points. Patients enrolled in these trials should meet the Rome criteria for IBS and should, where appropriate, be categorized according to their predominant symptoms, with special consideration given to gender differences. New agents also need to consider new targets for drug action in IBS, such as the brain-gut axis, intestinal fluid secretion, the gut flora, and inflammation.