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Drugs for Treatment of Constipation-Predominant IBS01:21

Drugs for Treatment of Constipation-Predominant IBS

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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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Drugs for Treatment of Diarrhea-Predominant IBS01:17

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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.
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
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Drugs Affecting GI Tract Motility: Bulk-Forming and Stimulant Laxatives01:22

Drugs Affecting GI Tract Motility: Bulk-Forming and Stimulant Laxatives

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Laxatives enhance bowel movements and alleviate constipation. They augment the stool's bulk, stimulate intestinal muscle contractions, draw water into the intestines, or soften the stool. There are five key types of laxatives: bulk laxatives, stimulant laxatives, osmotic laxatives, stool softeners, and lubricant laxatives.
Bulk-forming laxatives, such as psyllium, methylcellulose, and polycarbophil, absorb water in the intestine, increasing stool bulk and promoting bowel movement. This...
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Drugs Affecting GI Tract Motility: Other Laxatives01:20

Drugs Affecting GI Tract Motility: Other Laxatives

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Laxatives are primarily used to alleviate constipation, a common gastrointestinal disorder characterized by infrequent bowel movements and difficulty passing stools. They work by various mechanisms to increase the volume or frequency of bowel movements. The primary modes of action of laxatives include increasing stool bulk, softening the stool, stimulating intestinal motility, and osmotically drawing water into the intestines.
Osmotic or saline laxatives, like magnesium hydroxide or milk of...
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Drugs Affecting GI Tract Motility: Adsorbents as Antidiarrheal Agents01:20

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Diarrhea is characterized by the occurrence of frequent, watery bowel movements. Various factors can trigger diarrhea, including viral or bacterial infections, foodborne illnesses, side effects from certain medications, and underlying digestive disorders. If not adequately managed, diarrhea can lead to complications such as dehydration, electrolyte imbalances, and nutrient deficiencies. Severe diarrhea can lead to significant weight loss, malnutrition, and weakened immune function.
Adsorbents...
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Drugs Affecting GI Tract Motility: Serotonin Receptor Agonists01:23

Drugs Affecting GI Tract Motility: Serotonin Receptor Agonists

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Serotonin, a crucial neurotransmitter synthesized by enterochromaffin cells, plays a cardinal role in regulating gastrointestinal (GI) motility. With over 90% of the body's total serotonin in the GI tract, its influence on digestive processes is profound. Serotonin is swiftly released upon various stimuli, such as food boluses or certain drugs, triggering intrinsic sensory neurons in the myenteric plexus and extrinsic vagal and spinal sensory neurons. This leads to the activation of the...
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Ruminococcus bromii alleviates constipation by pullulanase-driven resistant starch degradation and microbiota

Rong Li1, Qianqian Yang1, Junqing He1

  • 1Key Laboratory of Molecular Biophysics of the Ministry of Education, Hubei Key Laboratory of Bioinformatics and Molecular Imaging, Department of Biotechnology, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, Hubei, China.

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Ruminococcus bromii alleviates constipation by degrading resistant starch, boosting beneficial gut bacteria and short-chain fatty acids. This finding highlights R. bromii as a potential target for constipation therapies.

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Area of Science:

  • Microbiology
  • Gastroenterology
  • Metabolic pathways

Background:

  • Constipation is a common gastrointestinal issue linked to gut microbiota changes.
  • Specific microbial targets and mechanisms for constipation remain unclear.
  • The genus Ruminococcus is found to be depleted in constipated individuals.

Purpose of the Study:

  • To investigate the role of Ruminococcus species in constipation.
  • To identify microbial mechanisms underlying constipation relief.
  • To evaluate R. bromii as a potential therapeutic agent for constipation.

Main Methods:

  • Analysis of gut microbiota composition in constipated patients.
  • Testing four Ruminococcus species (R. bromii, R. torques, R. obeum, R. gnavus) in a mouse model of constipation.
  • Investigating the enzymatic activity of R. bromii, specifically its pullulanase.
  • Assessing the impact of resistant starch degradation on gut microbiota and short-chain fatty acid production.
  • Conducting a clinical trial to validate findings in humans.

Main Results:

  • All tested Ruminococcus species alleviated constipation symptoms in mice.
  • R. bromii demonstrated the most significant efficacy.
  • R. bromii's pullulanase enzyme degrades resistant starch, increasing short-chain fatty acids.
  • Resistant starch intake promoted beneficial bacteria like Akkermansia and Bifidobacterium.
  • Clinical trials confirmed that the efficacy of resistant starch for constipation relief is dependent on R. bromii abundance.

Conclusions:

  • R. bromii is identified as a key microbial mediator in constipation relief.
  • The mechanism involves resistant starch metabolism, leading to beneficial microbial shifts.
  • R. bromii represents a promising candidate for novel probiotic or synbiotic constipation therapies.