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)