The effect of trimebutine on the psychosocial adjustment to illness in the irritable bowel syndrome

Abstract

Background and aim: Irritable bowel syndrome (IBS) is a harassing condition leading to the impairment of the quality of life. Adjustment to illness is an important personality factor able to influence the outcome. We looked for the psychological adjustment to illness in IBS. We also investigated the effect of trimebutine, a drug frequently used in IBS, on symptoms and psychosocial adjustment to illness in IBS.

Methods: A prospective randomized controlled trial including 50 consecutive patients with irritable bowel syndrome. They received either trimebutine 100 mg t.i.d (n=25, 11M/14F, aged 44+/-12 years) or placebo t.i.d. (n=25, 12M/13F, 48+/-10 years) for 2 weeks. Seven digestive symptoms were evaluated on a 0-16 scale, as well as the patient's satisfaction (scale 1-10) and the physician's satisfaction (scale 0-4) with the therapy. The psychosocial adjustment to illness was assessed by the PAIS-SR scale (self-report).

Results: Trimebutine increased significantly the following items of the PAIS-SR questionnaire: vocational environment, domestic environment, sexual relationships, extended family relationships, social environment but not health care orientation and psychological distress. Symptom score (mean+/-SD) for pain was reduced from 13.1+/-4.0 to 2.7+/-1.1, p<0.0001 by trimebutine and from 12.5+/-3.6 to 7.7+/-2.5, p<0.05 by placebo. Bloating score was decreased by trimebutine from 10.3+/-3.6 to 2.6+/-1.2 (p<0.0001) and not by placebo (from 10.5+/-4.5 to 8.8+/-3.6 N.S.). Nausea, emesis, anorexia, diarrhea and constipation were also improved by trimebutine. Placebo improved anorexia and tended to improve nausea. Patient' s satisfaction score was 8.1+/-1.1 with trimebutine and 5.2+/-3.5 with placebo (p<0.01). Physician's satisfaction score was 3.0+/-0.7 with trimebutine and 2.2+/-1.1 with placebo (p<0.02).

Conclusions: Trimebutine improved symptoms and psychological adjustment to illness in irritable bowel syndrome in comparison with placebo.