Anticholinergic and antispasmodic agents
act by antagonizing cholinergic muscarinic receptors, through which different parasympathetic nerve impulses evoke detrusor contraction.
As such, most patients with nonCEconstipating IBS are treated with drugs that are either not indicated for IBS and are of unproven or limited efficacy in this population, including antispasmodic agents
, antidepressants and probiotics[Brandt 2009; Hammerle 2008].
7,8] Patients with mild and intermittent abdominal complaints, like our patient, can be treated with counselling, dietary recommendations (higher consumption of fibre, increased fluid intake) and antispasmodic agents
to support the intestinal functions.
decrease the intestinal smooth muscle activity, which might decrease abdominal discomfort if the pain is secondary to spasm of the intestinal smooth muscle.
Treatment includes advice on diet and exercise, information on stress management, and possible pharmacologic interventions--including antispasmodic agents
, antidepressants or anxiolytics, and fiber or laxatives, depending on symptoms.
Treatment includes offering advice on diet and exercise; providing information on stress management; and perhaps using pharmacologic interventions--including antispasmodic agents
, antidepressants or anxiolytics, and fiber or laxatives, depending on the patient's symptoms.
The antispasmodic agents
hyoscyamine and dicyclomine may give symptomatic relief of cramps and diarrhea, but there are insufficient data to make a recommendation about their use.
may be useful in the treatment of IBS because they: