FRIDAY, Nov. 14 (HealthDay News) -- Fiber, antispasmodics and peppermint oil should all become first-line treatments for irritable bowel syndrome, and should not be disregarded in favor of more expensive treatments, according to research published Nov. 13 in BMJ Online First.
Alexander C. Ford, M.D., of McMaster University in Hamilton, Ontario, Canada, and colleagues conducted a review of placebo-controlled trials, including 12 on fiber (including 591 patients), 22 on antispasmodics (including 1,778 patients) and four on peppermint oil (including 392 patients).
The fiber ispaghula had a relative risk of symptoms persisting of 0.78, the researchers found. The antispasmodics otilonium and hyoscine consistently showed evidence of efficacy, with a relative risk of symptoms persisting of 0.55 and 0.63, respectively. Peppermint oil also achieved more effective results than placebo, the investigators found (relative risk of symptoms persisting, 0.43).
"This systematic review and meta-analysis shows that ispaghula husk, antispasmodics (particularly hyoscine) and peppermint oil are all effective treatments for irritable bowel syndrome. Many of these are safe and available over the counter but, with the advent of newer more expensive drugs, are often overlooked as potentially effective treatments," the authors write. "Further large trials of these three agents in patients with irritable bowel syndrome
and using validated outcome measures are warranted. In the interim, current national guidelines for the management of the condition should be updated to include these data."
Several study authors disclosed financial ties to the pharmaceutical industry.
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