MEBEVERINE DECREASES MASS MOVEMENTS AND STOOL FREQUENCY IN LACTULOSE-INDUCED DIARRHEA

Background: In spite of its frequent use in the treatment of irritable bowel disease little is known about mebeverine's mode of action in ma n, Aim: To examine mebeverine's effect on transit though the gut durin g lactulose-induced diarrhoea. Methods: Nine healthy volunteers undert ook a two-way randomized crossover study, Diarrhoea was induced using lactulose pre-treatment (20 m t.d,s,, 4 days) and subjects received ei ther mebeverine (135 mg t,d,s,) or no treatment, Transit of two enteri c-coated capsules containing radiolabelled 8.4 mm tablets and 180-250 mu M ion exchange resin were followed using gamma scintigraphy, Stool frequency and symptoms were assessed by diary cards, Results: Mebeveri ne reduced mean daily stool frequency associated with lactulose ingest ion from a median of 2.25 (interquartile range (IQR) 1.75-2.75) to 1,5 (IQR 1.25-2.25) movements, Mebeverine significantly reduced the numbe r of mass movements observed in the colon during the 11 h of the study from 2 (2-2) to 1 (1-2), and the number of retrograde movements from 1 (0-2) to 0 (0-0) (P < 0.05). Mebeverine did not significantly alter the gastric emptying rate of the intact capsule (2.9 (1.9-3.2) to 2.8 (2.6-4.0) h) however it induced a small but significant acceleration i n small intestinal transit of the capsule (1.6 (0.8-2.0) h to 1.0 (0.5 2-1.32) h, P = 0.02), Conclusion: Mebeverine reduces the diarrhoeal ef fect of lactulose by decreasing the mass movements induced in the asce nding colon, This effect may contribute to its clinical effect in irri table bowel syndrome.