What is the use of Bentyl (Dicyclomine)?

From the Guidelines

Bentyl, also known as dicyclomine, is recommended for the treatment of irritable bowel syndrome (IBS) due to its effectiveness in relieving muscle spasms in the gastrointestinal tract, as supported by the most recent guideline from the American Gastroenterological Association (AGA) in 2022 1.

Key Points to Consider

• The typical adult dosage of Bentyl is 20-40 mg taken orally 4 times daily, with a maximum daily dose of 160 mg.
• Treatment duration varies based on symptom control but is often ongoing for chronic conditions.
• Bentyl works as an anticholinergic agent by blocking acetylcholine receptors, which reduces smooth muscle contractions in the digestive system.
• Common side effects include dry mouth, blurred vision, dizziness, and constipation.
• This medication should be used with caution in elderly patients and those with certain conditions like glaucoma, urinary retention, or severe heart disease.

Important Considerations

• It's best taken 30-60 minutes before meals for optimal effect.
• Patients should avoid alcohol while taking Bentyl as it can increase drowsiness and other side effects.
• If symptoms don't improve after 2 weeks of treatment, patients should consult their healthcare provider for reevaluation.

Evidence Summary

• A Cochrane Review included 22 RCTs evaluating 2983 patients with IBS, which found that antispasmodics, including Bentyl, had a significantly greater proportion of patients with adequate global relief of IBS symptoms compared to placebo (RR, 0.67; 95% CI, 0.55–0.80) 1.
• Another study published in Gut in 2021 also found that antispasmodics, including dicycloverine and hyoscine butylbromide, reduced intestinal motility and ameliorated IBS symptoms 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.

The drug Bentyl is another name for dicyclomine, which is used for the treatment of functional bowel/irritable bowel syndrome 2.

From the Research

Bentyl Overview

• Bentyl, also known as dicyclomine, is an antispasmodic medication used to treat irritable bowel syndrome (IBS) symptoms such as abdominal pain, cramps, and bloating 3, 4.
• It works by relaxing the muscles in the stomach and intestines, which helps to reduce spasms and discomfort.

Efficacy of Antispasmodics in IBS Treatment

• Research has shown that antispasmodics, including Bentyl, are effective in treating IBS symptoms such as abdominal pain and bloating 4.
• A systematic review of 29 studies on antispasmodics found that they were significantly more effective than placebo in improving abdominal pain and global assessment of IBS symptoms 4.
• The review also found that specific antispasmodics, including cimetropium/dicyclomine, peppermint oil, pinaverium, and trimebutine, were effective in treating IBS symptoms 4.

Comparison with Other IBS Treatments

• Bentyl has been compared to other IBS treatments, including fiber supplements, antidepressants, and serotonergic agents 3, 5, 6, 7.
• While fiber supplements have not been shown to be effective in treating IBS symptoms, antidepressants and serotonergic agents have been found to be effective in some patients 4, 7.
• Newer treatments, such as rifaximin and eluxadoline, have also been shown to be effective in treating IBS-D symptoms, including abdominal pain and diarrhea 6.

Treatment Considerations

• Bentyl is typically used intermittently to treat IBS symptoms, and its use should be tailored to the individual patient's needs 3.
• Patients should be educated on how to use Bentyl effectively, including taking it as needed and monitoring for side effects 3.
• Alternative therapies, such as relaxation techniques and hypnosis, may also be beneficial for some patients with IBS 3, 7.