From the Guidelines
Hyoscine N-butylbromide is not recommended for treating Gastroesophageal Reflux Disease (GERD) as it may worsen symptoms by relaxing the lower esophageal sphincter and reducing saliva production, which can exacerbate acid reflux. This medication is an anticholinergic drug primarily used to treat abdominal cramps, intestinal colic, and other gastrointestinal spasms, but it is not specifically indicated for GERD treatment 1.
For GERD management, the standard approach typically includes:
- Lifestyle modifications (e.g., weight loss, avoiding trigger foods, not lying down after meals)
- Antacids for immediate symptom relief
- H2 receptor antagonists (e.g., ranitidine) for moderate symptoms
- Proton pump inhibitors (e.g., omeprazole) for more severe cases
According to the AGA clinical practice update on the personalized approach to the evaluation and management of GERD, a stepwise diagnostic approach should be used to identify the mechanisms driving symptoms, and patients should receive education on GERD pathophysiology and lifestyle modifications 1. The update also recommends a 4- to 8-week trial of single-dose PPI therapy for patients with typical reflux symptoms and no alarm symptoms, with escalation to twice-a-day dosing or switching to a more potent acid suppressive agent if symptoms persist 1.
In real-life clinical practice, it is essential to prioritize the patient's safety and well-being, and to use the most recent and highest-quality evidence to guide treatment decisions. In this case, the evidence suggests that Hyoscine N-butylbromide is not an effective or recommended treatment for GERD, and that other treatments, such as lifestyle modifications and acid suppressive therapy, should be used instead. If you're experiencing GERD symptoms, consult with a healthcare provider for appropriate treatment options tailored to your specific condition.
From the Research
Hyoscine N-butylbromide in Gastroesophageal Reflux Disease (GERD)
- The use of hyoscine N-butylbromide in GERD has been studied, and the results suggest that it may not be recommended for treatment [ 2 ].
- A study published in 2001 found that hyoscine N-butylbromide increased the total number of esophageal acid refluxes in patients with GERD and in controls [ 2 ].
- The study concluded that hyoscine N-butylbromide, an anticholinergic agent, is not recommended in the treatment of GERD due to its potential to worsen symptoms [ 2 ].
Alternative Uses of Hyoscine N-butylbromide
- Hyoscine N-butylbromide is commonly used to induce smooth muscle relaxation and reduce spasmodic activity of the gastrointestinal (GI) tract during endoscopic procedures [ 3 ].
- It is also used to treat abdominal pain associated with cramps induced by GI spasms [ 4 ].
- A review of its use in the treatment of abdominal cramping and pain found that hyoscine N-butylbromide is a valuable treatment option for patients with symptoms of abdominal pain or discomfort associated with cramping [ 4 ].
Safety and Efficacy
- Hyoscine N-butylbromide is generally well tolerated, with few adverse events reported [ 4 ].
- A study on the use of intramuscular hyoscine N-butylbromide in severe irritable bowel syndrome found that it provided effective relief for pain episodes and reduced analgesic escalation and excessive healthcare utilization [ 5 ].
- However, its use should be cautious in patients with cardiac comorbidities, prostatic hypertrophy with urinary retention, and glaucoma [ 3 ].