Lubiprostone does not influence visceral pain thresholds in patients with irritable bowel syndrome.

Abstract

BACKGROUND:

In clinical trials, lubiprostone reduced the severity of abdominal pain. The primary aim was to determine whether lubiprostone raises the threshold for abdominal pain induced by intraluminal balloon distention. A secondary aim was to determine whether changes in pain sensitivity influence clinical pain independently of changes in transit time.

METHODS:

Sixty-two patients with irritable bowel syndrome with constipation (IBS-C) participated in an 8-week cross-over study. All subjects completed a 14-day baseline ending with a barostat test of pain and urge sensory thresholds. Half, randomly selected, then received 48 μg day(-1) of lubiprostone for 14 days ending with a pain sensitivity test and a Sitzmark test of transit time. This was followed by a 14-day washout and then a crossover to 14 days of placebo with tests of pain sensitivity and transit time. The other half of the subjects received placebo before lubiprostone. All kept symptom diaries.

KEY RESULTS:

Stools were significantly softer when taking lubiprostone compared to placebo (Bristol Stool scores 4.20 vs 3.44, P < 0.001). However, thresholds for pain (17.36 vs 17.83 mmHg, lubiprostone vs placebo) and urgency to defecate (14.14 vs 14.53 mmHg) were not affected by lubiprostone. Transit time was not significantly different between lubiprostone and placebo (51.27 vs 51.81 h), and neither pain sensitivity nor transit time was a significant predictor of clinical pain.

CONCLUSIONS & INFERENCES:

Lubiprostone has no effect on visceral sensory thresholds. The reductions in clinical pain that occur while taking lubiprostone appear to be secondary to changes in stool consistency.

• Authors: W E Whitehead, O S Palsson, L Gangarosa, M Turner, J Tucker
• Journal: Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society (Neurogastroenterol Motil) Vol. 23 Issue 10 Pg. 944-e400 (Oct 2011) ISSN: 1365-2982 [Electronic] England
• PMID: 21914041 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: © 2011 Blackwell Publishing Ltd.

Chemical References

• Lubiprostone
• Alprostadil

Topics

• Adult
• Alprostadil (analogs & derivatives, therapeutic use)
• Cross-Over Studies
• Defecation (drug effects)
• Dilatation
• Double-Blind Method
• Female
• Humans
• Irritable Bowel Syndrome (complications, drug therapy)
• Lubiprostone
• Male
• Pain (drug therapy, etiology)
• Pain Threshold (drug effects)