What medications are used to treat bowel spasms?

From the Guidelines

Antispasmodics, such as hyoscine butylbromide, are the most effective treatment for bowel spasms, with a significant benefit in reducing global symptoms and abdominal pain, as shown in a meta-analysis of 26 RCTs containing 2811 patients 1.

Treatment Options

• Antispasmodics, including dicycloverine, propantheline, otilonium bromide, and hyoscine butylbromide, reduce intestinal motility and can be used to treat bowel spasms 1.
• Direct-acting intestinal smooth muscle relaxants, such as alverine and mebeverine, can also be used to treat bowel spasms 1.
• Peppermint oil capsules have natural antispasmodic properties and can be used for over-the-counter relief 1.

Dosage and Administration

• Hyoscine butylbromide can be taken at a dose of 10mg three times daily 1.
• Peppermint oil capsules can be taken at a dose of 0.2-0.4ml three times daily 1.

Important Considerations

• If symptoms persist beyond 1-2 weeks or are accompanied by fever, blood in stool, or significant weight loss, medical evaluation is necessary as bowel spasms may indicate underlying conditions like irritable bowel syndrome or inflammatory bowel disease that require specific treatment 1.
• Central neuromodulation with tricyclic antidepressants (TCAs) or selective serotonin reuptake inhibitors (SSRIs) can be used as second-line treatment for abdominal pain 1.

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.

12 CLINICAL PHARMACOLOGY 12. 1 Mechanism of Action Dicyclomine relieves smooth muscle spasm of the gastrointestinal tract

Bowel Spasm Medication: Dicyclomine is used to treat functional bowel/irritable bowel syndrome and relieves smooth muscle spasm of the gastrointestinal tract, making it a suitable medication for bowel spasm 2 2.

• Key Mechanism: Dicyclomine works through a dual mechanism: a specific anticholinergic effect and a direct effect upon smooth muscle.
• Clinical Use: It is indicated for the treatment of patients with functional bowel/irritable bowel syndrome.

From the Research

Bowel Spasm Medication

• Bowel spasm medication can include various types of drugs, such as antispasmodics, which are used to relieve symptoms of abdominal pain and discomfort in patients with irritable bowel syndrome (IBS) 3, 4, 5.
• Antispasmodics can be effective in reducing abdominal pain and improving bowel habits in patients with IBS, with some studies showing significant benefits for certain types of antispasmodics, such as cimetropium/dicyclomine, peppermint oil, pinaverium, and trimebutine 6.
• Other medications, such as antidepressants, may also be used to treat IBS symptoms, including abdominal pain and discomfort, with selective serotonin releasing inhibitors (SSRIs) and tricyclic antidepressants (TCAs) showing significant benefits in some studies 6.
• The efficacy and safety of antispasmodics can vary depending on the specific agent and patient population, and more research is needed to fully understand their role in treating bowel spasms and IBS symptoms 4, 5.

Types of Antispasmodics

• Alverine citrate is a spasmolytic that decreases the sensitivity of smooth muscle contractile proteins to calcium and is a selective 5-HT1A receptor antagonist, which has been shown to effectively reduce abdominal pain and discomfort in patients with IBS 5.
• Mebeverine is a musculotropic agent that potently blocks intestinal peristalsis, but its efficacy in treating IBS symptoms is unclear, with some studies showing positive effects and others showing no benefit 5.
• Otilonium bromide is an L-type calcium channel blocker that acts locally in the GI tract and has been shown to effectively reduce pain and improve defecation alterations in patients with IBS 5.
• Pinaverium bromide is also an L-type calcium channel blocker that acts locally in the GI tract and has been shown to improve motility disorders and reduce stool problems in patients with IBS 5.

Treatment of IBS Symptoms

• Antispasmodics can be used to treat a range of IBS symptoms, including abdominal pain, bloating, and changes in bowel habits 3, 5.
• The choice of antispasmodic agent may depend on the specific symptoms and patient population, with some agents showing greater efficacy for certain symptoms or patient groups 6.
• Antispasmodics may be used in combination with other medications, such as antidepressants or laxatives, to treat IBS symptoms 3, 6.