Anticholinergics (antispasmodics) for irritable bowel syndrome

Examples

Generic Name	Brand Name
	atropine sulfate
dicyclomine hydrochloride	Bentyl
hyoscyamine sulfate	Anaspaz, Cystospaz-M, Levsin
propantheline bromide	Pro-Banthine
scopolamine	Transderm-Scop skin patch

How It Works

Antispasmodics relax the smooth muscles of the gut, helping to prevent or relieve painful cramping spasms in the intestines. These medications are taken 30 to 45 minutes before meals to help relieve cramping that occurs after eating.

Why It Is Used

Antispasmodics are used to relieve cramps or spasms of the stomach, intestines, or bladder. They are the most commonly prescribed medications for treating irritable bowel syndrome (IBS).¹

IBS is a disorder of the intestines that causes abdominal pain or discomfort with constipation or diarrhea (and sometimes alternating episodes of both). Other common symptoms include bloating and passing mucus in the stools. The condition is more common in women than in men.

Do not use antispasmodics if you suffer from:

• Glaucoma.
• Urinary retention.

How Well It Works

Several studies suggest that antispasmodics improve symptoms of IBS and reduce pain.² They can substantially reduce stomach and intestinal cramps and the urgency for a bowel movement after eating when taken 30 minutes before meals, especially meals that are expected to cause cramps.

Antispasmodics have no effect on diarrhea or constipation.

Side Effects

Side effects may include drowsiness, dry mouth, blurred vision, or inability to urinate. Antispasmodics may make constipation—often a main symptom of IBS—worse.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Antispasmodics can be taken as needed for cramps, before meals that are expected to cause symptoms, or when symptoms would be inconvenient or bothersome.

If constipation is your main symptom, antispasmodics may not work for you. In some cases, use of antispasmodics can make constipation worse.

If you are pregnant, ask your doctor about taking antispasmodics. Some studies have suggested that some antispasmodics can increase the heartbeat of a fetus, and that some are related to birth defects, though they have not been proven to cause these defects.

If you suffer from glaucoma or urinary retention, do not use antispasmodics.

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Author:	Robin Parks, MS	Last Updated June 15, 2006
Medical Review:	Kathleen Romito, MD - Family Medicine Arvydas D. Vanagunas, MD - Gastroenterology
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