The use of a combined herbal remedy for some functional bowel diseases is the implementation of the concept of multitarget therapy

Aim of investigation: to evaluate the effectiveness and safety of the use of dietary supplement "Tummy ease" in the treatment of patients with functional constipation and IBS with a predominance of constipation. Materials and methods: The treatment of 33 patients was analyzed. 18 patients with FС (2 men and 16 women, mean age 50.6 ± 4.0 g) and 15 patients with IBS-C (2 men, 13 women, mean age 51.8 ± 4.5 years). Patients received Tummy ease 2-3 capsules/day for 28 days. The safety of treatment was assessed by the dynamics of biochemical parameters, the frequency and presence of side effects. To evaluate the effectiveness, we studied: the time of the carbolenic test, the dynamics of constipation symptoms according to the sum of points of the counting scale for assessing the severity of constipation and the PAC-SYM questionnaire, the dynamics of symptoms of the gastrointestinal tract according to the GIS questionnaire, the dynamics of quality of life according to the GSRS questionnaire. Results of the study: in patients with FC and IBS, there was a significant decrease in the symptoms of constipation (difficulty/pain during defecation, feeling of incomplete emptying, abdominal pain, time spent in the toilet, assistance with defecation, unsuccessful attempts to empty) and an increase in the frequency of defecation. According to the PAC-SYM questionnaire, patients with FC and IBS-C showed a significant decrease in abdominal discomfort, bloating, straining, feeling of incomplete emptying, defecation scarcity and difficulty, and the total symptom score. Patients with IBS-C additionally noted a decrease in abdominal pain, painful bowel movements and the number of false urges. The time of the carbolenic test significantly decreased in patients with FC from 49.4 ± 3.8 to 30.0 ± 2.3 hours (p = 0.00003), in patients with IBS-C from 62.7 ± 6.9 to 43.8 ± 6.4 hours (p= 0.002). In patients with FC and IBS-C, there was a significant positive dynamics of the symptoms of the gastrointestinal tract according to the GIS questionnaire and a significant improvement in the quality of life according to the GSRS questionnaire. Conclusion: The drug (BAA) Tummy ease is effective and safe in the treatment of patients with functional constipation and IBS-C and can be used as an alternative therapy.

irritable bowel syndrome, functional constipation, Tamiz

1. Mearin F., Lacy B. E., Chang L., Chey W. D., Lembo A. J., Simren M., Spiller R. Bowel Disorders. Gastroenterology. 2016 Feb 18: S0016-5085(16)00222-5. doi: 10.1053/j.gastro.2016.02.031.

2. Porter C.K., Gormley R., Tribble D. R., Cash B. D., Riddle M. S. The Incidence and gastrointestinal infectious risk of functional gastrointestinal disorders in a healthy US adult population. Am J Gastroenterol. 2011 Jan;106(1):130-8. doi: 10.1038/ajg.2010.371.

3. Lazebnik L.B., Prilepskaia S. I., Baryshnikov E. N., Parfenov A. I., Kosacheva T. N. [Prevalence and risk factors of constipation in the adult population of Moscow (according to population-based study MUSA)]. Eksp Klin Gastroenterol. 2011;(3):68-73.Russian. PMID: 21695954. @@Прилепская С. И., Парфенов А. И., Лазебник Л. Б. и др. Распространенность и факторы риска запоров у взрослого населения Москвы по данным популяционного исследования «МУЗА». Эксперим. и клин. гастроэнтерология 2011; 3:68-73;

4. Sanchez M.I., Bercik P. Epidemiology and burden of chronic constipation. Can J Gastroenterol. 2011 Oct;25 Suppl B(Suppl B):11B-15B. doi: 10.1155/2011/974573.

5. Pare P., Ferrazzi S., Thompson W. G., Irvine E. J., Rance L. An epidemiological survey of constipation in canada: definitions, rates, demographics, and predictors of health care seeking. Am J Gastroenterol. 2001 Nov;96(11):3130-7. doi: 10.1111/j.1572-0241.2001.05259.x.

6. Stewart W.F., Liberman J. N., Sandler R. S., et al. Epidemiology of constipation (EPOC) study in the United States: relation of clinical subtypes to sociodemographic features. Am J Gastroenterol. 1999 Dec;94(12):3530-40. doi: 10.1111/j.1572-0241.1999.01642.x.

7. Chang J.Y., Locke G. R., Schleck C. D., Zinsmeister A. R., Talley N. J. Risk factors for chronic constipation and a possible role of analgesics. Neurogastroenterol Motil. 2007 Nov;19(11):905-11. doi: 10.1111/j.1365-2982.2007.00974.x.

8. Dukas L., Willett W. C., Giovannucci E. L. Association between physical activity, fiber intake, and other lifestyle variables and constipation in a study of women. Am J Gastroenterol. 2003 Aug;98(8):1790-6. doi: 10.1111/j.1572-0241.2003.07591.x.

9. Suares NC, Ford AC. Prevalence of, and risk factors for, chronic idiopathic constipation in the community: systematic review and meta-analysis. Am J Gastroenterology 2011;106:1582-1591.

10. Frank L., Kleinman L., Farup C., Taylor L., Miner P. Jr. Psychometric validation of a constipation symptom assessment questionnaire. Scand J Gastroenterol. 1999 Sep;34(9):870-7. doi: 10.1080/003655299750025327.

11. Agachan F., Chen T., Pfeifer J., Reissman P., Wexner S. D. A constipation scoring system to simplify evaluation and management of constipated patients. Dis Colon Rectum. 1996 Jun;39(6):681-5. doi: 10.1007/BF02056950.

12. Novik A.A., Ionova T. I. Guidelines for the study of quality of life in medicine. Moscow. OLMA Media Group, 2007. 320 P. (in Russ.) @@Новик А. А., Ионова Т. И. Руководство по исследованию качества жизни в медицине. - М.: ОЛМА Медиа Групп, 2007. - 320 с.

13. Holtmann G., Adam B., Grote E., Saadat-Gilani K., Vinson B. Validation of the Gastrointestinal Symptom Score (GIS) in Patients With Functional Dyspepsia. Gastroenterology. 2004, 126 Suppl., A441.

14. Minushkin O. N., Maslovskiy L. V., Bulanova M. I., Gordienko E. S., Topchiy T. B., Beylina N. I. Experience of using metaprebiotics in the treatment of certain functional gastrointestinal disorders. Meditsinskiy sovet = Medical Council. 2020;(15):105-111. (In Russ.) doi: 10.21518/2079-701X-2020-15-105-111. @@Минушкин О. Н., Масловский Л. В., Буланова М. И., Гордиенко Е. С., Топчий Т. Б., Бейлина Н. И. Опыт применения метапребиотиков в лечении некоторых функциональных заболеваний кишечника. Медицинский Совет. 2020;(15):105-111. doi: 10.21518/2079-701X-2020-15-105-111.