Inhibition of gastric secretion relieves diarrhea and postprandial urgencyassociated with irritable bowel syndrome or functional diarrhea

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.