B. Dave et W. Rubin, Inhibition of gastric secretion relieves diarrhea and postprandial urgencyassociated with irritable bowel syndrome or functional diarrhea, DIG DIS SCI, 44(9), 1999, pp. 1893-1898
Five patients with gastroesophageal reflux disease (GERD), who also had chr
onic functional diarrhea and postprandial urgency, unexpectedly noted rapid
relief of their diarrhea and urgency when they took lansoprazole for their
heartburn. To determine if this surprising result was not fortuitous, all
20 patients seen during the next six months for chronic diarrhea and postpr
andial urgency due to irritable bowel syndrome (IBS) or functional diarrhea
were treated with inhibitors of gastric secretion: 14 with proton-pump inh
ibitors and 6 with H-2 blockers. All patients had rapid, marked improvement
. Usually within three days, their symptoms abated and they usually had one
to three formed stools per day. Relief continued during the one to six mon
ths they were followed on therapy. Five patients stopped therapy, had recur
rent diarrhea, and rapid relief upon resuming therapy. Thus, inhibition of
gastric secretion effectively controls the diarrhea and postprandial urgenc
y associated with IBS or functional diarrhea, probably by diminishing the g
astrocolic or gastroenteric reflex.