Can the patient be given Bentyl (dicyclomine) for abdominal bloating and pain, characterized by lower abdominal and pelvic discomfort, with a recent history of constipation and bloating, pending the results of a computed tomography (CT) scan of the abdomen and pelvis?

From the Guidelines

The patient can be given Bentyl (dicyclomine) for abdominal bloating and pain, as antispasmodics have been shown to reduce global symptoms and abdominal pain in patients with irritable bowel syndrome (IBS) 1. The typical starting dose is 10-20 mg orally three to four times daily before meals and at bedtime. Dicyclomine is an anticholinergic antispasmodic medication that works by relaxing smooth muscle in the gastrointestinal tract, which can help reduce abdominal pain, bloating, and discomfort associated with IBS and other functional gastrointestinal disorders. Some key points to consider when prescribing dicyclomine include:

• Common side effects include dry mouth, blurred vision, constipation, and urinary retention
• The patient should be advised to avoid alcohol while taking this medication and to stay hydrated
• It's essential to follow up with the patient once the CT results are available, as the treatment plan may need adjustment based on those findings
• If symptoms worsen or don't improve within a few days, the patient should contact you for further evaluation According to the British Society of Gastroenterology guidelines on the management of IBS, antispasmodics, including dicyclomine, can be effective in reducing symptoms of IBS, with a significant reduction in persistent global symptoms or abdominal pain (RR 0.65; 95% CI 0.56 to 0.76) 1. Key considerations for the patient's recent history of constipation and bloating include:
• Monitoring for worsening constipation, as dicyclomine can exacerbate this symptom
• Encouraging the patient to maintain a bowel diary to track symptoms and adjust the treatment plan as needed
• Considering alternative treatments if the patient's symptoms do not improve or worsen with dicyclomine therapy.

From the FDA Drug Label

1 INDICATIONS AND USAGE Dicyclomine hydrochloride tablets, USP are indicated for the treatment of patients with functional bowel/irritable bowel syndrome.

The patient can be given Bentyl (dicyclomine) for abdominal bloating and pain, characterized by lower abdominal and pelvic discomfort, with a recent history of constipation and bloating, as it is indicated for the treatment of functional bowel/irritable bowel syndrome 2.

From the Research

Abdominal Bloating and Pain Treatment

• The patient's symptoms of abdominal bloating and pain, characterized by lower abdominal and pelvic discomfort, with a recent history of constipation and bloating, can be addressed with various treatment options 3, 4, 5.
• Bentyl (dicyclomine) is an antispasmodic medication that can be used to treat abdominal bloating and pain, but its effectiveness depends on the underlying cause of the symptoms 4.
• Other treatment options for abdominal bloating and pain include dietary changes, probiotics, antibiotics, prokinetic agents, and neuromodulators 4, 6.
• A computed tomography (CT) scan of the abdomen and pelvis can help identify any underlying conditions that may be causing the symptoms, such as a large benign submucosal lipoma 7.

Considerations for Treatment

• The patient's recent history of constipation and bloating should be taken into account when selecting a treatment option, as some medications may exacerbate these symptoms 3, 5.
• A multifaceted approach to treatment, including dietary changes and botanical therapy, may be beneficial in addressing the patient's symptoms 3.
• The patient's symptoms should be monitored closely, and the treatment plan should be adjusted as needed to ensure optimal management of the symptoms 4, 5.