Eight patients refused diclofenac, but did receive piritramide when a renal colic arose. If blood pressure medicines help my kidneys, why all this extra caution? Patients were asked to rate their level of pain using NRS at the start of the study period and subsequently at 1, 4, 8, and 24h. Also, experience of side effects was asked. In normal, everyday circumstances, taking your blood pressure medicines as prescribed helps protect your kidneys. WebYes, you can take Buscopan at the same time as everyday painkillers like paracetamol and ibuprofen. You also can look for NSAIDs on Drug Facts labels like the one below. Both peppermint oil and mebeverine are available to buy from pharmacies. This indicates that placebo is non-inferior to butylscopolamine. Purpose To investigate whether placebo is non-inferior to continuous infusion of butylscopolamine in patients with renal colic. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Administration of PPIs (such as esomeprazole), has been associated with acute interstitial nephritis, a severe inflammation of the kidneys. https://www.drugs.com/pro/esomeprazole-capsules.html. The upper limit of the confidence interval remained below the non-inferiority margin of 0.5 (p=0.04). Skelaxin Descriptions Metaxalone is used to help relax the muscles in your body and relieve the discomfort caused by acute (short-term), painful muscle or bone conditions. Your doctor or pharmacist can help you plan ahead to keep your kidneys safe until you get well. Weltings, S., Buddingh, K.T., van Diepen, D.C. et al. What can I take or do to relieve a headache or other pain? Researchers also use clinical trials to look at other aspects of care, such as improving the quality of life for people with chronic illnesses. The phase IV clinical study analyzes which people take Buscopan and have Acute kidney failure. Buscopan Cramps and Buscopan IBS Relief are essentially identical. If you do not remember until it's nearly time for the next dose, skip the missed dose and take the next one at the usual time. Having kidney disease puts people at higher risk of complications with COVID-19. You can report any suspected side effect using the Yellow Card safety scheme. Available for Android and iOS devices. Cochrane Kidney and Transplant Group, editor. Medicines that interact with pantoprazole may either decrease its effect, affect how long it works, increase side effects, or have less of an effect when taken with pantoprazole. As a result, the pressure in your kidneys can be low, too. WebNSAIDs can make your body hold onto fluid and can affect how well your kidneys work. There was no statistical difference in time until last escape medication: a median of 7.0h in the butylscopolamine arm and 9.3h in the placebo arm. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Delayed-release granules should be sprinkled on one teaspoonful of apple sauce or apple juice and then swallowed whole. A fair number of previous studies have been performed using different administrations of butylscopolamine, e.g., oral, intramuscular, or, in few cases, intravenously [3, 10]. Buscopan IBS Relief is available from most pharmacies and supermarkets. It's better to only take occasional doses or only take it for a short time. Ask questions and evaluate the risks and benefits based on your specific health needs. A few trials assessed efficacy of IV butylscopolamine with a single dose of 20mg [9]. Find out if clinical trials are right for you. Placebo- and paracetamol-controlled study on the efficacy and tolerability of hyoscine butylbromide in the treatment of patients with recurrent crampy abdominal pain. They However, this research studied the effect of a single dose of 20mg butylscopolamine IV in patients suspected of renal colic, not confirmed in 40 cases [5]. ever had an allergic reaction to Buscopan or any other medicine, a condition where your bowel is blocked and does not work properly, such as paralytic ileus, are pregnant, trying to get pregnant or breastfeeding, are feeling or being sick (nausea or vomiting), are feeling tired and looking paler than usual, think you may have food poisoning (especially if you have recently travelled abroad), have a very fast heart rate or any other heart problems, have difficulty or pain when peeing (for example, men with prostate problems), get a painful red eye with loss of vision (this could be caused by increased pressure in your eye), you get a skin rash that may include itchy, red, swollen, blistered or peeling skin, your mouth, face, lips, tongue or throat start swelling, some medicines for mental health problems like, quinidine or disopyramide (heart medicines). BJU Int John Wiley & Sons Ltd (10.1111) 98(3):651655. If I get sick, are there medicines I should not take while Im sick? The mixture should be transferred to an amber-colored bottle and labeled "shake well" and "refrigerate". The null hypothesis assumed that placebo is not inferior to treatment with butylscopolamine on the effect of using extra analgesics. The trial was registered in the Netherlands Trial Registry (Trial NL7819). Three of the four patients that were excluded after randomization developed fever soon after admission and required urgent upper tract drainage. Results of our real-world drug study have been referenced on 600+ medical publications, including The Lancet, Mayo Clinic Proceedings, and Nature. why you sometimes need to take special care with medicines; for example, when youre sick. This may raise your blood pressure. The safety and efficacy of IV esomeprazole has not been established beyond 10 days. Some older studies suggest drugs like Buscopan are effective in treating IBS. Discontinue pantoprazole and seek medical advice. Additional clinical studies have found that Buscopan is well-tolerated with minimal side effects. However, a study using patients who suffered from "crampy abdominal pain", but not necessarily IBS, found that acetaminophen was just as effective as Buscopan as compared to placebo.. Talk to your doctor if your symptoms change, get worse or have not improved after 2 weeks. After assessing for eligibility and exclusion criteria, 128 were randomized and data of 124 patients were available for analysis. Call If you don't know how well your kidneys are working, you may not realize that certain medications could be damaging your kidneys and other parts of your body. Both prescription and over-the-counter medications are filtered by the kidneys. One RCT of Holdgate concluded that there is no support for the addition of butylscopolamine IV to reduce the need for opioids. Results of our real-world drug study have been referenced on 600+ medical publications, including The Lancet, Mayo Clinic Proceedings, and Nature. May be used for up to 12 months to maintain the healing of erosive esophagitis. Available IV which may be a good short-term alternative to oral treatment in people with erosive esophagitis who are unable to take the drug orally. 2023 eHealthMe.com. Administration of PPIs (such as esomeprazole), has been IV pantoprazole contains EDTA and zinc supplementation may be needed in people prone to zinc deficiency. Buscopan may also reduce the amount of milk you produce. It's not known how much Buscopan gets into breast milk, but it's likely to be a small amount. Always speak with your clinician and pharmacist to determine whether the medications that you're taking should be adjusted based on your kidney function. In some hospitals, 120mg of butylscopolamine per 24h is used, rather than the 100mg in this study. Drugs. 2. WebHyoscine butylbromide tablets can be sold to the public for medically confirmed irritable bowel syndrome, provided single dose does not exceed 20 mg, daily dose does not Please seek medical advice. KTB: protocol/project development, data collection and management, data analysis, and manuscript writing/editing. MR: protocol/project development and manuscript writing/editing. All information is observation-only. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. Anyone you share the following link with will be able to read this content: Sorry, a shareable link is not currently available for this article. SW: Protocol/project development, data collection and management, data analysis, and manuscript writing/editing. In patients with normal kidney function, most of the gadolinium contrast medium injected (over 90%) is passed out in the urine within 24 hours. The sample size was calculated using a one-sided, two-sample t test [PASS version 08.0.16 (Hintze J, 2008); NCSS, LLC, Kaysville, Utah, USA]. With the power fixed to 80% and a one-sided significance of =5%, the required sample size to detect non-inferiority was calculated to be 51 patients in each arm. Rather, Buscopan acts locally on the muscles in the abdomen to prevent spasms from occurring. Pantoprazole. Do Over-the-Counter Remedies for IBS Really Work? The pharmacological effect of a single dose completely wears off after 3040min [9]. It can really help to understand which, if any, foods trigger your cramps and then reduce or remove them from your diet. It's an offence to drive a car if your ability to drive safely is affected. Never take an extra dose to make up for a forgotten one. Euro Urol 69:468474, Article Metoclopramide and domperidone increase the movement of the gut, whereas Buscopan reduces it. All patients had confirmed renal stones on CT-scan (88%) or ultrasound. Medically reviewed by Carmen Fookes, BPharm. Utrecht, (2014) 1102, Holdgate A, Oh CM (2005) Is there a role for antimuscarinics in renal colic? No other funding was received. Decreasing the production of stomach acid allows damaged tissue in the esophagus, stomach, and duodenum to heal. Non-steroidal anti-inflammatory drugs (NSAIDs) are the agents of first choice to control the pain in these patients. Prolonged treatment (greater than 24-36 months) may cause vitamin B12 deficiency. Seventy-two patients left the hospital after the study period of 24h to be further monitored in the outpatient department. If you have chronic kidney disease (CKD), diabetes, or high blood pressureor if you take certain blood pressure medicines that affect your kidneysyou should take steps to protect your kidneys from harm. in 1994 showed a pain intensity reduction at 30 and 50min after a 20mg bolus of butylscopolamine similar to tramadol (100mg IV), but significantly lower than values reached with metamizole (2.5g IV) [6]. It does this by reducing the wave-like contractions of the muscle in the walls of the stomach, bowel and bladder. Pantoprazole is an acid-suppressing agent that may be used to treat conditions associated with excessive stomach acid production, such as gastroesophageal reflux (GERD), stomach ulcers, erosive esophagitis, and Zollinger-Ellison syndrome. If you often forget doses, it may help to set an alarm to remind you. Visit Yellow Card for further information. It's not the same as hyoscine hydrobromide, which is a different medicine taken to prevent motion sickness. Buscopan helps to treat stomach cramps and period pains, but does not cure them. Antimuscarinic agents such as butylscopolamine can induce smooth-muscle relaxation and decrease of ureteral spasm as well [14]. 2014;20(27):87968806. When you get sick from something like the flu or diarrhea, or have trouble drinking enough fluids, the blood pressure in your body may decrease. A research grant of 2000 was given by the science bureau of Haga teaching hospital. 1-888-373-1470, Need help? Buscopan is currently rarely prescribed in the United States but may be more commonly recommended by physicians outside the U.S. Tytgat GN. Common medications that may interact with esomeprazole include: Note that this list is not all-inclusive and includes only common medications that may interact with esomeprazole. WebThere's not enough information to say that complementary medicines and herbal remedies or supplements are safe to take with Buscopan. We comply with the HONcode standard for trustworthy health information. Webvery safe. IV butylscopolamine is an integral part of renal colic management in The Netherlands, and we estimate that it is administered to several thousands of patients per year. The proton pump is located in the parietal cells of the stomach wall. WARNING: Please DO NOT STOP MEDICATIONS without first consulting a physician since doing so could be hazardous to your health. Bmj. WebMedical uses A package of injectable buscopan Hyoscine butylbromide is effective in treating crampy abdominal pain. 2008;337(nov13 2). Finally, it is common practice to advise the patient to stay hospitalized for several hours after stopping the infusion to evaluate if he or she remains pain free without butylscopolamine. When your kidneys dont function the way they should, prescription and over-the-counter medications can build up in your blood and may cause additional damage to your kidneys or other parts of your body. There have also been reports of false-positive urine screening tests for tetrahydrocannabinol (THC) in patients receiving PPIs, such as pantoprazole. Esomeprazole delayed-release capsules and esomeprazole for delayed-release oral suspension are bioequivalent (the same dosage has the same effect in the body). This adequately powered and double blinded trial confirms what previous limited studies already suggested: there is no benefit of intravenous butylscopolamine for renal colic. Groups were not different when comparing for baseline characteristics, stone location, or stone size, as shown in Table 1. Our phase IV clinical studies alone cannot establish cause-effect relationship. Hyoscine butylbromide - buscopan is an antispasmodic medicine which is taken to relieve cramps in the stomach, intestines or bladder. Treatment of Pain WebAcute kidney failure is found among people who take Buscopan, especially for people who are male, 60+ old, have been taking the drug for < 1 month. When used to treat GERD, guidelines recommend a 4- to 8-week treatment course; if an improvement is seen after 4 to 8 weeks consider a possible wean. Buscopan contains the active ingredient hyoscine butylbromide. You can use the study as a second opinion to make health care decisions. others, such as cilostazol, cisapride, cyclosporine, dabigatran, delavirdine, diazepam, digoxin, enzalutamide, mesalamine, methotrexate, moclobemide, modafinil, mycophenolate mofetil, rifampin, or tacrolimus. May make these conditions worse. Never take 2 doses at the same time. DISCLAIMER: All material available on eHealthMe.com is for informational purposes only, and is not a substitute for medical advice, diagnosis, or treatment provided by a qualified healthcare provider. In 2016, the uncertain benefit of a continuous butylscopolamine infusion was identified as an important clinical knowledge gap by the Dutch Association of Urology, supported by the Netherlands Patients Federation [4, 11]. Tell your doctor or pharmacist if you're taking any other medicines, including herbal medicines, vitamins or supplements. Only make changes to your prescription medications with the supervision of your trained medical practitioner. Do not take this medicine if you have fructose intolerance. No benefit of butylscopolamine in reducing opioid or metamizole need in renal colic was seen. See your doctor if you develop any unexplained fever, rash (particularly one that gets worse after you have been in the sun), new or worsening joint pain, persistent diarrhea, or generalized aches and pains. Data sources include IBM Watson Micromedex (updated 5 June 2023), Cerner Multum (updated 25 June 2023), ASHP (updated 11 June 2023) and others. The use of the eHealthMe site and its content is at your own risk. It is, therefore, reasonable to assume that the study population accurately reflects the entire population of patients with renal colic and the findings may be extrapolated as such. Alimentary Pharmacology and Therapeutics. This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases 2023 eHealthMe.com. Is Buscopan safe for kidneys? Talk to your doctor about how long you need to stay on pantoprazole. eHealthMe is studying from 4,794 Buscopan users for its effectiveness, alternative drugs and more. doi:10.1136/bmj.a2313, Mueller-Lissner S, Tytgat GN, Paulo LG. 4,679 people reported to have side effects when taking Buscopan. Speak to your doctor about how drug interactions should be managed. Any significant effect of butylscopolamine is, therefore, only to be expected after parenteral administration. The data are drawn from populations with standard deviations of 1.0 and 1.0. All rights reserved. A recent cochrane analysis showed that addition of antimuscarinics to NSAIDs is not superior to NSAID monotherapy regarding pain reduction and use of escape medication [17, 18]. Approval was given by the Dutch ethics committee. It's commonly used to treat spasms caused by gallbladder obstruction, kidney stones, and some surgeries where PubMed CAS If you're breastfeeding or planning to breastfeed, talk to your doctor or pharmacist, as other medicines might be better while you're breastfeeding. May be used off-label for aspiration prophylaxis in patients undergoing anesthesia, for Barrett's esophagus, for functional dyspepsia, for helicobacter pylori eradication, for primary prevention of NSAID-induced ulcers, for stress ulcer prophylaxis, and peptic ulcer disease. When prescribed new medications, ask your doctor or pharmacist if the medication is safe to take with CKD, and tell them your current GFR. These side effects happen in more than 1 in 100 people. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. Do not take Buscopan at the same time as other irritable bowel syndrome (IBS) remedies just take one type of remedy at a time. What Buscopan is and what it is used for. Buscopan has active ingredients of hyoscine butylbromide. Common triggers include caffeine, fizzy drinks and fried food. All Rights Reserved. The use of butylscopolamine stems from tradition, not based on scientific evidence [3]. Every effort has been made to ensure that all information is accurate, up-to-date, and complete, but no guarantee is made to that effect. It is unlikely, but cannot be completely excluded, that the additional 20mg would have changed the outcome of this study. One type of antimuscarinic that received interest over the past decades is butylscopolamine. May interact with some other medications including methotrexate, rilpivirine, and other antisecretory agents. People on high-dose or long-term therapy are more at risk. What's the difference between Buscopan products? Side effects or reactions are uncommon, but can occur. It is advised by the Dutch National DISCLAIMER: All material available on eHealthMe.com is for informational purposes only, and is not a substitute for medical advice, diagnosis, or treatment provided by a qualified healthcare provider. Our original studies have been referenced on 600+ medical publications including The Lancet, Mayo Clinic Proceedings, and Nature. However, the 2021 clinical guidance from the American College of Gastroenterology WebBUSCOPAN Tablets are not recommended for children under 6 years. PPIs (including esomeprazole) have been associated with an increased risk of osteoporosis-related fractures of the hip, wrist, or spine. May occur on medication initiation or at any point of therapy. In people who have difficulty swallowing, the capsule may be opened and the contents mixed with applesauce and swallowed immediately. Symptoms include fever, rash, and generalized aches and pains. During the study period, a total of 290 patients were admitted for renal colic in the two participating centers. Read about what else you can do to keep your kidneys healthy. antidepressants, such as citalopram, clomipramine, escitalopram, imipramine, St John's wort, or trimipramine, antifungals, such as fluconazole, itraconazole, ketoconazole, or voriconazole, attention deficit hyperactivity disorder (ADHD) medications (eg, dextroamphetamine, dexmethylphenidate, lisdexamfetamine, methylphenidate), bisphosphonates, such as alendronate, etidronate, or risedronate, cancer treatments, such as bosutinib, dabrafenib, dasatinib, erlotinib, or pazopanib, diuretics, such as bendroflumethiazide or furosemide, epilepsy medications, such as carbamazepine, fosphenytoin, phenobarbital, or phenytoin, hepatitis medications, such as boceprevir, ledipasvir, sofosbuvir, and telaprevir, HIV medications (eg, atazanavir, indinavir, ritonavir, or saquinavir), iron supplements, such as ferrous fumarate, ferrous gluconate, or ferrous sulfate, nitrates (eg, amyl nitrate, isosorbide dinitrate, isosorbide mononitrate, or nitroglycerin), proton pump inhibitors (eg, lansoprazole, omeprazole, pantoprazole), statins, such as atorvastatin, lovastatin, or simvastatin, warfarin or other anticoagulants, such as dabigatran. May be used for the short-term treatment of symptomatic GERD in people with or without erosive esophagitis. If administering twice daily take the first dose before breakfast and the second dose before dinner. Buscopan Cramps is only available from behind the pharmacy counter. Here are 5 common types of prescription and over-the-counter medications may need to be adjusted or replaced if you have kidney damage. The usual dose of Buscopan for stomach cramps (or cramping pain) in adults and children aged 12 years and over is 2 tablets, taken 4 times a day. BJU Int John Wiley & Sons, Ltd (10.1111) 95(3):297300. They also received oral tamsulosin 0.4mg once daily. There were a few minor protocol violations: administration of morphine instead of piritramide in two cases and refusal of diclofenac in eight cases, and these were evenly spread among the two arms. They're not tested in the Be sure to drink a full glass of water when taking Buscopan. If you or a loved one have kidney disease. Phosphorus is an important mineral. The 95% confidence interval (CI) of the difference between the randomized treatment groups is based on these robust standard errors. See your doctor if you develop any unexplained fever, rash (particularly one that gets worse after you have been in the sun), new or worsening joint pain, persistent diarrhea, or generalized aches and pains. Buscopan comes as tablets and is available on prescription. Pantoprazole can also reduce the absorption of drugs that are dependent on a certain gastric pH for their absorption. If you use this eHealthMe study on publication, please acknowledge it with a citation: study title, URL, accessed date. One recent RCT studied the effect of 80mg IV butylscopolamine compared to placebo on renal colic and concluded that there was no statistical difference between the placebo and butylscopolamine group [10]. Chronic kidney disease can change the way your body processes certain substances, so its important that you talk to your doctor or pharmacist about all over-the-counter and prescription medications, as well as supplements or vitamins you take. Pantoprazole lasts for 24 hours (oral and IV). Escape medication was used to maintain adequate pain relief, and a pain score below 4 was accepted as adequate pain management. Should not be used in people with previous hypersensitivity to pantoprazole or other substituted benzimidazole proton pump inhibitors. Check whether Acute kidney failure is associated with a drug or a condition, Acute kidney failure and drugs with ingredients of hyoscine butylbromide, Acute kidney failure in Moderna COVID Vaccine, Acute kidney failure in Pfizer BioNTech Covid Vaccine, Acute kidney failure in Johnson and Johnson Covid Vaccine, Haemarthrosis and drugs of ingredients of oxycodone hydrochloride, Joint Swelling and drugs of ingredients of celecoxib, Valacyclovir and Buspirone Hcl drug interaction, Fever and drugs of ingredients of niacinamide; pyridoxine hydrochloride; tyrosine, Cholestasis (a condition where bile cannot flow from the liver to the duodenum): 3 people, 11.11%, Nausea (feeling of having an urge to vomit): 3 people, 11.11%, Subarachnoid Haemorrhage (blood leaks into the space between two membranes that surround the brain): 2 people, 7.41%, Urinary Tract Infection: 2 people, 7.41%, Metastatic Renal Cell Carcinoma (spreadable kidney cell tumour): 5 people, 18.52%, Hypokalemia (low potassium): 4 people, 14.81%, Rheumatoid Arthritis (a chronic progressive disease causing inflammation in the joints): 3 people, 11.11%, Pancreatic Carcinoma (pancreatic cancer): 2 people, 7.41%. Has also been associated with other conditions such as lupus erythematosus, magnesium deficiency, and fundic gland polyps. Escape analgesics consisted of piritramide 15mg subcutaneously as needed up to a maximum of five times. The primary objective was to assess whether placebo is non-inferior to continuous intravenous infusion with butylscopolamine in patients admitted for pain due to renal colic with regards to amount of opioid escape medication needed. Our analysis results are available to researchers, health care professionals, patients (testimonials), and software developers (open API). Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. The phase IV clinical Many of these off-label uses feature in international and national guidelines. https://www.drugs.com/pro/pantoprazole.html. The risk is greater in women, people aged less than 30, and with higher dosages. J Pak Med Assoc 48(12):370372, CAS Dosage of drugs is not considered in the study. The study recruited a remarkably high proportion of all eligible patients and accrual was completed well within the planned time-frame of 24months. For children aged 6 to 11 years, the usual dose is 1 tablet, taken 3 times a day. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. The study uses data from the FDA. Median number of doses of escape medication was one in both groups. Buscopan relieves the pain of stomach cramps by helping your gut to relax. The use of the eHealthMe site and its content is at your own risk. Although butylscopolamine is generally safe, a recent update in the UK emphasizes potential dangers of this drug in patients with underlying cardiac disease [21]. A dosage of 20mg esomeprazole should not be exceeded in people with severe liver disease. Study allocation remained blinded until completion of the entire study. Drug Safety Update. It's your responsibility to decide if it's safe to drive. Pantoprazole works by irreversibly blocking the actions of an enzyme responsible for acid production, called H+/K+ ATPase (also known as the gastric proton pump). The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support research into many diseases and conditions. The protocol was approved by the independent ethics committee (IEC, approval number 17-081) and participants gave written informed consent prior to inclusion. Allowing for 20% drop-out, inclusion of 128 patients was planned. The mixture is stable for 62 days when it is refrigerated. Only take Buscopan IBS Relief tablets if your doctor has said that you have irritable bowel syndrome. Furthermore, the medical staff was not blinded to the study medication. Previous studies dismissing buscopan as ineffective have noteworthy flaws. Buscopan tablets start to work within 15 minutes. However, certain situations, such as when youre dehydrated from the flu or diarrhea, can lower the blood flow to your kidneys and cause harm. Three studies were performed with a single dose of intravenous butylscopolamine. Chronic kidney disease is found to be associated with 2,532 drugs and 1,227 conditions by eHealthMe. Mostly single dose was used in these trials and mainly butylscopolamine was used as an additive in comparing different types of analgesics in patients with colic pain such as NSAIDs or opioids. Hyperperistalsis of the ureter, modulated by alpha- and beta-adrenergic receptors, plays a part in this physiologic process as well. You can discuss the study with your doctor, to ensure that all drug risks and benefits are fully discussed and understood. However, if you keep taking your blood pressure medicines when youre dehydrated or have low blood pressure, your kidneys might have a hard time protecting themselves. Dosing in obese children should be based on lean body weight. This randomized-controlled clinical trial recruited patients in two general hospitals in The Netherlands between January 2018 and November 2019. Prolonged treatment (greater than 24-36 months) may cause vitamin B12 deficiency. However, the preparation and monitoring of a continuous infusion does form a burden on the nursing staff. Thank you, {{form.email}}, for signing up. Flaxseed for Constipation and IBS Symptoms, 9 Signs That Your Stomach Issues May Not Be IBS, Effect of fibre, antispasmodics, and peppermint oil in the treatment of irritable bowel syndrome: systematic review and meta-analysis, Placebo- and paracetamol-controlled study on the efficacy and tolerability of hyoscine butylbromide in the treatment of patients with recurrent crampy abdominal pain, Irritable bowel syndrome: a concise review of current treatment concepts.
