Curbside Consultation in IBS: 49 Clinical Questions

Brian E. Lacy, PhD, MD

Question 34: Which Patient with IBS is Likely to Benefit from Smooth Muscle Antispasmodics? (continued)

Alexander Ford, MD

To answer this question, first one needs to be aware of the evidence for any benefit of antispasmodic drugs in irritable bowel syndrome (IBS), and, second, one has to take a pertinent history from the patient with whom one is consulting because of an exacerbation of their IBS symptoms. The majority of smooth muscle antispasmodic drugs, such as dycycloverine, hyoscine, and alverine, act chiefly by competing with acetylcholine at postganglionic parasympathetic nerve endings, thereby inhibiting smooth muscle contraction. Peppermint oil, which is a natural herbal remedy, also appears to have…