PP  Vol.2 No.2 , April 2011
Symptoms and Their Interpretation in Patients Self-Treating Abdominal Cramping and Pain with a Spasmolytic (Butylscopolamine Bromide)—A Pharmacy-Based Survey
Abstract: Background: A majority of people suffering from functional abdominal complaints treat themselves with OTC medication. Aim: To gain information on symptoms and their interpretation in patients self-treating abdominal cramping and pain with a spasmolytic (butylscopolamine). Method: 4,680 questionnaires were distributed by 306 pharmacists in Germany to patients suffering from abdominal complaints and buying butylscopolamine. Key findings: Questionnaires from 1,539 respondents were returned, and 1,417 could be evaluated. Abdominal cramping was the major reason for buying butylscopolamine. Only a minority of respondents had consulted a general practitioner (27.3%) and even less a specialist (12.5%). Only a minority of subjects met expert criteria for irritable bowel syndrome (13%). There was a large overlap between self-reported dysmenorrhoea and bowel symptoms (35%). Conclusions: Real life conditions do not seem to be well covered by expert criteria. Differentiating bowel origin from uterine origin in pelvic pain syndromes seems especially problematic. This may particularly apply to the OTC market.
Cite this paper: nullS. Müller-Lissner, E. Schäfer and A. Kondla, "Symptoms and Their Interpretation in Patients Self-Treating Abdominal Cramping and Pain with a Spasmolytic (Butylscopolamine Bromide)—A Pharmacy-Based Survey," Pharmacology & Pharmacy, Vol. 2 No. 2, 2011, pp. 82-87. doi: 10.4236/pp.2011.22010.

[1]   E. M. M. Quigley, G. R. Locke, S. Mueller-Lissner, et al., “Prevalence and Management of Abdominal Cramping and Pain: A Multinational Survey,” Alimentary Pharma- cology and Therapeutics, Vol. 24, No. 2, 2006, pp. 411-419. doi:10.1111/j.1365-2036.2006.02989.x

[2]   D. A. Drossman, Z. Li, E. Andruzzi, et al., “U.S. House- holder Survey of Functional Gastrointestinal Disorders,” Prevalence, Sociodemography, and Health Impact, Di- gestive Disease and Sciences, Vol. 38, No. 9, 1993, pp. 1569-1580.

[3]   A. P. S. Hungin, P. J. Whorwell, J. Tack and F. Mearin, “The Prevalence, Patterns and Impact of Irritable Bowel Syndrome: an International Survey of 40,000 Subjects,” Alimentary Pharmacology and Therapeutics, Vol. 17, 2003, pp. 643-650. doi:10.1046/j.1365-2036.2003.01456.x

[4]   A. Icks, B. Haastert, P. Enck, W. Rathmann and G. Giani, “Prevalence of Functional Bowel Disorders and Related Health Care Seeking: A Population-Based Study,” Zeitschrift für Gastroenterologie, Vol. 40, No. 3, 2002, pp. 177-183. doi:10.1055/s-2002-22324

[5]   S. Mueller-Lissner, E. M. M. Quigley, I. Helfrich and E. Schaefer, “Drug Treatment of Chronic-Intermittent Abdominal Cramping and Pain: A Multi-National Survey on Usage and Attitudes,” Alimentary Pharmacology and Therapeutics, Vol. 32, No. 3, 2010, pp. 472-477. doi:10.1111/j.1365-2036.2010.04368.x

[6]   G. N. Tytgat, “Hyoscine Butylbromide—A Review of Its Use in the Treatment of Abdominal Cramping and Pain,” Drugs, Vol. 67, No. 9, 2008, pp. 1343-1357.

[7]   W. G. Thompson, G. F. Longstreth, D. A. Drossman, et al., “Functional Bowel Disorders and Functional Abdo- minal Pain,” Gut, Vol. 45, Suppl. 2, 1999, pp. 43-47. doi:10.1136/gut.45.2008.ii43

[8]   L. Chang, “Review Article: Epidemiology and Quality of Life in Functional Gastrointestinal Disorders,” Alimen- tary Pharmacology and Therapeutics, Vol. 20, Suppl. 7, 2004, PP. 31-39

[9]   F. Mearin, X. Badia, A. Balboa, et al., “Irritable Bowel Syndrome Prevalence Varies Enormously Depending on the Employed Diagnostic Criteria: Comparison of Rome II versus Previous Criteria in a General Population,” Scandinavian Journal of Gastroenterology, Vol. 36, No. 11, 2001, pp. 1155-1161.

[10]   A. P. S. Hungin, L. Chang, G. R. Locke, E. H. Dennis and V. Barghout, “Irritable Bowel Syndrome in the United States: Prevalence, Symptom Patterns and Impact,” Ali- mentary Pharmacology and Therapeutics, Vol. 21, No. 11, 2005, pp. 1365-1375. doi:10.1111/j.1365-2036.2005.02463.x

[11]   M. Proctor and C. Farquhar, “Diagnosis and Management of Dysmenorrhoea,” British Medical Journal, Vol. 332, No. 7550, 2006, pp. 1134-1138. doi:10.1136/bmj.332.7550.1134

[12]   D. B. Silk, “Impact of Irritable Bowel Syndrome on Personal Relationships and Working Practices,” Euro- pean Journal of Gastroenterology, Vol. 13, No. 11, 2001, pp. 1327-1332. doi:10.1097/00042737-200111000-00011

[13]   G. Altman, K. C. Cain, S. Motzer, et al., “Increased Symptoms in female IBS Patients with Dysmenorrhea and PMS,” Gastroenterology Nursing, Vol. 29, No. 1, 2006, pp. 4-11. doi:10.1097/00001610-200601000-00002

[14]   M. D. Crowell, N. H. Dubin, J. C. Robinson, et al., “Functional Bowel Disorders in Women with Dysme- norrhea,” American Journal of Gastroenterology, Vol. 89, No. 11, 1994, pp. 1973-1977.

[15]   W. Brinkert, G. Dimcevski, L. Arendt-Nielsen, A. M. Drewes and O. H. Wilder-Smith, “Dysmenorrhoea is Associated with Hypersensitivity in the Sigmoid Colon and Rectum,” Pain, Vol. 132, Suppl. 1, 2007, pp. 46-51. doi:10.1016/j.pain.2006.12.011

[16]   A. R. de los Santos, R. Zmijanovich, M. S. Perez, M. L. Marti and G. Di Girolamo, “Antispasmodic/Analgesic Associations in Primary Dysmenorrhea Double-Blind Crossover Placebo-Controlled Clinical Trial,” International Journal of Clinical Pharmacology Research, Vol. 21 No. 1, 2001, pp. 21-29.

[17]   J. H. Kemp, “Buscopan in Spasmodic Dysmenorrhoea,” Current Medical Research and Opinion, Vol. 1, No. 1, 1972, pp. 19-25. doi:10.1185/03007997209111141

[18]   K. Fujimoto, A. Nakai, T. Okada, T. Ikeuchi, N. Satogami, S. Daido, M. Yakami and K. Togashi, “Effect of Hyoscine Butylbromide (HBB) on the Uterine Corpus: Quantitative Assessment with T2-Weighted (T2W) MRI in Healthy Volunteers,” Journal of Magnetic Resonance Imaging, Vol. 32, No. 2, 2010, pp. 441-445. doi:10.1002/jmri.22252

[19]   O. Ylikorkala and M. Y. Dawood, “New Concepts in Dysmenorrhea,” American Journal of Obstetrics and Gynecology, Vol. 130, No. 7, 1978, pp. 833-847.

[20]   S. Altunyurt, M. Gol, S. Altunyurt, O. Sezer and N. Demir, “Primary Dysmenorrhea and Uterine Blood Flow: A Color Doppler Study,” Journal of Reproductive Medicine, Vol. 50, No. 4, 2005, pp. 251-255.

[21]   K. Hellstrom, A. Rosen and K. Soderlund, “The Gastrointestinal Absorption and the Excretion of H3 Butylscopolamine (Hyoscine Butylbromide) in Man,” Scandinavian Journal of Gastroenterology, Vol. 5, No. 7, 1970, pp. 585-592.

[22]   A. R. Pomeroy and M. J. Rand, “Anticholinergic Effects and Passage through the Intestinal Wall of N-Buthyl- hyoscine Bromide,” Journal of Pharmacy and Pharma- cology, Vol. 21, No. 3, 1969, pp. 180-187. doi:10.1111/j.2042-7158.1969.tb08224.x

[23]   A. Sagrada, A. Schiavone, A. Cefala, P. Trespi and A. Giachetti, “N-Butyl Hyoscine Exerts Local Spasmolytic Effect in the Small and Large Bowel of the Conscious Dog,” Archives Internationales de Pharmacodynamie et de Therapie, Vol. 287, No. 2, 1987, pp. 237-247.

[24]   Z. Ge, Y. Yuan, S. Zhang, X. Hou, J. Wang, J. Cai, R. Shi, Y. Li, B. Wang and F. Ji, E. Richter and E. Schaefer, “Efficacy and Tolerability of Two Oral Hyoscine Butyl- bromide Formulations in Chinese Patients With Recurrent Episodes of Self-Reported Gastric or Intestinal Spasm- Like Pain,” International Journal of Clinical Pharmac- ology and Therapeutic, Vol. 49, No. 3, 2011, pp. 198-205.