Digestive Health Irritable Bowel Syndrome Treatment Can Antispasmodics Treat IBS? How drugs target smooth muscle to alleviate symptoms By Barbara Bolen, PhD Barbara Bolen, PhD Twitter Barbara Bolen, PhD, is a licensed clinical psychologist and health coach. She has written multiple books focused on living with irritable bowel syndrome. Learn about our editorial process Updated on March 22, 2022 Medically reviewed Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Jay N. Yepuri, MD, MS Medically reviewed by Jay N. Yepuri, MD, MS Facebook LinkedIn Twitter Jay Yepuri, MD, MS, is a board-certified gastroenterologist and a practicing partner at Digestive Health Associates of Texas (DHAT). Learn about our Medical Expert Board Print Studies have suggested that approximately 5% of Americans experience the symptoms of irritable bowel syndrome (IBS), a functional gastrointestinal disorder that causes abdominal pain and changes in bowel habits. As researchers have yet to identify the cause of IBS, treatment is primarily aimed at relieving the symptoms of the disorder, which can include abdominal pain, cramping, bloating, diarrhea, and constipation. Particularly among people with the diarrhea-predominant subtype (IBS-D), some antispasmodics (also referred to as "spasmolytics") have proven moderately effective in alleviating symptoms by targeting and relaxing the smooth muscles of the digestive tract, preventing spasms. Because symptoms of IBS tend to be worst after eating, taking these medications 30 to 60 minutes before a meal may help prevent symptoms. There are a couple types of antispasmodic medications used to treat IBS, including: AnticholinergicsPeppermint oil BSIP / UIG / Getty Images Anticholinergics Anticholinergics are a class of drug designed to block the neurotransmitter acetylcholine. This is a chemical produced by the body that acts on the autonomic nervous system, the part of the nervous system associated with involuntary functions. By blocking acetylcholine receptors in the digestive tract, anticholinergics can decrease the severity of muscle spasms and the overproduction of mucus. Unfortunately, the drugs can also affect other organ systems, triggering side effects such as blurred vision, constipation, decreased urination, and dizziness. Due to the risk of constipation, anticholinergics are best used in cases of diarrhea-predominant IBS (IBS-D) rather than constipation-predominant IBS (IBS-C). Gastric reflux is also a common side effect. Some commonly prescribed anticholinergics include: Bentyl (dicyclomine) Buscopan (hyoscine butylbromide) Levsin (hyoscyamine) However, in their 2021 "Clinical Guideline for Management of Irritable Bowel Syndrome," the American College of Gastroenterology (ACG) recommends against using any of the medications above, citing a lack of good evidence that they actually work. Mebeverine The exact mechanism of action of mebeverine is not known, but it is classified as a synthetic anticholinergic. Mebeverine is prescribed outside of the United States, and it is available under many different brand names including Dusputal, Duspamen, and Duspatalin. Mebeverine is a musculotropic spasmolytic that works similarly to anticholinergics but does not have the acetylcholine side effects. That means that mebeverine targets muscles specifically to reduce muscle spasms. It works similarly to other anticholinergics, but it doesn't have the side effects that impact other parts of the body. Allergic reactions have been reported in some people, mostly in the form of low-grade rashes. Mebeverine is not currently approved for use in the United States, but it is used in the United Kingdom, where it is sold under the names Colofac, Colofac IBS, and Aurobeverine. In the UK, it is also possible to buy mebeverine mixed with the soluble fiber called ispaghula (or psyllium) husk under the brand name Fybogel Mebeverine. Peppermint Oil Peppermint oil is an over-the-counter supplement that contains menthol, a substance that scientists believe relaxes smooth muscle by operating on calcium channels in smooth muscle cells in the gut. Some prescription calcium channel blockers are used similarly to treat high blood pressure (hypertension) and other cardiovascular disorders, because they relax smooth muscles in the blood vessels. The American College of Gastroenterology recommends peppermint oil for its antispasmodic properties. They also suspect that peppermint exerts direct antimicrobial effects and anti-inflammatory effects, and may help with feelings of distress caused by IBS. A 2014 review of studies by the University of California, San Diego concluded that persons with IBS symptoms were nearly three times more likely to achieve relief with peppermint oil than with a placebo. While considered safe for short-term use, peppermint oil is known to cause heartburn in some people (a situation which may be avoided with the use of enteric-coated capsules). Be sure to consult your healthcare provider before taking peppermint oil or any other over-the-counter supplement. Peppermint oil should be used with caution in people with heartburn, hiatal hernia, severe liver damage, gallbladder inflammation, or bile duct obstruction. Dietary Changes In addition to antispasmodic medications, dietary changes can also significantly improve IBS symptoms. Depending on the symptoms you're experiencing, you may want to: Increase dietary fiber or use a fiber supplement to relieve IBS constipation or diarrhea. Increase water intake if constipated. Avoid caffeine (peppermint tea is an excellent substitute). Avoid legumes to decrease bloating. Limit foods containing lactose, fructose, or FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols). Frequently Asked Questions What are spasmolytics? Spasmolytics are better known as antispasmodics. These are medications that target smooth muscle tissue to prevent spasms. Spasmolytics are part of a class of drugs known as anticholinergics, which block the neurotransmitter acetylcholine. This decreases the severity of muscle spasms. Do antispasmodics work for IBS? Sometimes. Antispasmodics are helpful for slowing the production of mucus and easing muscle spasms. They are useful for diarrhea prominent IBS (IBS-D). However, constipation is a side effect of antispasmodics and should not be used for people with constipation-predominant IBS. Is there a natural antispasmotic? Yes, peppermint oil contains menthol, which relaxes smooth muscles cells in the gut. Be sure to use enteric-coated capsules which are easier on the digestive tract and prevent heartburn. Was this page helpful? Thanks for your feedback! One of the most challenging aspects of having IBS is trying to figure out what's safe to eat. Our recipe guide makes it easier. Sign up and get yours now! Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 8 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Palsson OS, Whitehead W, Törnblom H, Sperber AD, Simren M. Prevalence of Rome IV functional bowel disorders among adults in the United States, Canada, and the United Kingdom. Gastroenterology. 2020;158(5):1262-1273.e3. doi:10.1053/j.gastro.2019.12.021 Saha L. Irritable bowel syndrome: Pathogenesis, diagnosis, treatment, and evidence-based medicine. World J Gastroenterol. 2014;20(22):6759-73. doi:10.3748/wjg.v20.i22.6759 Annaházi A, Róka R, Rosztóczy A, Wittmann T. Role of antispasmodics in the treatment of irritable bowel syndrome. World J Gastroenterol. 2014;20(20):6031-6043. doi: 10.3748/wjg.v20.i20.6031 Costa VA, Ovalle Hernández AF. The role of antispasmodics in managing irritable bowel syndrome. Rev Colomb Gastroenterol. 2019;34(3):269-276. doi: 10.22516/25007440.309 Lacy BE, Pimentel M, Brenner DM et al. Clinical guideline: Management of irritable bowel syndrome. Am J Gastroenterol. 2021 Jan 1;116(1):17-44. doi: 10.14309/ajg.0000000000001036 NIH: National Center for Advancing Translational Sciences. Inxight: Drugs, Mebeverine. Alammar N, Wang L, Saberi B, et al. The impact of peppermint oil on the irritable bowel syndrome: a meta-analysis of the pooled clinical data. BMC Complement Altern Med. 2019;19(1):21. doi:10.1186/s12906-018-2409-0 Khanna R, MacDonald JK, Levesque BG. Peppermint oil for the treatment of irritable bowel syndrome: a systematic review and meta-analysis. J Clin Gastroenterol. 2014 Jul;48(6):505-12. doi:10.1097/MCG.0b013e3182a88357 Additional Reading Ford A, Moyyadedi P, Lacy B, et.al. American College of Gastroenterology monograph on the management of irritable bowel syndrome and chronic idiopathic constipation. Amer J Gastroenterol. 2014;109: S2-S26. doi:10.1038/ajg.2014.187