Home' Australian Pharmacist : Australian Pharmacist October 2012 Contents Australian Pharmacist October 2012 I © Pharmaceutical Society of Australia Ltd.
THE COMPLEMENTARY APPROACH
1. Which CAM regimen is most likely to
benefit patients with IBS?
a) A combination of wheat bran and
peppermint oil to improve symptoms
of constipation and bloating.
b) A diet restricting fruit and cruciferous
c) A diet restricting all sources of wheat
and dairy products.
d) Identifying and treating the specific
cause depending on the individual’s
2. Under what circumstance might a
pharmacist recommend over-the-
counter remedies for patients with
a) When the patient has been
experiencing recurrent abdominal
pain with frequent loose bowel
motions for more than 6 months.
b) When the patient has been previously
diagnosed with IBS and is not
experiencing rectal bleeding or weight
c) When the patient reports sudden
onset of constipation.
d) When the patient reports sudden
onset of diarrhoea and stool tests have
not identified an infection.
3. Which of the following statements
is supported by the scientific
a) A recent meta-analysis of six controlled
trials involving 321 IBS patients who
received a traditional chinese medicine
(TCM) herbal formulation for between
four weeks and three months noted an
improvement in 48% of patients.
b) A recent meta-analysis of six controlled
trials involving 321 IBS patients who
had maintained a gluten-free diet for
between four weeks and three months
noted an improvement in 48% of
c) The fixed herbal combination STW
5 has demonstrated improvements
in abdominal pain and IBS symptom
d) As food allergy is a common feature in
IBS patients, elimination diets should
be recommended as first-line therapy.
4. Which of the following should
be routinely considered when
recommending dietary restriction to
patients with IBS?
a) Replacing omitted foods with readily
available and palatable options that
ensure nutritional sufficiency.
b) Avoiding wheat and dairy as a first-line
treatment as these are the most likely
contributors to symptom exacerbation
c) Replacing insoluble fibre with soluble
fibre to maintain bowel regularity
whilst reducing bloating and flatus.
d) Ensuring calcium status by replacing
dairy with soy alternatives.
22. Pilichiewicz AN, Horowitz M, Russo A, et al. Effects of Iberogast
on proximal gastric volume, antropyloroduodenal motility
and gastric emptying in healthy men. Am J Gastroenterol
23. Allescher HD, Wagner H. [STW 5/Iberogast: multi-target-action
for treatment of functional dyspepsia and irritable bowel
syndrome]. Wien Med Wochenschr 2007;157(13–14):301–7 .
24. Krueger D, Gruber L, Buhner S, et al. The multi-herbal drug STW
5 (Iberogast) has prosecretory action in the human intestine.
Neurogastroenterol Motil 2009;21(11):1203–e110.
25. Ammon HP, Kelber O, Okpanyi SN. Spasmolytic and tonic
effect of Iberogast (STW 5) in intestinal smooth muscle.
Phytomedicine 2006;13 Suppl 5:67–74 .
26. Michael S, Abdel-Aziz H, Weiser D, et al. Adenosine A2A
receptor contributes to the anti-inflammatory effect of
the fixed herbal combination STW 5 (Iberogast®) in rat
small intestinal preparations. Naunyn Schmiedebergs Arch
27. Madisch A, Holtmann G, Plein K, et al. Treatment of irritable
bowel syndrome with herbal preparations: results of a double-
blind, randomized, placebo-controlled, multi-centre trial.
Aliment Pharmacol Ther 2004;19(3):271–9.
28. Heizer WD, Southern S, McGovern S. The role of diet in
symptoms of irritable bowel syndrome in adults: a narrative
review. J Am Diet Assoc 2009;109(7):1204–14 .
29. Madden JA, Hunter JO. A review of the role of the gut
microflora in irritable bowel syndrome and the effects of
probiotics. Br J Nutr 2002;88 Suppl 1:S67–72.
30. Friedman G. Diet and the irritable bowel syndrome.
Gastroenterol Clin North Am 1991;20(2):313–24.
31. Drisko J, Bischoff B, Hall M, et al. Treating irritable bowel
syndrome with a food elimination diet followed by food
challenge and probiotics. J Am Coll Nutr 2006;25(6):514–22.
Autism test trialled
A team of Australian researchers, led by
Professor Stan Skafidas, Director of the
Centre for Neural Engineering at the
University of Melbourne has developed a
genetic test that is able to predict the risk of
developing Autism Spectrum Disorder, ASD.
Professor Skafidas said, ‘this test could assist
in the early detection of the condition
in babies and children and help in the
early management of those diagnosed.
It would be particularly relevant for families
who have a history of Autism or related
conditions such as Asperger’s Syndrome,’
Autism affects around one in 150 births
and is characterised by abnormal social
interaction, impaired communication and
The test correctly predicted ASD with more
than 70% accuracy in people of central
European descent. Ongoing validation tests
are continuing including the development
of accurate testing for other ethnic groups.
Clinical neuropsychologist, Dr Renee
Testa from the University of Melbourne
and Monash University, said the test
would allow clinicians to provide early
interventions that may reduce behavioural
and cognitive difficulties that children and
adults with ASD experience.
‘Early identification of risk means we can
provide interventions to improve overall
functioning for those affected, including
families,’ she said.
A genetic cause has been long sought with
many genes implicated in the condition,
but no single gene has been adequate for
Using US data from 3,346 individuals
with ASD and 4,165 of their relatives from
Autism Genetic Resource Exchange (AGRE)
and Simons Foundation Autism Research
Initiative (SFARI), the researchers identified
237 genetic markers (SNPs) in 146 genes
and related cellular pathways that either
contribute to or protect an individual from
The next step is to further assess the
accuracy of the test by monitoring children
who are not yet diagnosed over an
The study results were published last
month in the journal Molecular Psychiatry.
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