Mebeverine decreases mass movements and stool frequency in lactulose-induced diarrhoea.
BACKGROUND
In spite of its frequent use in the treatment of irritable bowel disease little is known about mebeverine's mode of action in man.


OBJECTIVE
To examine mebeverine's effect on transit though the gut during lactulose-induced diarrhoea.


METHODS
Nine healthy volunteers undertook a two-way randomized crossover study. Diarrhoea was induced using lactulose pre-treatment (20 m t.d.s., 4 days) and subjects received either mebeverine (135 mg t.d.s.) or no treatment. Transit of two enteric-coated capsules containing radiolabelled 8.4 mm tablets and 180-250 microM ion exchange resin were followed using gamma scintigraphy. Stool frequency and symptoms were assessed by diary cards.


RESULTS
Mebeverine reduced mean daily stool frequency associated with lactulose ingestion from a median of 2.25 (interquartile range (IQR) 1.75-2.75) to 1.5 (IQR 1.25-2.25) movements. Mebeverine significantly reduced the number of mass movements observed in the colon during the 11 h of the study from 2 (2-2) to 1 (1-2), and the number of retrograde movements from 1 (0-2) to 0 (0-0) (P < 0.05). Mebeverine did not significantly alter the gastric emptying rate of the intact capsule (2.9 (1.9-3.2) to 2.8 (2.6-4.0) h) however it induced a small but significant acceleration in small intestinal transit of the capsule (1.6 (0.8-2.0) h to 1.0 (0.52-1.32) h, P=0.02).


CONCLUSIONS
Mebeverine reduces the diarrhoeal effect of lactulose by decreasing the mass movements induced in the ascending colon. This effect may contribute to its clinical effect in irritable bowel syndrome.
Department of Surgery, University Hospital, Queen's Medical Center, Nottingham, UK.
N
N
Washington
P
P
Ridley
C
C
Thomas
R C
RC
Spiller
P J
PJ
Watts
C G
CG
Wilson
D000293:Adolescent; D000328:Adult; D003106:Colon / Q000187:drug effects; D018592:Cross-Over Studies; D003672:Defecation / Q000187:drug effects*; D003967:Diarrhea / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D005746:Gastric Emptying / Q000187:drug effects; D005765:Gastrointestinal Agents; D005772:Gastrointestinal Transit / Q000187:drug effects; D006801:Humans; D007792:Lactulose; D008297:Male; D010276:Parasympatholytics / Q000627:therapeutic use*; D010627:Phenethylamines / Q000627:therapeutic use*; D011877:Radionuclide Imaging
D005765:Gastrointestinal Agents; D010276:Parasympatholytics; D010627:Phenethylamines; D007792:Lactulose; C005096:mebeverine