Question

Arwen, a 40-year old female, has been newly diagnosed with constipation-predominant irritable bowel syndrome. She complains of severe pain, constipation, and often vomiting. Her doctor has prescribed lubiprostone and fluoxetine.

a. Explain how lubiprostone would help treat her symptoms.

b. Rationalise the use of fluoxetine in her treatment regimen.

c. Would ondansetron be appropriate as an anti-emetic? Justify your reason

Answer 1

a. Lubiprotone - one of the main uses of lubiprotone is to treat irritable bowel syndrome with constipation, a condition that causes stomach pain,cramps,bloating and difficult passage of stools.Lubiprostone stimulates chlorine channels in epithelial cells and promotes intestinal fluid secreation in Gastrointestinal Tract , the fluid adds to stool and promotes increased transit.

b.Use of antidipressent in IBS is common practice,therefore use of Fluoxetine  helps to minimize the psychological symptoms like dipression , anxiety which intensify the digestive complaints of IBS patients.This also have local effects on GT which improve sensory motor function of bowel.It helps in decreasing abdominal pain, discomfort , increasing frequency of bowel- movement and decreasing consistency of stool.

c.No, Ondansetron will not be an appropriate anti-emenatic as it is well know to be used in vomiting and nauseatic conditions during chemotherapy, radiotherapy or surgery, however it was also studied that ondasetron releives some of the most intusive symptoms of IBS-Diarrhea (fewer days with urgency, less frequent defecation, and less bloating) which is not our case.