Expert Opinion on the Efficacy and Safety of Antispasmodics with a Focus on Irritable Bowel Syndrome.

Serhat Bor, Hasan Özen, İsmail Hakkı Kalkan, Filiz Akyüz, Altay Çelebi, Dinç Dinçer, Yusuf Serdar Sakin

Journal: The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology 2026;36(Suppl 2):S1-S38

PMID: 41866875

Abstract

Antispasmodics are commonly used to treat irritable bowel syndrome (IBS) symptoms. They are generally regarded as safe.However, some have been found to be ineffective or not cost-effective. Marked discrepancies in the availability and formulation of antispasmodic agents across countries—ranging from the limitation to only fundamental compounds in regions such as the United States to the marketing of diverse combination products elsewhere—have generated considerable ambiguity and debate within the field. Meta-analyses show varying results on the efficacy of antispasmodics, indicating the need for further analysis. This article aims to evaluate the effectiveness of antispasmodic drugs in relieving symptoms in IBS patients. We conclude that most drugs are considered safe and effective, with pinaverium, otilonium, and peppermint oil having meta-analyses supporting their efficacy. However, there is a lack of high-quality data for drugs like alverine, trimebutine, and cimetropium, and some drugs, such as simeticone or combinations of spasmolytic agents and simeticone, have insufficient research data. Clinicians should prioritize evidence-based medicine when selecting antispasmodic agents.

https://creativecommons.org/licenses/by/4.0/deed

Address: Department of Gastroenterology, Ege University Faculty of Medicine, İzmir, Türkiye.; Department of Pediatric Gastroenterology, Hepatology and Nutrition, Hacettepe University Faculty of Medicine, Ankara, Türkiye.; Department of Gastroenterology, TOBB University of Economics and Technology School of Medicine, Ankara, Türkiye.; Department of Gastroenterology, İstanbul University İstanbul Faculty of Medicine, İstanbul, Türkiye.; Department of Gastroenterology, Kocaeli University School of Medicine, Kocaeli, Türkiye.; Department of Gastroenterology, Akdeniz University School of Medicine, Antalya, Türkiye.; Department of Gastroenterology, Acıbadem Kent Hospital, İzmir, Türkiye.

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