IBS and RLS Together? Wow!

Both the irritable bowel syndrome (IBS) and the restless legs syndrome (RLS) are difficult-to-treat conditions that cause real distress. The availability of effective drugs to treat them has led to what some may call “disease-mongering” on the part of the pharmaceutical industry. This means increasing the recognition of a disease that may not be readily diagnosed by physicians, with the ultimate aim of increasing the potential patient base for treatment with the effective drug. Now there’s a report from the Digestive Disease Week meeting that suggests possible co-existence of both conditions in the same patient – a so-called example of comorbidity.

The physician had heard of reports linking IBS with fibromyalgia, which has in turn been linked with RLS. When his cousin came down with both IBS and RLS (after a case of traveler’s diarrhea), he decided to see if an antibiotic (rifamaxim, which is approved for E. coli-related traveler’s diarrhea) could help. He found 13 patients suffering from both conditions; all 13 showed improvement in IBS symptoms and 10 obtained marked relief from their RLS symptoms with 10 days of the antibiotic.

I guess now all that remains is to try antibiotic therapy in patients with combined IBS and fibromyalgia (or someone with all 3 conditions). Joking aside, these 3 disorders cause considerable distress and should be taken seriously by physicians. Withdrawal of two specific drugs for IBS symptoms (tegaserod, or Zelnorm®, and alosetron, or Lotronex®) has left patients ill-served, so that new approaches are needed.