EVIDENCIAS BMJ SOBRE SINDROME DE INTESTINO IRRITABLE

 

 

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Irritable bowel syndrome

vía Clinical Evidence el 5/01/10

New evidence; conclusions changed for:

• CBT Two systematic reviews and one RCT added. These supersede three older previously reported systematic reviews, as they provided more information, included many of the same studies, and reached similar conclusions. Categorisation changed from Unknown effectiveness to Likely to be beneficial.
• Hypnotherapy Two systematic reviews added. These supersede a previously reported early narrative systematic review as they include some of the same studies, provide more information, and reach similar conclusions. One of the new systematic reviews carried out a meta-analysis and found that hypnotherapy reduced global symptoms or abdominal pain compared with placebo.Categorisation changed (from Unknown effectiveness to Likely to be beneficial).

New evidence; conclusion confirmed for:

• Antidepressants Two systematic reviews and one RCT added. The two reviews supersede three older systematic reviews previously reported in this Clinical Evidence review, which included some of the same studies and reached similar conclusions. Categorisation unchanged (Likely to be beneficial).
• Antispasmodics One systematic review and one RCT added. The review supersedes two older systematic reviews previously reported in this Clinical Evidence review, which included many of the same studies and reached similar conclusions. Categorisation unchanged (Likely to be beneficial).
• Soluble fibre supplementation One systematic review added. This supersedes an older systematic review previously reported in this Clinical Evidence review, which included many of the same studies and reached similar conclusions. Categorisation unchanged (Likely to be beneficial).
• Insoluble fibre supplementation One systematic review added. This supersedes an older systematic review previously reported in this Clinical Evidence review, which included many of the same studies and reached similar conclusions. Categorisation unchanged (Unknown effectiveness).
• 5HT₄ receptor agonists One systematic review added. This systematic review supersedes two older previously reported reviews, as it reports many of the same RCTs and reaches the same conclusion. Categorisation unchanged (Trade-off between benefits and harms).
• 5HT₃ receptor antagonists: One systematic review added comparing alosetron versus placebo. It pooled results from five RCTs previously reported in this Clinical Evidence review and three subsequent RCTs. It found that alosetron significantly improved global symptoms or abdominal pain compared with placebo. Categorisation unchanged (Trade-off between benefits and harms).
• 5HT₃ receptor antagonists other than alosetron (ramosetron) One RCT added.It found that ramosetron increased response to treatment and patient-reported relief of abdominal pain or discomfort and improvement in abnormal bowel habits compared with placebo after 12 weeks' treatment. Categorisation unchanged (Unknown effectiveness).

 

 

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