Abstract
A previous therapeutic trial of factorial design showed that a combination of a psychotropic drug, a smooth-muscle relaxant, and a bulk former (lorazepam, hyoscine hydrobromide, and ispaghula husk) relieved symptoms of the irritable bowel syndrome more effectively than the same agents given singly. Another trial of similar design was undertaken to compare each of these three agents with another having the equivalent clinical actions--namely, Motival (fluphenazine/nortriptylene mixture), mebeverine, and bran. Ninety-six patients took part; all received three agents, one from each of the three pairs being compared, and no placebos were used. Fifty-six patients reported a sustained symptomatic improvement, which was a significantly higher incidence than in the previous trial, when placebos were used. Ispaghula was significantly more effective than bran. The combination of ispaghula, Motival, and mebeverine improved 11 out of 12 patients--significantly more than bran, Motival, and hyoscine (five improved), or bran, lorazepam, and mebeverine (four improved). Mebeverine was significantly more effective when combined with Motival (18 out of 24 improved) than with lorazepam (10 improved). These results confirm the value of a combined therapeutic approach to the relief of the irritable bowel syndrome and suggest the possibility of synergism between agents.
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Selected References
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- Brodribb A. J. Treatment of symptomatic diverticular disease with a high-fibre diet. Lancet. 1977 Mar 26;1(8013):664–666. doi: 10.1016/s0140-6736(77)92112-2. [DOI] [PubMed] [Google Scholar]
- Connell A. M. Physiological and clinical assessment of the effect of the musculotropic agent mebeverine on the human colon. Br Med J. 1965 Oct 9;2(5466):848–851. doi: 10.1136/bmj.2.5466.848. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Eastwood M. A., Smith A. N., Brydon W. G., Pritchard J. Comparison of bran, ispaghula, and lactulose on colon function in diverticular disease. Gut. 1978 Dec;19(12):1144–1147. doi: 10.1136/gut.19.12.1144. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Fielding J. F., Melvin K. Dietary fibre and the irritable bowel syndrome. J Hum Nutr. 1979 Aug;33(4):243–247. doi: 10.3109/09637487909143381. [DOI] [PubMed] [Google Scholar]
- Herxheimer A., Misiewicz J. J. Oral hyoscine butylbromide for irritable bowel syndrome? Br Med J. 1979 Mar 17;1(6165):752–752. doi: 10.1136/bmj.1.6165.752. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Manning A. P., Heaton K. W., Harvey R. F. Wheat fibre and irritable bowel syndrome. A controlled trial. Lancet. 1977 Aug 27;2(8035):417–418. doi: 10.1016/s0140-6736(77)90605-5. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ritchie J. A., Truelove S. C. Treatment of irritable bowel syndrome with lorazepam, hyoscine butylbromide, and ispaghula husk. Br Med J. 1979 Feb 10;1(6160):376–378. doi: 10.1136/bmj.1.6160.376. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Soltoft J., Krag B., Gudmand-Hoyer E., Kristensen E., Wulff H. R. A double-blind trial of the effect of wheat bran on symptoms of irritable bowel syndrome. Lancet. 1976 Feb 7;1(7954):270–272. doi: 10.1016/s0140-6736(76)91402-1. [DOI] [PubMed] [Google Scholar]
- Tasman-Jones C. Mebeverine in patients with the irritable colon syndrome: double blind study. N Z Med J. 1973 Apr;77(491):232–235. [PubMed] [Google Scholar]