Irritable bowel syndrome: focus on otilonium bromide

Abstract

Irritable bowel syndrome is a prevalent and chronic disorder, characterized by recurrent abdominal pain/discomfort, bloating and altered bowel habits. This condition affects an estimated 10-15% of the population worldwide and impacts heavily on a patient's daily life and ability to work, as well as healthcare resource utilization. Drug therapy aimed at correcting the primary symptoms of diarrhea/constipation/bloating may have little effect on abdominal pain, which results from visceral hypersensitivity. Smooth muscle relaxants or antispasmodics decrease the tone and contractility of intestinal smooth muscle, effectively managing abdominal pain. Otilonium bromide has been widely used worldwide and has been found to be safe and well tolerated, and superior to placebo for the reduction of symptoms and the prevention of symptom relapse in patients with irritable bowel syndrome.

Changes in nitrergic and tachykininergic pathways in rat proximal colon in response to chronic treatment with otilonium bromide

“…The reduced expression of myenteric SP likely affects both sensory perception and motility of the colon. As both afferent signaling and contractility have been implicated in the action of OB, our observations further expand the current knowledge by identifying potential mechanisms involved at the level of myenteric plexus.…”

“…In support of its clinical utility, clinical trials have studied the efficacy of OB in IBS (reviewed in Refs. ). For example, Clave et al .…”

“…In support of its clinical utility, clinical trials have studied the efficacy of OB in IBS (reviewed in Refs. [3][4][5]. For example, Clave et al 6 reported superior efficacy of OB treatment over placebo in IBS patients, specifically noting reductions in the frequency of abdominal pain and severity of abdominal bloating.…”

Effect of herbal extract granules combined with otilonium bromide on irritable bowel syndrome with diarrhoea: a study protocol for a randomised controlled trial

“…OB is a representative conventional medicine used for D-IBS treatment. 8 21 23 38 39 It is a spasmolytic agent that exerts its activity primarily in the distal GI tract through the inhibition of Ca++ flux and direct activation of contractile proteins in the smooth muscle. 20 21 OB has also been shown to reduce hypermotility and modulate visceral sensation, the effect of which is to improve D-IBS symptoms.…”

Theoretical justification of basic structures for purposeful synthesis of potential antispasmodics

“…Усі мають спазмолітичний ефект не тільки у верхніх від-ділах ШКТ (шлунок, пілоричний сфінктер), біліарній системі (сфінктер Одді), але й ефективно пригнічують перистальтику і спазми товстої кишки. При лікуванні біліарних болів препарати цієї групи не мають значних переваг перед іншими спазмолітиками [3,6,8,9,11,13]. Відзначимо, що ці речовини за хімічною будовою також є солями четвертинних азотистих основ.…”