Medicines

IBS treatments

Category: Medicines

Type

Involuntary and voluntary

Introduction and description

A great swathe of pharmaceuticals have been developed to deal with one or more of the symptoms of IBS.

If you turn to the description of IBS you will see that it can be caused by a great number of different things, all of which need to be investigated.

But we have a problem here in that the medical profession in their ultimate wisdom seem reluctant to search out the true cause of these symptoms.

This means that the medication given is symptom based and because it is single symptom based, the people may be getting medication that is actually highly inappropriate to their condition.

The types of medication often prescribed for IBS symptoms include:

Laxatives for the constipation - such as polyethylene glycol, sorbitol, and lactulose; if the constipation is really bad then a drug like Lubiprostone (Amitiza), might be given – this is a gastrointestinal agent used for the treatment of chronic constipation

Antidiarrheals for the diarrhoeia - e.g., opiate, opioid, or opioid analogs such as loperamide, codeine, diphenoxylate) for the diarrhea. [This must totally confuse the poor body if the symptoms of diarrheia and constipation alternate].

Anti-depressants for the misery - then of course the doctors wheel out all the old stand-bys - SSRIs and anti depressants for the depression and misery the symptoms are causing, I quote “There is conflicting evidence about the benefit of antidepressants in IBS. Some meta-analysis have found a benefit while others have not. A meta-analysis of randomized controlled trials of mainly TCAs found 3 patients have to be treated with TCAs for one patient to improve.” So for every 3 patients 2 people are being misprescribed them

Codeine and paracetemol - for the headache and the stomach pain

Antibiotics for the bacteria - An antibiotic is any compound or substance that kills or slows down the growth of bacteria and is intended to be used for patients in order to help treat them for bacterial infection. Given, however, that our entire intestinal system is dependent for its effective working on bacteria, the prescribing of antibiotics would seem a little unwise. Rifaximin, for example, is used in the treatment of traveler's diarrhea caused by E. coli. Unfortunately it is also used without first testing for the cause of the symptoms to treat “the symptoms of bloating and flatulence that are common in irritable bowel syndrome”. Misuse of agents such as this may explain why the flora in the stomach get so out of balance

Antispasmodics - The use of antispasmodic drugs e.g., anticholinergics such as hyoscyamine or dicyclomine is intended to help people with stomach cramp. I quote “A meta-analysis by the Cochrane Collaboration concludes that if 6 patients are treated with antispasmodics, 1 patient will benefit”. And 5 won’t, which means that 5 people out of 6 being given these drugs are being misprescribed
Gastroprotective agents - the final class of drug is based on the agonistic action on serotonin receptors. One of serotonin's functions is to control the motility of the intestines, as such these drugs are used for both general intestinal diseases and IBS.

These can produce an extraordinary variety of hallucinations and other interesting experiences.

Give someone who has a virus a laxative and you get some interesting results. Give them an anticholergen and you get some amazing results – out of body experiences, near death, this is witch’s brew stuff!!

I have covered anti-depressants, TCAs, antibiotics and opiates in separate sections as well as the laxatives. Thus this then leaves the anti-spasmodics and so-called 'gastroprotective agents'.

Side-effects

If we take an example drug like Mebeverine and use the information collated by the eHealthme website from Adverse Drug reports submited by doctors to the FDA and SEDA we find:

The Most common side effects by gender :

Female	Male
Dyspnoea	Diarrhoea
Memory Impairment	Urine Flow Decreased
Tremor	Abdominal Pain
Fatigue	Vomiting
Chest Pain	Aneurysm
Confusional State	Tenderness
Lethargy	Urinary Retention
Hypersomnia	Rectal Haemorrhage
Myalgia	Epistaxis
Angina Pectoris	Pancreatitis Acute

Again using eHealthme and using the Gastroprotective agent Propulsid we find:

Most common Propulsid side effects:

Chest Pain in Propulsid (847 reports)
Heart Palpitations in Propulsid (793 reports)
Tachycardia in Propulsid (789 reports)
Arrhythmias in Propulsid (789 reports)
Pain in Propulsid (714 reports)
Electrocardiogram Qt Prolonged in Propulsid (658 reports)
Cardiac Disorder in Propulsid (647 reports)
Anhedonia in Propulsid (607 reports)
Stress And Anxiety in Propulsid (562 reports)
Ventricular Tachycardia in Propulsid (543 reports)

Death

If we now take a look at the ultimate spiritual experience - death and use the figures from ehealthme derived from the Adverse drug reports submitted by doctors to SEDA and the FDA, we find the following:

Dicyclomine hydrochloride - On Aug, 1, 2015: 479 people reported to have side effects when taking Dicyclomine hydrochloride. Among them, 4 people (0.84%) have Death.

Bentyl - On Jul, 18, 2015: 3,311 people reported to have side effects when taking Bentyl. Among them, 27 people (0.82%) have Death.

Mebeverine - On Aug, 16, 2015: 224 people reported to have side effects when taking Mebeverine hydrochloride. Among them, 4 people (1.79%) have Death.

Propulsid - On Aug, 11, 2015: 7,936 people reported to have side effects when taking Propulsid. Among them, 159 people (2.00%) have Death

Asacol - On Aug, 16, 2015: 7,372 people reported to have side effects when taking Asacol. Among them, 56 people (0.76%) have Death

Metoclopramide - under four formulations and names

Metoclopramide - On Jul, 20, 2015: 37,374 people reported to have side effects when taking Metoclopramide. Among them, 627 people (1.68%) have Death
Metoclopramide hcl - On Aug, 16, 2015: 958 people reported to have side effects when taking Metoclopramide hcl. Among them, 30 people (3.13%) have Death.
Metoclopramide hydrochloride - On Aug, 16, 2015: 4,149 people reported to have side effects when taking Metoclopramide hydrochloride. Among them, 79 people (1.90%) have Death
Maxolon - On Aug, 16, 2015: 977 people reported to have side effects when taking Maxolon. Among them, 20 people (2.05%) have Death

In other words 756 deaths in total

Ondansetron under three formulations/names:

On Jul, 30, 2015: 2,839 people reported to have side effects when taking Ondansetron. Among them, 38 people (1.34%) have Death.
On Aug, 16, 2015: 1,466 people reported to have side effects when taking Ondansetron hydrochloride. Among them, 23 people (1.57%) have Death
On Aug, 16, 2015: 127 people reported to have side effects when taking Ondansertron hydrochloride. Among them, 4 people (3.15%) have Death

Zelnorm - I have included the chart as this is a product that was supposed to have been withdrawn from the market in 2007. On Jul, 18, 2015: 6,928 people reported to have side effects when taking Zelnorm. Among them, 86 people (1.24%) have Death.

How it works

Gastroprotectives

Appear to work almost universally via Serotonin imbalance.

Anticholinergics

For those drugs that are anticholinergics you need to look at this entry to see how they work. Simply put the threat posed by the drugs on the system blots out reason and memory and the composer takes over.

The ability of anticholergenic drugs to cause vivid exotic and realistic hallucinations is well known in the so called 'recreational drug user ' community and has led to not only plants being used but also some of the drugs supplied from the pharmaceutical companies.

Effects of the selective M1 muscarinic receptor antagonist dicyclomine on emotional memory. Fornari RV, Moreira KM, Oliveira MG.; Department of Psychobiology, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros 925 CEP 04024-002, São Paulo SP, Brazil.
The nonselective muscarinic antagonist scopolamine is known to impair the acquisition of some learning tasks such as inhibitory avoidance. There has been recent research into the effects of this drug in contextual fear conditioning and tone fear conditioning paradigms. The purpose of the present study was to assess the role of the selective M1 muscarinic antagonist dicyclomine in these paradigms and in the inhibitory avoidance test. Rats were administered different doses of dicyclomine or saline 30 min before acquisition training. The animals were tested 24 hr later, and it was observed that 16 mg/kg of dicyclomine impaired both contextual fear conditioning and inhibitory avoidance. However, dicyclomine (up to 64 mg/kg) did not affect tone fear conditioning. These results suggest that the selective M1 muscarinic antagonist dicyclomine differentially affects aversively motivated tasks known to be dependent on hippocampal integrity (such as contextual fear conditioning and inhibitory avoidance) but does not affect similar hippocampus-independent tasks.

References and further reading

Papers

Harv Womens Health Watch. 2007 Jun;14(10):3-4. Managing irritable bowel syndrome without special drugs. Another IBS drug has been taken off the market because of serious side effects. Now what? PMID: 18018315
Greenblatt DJ, Allen MD, Koch Weser J, Shader RI.
“Accidental Poisoning with Psychotropic Drugs in Children.”. Am.J.Dis.Child.. 1976;130(5):507-511

Photos

All the photos on this page are by Monchak Yaroslav and were chose for their originality and beauty rather than their match with the subject! Monchak was born and raised in Stry (Lviv region) in the Ukraine. He currently lives in Lviv. He specialises in portrait photography and commercial photography. We like his work so much that more examples also appear on other pages.
Email: smonchak@gmail.com
Website: monchak.net
Blog: facebook.com/jaroslav.

Observations

The following table shows the total hallucinations caused by these drugs

Observation no	Name	No of hallucinations
005413	Dicyclomine, Bentyl	40
005412	Mebeverine/Duspatal	7
005414	AZD7371	8
005415	Asacol	43
017432	Cisapride/Propulsid	34
005415	Mesalamine	4
017335	Maxolon or Metaclopramide	211
017360	Cesamet and Nabilone	6
005699	Ondansetron	34
017433	Tegaserod, Zelnorm and Zelmac	16
	TOTAL	403

The following drug has no figures given on the eHealthme site, but the reasons may be various, for example it may be only infrequently prescribed or not be a drug sold in the USA

Trimebutine is a drug with antimuscarinic and weak mu opioid agonist effects. The maleic acid salt of trimebutine is marketed under the tradenames of Debridat, Recutin, Polybutin, or Modulon for treatment of irritable bowel syndrome and other gastrointestinal disorders. It is not sold in the USA
Cinitapride (Cintapro, Pemix) is marketed as a gastroprokinetic agent and antiulcer agent in India, Mexico, Pakistan and Spain. It acts as an agonist of the 5-HT1 and 5-HT4 receptors and as an antagonist of the 5-HT2 receptors
Prucalopride (brand name Resolor) is a drug acting as a selective, high affinity 5-HT4 receptor agonist which targets the impaired motility associated with chronic constipation. Prucalopride was approved for use in Europe in 2009 and in Canada (named Resotran) on December 7, 2011 but it has not been approved by the Food and Drug Administration for use in the United States. Thus no figures
Mosapride is a gastroprokinetic agent that acts as a selective 5HT4 agonist. The major active metabolite of mosapride, known as M1, additionally acts as a 5HT3 antagonist. It is used for the treatment of gastritis, gastro-oesophageal reflux disease, functional dyspepsia and irritable bowel syndrome. It is not sold in the USA.

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Medicines

IBS treatments

Type

Introduction and description