Irritable bowel syndrome and role of pinaverium bromide: pharmacological profile and clinical efficacy
DOI:
https://doi.org/10.18203/2320-6012.ijrms20242252Keywords:
Calcium channel blocker, Gut-brain disorder, Irritable bowel syndrome, Pinaverium, Post-treatment therapeutic effectAbstract
Irritable bowel syndrome (IBS) is a common gut brain interaction disorder that is diagnosed via patient-reported symptoms and various diagnostic criteria. Multiple factors, such as visceral hypersensitivity, gut dysbiosis, dysmotility, gut-brain dysregulation, lifestyle, and dietary habits, are involved in the development of IBS and manifestation of its symptoms of abdominal pain, bloating, and abnormal bowel movements. Lifestyle modifications and dietary changes, behavioral therapy, and pharmacological treatments, namely antispasmodics and antianxiety drugs, are commonly prescribed for IBS management. Pinaverium bromide is a selective calcium channel blocker that acts locally in the gastrointestinal tract and relieves spasms making it an effective agent for the treatment of IBS. This review provides a background on the diagnostic criteria and pathogenic mechanisms of IBS from an Indian clinician standpoint and provides an in-depth overview on clinical studies of pinaverium emphasizing its role in IBS treatment.
Metrics
References
Lacy BE, Mearin F, Chang L, Chey WD, Lembo AJ, Simren M. Bowel Disorders. Gastroenterol. 2016;150:1393-407.
Longstreth GF, Thompson WG, Chey WD, Houghton LA, Mearin F, Spiller RC. Functional bowel disorders. Gastroenterol. 2006;130(5):1480-91.
Barberio B, Yiannakou Y, Houghton LA, Black CJ, Savarino EV, Ford AC. Overlap of Rome IV irritable bowel syndrome and functional dyspepsia and effect on natural history: a longitudinal follow-up study. Clin Gastroenterol Hepatol. 2022;20(2):89-101.
Goodoory VC, Ng CE, Black CJ, Ford AC. Direct healthcare costs of Rome IV or Rome III-defined irritable bowel syndrome in the United Kingdom. Ailment Pharmacol Ther. 2022;56(1):110-20.
Sperber AD, Bangdiwala SI, Drossman DA, Ghoshal UC, Simren M, Tack J et al. Worldwide prevalence and burden of functional gastroinstestinal disorders, results of Rome foundation global study. Gastroenterol. 2021;160(1):99-114.
Sperber AD, Dumitrascu D, Fukudo S, Gerson C, Ghoshal UC, Gwee KA. The global prevalence of IBS in adults remains elusive due to the heterogeneity of studies: a Rome foundation working team literature review. Gut. 2017;66(6):1075-82.
Oka P, Parr H, Barberio B, Black CJ, Savarino EV, Ford AC. Global prevalence of irritable bowel syndrome according to Rome III or IV criteria: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2020;5(10):908-17.
Patel N, Shackelford K. Irritable bowel syndrome. In StatsPearl [Internet]. Treasure Island (FL): StatsPearl Publishing. 2023.
Kanazawa M, Endo Y, Whitehead WE, Kano M, Hongo M, Fukudo S. Patients and nonconsulters with irritable bowel syndrome reporting a parenteral history of bowel problems have more impaired psychological distress. Dig Dis Sci. 2004;49(6):1046-53.
Strege PR, Mazzone A, Bernard CE, Neshatian L, Gibbons SJ, Saito YA et al. Irritable bowel syndrome patients have SCN5A channelopathies that lead to increased Nav1.5 current and mechanosensitivity. Am J Physiol Gastrointest Liver Physiol. 2018;313(4):503-949.
Thabane M, Kottachchi DT, Marshall JK. Systematic review and meta-analysis: the incidence and prognosis of post-infectious irritable bowel syndrome. Ailment Pharmacol Ther. 2007;26(4):535-44.
Dunlop SP, Coleman NS, Blackshaw E, Perkins AC, Singh G, Mardsen CA et al. Abnormalities of 5-hydroxytryptamine metabolism in irritable bowel syndrome. Clin Gastroenterol Hepatol. 2005;3(4):349-57.
Mayer EA, Knight R, Mazmanian SK, Cryan JF, Tillisch K. Gut microbes and the brain: paradigm shift in neuroscience. J Neurosci. 2014;34(46):15490-6.
Vazquez-Roque MI, Camilleri M, Smyrk T, Murray JA, Marietta E, O’Neill J, Carlson P et al. A controlled trial of gluten-free diet in patients with irritable bowel syndrome-diarrhea: effects on bowel frequency and intestinal function. Gastroenterol. 2013;144(5):903-11.
Lowell RM, Ford AC. Global prevalence and risk factors for irritable bowel syndrome: a meta-analysis. Clin Gastroenterol Hepatol. 2012;10(7):712-21.
Klem F, Wadhwa A, Prokop LJ, Sundt WJ, Farrugia G, Camilleri M et al. Prevalence, risk factors, and outcomes of irritable bowel syndrome after infectious enteritis: a systematic review and meta-analysis. Gastroenterol. 2017;152(2):1042-54.
Van der Veek PPJ, Van Rood YR, Masclee AAM. Symptom severity but not psychopathology predicts visceral hypersensitivity in irritable bowel syndrome. Clin Gastroenterol Hepatol. 2008;6(3):321-8.
Barbara G, Giorgio RD, Stanghellini V, Cremon C, Corinaldesi R. A role for inflammation in irritable bowel syndrome? Gut. 2002;51(1):41-44.
Akbar A, Yiangou Y, Facer P, Walters JRF, Anand P, Ghosh S. Increased capsaicin receptor TRPV1-expressing sensory fibres in irritable bowel syndrome and their correlation with abdominal pain. Gut. 2008;57(7):923-9.
Spiller RC. Effects of serotonin on intestinal secretion and motility. Curr Opin Gastroenterol. 2001;17(2):99-103.
Wang L., Alammar N, Singh R, Nanavati J, Song Y, Chaudhary R et al. Gut microbial dysbiosis in the irritable bowel syndrome: a systematic review and meta-analysis of case-control studies. J Acad Nutr Diet. 2019;120(4):565-86.
Chang L. The role of stress on physiologic responses and clinical symptoms in irritable bowel syndrome. Gastroenterol. 2011;140(3):761-765.
Chung C-S, Chang P-F, Liao C-H, Lee T-H, Chen Y, Lee Y-C et al. Differences in microbiota in small bowel and faeces between irritable bowel syndrome patients and healthy subjects. Scand J Gastroenterol. 2016;51(4):410-9.
Manning AP, Thomspon WG, Heaton KW, Morris AF. Towards a positive diagnosis of the irritable bowel. Br Med J. 1978;2(6138):653-4.
Thompson WG, Longstreth GF, Drossman DA, Heaton KW, Irvine EJ, Muller-Lissner SA. Functional bowel disorders and functional abdominal pain. Gut. 1994;45(2):143-7.
Black CJ, Craig O, Gracie DJ, Ford AC. Comparison of the Rome IV criteria with the Rome III criteria for the diagnosis of irritable bowel syndrome in secondary care. Neurogastroenterol. 2020;1-7.
Blake MR, Raker JM, Whelan K. Validity and reliability of the Bristol stool form scale in healthy adults and patients with diarrhoea-predominant irritable bowel syndrome. Alim Pharmacol Ther. 2016;44:693-703.
Gwee KA, Bak Y-T, Ghoshal UC, Gonlachanvit S, Lee OY, Fock KM et al. Asian consensus on irritable bowel syndrome. J Gastroenterol Hepatol. 2010;25(7):1189-1205.
Ghoshal UC, Sachdeva S, Pratap N, Karyampudi A, Mustafa U, Abraham P. Indian consensus statement on irritable bowel syndrome in adults:a guideline by the Indian neurogastroenterology and motility association and jointly supported by the Indian society of gastroenterology. Indian J Gastroenterol. 2023;42(2):249-73.
Goyal O, Nohria S, Dhaliwal AS, Goyal P, Soni RK, Chhina RS et al. Prevalence, overlap, and risk factors for Rome IV functional gastrointestinal disorders among college students in northern India. Indian J Gastroenterol. 2021;40(2):144-53.
Ghoshal UC, Abraham P, Bhatia SJ, Misra SP, Choudhuri G, Biswas KD. Comparison of Manning, Rome I, II, and III, and Asian diagnostic criteria:report of the multicentric Indian irritable bowel syndrome (MIIBS) study. Indian J Gastroenterol. 2013;32:369-75.
Krueger D, Michel K, Allam S, Weiser T, Demir IE, Ceyhan GO et al. Effect of hyoscine butylbromide (Buscopan®) on cholinergic pathways in the human intestine. Neurogastroentrol Motil. 2013;25(8):530-9.
De Ponti F, Giaroni C, Cosentino M, Lecchini S, Frigo G. Calcium-channel blockers and gastrointestinal motility:basic and clinical aspects. Pharmacol Ther. 1993;60(1):121-48.
Evangelist MO. Action of pinaverium bromide, a calcium-antagonist, on gastrointestinal motility disorders. Gen Pharmacol. 1990;21(6):821-825.
Levy C, Charbonnier A, Cachin M. Pinaverium bromide and functional colonic disease (double-blind study). Sem Hop Ther. 1977;53(7-8):372-4.
Delmont J. The value of adding antispasmodic musculotropic agent in the treatment of painful constipation in functional colopathies with bran. Double-blind study. Med Chir Dig. 10981;10:365-70.
Awad R, Dibildox M, Ortiz F. Irritable bowel syndrome treatment using pinaverium bromide as a calcium channel blocker. A randomized double-blind placebo-controlled trial. Acta Gastroenterol Latinoam. 1995;25(3):137-44.
Wittmann T, Feher A, Rosztoczy A, Janosi J. Effectiveness of pinaverium bromide therapy on colonic motility disorders in irritable bowel syndrome. Orv Hetil. 1999;140(9):469-73.
Dubarry JJ, Quinton A. Effet a court terme du bromure de pinaverium dans les oesophagitis, gastroduodenites, et colopathies fonctionnelles, essiais controle. Bordeaux Med. 1977;10:1457-9.
Virat J. Hueber D. Douleur du colopathe et dicetel. La Practique Medicale. 1987;43:32-34.
Wu X-W, Hou Y, Ji H-Z, Liang M-M, Xu L-E, Wang F-Y. Treating irritable bowel syndrome by wuling capsule combined pinaverium bromide:a clinical research. Zhongguo Zhonh Xi Yi Jie Ha Za Zhi. 2015;35(4):415-418.
Zheng L, Lai Y, Lu W, Li B, Fan H, Yan Z et al. Pinaverium reduces symptoms of irritable bowel syndrome in multicenter, randomized, controlled trial. Clin Gastroenterol Hepatol. 2015;13(7):1285-1292.
Qin Y, Yi W, Lin S, Yang C, Zhuang Z. Clinical effect of abdominal acupuncture for diarrhea irritable bowel syndrome. Zhongguo Zhen Jiu. 2017;37(12):1265-1268.
Qu L, Xing L, Norman W, Chen H, Gao S. Irritable bowel syndrome treated by traditional Chinese spinal orthopedic manipulation. J Tradit Chin Med 2012;32(4):565-570.
Sun J, Wu X, Xia C, Xu L, Pei L, Hao L et al. Clinical evaluation of soothing gan and invigorating pi acupuncture treatment on diarrhea-predominant irritable bowel syndrome. Chin J Integr Med. 2011;17(10):780-785.
Li H, Pei L-X, Zhou J-L. Comparative observation on therapeutic effects between acupuncture and western medication for diarrhea-predominant irritable bowel syndrome. Zhongguo Zhen Jiu. 2012;32(8):679-682.
Bor S, Lehert P, Chalbaud A, Tack J. Efficacy of pinaverium bromide in the treatment of irritable bowel syndrome:a systematic review and meta-analysis. Therap Adv Gastroenterol. 2021;14:17562848211033740.
Ruepert L, Quartero AO, de Wit NJ, van der Heijden GJ, Rubin G, Muris JW. Bulking agents, antispasmodics and antidepressants for the treatment of irritable bowel syndrome. Cochrane Database Syst Rev. 2011;2011(8):CD003460.
Hou X, Chen S, Zhang Y, Sha W, Yu X, Elsawah H et al. Quality of life in patients with irritable bowel syndrome (IBS) assessed using the IBS-quality of life (QOL) measure after 4 and 8 weeks of treatment with mebeverine hydrochloride or pinaverium bromide:results of an international prospective observational cohort study in Poland, Egypt, Mexico and China. Clin Drug Investig. 2014;34(11):783-793.
Jayanthi V, Malathi S, Ramathilakam B, Dinakaran N, Balasubramanian V, Mathew S. Role of pinaverium bromide in south Indian patients with irritable bowel syndrome. J Assoc Physicians India. 1998;46(4):369-371.
Fuentes IM, Christianson JA. Ion channels, ion channel receptors, and visceral hypersensitivity in irritable bowel syndrome. Neurogastroenterology & Motility. 2016 Nov;28(11):1613-8.
Costa Barney VA, Hernandez AFO. The role of antispasmodics in managing irritable bowel syndrome. Rev Colomb Gastroenterol. 2019;34(3):267-273.
Qin D, Tao Q-F, Huang S-L, Chen M, Zheng H. Eluxadoline versus antispasmodics in the treatment of irritable bowel syndrome:an adjusted indirect treatment comparison meta-analysis. Front Pharmacol. 2022;13:Article AZ757969.
Enck P, Aziz Q, Barbara G, Framer AD, Fukudo S, Mayer EA et al. Irritable bowel syndrome. Nat Rev. 2016;2:Article 16014.
Wouters MM, Balemans D, Wanrooy SV, Dooley J, Cibert-Groton V, Alpizar YA et al. Histamine receptor H1-mediacted sensitization of TRPV1 mediates visceral hypersensitivity and symptoms in patients with irritable bowel syndrome. Gastroenterol. 2016;150:875-887.
Hadjvaslis A, Tsioutis C, Michalinos A, Ntourakis D, Christodoulou DK, Agouridis AP. New insights into irritable bowel syndrome:from pathophysiology to treatment. Ann Gastroenterol. 2019;32:1-11.