A Blood Test for Irritable Bowel Syndrome?

Researchers presented a paper at the annual Digestive Disease Week meeting which introduced a commercial blood test which can help distinguish irritable bowel syndrome (IBS) from Cohn’s Disease or Ulcerative Colitis (Inflammatory Bowel Diseases) and Celiac Disease ( Gluten Sensitive Enteropathy). The test was especially effective in identifying the diarrhea predominant form of Irritable bowel syndrome. The issue was discussed today on line in the periodical MedPage Today.

Patients with Irritable Bowel Syndrome get sudden abdominal bloating, cramping and progressively watery loose bowel movements. The symptoms often occur after a meal and leave the patient frightened and exhausted. Symptoms can be prolonged and emotionally and physically incapacitate an individual. Until now physicians were forced to schedule barium enemas, small bowel x ray series and fiber optic examinations (sigmoidoscopies, colonoscopies, upper endoscopies) to distinguish irritable bowel syndrome from the more ominous inflammatory bowel diseases. Very often we needed to collect stool specimens to look for white blood cells, red blood cells, bacteria, parasites and chemical constituents. The cost, radiation exposure and risks of invasive procedures causing complications made the experience expensive and unpleasant but necessary.

The current blood tests, used in a trial of 2700 patients, detect antibodies to cytolethal distending toxin B and vinculin. Mark Pimental, MD of Cedars-Sinai Medic al Center in Los Angeles said to the tests were successful in distinguishing IBS from the other entities with specificity well above 90% and a positive predictive value of 98.6% allowing clinicians to rule out Crohn’s Disease or Ulcerative Colitis.

This is a step in the right direction but it remains to be seen when the test will be available locally through commercial labs and if it really will allow us to eliminate the many tests we now do to distinguish these problems from one another.

Irritable Bowel Syndrome Responds To Rifaximin

StomachIn a study presented at the annual meeting of The American College of Gastroenterology, Anthony Lembo, MD, of the Harvard Medical School and Beth Israel Deaconess Medical Center presented data that showed that the non-absorbable antibiotic Rifaximin helps control cramping and diarrhea related Irritable Bowel Syndrome (IBS). Irritable bowel cripples individuals by causing abdominal cramping and multiple loose or watery stools per day. These patients have been screened by colonoscopy and imaging studies for more serious diseases such as Crohn’s Disease and ulcerative colitis with testing ruling these entities out. They are left with severe symptoms but no objective findings on available tests.

Over 2,500 patients participated in this study and received either Rifaximin or placebo three times per week. The decision to try an antibiotic was based on the theory that some IBS patients have excessive bacteria in the gut causing the problem. The treatment was successful in a significant number of participants compared to placebo based on a reduction of pain and frequency and number of stools. The patients were then observed for four (4) weeks during which time some patients relapsed. If these patients were treated for another two (2) weeks they showed significant improvement.

Irritable bowel incapacitates millions of individuals. While this data is extremely preliminary, it gives us hope of another treatment regimen, becoming available soon, that is effective and safe.