Trouble with Accutane: Irritable Bowel Syndrome (IBS) Facts

In many instances, Accutane has caused patients problems with Irritable Bowel Syndrome. Use this page to learn more:

Irritable Bowel Syndrome (IBS) or spastic colon is a group of functional bowel disorders which are fairly common and make up 20–50% of visits to gastroenterologists. There are three forms, dependant on which symptom predominates: diarrhea-predominant (IBS-D), constipation-predominant (IBS-C) and IBS with alternating stool pattern (IBS-A).

Features

Symptoms of IBS are abdominal pain or discomfort associated with changes in bowel habits in the absence of any structural abnormality. Colonic hypersensitivity is a sensitive but less specific sign of IBS. The pain is typically relieved by defecating.

There appears to be an overlap of IBS with stress, chronic pelvic pain, fibromyalgia and various mental disorders (in a small minority). While no good explanation for this phenomenon exists, it does strengthen the view that there is a neurological component to IBS.

Diagnosis

According to the Rome II consensus conference of the American Gastroenterological Association and international medical societies on functional bowel disorders, the diagnosis of IBS can be made when the following criteria are fulfilled:

At least 12 weeks, which need not be consecutive, in the preceding 12 months of abdominal discomfort or pain that has 2 of 3 features:

1. Relieved with defecation; and/or
2. Onset associated with a change in frequency of stool; and/or
3. Onset associated with a change in form (appearance) of stool

Symptoms that cumulatively support the diagnosis of IBS:

• Abnormal stool frequency (for research purposes, “abnormal” may be defined as greater than 3 bowel movements per day and less than 3 bowel movements per week);
• Abnormal stool form (lumpy/hard or loose/watery stool);
• Abnormal stool passage (straining, urgency, or feeling of incomplete evacuation);
• Passage of mucus;
• Bloating or feeling of abdominal distention

The diagnosis of a functional bowel disorder always presumes the absence of a structural or biochemical explanation for the symptoms. This has to be excluded carefully via:

• colonoscopy
• esophagogastroduodenoscopy (EGD)
• abdominal ultrasound
• blood tests: full blood count, liver enzymes, electrolytes, renal function
• stool chemistry (e.g. tests for exocrine pancreas insufficiency and other malabsorption conditions), stool microbiology, fecal fat
• H2-tests for lactose intolerance and fructose malabsorption
• blood tests or deep duodenal biopsy for celiac disease

A diagnostic test for IBS via assessment of colonic/rectal hypersensitivity using a barostat is currently being discussed. However, sensitivity and specificity are not yet high enough to render the method widely applicable.

Treatment

The most important therapeutic measure is reassuring the patient that he has no fatal or otherwise threatening disease, as this is the major concern of patients seeking medical help. Dependent on symptoms, treatment can consist of dietary advice, stool softeners and laxatives in constipation-predominant, and antidiarrheals (loperamide) in diarrhea-predominant IBS. The use of antispasmodic drugs (e.g. anticholinergics such as hyoscine) is not encouraged as the therapeutic benefit over placebo is hardly proven. Newer drugs include alosetron and tegaserod, both of which are heavily advertised but appear to have only a limited effect with the risk of side-effects.

As there appears to be a psychological component to IBS, psychotherapy is occasionally advised. Though not specifically indicated for IBS, the use of antidepressant drugs (e.g. amitriptyline in a low dosage or an SSRI) to treat the symptoms is common and has positive effects for some patients.

Prognosis

IBS is not fatal nor is linked to the development of other serious bowel diseases. However, due to the chronic pain, discomfort, and other symptoms, work absenteeism, social phobias and other negative quality-of-life effects can be common in more serious cases. Individuals lucky enough to find a successful treatment for their symptoms can lead normal lives.

If you or someone you love has experienced side effects from using Accutane, an experienced Weitz and Luxenberg lawyer may be able to get you the compensation you deserve. To find out, fill out the form below for a free case evaluation.

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