Irritable bowel syndrome: The evolution of multi-dimensional looking and multidisciplinary treatments

Table 1 Potential drugs and measures to treat irritable bowel syndrome

Category	Functions	Examples
Antispasmodics	Antagonists of muscarinic receptors and calcium channels of smooth muscle	Cimetropium bromide, dicyclomine, hyoscine butylbromide, mebeverine, otilonium bromide, peppermint oil, pinaverium bromide, trimebutine maleate
Antidiarrheals	Agonists of μ-opioid receptors	Loperamide
Laxatives	Osmotic, stimulant	Bisacodyl, lactulose, magnesium citrate, magnesium sulfate, polyethylene glycol
Bulking agents	Water binding to increase stool bulk	Methylcellulose, psyllium, wheat bran
Receptor targeted new drugs	Agonists and antagonists of 5-HT	Alosetron, cilansetron, naronapride, prucalopride, ramosetron, tegaserod
	Chloride channel activators	Lubiprostone
	Agonists of GC-C	Linaclotide
	Antagonists of NK1 receptors	Ezlopitant, TAK 637
	Agonists of κ-opioid receptors	Asimadoline
	Agonists of α2 adrenergic receptors	AGN-203818, clonidine, solabegron
	Antagonists of CCK1 receptors	Loxiglumide
	Agonists of somatostatin receptors	Octreotide
Psychiatrics	Tricyclic antidepressants	Amitriptyline, desipramine, doxepin, imipramine, trimipramine
	SSRIs	Citalopram, fluoxetine, paroxetine, venlafaxine
	Psychotherapy	Biofeedback, cognitive behavioral therapy, dynamic psychotherapy, hypnotherapy, relaxation training
Probiotics	To balance gut microbiota	VSL-3, lactobacilli, bifidobacteriae
Fecal transplantation	Living microbiota supplement	Through nasogastric tube, enema or colonoscopy
Anti-inflammation	Mast cell stabilizers, PAR-2 blockers TRPV receptor type 1 and 4 blockers	Capsazepine, GB88, ketotifen, RN1734
Antibiotics	To inhibit gut microorganisms	Neomycin, rifaximin
Miscellaneous	Antinociceptive substance	Melatonin
	Bile acid sequestrant	Cholestyramine
	To diminish inflammation? To absorb bacteria and enterotoxins?	Diosmectite
Food	To enhance immunity?	Kiwifruit
Complementary and alternative medicine	Mysterious	Acupuncture, aromatic therapy, ginger, herb drugs, holistic medicine, homeopathy, massage, reflexology

5-HT: 5-hydroxytryptamine; CCK: Cholecystokinin; GC-C: Guanylate cyclase C; NK: Neurokinin; PAR: Protease-activated receptor; SSRIs: Selective 5-hydroxytryptamine re-uptake inhibitors; TRPV: Transient receptor potential vanilloid.