Which medications in the drug class Antispasmodic and anticholinergic agents are used in the treatment of Pediatric Irritable Bowel Syndrome (IBS)?

Updated: Dec 30, 2019
  • Author: Mohammad F El-Baba, MD; Chief Editor: Carmen Cuffari, MD  more...
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Antispasmodic and anticholinergic agents

These are the most frequently used medications (ie, hyoscyamine, dicyclomine) in the United States for the treatment of pain episodes in patients with irritable bowel syndrome. Results from adult studies on the efficacy of these medications have provided conflicting data. The meta-analysis of the use of smooth muscle relaxants (eg, cimetropium, otilonium bromide, pinaverium, mebeverine, trimebutine) by Poynard et al showed efficacy over placebo in irritable bowel syndrome. These drugs have calcium channel–blocking properties or antimuscarinic activities. No pediatric data are available with which to evaluate their efficacy or adverse effects.

Hyoscyamine (Levsin, Levbid)

Blocks action of acetylcholine at parasympathetic sites in smooth muscle, secretory glands, and CNS, which in turn has antispasmodic effects.

Dicyclomine (Bentyl)

Treats GI motility disturbances. Blocks action of acetylcholine at parasympathetic sites in secretory glands, smooth muscle, and CNS.

Reports show that administration of dicyclomine syrup in infants has been followed by serious respiratory symptoms, seizures, syncope, pulse rate fluctuations, and coma. Death has been reported.

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