Otilonium bromide enhances sensory thresholds of volume and pressure in patients with irritable bowel syndrome

Visceral hyperalgesia has been suggested to play a role in the development of symptoms presented by irritable bowel syndrome patients. Otilonium bromi de was developed to block smooth muscle Ca release to control cramping pain of these patients. Aims: to determine whether otilonium bromide can influe nce sensory thresholds of patients suffering from irritable bowel syndrome. Methods: 15 patients with Rome-II positive IBS were tested by Synectics Vi sceral Stimulator Barostat using rapid phasic distension (870 ml/min). The sensory threshold for first sensation, stool, pain and maximum tolerable vo lume and pressure were measured. All of the parameters were tested before a nd I week after the initiation of otilonium bromide (Spasmomen, Berlin Chem ie, 3x40 mg) therapy. Results: The perceptual thresholds for first sensatio n, stool, pain and maximum tolerable distention were, 8.8 +/-1.7 Hgmm, 19.2 +/-2.1 Hgmm, 26.3 +/-2.8 Hgmm, 28.7 +/-2.8 Hgmm for pressure, 90 +/- 21 ml , 145 +/- 28 ml, 208 +/- 25 ml, 213 +/- 28 ml for volume, before treatment, respectively. Otilonium bromide treatment did not influence the thresholds for first sensation and stool, 7.4 +/-1.4 Hgmm, 20.7 +/-4.6 Hgmm and 83 +/ - 21 ml, 178 +/- 35.8 ml, respectively. The pressure threshold of pain was significantly higher I week after treatment (26.3 +/-2.8 Hgmm vs. 29.1 +/-5 .5 Hgmm, P < 0.05), but the volume threshold of this sensation remained unc hanged (208 +/- 25 ml vs. 234 +/- 39 ml, not significant). The pressure (28 .7 +/-2.8 Hgmm vs. 38.1 +/-3.4 Hgmm, P <0.05) and volume (213 +/- 28 ml vs. 278 +/- 27ml, P <0.05) thresholds for maximum tolerable volume were increa sed by 7 days otilonium bromide treatment. Conclusion: These data suggest t hat otilonium bromide enhances sensory thresholds to recto-sigmoideal diste ntion. (C) 2001 Published by Elsevier Science Ltd.