Irritable Bowel Syndrome: Pathophysiological and Pharmacological Aspects and Use of Otilonium Bromide or Pinaverium Bromide

The Irritable bowel syndrome (IBS) is the most common gastrointestinal disorder worldwide with unclear etiology. It is considered a chronic, multifactorial, relapsing functional bowel disorder normally related to altered motility of gastrointestinal system and the mechanisms involved in its onset and progression are not clear. The abdominal discomfort or pain and modifications in bowel habit are not related to organic causes. Constipation, diarrhea, alternating diarrhea and constipation, mucus in stools, bloating, gas, dyspepsia, rectal pain are possible symptoms to IBS patients. Many clinical trials show positive effects in the main symptoms of IBS, showing that antispasmodics may regulate abdominal pain, distention, mucus in stool, stool consistency, and reduce defecation straining and urgency. Antispasmodics are the most common drugs used in the treatment of IBS and belong to a heterogeneous group of drugs that reduce smooth muscle contractility of the gut. These drugs are divided in agents that act directly on the calcium channels thus affecting intestinal smooth muscle and agents possessing anticholinergic/antimuscarinic activities. Otilonium and Pinaverium Bromide are related to the first group and many clinical trials with these agents show positive effects in the main symptoms of IBS, showing that these antispasmodics may regulate abdominal pain, distention, mucus in stool, stool consistency, and reduce defecation straining and urgency.