Assessment of pain intensity and methods of its relief in patients with irritable bowel syndrome

Abstract

Objective — to develop a questionnaire for assessing the condition of patients with irritable bowel syndrome (IBS); to evaluate clinical effectiveness of personalized diet, synthetic agonist of peripheral opioid receptors m‑, k‑, and d‑ trimebutine maleate, and complex pro‑prebiotic drug (Lactobacillus acidophilus 500 million, Lactobacillus rhamnosus 1 billion, Sacchromyces boulardii 30 million, Bifidobacterium lactis 275 million, Bifidobacterium longum 1 billion, Clostridium butyricum 2 million, Bacillus clausii spores 2 billion, Fructo oligosaccharides 100 mg) in patients with IBS.
 Materials and methods. To evaluate the clinical effectiveness of the treatment, 28 patients with IBS have been examined. The investigated group included 15 (53.6%) patients with IBS and diarrhea, 11 (39.3%) subjects with mixed IBS, and two (7.1%) patients with IBS and constipation. The age of the patients was 32.5±3.1 years; from them 17 (51.7%) were women and 11 (39.3%) men. Nine women (52.9%) and five (45.5%) men were married, and 11 (64.7%) women and 7 (63.3%) men had higher education. The average duration of the disease in women was 3.4±1.8 years, and 3.1±1.5 years in men. The diagnosis of IBS was established according to the Rome criteria IV revision. Defecation was evaluated according to the Bristol stool scale. All patients filled out the «Questionnaire for a patient with irritable bowel syndrome» before the treatment start and during the treatment. The examined patients were prescribed a personalized diet with account their nutritional status, and drug therapy that included trimebutine maleate (film‑coated tablets) in a dose of 200 to 600 mg depending on pain intensity, and synbiotic (Lactobacillus acidophilus, Lactobacillus rhamnosus, Sacchromyces boulardii, Bifidobacterium lactis, Bifidobacterium longum, Clostridium butyricum, Bacillus clausii spores, Fructo oligosaccharides) in a dose of one capsule twice a day, regardless of the severity of the pain syndrome.
 Results. Complex treatment with the use of personalized dietary recommendations, synthetic agonist of peripheral opioid receptors trimebutine maleate and synbiotic that included Lactobacillus acidophilus, Lactobacillus rhamnosus, Sacchromyces boulardii, Bifidobacterium lactis, Bifidobacterium longum, Clostridium butyricum, Bacillus clausii spores, Fructo oligosaccharides, promoted to the decrease of pain syndrome severity, improvement of the psychoemotional state and quality of life of patients.
 Conclusions. The developed questionnaire for a patient with IBS was comprehensible and easy to fill out by patients; it allowed a practitioner to quickly analyze the dynamics of the pain syndrome. Personalized dietary treatment, a differentiated approach in administration of the peripheral opioid receptor agonist trimebutine maleate and synbiotics (Lactobacillus acidophilus, Lactobacillus rhamnosus, Sacchromyces boulardii, Bifidobacterium lactis, Bifidobacterium longum, Clostridium butyricum, Bacillus clausii spores, IBS oligosaccharides) was clinically effective for patients with IBS, it promoted the significant pain relief and improvement of the quality of life of patients.