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Role of antispasmodics in the treatment of irritable bowel syndrome.
World J Gastroenterol. 2014 May 28; 20(20):6031-43.WJ

Abstract

Irritable bowel syndrome (IBS) is a long-lasting, relapsing disorder characterized by abdominal pain/discomfort and altered bowel habits. Intestinal motility impairment and visceral hypersensitivity are the key factors among its multifactorial pathogenesis, both of which require effective treatment. Voltage-gated calcium channels mediate smooth muscle contraction and endocrine secretion and play important roles in neuronal transmission. Antispasmodics are a group of drugs that have been used in the treatment of IBS for decades. Alverine citrate, a spasmolytic, decreases the sensitivity of smooth muscle contractile proteins to calcium, and it is a selective 5-HT1A receptor antagonist. Alverine, in combination with simethicone, has been demonstrated to effectively reduce abdominal pain and discomfort in a large placebo-controlled trial. Mebeverine is a musculotropic agent that potently blocks intestinal peristalsis. Non-placebo-controlled trials have shown positive effects of mebeverine in IBS regarding symptom control; nevertheless, in recent placebo-controlled studies, mebeverine did not exhibit superiority over placebo. Otilonium bromide is poorly absorbed from the GI tract, where it acts locally as an L-type calcium channel blocker, an antimuscarinic and a tachykinin NK2 receptor antagonist. Otilonium has effectively reduced pain and improved defecation alterations in placebo-controlled trials in IBS patients. Pinaverium bromide is also an L-type calcium channel blocker that acts locally in the GI tract. Pinaverium improves motility disorders and consequently reduces stool problems in IBS patients. Phloroglucinol and trimethylphloroglucinol are non-specific antispasmodics that reduced pain in IBS patients in a placebo-controlled trial. Antispasmodics have excellent safety profiles. T-type calcium channel blockers can abolish visceral hypersensitivity in animal models, which makes them potential candidates for the development of novel therapeutic agents in the treatment of IBS.

Authors+Show Affiliations

Anita Annaházi, Richárd Róka, András Rosztóczy, Tibor Wittmann, First Department of Medicine, University of Szeged, 6720 Szeged, Hungary.Anita Annaházi, Richárd Róka, András Rosztóczy, Tibor Wittmann, First Department of Medicine, University of Szeged, 6720 Szeged, Hungary.Anita Annaházi, Richárd Róka, András Rosztóczy, Tibor Wittmann, First Department of Medicine, University of Szeged, 6720 Szeged, Hungary.Anita Annaházi, Richárd Róka, András Rosztóczy, Tibor Wittmann, First Department of Medicine, University of Szeged, 6720 Szeged, Hungary.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

24876726

Citation

Annaházi, Anita, et al. "Role of Antispasmodics in the Treatment of Irritable Bowel Syndrome." World Journal of Gastroenterology, vol. 20, no. 20, 2014, pp. 6031-43.
Annaházi A, Róka R, Rosztóczy A, et al. Role of antispasmodics in the treatment of irritable bowel syndrome. World J Gastroenterol. 2014;20(20):6031-43.
Annaházi, A., Róka, R., Rosztóczy, A., & Wittmann, T. (2014). Role of antispasmodics in the treatment of irritable bowel syndrome. World Journal of Gastroenterology, 20(20), 6031-43. https://doi.org/10.3748/wjg.v20.i20.6031
Annaházi A, et al. Role of Antispasmodics in the Treatment of Irritable Bowel Syndrome. World J Gastroenterol. 2014 May 28;20(20):6031-43. PubMed PMID: 24876726.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Role of antispasmodics in the treatment of irritable bowel syndrome. AU - Annaházi,Anita, AU - Róka,Richárd, AU - Rosztóczy,András, AU - Wittmann,Tibor, PY - 2013/09/28/received PY - 2014/01/08/revised PY - 2014/04/01/accepted PY - 2014/5/31/entrez PY - 2014/5/31/pubmed PY - 2015/4/14/medline KW - Calcium channel blockers KW - Irritable bowel syndrome KW - Motility KW - Spasmolytics KW - Treatment SP - 6031 EP - 43 JF - World journal of gastroenterology JO - World J Gastroenterol VL - 20 IS - 20 N2 - Irritable bowel syndrome (IBS) is a long-lasting, relapsing disorder characterized by abdominal pain/discomfort and altered bowel habits. Intestinal motility impairment and visceral hypersensitivity are the key factors among its multifactorial pathogenesis, both of which require effective treatment. Voltage-gated calcium channels mediate smooth muscle contraction and endocrine secretion and play important roles in neuronal transmission. Antispasmodics are a group of drugs that have been used in the treatment of IBS for decades. Alverine citrate, a spasmolytic, decreases the sensitivity of smooth muscle contractile proteins to calcium, and it is a selective 5-HT1A receptor antagonist. Alverine, in combination with simethicone, has been demonstrated to effectively reduce abdominal pain and discomfort in a large placebo-controlled trial. Mebeverine is a musculotropic agent that potently blocks intestinal peristalsis. Non-placebo-controlled trials have shown positive effects of mebeverine in IBS regarding symptom control; nevertheless, in recent placebo-controlled studies, mebeverine did not exhibit superiority over placebo. Otilonium bromide is poorly absorbed from the GI tract, where it acts locally as an L-type calcium channel blocker, an antimuscarinic and a tachykinin NK2 receptor antagonist. Otilonium has effectively reduced pain and improved defecation alterations in placebo-controlled trials in IBS patients. Pinaverium bromide is also an L-type calcium channel blocker that acts locally in the GI tract. Pinaverium improves motility disorders and consequently reduces stool problems in IBS patients. Phloroglucinol and trimethylphloroglucinol are non-specific antispasmodics that reduced pain in IBS patients in a placebo-controlled trial. Antispasmodics have excellent safety profiles. T-type calcium channel blockers can abolish visceral hypersensitivity in animal models, which makes them potential candidates for the development of novel therapeutic agents in the treatment of IBS. SN - 2219-2840 UR - https://www.unboundmedicine.com/medline/citation/24876726/Role_of_antispasmodics_in_the_treatment_of_irritable_bowel_syndrome_ L2 - https://www.wjgnet.com/1007-9327/full/v20/i20/6031.htm DB - PRIME DP - Unbound Medicine ER -