Antispasmodics help relieve gut spasms and cramps associated with irritable bowel syndrome. However, they may have potential side effects. You may need to try more than one to find relief from your IBS symptoms.
Irritable bowel syndrome (IBS) is a digestive disorder that can cause a range of painful and uncomfortable symptoms. Treatment commonly includes antispasmodic medications, which control gut spasms and help ease symptoms such as diarrhea, constipation, and abdominal pain.
Antispasmodics are a type of muscle-relaxing medication. They may be used to relieve IBS symptoms, rather than every day as preventive medications.
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- diarrhea
- constipation
- abdominal pain
- bloating
A 2021 report in The American Journal of Gastroenterology suggests that antispasmodic therapy could a cornerstone of IBS treatment.
There are several types of antispasmodics for IBS. Each one works a little differently to boost the health and function of the gastrointestinal (GI) tract.
Anticholinergics
Anticholinergics help with IBS symptoms by blocking signals to the cells that cause GI tract muscles to contract. They work by blocking the action of a neurotransmitter called acetylcholine, which works on the body’s autonomous nervous system.
Other anticholinergic medications are used to treat conditions such as overactive bladder and even certain respiratory disorders.
Examples of anticholinergic medications that may help symptoms of IBS include:
- dicyclomine (Bentyl)
- hyoscyamine (Levsin, NuLev, Levbid)
Calcium channel inhibitors
While more commonly used to treat high blood pressure, calcium channel inhibitors (also known as calcium channel blockers) may also help treat IBS by interfering with the action of calcium in the GI tract. Calcium is an electrolyte that helps trigger muscle contraction.
Examples of calcium channel inhibitor medications that may help symptoms of IBS include:
- otilonium (Spasmomen, Bromotil Ariston)
- pinaverium (Dicetel and Eldicet)
- alverine (Spasmonal, Audmonal, Gielism)
While not currently approved for use in the United States, another type of calcium channel inhibitor works on the smooth muscle of the GI tract only, affecting the movement of sodium and calcium within the GI tract to relieve abdominal pain.
Some researchers think they may be more effective than certain anticholinergics and tend to have fewer side effects. An example of this type of medication is Mebeverine.
Peppermint oil
Peppermint oil is an herbal supplement that has antispasmodic properties. It’s generally safe, but you should discuss the risks and benefits of peppermint oil with your doctor before trying it. Menthol in peppermint oil
Probiotics
Probiotics are good bacteria that help you maintain a healthy balance of “good” and “bad” bacteria in the body to promote healthy function of the GI tract, urinary tract, and elsewhere in the body. A
Like any powerful medication, antispasmodics come with several possible side effects, some of which are minor, but uncomfortable. Among the more common side effects are:
If any of these symptoms linger, become severe, or if you develop shortness of breath, see a doctor immediately.
Benefits of antispasmodics for treating IBS
- They are generally well tolerated and can be taken by most people.
- There are different types of antispasmodics you can try if one isn’t effective or causes side effects.
- They can be taken before meals to easily time them to be most effective when post-meal symptoms begin.
Risks of using antispasmodics for treating IBS
- They don’t work for everyone.
- They can cause many kinds of side effects, some of which can be worse than IBS symptoms.
- They may take up to an hour to relieve symptoms.
If you’re prescribed antispasmodics for IBS, make sure your prescribing physician has your complete medical history and knows all the medications and supplements you currently take. There are some conditions that might preclude the use of antispasmodics, including:
- benign prostatic hyperplasia (enlarged prostate)
- intestinal obstruction (blockage in the gastrointestinal tract)
- myasthenia gravis (a neuromuscular disorder)
- paralytic ileus (paralysis of the intestinal muscles)
- pyloric stenosis (thickening of the valve between the stomach and the small intestine)
If you’re pregnant or nursing, consult with your doctor before taking antispasmodics.
The first-line treatment for IBS is usually a change to your diet. Among the changes your doctor may recommend include:
- a low-FODMAP diet (FODMAPs are a type of carbohydrate, including beans, that can generate intestinal gas)
- more fiber in your diet
- no gluten
Other lifestyle changes that may help treat IBS include regular aerobic exercise and stress management. You may also benefit from psychotherapy, including cognitive behavioral therapy (CBT), which helps you reframe your thinking about IBS to ease symptom intensity.
Because IBS can include a variety of symptoms, treatments should be tailored to a person’s specific condition. For example, people with IBS who experience constipation may be prescribed a laxative. Conversely, individuals who frequently have IBS-related diarrhea may be prescribed anti-diarrheal medications such as loperamide.
Other IBS medications for various medications include:
- antidepressants to
help reduce abdominal pain intensity - retainagogues, which block the GI tract’s absorption of sodium from foods/beverages to increase water retention in the intestines
- secretagogues/prosecretory agents, such as linaclotide (Linzess) and lubiprostone (Amitiza), which improve fluid secretion and movement in the GI tract
Can children take antispasmodics?
Children and adolescents may take certain antispasmodics, such as hyoscyamine and loperamide. However, IBS treatment will usually focus first on diet and lifestyle adjustments.
Are antispasmodics available without a prescription?
Most antispasmodics are available as a prescription medications only. However, peppermint oil is avaiable is without a prescription.
Can I drink alcohol while taking antispasmodics?
Because antispasmodics and alcohol both depress the nervous system, you should limit or avoid alcohol while taking the medications so as not to worsen the effects of either one.
There’s currently no cure for IBS, but there are ways to help manage symptoms. In addition to diet, exercise, and stress management, medications such as antispasmodics can sometimes ease symptoms such as abdominal pain and bloating.
Antispasmodics don’t always work, but there are many other potential treatments that may help. Be patient and work with your healthcare team to develop the best plan to manage your symptoms and maintain the best quality of life possible with IBS.