[Clinical and instrumental evaluation by multiple colonic manometry of tiropramide, trimebutine and octylonium bromide in irritable colon. II. Repeated oral administration]

Abstract

Sixty out-patients with acute or sub-acute irritable colon were randomly allocated to receive 3 daily doses of 100 mg tiropramide, 150 mg trimebutine maleate or 20 mg octilonium bromide, orally during 5 consecutive days. Before and after treatment, multiple colonic manometry was performed, monitoring tonus, intensity and frequency of sinusoid contraction waves, transitories and vibrations, as well as the voluntary contraction capacity. Before treatment and after 2 and 5 days, the specific symptoms were also monitored, scored and recorded. Significant variations in tonus were not observed with any drug, but while tiropramide left unmodified the voluntary contractile ability, a significant inhibition was observed with trimebutine and, mainly, with octilonium. The overall power of spontaneous colonic contractions did not vary significantly with any drug. However, while with tiropramide a significant redistribution of muscular power was observed so as to increase propulsion waves and to decrease the ineffective transitory and vibrational contractions, with octilonium and trimebutine no clinically relevant redistribution of the power wasted in transient spasms was observed. Based on these observations, tiropramide was considered to be at least as effective an antispasmodic as octilonium and at least as effective a synchronizer as trimebutine, but was different from both reference drugs because it was the only one to act simultanously as both an antispasmodic and a synchronizer. The three drugs produced an improvement in each and all monitored symptoms as well as in the overall symptom intensity. Tiropramide, however, produced an improvement significantly faster, more progressively and to a greater extent than either reference drug.(ABSTRACT TRUNCATED AT 250 WORDS)