Treatment with the antidepressant amitriptyline can reduce symptoms and improve quality of life in adolescents with irritable bowel syndrome (known as IBS), the results of a small study suggest.
People with IBS suffer chronic discomfort with cramping, diarrhoea or constipation. The causes of IBS are unclear and there has been debate whether it is mostly due to psychological factors or biological triggers, or perhaps a combination.
"While research has shown that amitriptyline is effective for adults with IBS, only peppermint oil has been studied in children with this disorder in a double-blind, placebo-controlled fashion," said Dr Ron J. Bahar, from the University of California at Los Angeles.
As reported in The Journal of Paediatrics, Bahar and colleagues assessed the outcomes of 33 patients who were randomised to receive amitriptyline or placebo.
Improved quality of life
The study subjects were between 12 and 18 years of age and included 24 females. The 13-week study consisted of a two week symptom scoring phase, followed by eight weeks of treatment, and then a three week washout phase.
Compared with teens taking placebo, those taking amitriptyline were more likely to show improvements in quality of life during the study.
Amitriptyline therapy was also associated with significant reductions in IBS-related diarrhoea and pain.
According to Bahar, the study group was limited in size because the parents and guardians of many eligible patients declined participation out of concern over recent reports linking antidepressant use in children with suicide. However, he emphasised, the dose of amitriptyline used in the present study is well below that typically used to treat depression.
"Given the findings of our study, future investigations should appropriately focus on the judicious use of amitriptyline and other chronic pain medications in children with functional gastrointestinal disorders to complement biopsychosocial and antibiotic therapy in these patients," the researchers state. – (Reuters Health)
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