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Drugs for Treatment of Diarrhea-Predominant IBS

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Diarrhea-predominant irritable bowel syndrome (IBS-D) is a subtype of IBS characterized primarily by frequent, loose, or watery stools, abdominal pain, and abdominal discomfort. Therapeutic approaches to managing IBS-D include dietary changes, stress management techniques, and pharmaceutical interventions.
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Pharmacological therapies for IBS-C are designed to alleviate abdominal discomfort and enhance bowel function. In patients with IBS-C, fiber supplements may help soften stools and decrease straining, but may also lead to increased gas production and bloating. Osmotic laxatives like milk of magnesia are frequently used to soften stools and increase stool frequency in IBS-C patients. In addition, two drugs approved for use in severe IBS-C adult cases are linaclotide (Linzess) and lubiprostone...
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Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
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Updated: May 10, 2025

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Minimally Invasive Overactive Bladder Therapy After Prolapse Surgery.

Abigail Shatkin-Margolis1, Lufan Wang2, Farnoosh Nik-Ahd2

  • 1Department of Obstetrics and Gynecology, University of California, San Francisco, CA.

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Minimally invasive overactive bladder therapies were used in only 1.9% of older women post-prolapse surgery, despite a high disease prevalence. This highlights a gap in managing overactive bladder symptoms after pelvic organ prolapse repair.

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Area of Science:

  • Urogynecology
  • Geriatric Medicine
  • Health Services Research

Background:

  • Pelvic organ prolapse (POP) and overactive bladder (OAB) frequently coexist in older women.
  • Understanding treatment patterns for OAB following POP surgery is crucial for optimizing patient care.

Purpose of the Study:

  • To investigate the utilization of minimally invasive OAB therapies in older women after undergoing POP surgery.
  • To identify factors associated with the use of these therapies.

Main Methods:

  • Retrospective cohort study of Medicare beneficiaries undergoing POP surgery (2014-2015).
  • Primary outcome: new minimally invasive OAB therapy use within 2 years.
  • Secondary outcome: new OAB diagnosis.
  • Analysis included modified Poisson regression to determine relative risks.

Main Results:

  • 1.9% of 58,841 women received minimally invasive OAB therapy post-surgery.
  • 9.2% developed a new OAB diagnosis within 2 years.
  • Factors increasing therapy use included apical POP surgery, concomitant stress urinary incontinence surgery, pre-existing OAB, and frailty.

Conclusions:

  • Rates of minimally invasive OAB therapy are low in older women post-POP surgery.
  • A significant proportion of women develop new OAB diagnoses after surgery.
  • Further research is needed to understand and improve OAB management in this population.